Grounded theory and feminist inquiry: revitalizing links to the past

School and childcare facility air quality decision-makers' perspectives on using low-cost sensors for wildfire smoke response

BACKGROUND

During wildfire smoke episodes, school and childcare facility staff and those who support them rely upon air quality data to inform activity decisions. Where ambient regulatory monitor data is sparse, low-cost sensors can help inform local outdoor activity decisions, and provide indoor air quality data. However, there is no established protocol for air quality decision-makers to use sensor data for schools and childcare facilities. To develop practical, effective toolkits to guide the use of sensors in school and childcare settings, it is essential to understand the perspectives of the potential end-users of such toolkit materials.

METHODS

We conducted 15 semi-structured interviews with school, childcare, local health jurisdiction, air quality, and school district personnel regarding sensor use for wildfire smoke response. Interviews included sharing PM2.5 data collected at schools during wildfire smoke. Interviews were transcribed and transcripts were coded using a codebook developed both a priori and amended as additional themes emerged.

RESULTS

Three major themes were identified by organizing complementary codes together: (1) Low-cost sensors are useful despite data quality limitations, (2) Low-cost sensor data can inform decision-making to protect children in school and childcare settings, and (3) There are feasibility and public perception-related barriers to using low-cost sensors.

CONCLUSIONS

Interview responses provided practical implications for toolkit development, including demonstrating a need for toolkits that allow a variety of sensor preferences. In addition, participants expected to have a wide range of available time for monitoring, budget for sensors, and decision-making types. Finally, interview responses revealed a need for toolkits to address sensor uses outside of activity decisions, especially assessment of ventilation and filtration.

Critical Research and Qualitative Methodologies: Theoretical Foundations and Contribution to Nursing Research

Background: Methodological approaches that draw on critical perspectives (critical ethnography, critical phenomenology, and critical grounded theory) share common concepts, including social justice, reflexivity, positionality, pragmatism and social transformation. These approaches differ from conventional phenomenology, ethnography and grounded theory despite sharing common methodological grounds.Purpose: In this article, we will outline the major contributions of critical theory, as a research paradigm, to the development and evolution of qualitative methodologies. In particular, we will discuss their application to nursing research. The historical and conceptual underpinnings of these critical methodologies will first be described to highlight their paradigmatic characteristics and implications for nursing.Implications for Practice: Although not yet widely employed in nursing research, critical qualitative methodologies are particularly well suited to the discipline as they shed light on issues of power, social control, and marginalization among the vulnerable populations with whom nurses practise on a daily basis. The use of critical approaches can expose the epistemic injustice and social and health inequality that continue to prevail in our society.

"A Slap of Love": A Way of Showing Love and Resolving Conflict Among Young People in South Kivu, Democratic Republic of Congo

This article draws on qualitative study to examine Congolese male and female high school students' attitudes toward intimate partner violence. A total of 56 boys and girls aged 16-20 years from two urban and two rural high schools in South Kivu province took part in focus groups, and 40 of these were subsequently interviewed individually. To the majority of male and female participants, when the man or boy beats his wife or girlfriend that means he loves her and he wants her to change. They believed that if a boy does not love her, he may let her go on making mistakes. Some male participants viewed women and girlfriend beating as a way to let her realize her inferiority. However, some female participants disagreed with these assumptions but they concomitantly accepted a "slap of love." There is a strong need to re-educating both males and females to address the problem, and particularly train men to treat women respectfully and non-violently.

"A woman's honor tumbles down on all of us in the family, but a man's honor is only his": young women's experiences of patriarchal chastity norms

Purpose: In this qualitative study we explored how young women living in Sweden with ethnic and cultural roots in the Middle East and East Africa comply with or resist so-called honour norms and how they perceive that these norms affect their living conditions. Method: In depth interviews were performed with 14 young women. The majority were between 21 and 32 years of age with a mean age of 24. All interviews were transcribed verbatim and a grounded theory approach was used. To reflect the diversity in women's experiences, the grounded theory approach was conducted from a feminist perspective to transform women's personal narratives to a larger social context. Results: We analysed the core category "Honorable women in becoming" as the central emerging phenomenon related to categories about structural and individual control of women, the women's adjustment and resistance, and the continuum of severe consequences and violence that they experienced in their struggle for autonomy. Conclusion: Simone de Beauvoir's feminist theory about women as "the other" was an inspiration and gave us valuable input to highlight women's experiences and situations from a perspective of gender, power, and oppression.

Undergraduate nursing students' perceptions about creating culturally safe classrooms: Living the epistemology, ontology and pedagogy

Cultural Safety is a means of empowerment through antiracist actions, decolonising praxis, an understanding of the effects of a colonial history, and reconciliation to an equitable and inclusive place. The purpose of this paper is to share the perceptions of undergraduate students in northern Canada about the creation of culturally safe classrooms. A secondary analysis was conducted on archived data from undergraduate nursing student-led research. The findings illuminated four themes: sharing with genuineness, disrupting dissonance, addressing history and transforming through relationality. The themes inform a model that offers a beginning understanding of how culturally safe classrooms transpired in the Canadian north to enable students to become inclusive, relational, critical, and informed.

Approaches to reviewing the literature in grounded theory: a framework

BACKGROUND

There is considerable debate about how to review the literature in grounded theory research. Notably, grounded theory typically discourages reviewing the literature before data are collected and analysed, so that researchers do not form preconceptions about the theory. However, it is likely researchers will need to review the literature to show they intend to address a gap in knowledge with their research. This might confuse novice researchers, especially given that different approaches to grounded theory can have contrasting positions concerning how and when literature should be reviewed.

AIM

To provide an overview of grounded theory and how different approaches might tackle literature reviews.

DISCUSSION

A framework is presented to illustrate some of the commonalities between grounded theory approaches, to guide novice researchers in reviewing the literature. The framework acknowledges some of the tensions concerning researchers' objectivity and sketches three phases for researchers to consider when reviewing the literature.

CONCLUSION

Reviewing the literature has different meanings and implications when using grounded theory compared with other research methodologies.

IMPLICATIONS FOR PRACTICE

Novice researchers must be attuned to the different ways of reviewing the literature when using grounded theory.

A feminist approach to dating violence prevention: Creating change towards safety, equality and mutuality

The effectiveness of dating violence prevention programs in changing behaviors, attitudes and knowledge related to perpetration and victimization has been well documented in the literature. However, little attention has been paid to the question of how such positive outcomes have been obtained, and the debate continues as to their underlying theoretical rationale. The present study aimed to fill this gap by designing a dating violence prevention program from a feminist approach and to investigate the processes of change with a constructivist grounded theory methodology. Towards this goal, 56 Turkish college students completed the program and later participated in semi-structured individual interviews. The analysis showed that the program initiated a gradual move towards safety, equality and mutuality in dating and intimate relations through four processes: changing perspectives and norms, learning from peers, reflecting on self, and acting differently. Some of the processes were experienced differently depending on the nature of prior or current dating experiences and the strength of sexist beliefs. The present study argues that a feminist approach proves to be a useful framework for dating violence prevention efforts and concludes with recommendations for future preventive work.

Occupational Well-Being in Sexual Assault Victims and Survivors

Purpose: While researchers have established that sexual assault may adversely affect successful employment and academic achievement, little is known about the barriers and facilitators of occupational well-being from the perspective of sexual assault survivors. This study assessed the barriers and facilitators of occupational well-being. Design: Constructivist grounded theory. Method: Digitally recorded, semistructured interviews were used to collect data. Data were collected from 22 adult female sexual assault survivors. Analysis consisted of coding, creation of data matrices, and within and across case analysis. Findings: Theoretical saturation was achieved after interviews with 22 participants. Barriers to occupational well-being were mental health symptoms and diagnoses, substance abuse, inflexible attendance policies, and workplace bullying. Facilitators to occupational well-being were personal coping strategies, and organizational and social support. Conclusions: Sexual assault has significant effects on the occupational well-being of women. The work or academic environment can exacerbate the harms of sexual assault or facilitate healing in sexual assault survivors. To facilitate the occupational well-being of sexual assault survivors, workplaces and academic institutions can adopt a trauma-informed approach, create policies that allow for time off to deal with sequela of sexual assault, implement anti-bullying programs, and make resources for gendered violence available.

'Birds of the same feathers fly together': midwives' experiences with pregnant women and FGM/C complications - a grounded theory study in Liberia

Background

In Liberia, approximately 70% of the women of the North-Central and North-Western regions could have undergone female genital mutilation/cutting (FGM/C) in their childhood during a traditional ceremony marking their entrance into Sande, a secret female society. Little is known about FGM/C from Liberian women’s perspective. This study aimed to understand the health implications of FGM/C as perceived by qualified female midwives.

Methods

This qualitative study was conducted in 2017 in Monrovia, Liberia’s capital. Twenty midwives were approached. Of these, seventeen consented to participate in in-depth interviews. A thematic guide was used to gain insights about their knowledge on FGM/C and their experiences attending women victims of FGM/C. A feminist interpretation of constructivist grounded theory guided data generation and analysis.

Results

The midwives participants described how clitoridectomy was the most common FGM/C type done to the girls during the Sande initiation ceremonies. Sexual impairment and intrapartum vulvo-perineal laceration with subsequent hemorrhage were described as frequent FGM/C-attributable complications that some midwives could be unable to address due to lack of knowledge and skills. The majority of midwives would advocate for the abandonment of FGM/C, and for the preservation of the traditional instructions that the girls in FGM/C-practicing regions receive when joining Sande. The midwives described how migration to urban areas, and improved access to information and communication technologies might be fuelling abandonment of FGM/C.

Conclusion

Liberian midwives need tailored training to provide psychosexual counseling, and to attend the obstetric needs of pregnant women that have undergone FGM/C. In spite of FGM/C being seemingly in the decline, surveillance at clinic-level is warranted to prevent its medicalization. Any clinic- or community-based training, research, prevention and awareness intervention targeting FGM/C-practicing populations should be designed in collaboration with Sande members, and acknowledging that the Liberian population may place a high value in Sande’s traditional values.

Community-informed research on malaria in pregnancy in Monrovia, Liberia: a grounded theory study

BACKGROUND

Liberia is a West African country that needs substantial investment to strengthen its National Malaria Control Programme (NMCP), which was disrupted during the 2014-2016 Ebola epidemic. As elsewhere, Liberian pregnant women are especially vulnerable to malaria. Understanding prevention and treatment-seeking behaviours among the population is crucial to strategize context-specific and women-centred actions, including locally-led malaria research, to improve women's demand, access and use of NMCP strategies against malaria in pregnancy.

METHODS

In 2016, after the Ebola crisis, a qualitative inquiry was conducted in Monrovia to explore populations' insights on the aetiology, prevention and therapeutics of malaria, as well as the community and health workers' perceptions on the utility of malaria research for pregnant women. In-depth interviews and focus group discussions were conducted among pregnant women, traditional community representatives and hospital staff (n = 38), using a feminist interpretation of grounded theory.

RESULTS

The narratives indicate that some Liberians believed in elements other than mosquito bites as causes of malaria; many had a low malaria risk perception and disliked current effective prevention methods, such as insecticide-treated nets; and some would resort to traditional medicine and spiritual care to cure malaria. Access to clinic-based malaria care for pregnant women was reportedly hindered by lack of financial means, by unofficial user fees requested by healthcare workers, and by male partners' preference for traditional medicine. The participants suggested that malaria research in Liberia could help to design evidence-based education to change current malaria prevention, diagnostic and treatment-seeking attitudes, and to develop more acceptable prevention technologies.

CONCLUSION

Poverty, insufficient education on malaria, corruption, and poor trust in healthcare establishment are structural factors that may play a greater role than local traditional beliefs in deterring Liberians from seeking, accessing and using government-endorsed malaria control strategies. To increase access to and uptake of preventive and biomedical care by pregnant women, future malaria research must be informed by people's expressed needs and constructed meanings and values on health, ill health and healthcare.

'Researchers have love for life': opportunities and barriers to engage pregnant women in malaria research in post-Ebola Liberia

BACKGROUND

Adoption of prevention and therapeutic innovations to ensure that National Malaria Control Programmes meet their incidence reduction targets is highly dependent on the conduct of rigorous clinical trials. In Liberia, malaria control virtually halted during the recent Ebola epidemic, and could enormously benefit from innovations to protect its most vulnerable populations, including pregnant women, against malaria. Health policy-planners could feel more inclined to adopt novel interventions with demonstrated safety and efficacy when trialled among their women population. However, pregnant women are especially vulnerable when targeted as research participants. Whilst some studies in the region attempted to understand the ethical issues around the conduct of clinical research, there is need of such information from Liberia to inform future malaria research.

METHODS

This is a grounded theory study that aims to understand the barriers and opportunities for pregnant women to consent to participate in malaria research in Liberia. The study was conducted between November 2016 and May 2017 at the St Joseph's Catholic Hospital, Monrovia. In-depth interviews and focus group discussions were held with hospital staff, traditional community representatives, and pregnant women.

RESULTS

According to the participants, useful strategies to motivate pregnant women to consent to participate in malaria research could be providing evidence-based education on malaria and research to the general population and encouraging engagement of traditional leaders in research design and community mobilization. Fears and suspicions towards research and researchers, which were amplified during the conduct of Ebola vaccine and drug clinical trials, may influence women's acceptance and willingness to engage in malaria research. Population's mistrust in the public healthcare system might hinder their acceptance of research, undermining the probability of their benefiting from any improved malaria control intervention.

CONCLUSION

Benchmarking for acceptable practices from previous public health interventions; building community discussion and dissemination platforms; and mapping communication and information errors from how previous research interventions were explained to the Liberian population, are strategies that might help ensure a safe and fully informed participation of pregnant women in malaria research. Inequity issues impeding access and use of biomedical care for women must be tackled urgently.

Reducing symbolic-violence in the research encounter: collaborating with a survivor of domestic abuse in a qualitative study in UK primary care

This paper explores ideas of symbolic violence inherent in the research encounter (Bourdieu 1999). After defining symbolic violence and how the concept enters into domestic violence and abuse (DVA) research, we discuss the challenges arising from a (DVA) survivor taking on the role of interviewer in a qualitative study nested within a UK primary care based trial: IRIS (Identification and Referral to Improve Safety). KS, a survivor of DVA, conducted interviews with 12 women who had been referred to a domestic violence agency by primary care clinicians taking part in the IRIS trial in two UK cities (Bristol and east London) during 2009. Field notes were kept during all of the research meetings with KS and these were included in analysis. Our analysis maps the research pathway of 'non-violent communication' and discusses the role of social symmetry and proximity in the research encounter. We conclude that while a welcoming disposition, empathy and active listening are all generic skills to qualitative research; if a researcher can enter fieldwork with a claim of social proximity and symmetry, their use of these generic skills is enhanced through a process of shared objectification and empowerment talk. We explore the limitations of social proximity, its relationship to feminist and anthropological theories of 'insider' research and its relevance to primary care research.

Zambian Women in South Africa: Insights Into Health Experiences of Labia Elongation

Labia minora elongation consists in the manual stretching of the inner lips of the external genitalia. This practice is documented in east and southern Africa. The experiences of African women in the diaspora practicing elongation are not thoroughly understood. The purpose of this qualitative study was to explore the health harms and benefits associated with this practice of Zambian women who have migrated to Cape Town, South Africa. Twenty women and seventeen men participated in this study. Between December 2013 and May 2014, in-depth interviews and natural group discussions were conducted with the participants. The focus of this article is to report on the emic of the women related to notions of health, hygiene, and well-being. Labial elongation is perceived as a practice involving minor, short-term adverse effects that can be prevented by following some basic hygiene. Overall, personal and social value is placed on this practice because of its reported benefits for the sexual health of men and women, and for women's femininity and self-image. Further research is necessary on how female genital modifications influence Zambians' sexual preferences to inform the development of culturally appropriate health promotion interventions.

Scientometric analysis of research from a feminist perspective

In order to build a historical map of scientific production from a feminist perspective and to analyze the central themes that have been studied by the academics from this approach, a search was conducted using SCOPUS an international bibliometric database, for the period between 1960 and July 2013. The search strategy based on the use of four key words produced 54 articles, written by 86 specialists of 14 countries, among them USA, UK, Canada and Australia, 87% written in English and 4% in Spanish. Even though the feminist theoretical approach is interdisciplinary by definition, the main disciplines represented in the sample were social sciences and Psychology. 69% of the articles were written by a single author, and 78% of the authors were women. Citation varied between 137 and zero. The most cited studies were from Canada, USA and the UK. Articles covered a wide variety of themes emphasizing theoretical, methodological and empirical issues in different areas of knowledge. Additionally a very low presence of articles dealing with the impact of the feminist perspective in public policies was observed, as well as very few articles devoted to examine applications of the feminist theory on education. Conclusions highlight the challenge for Latin American feminist researchers to increase their presence in scientific journals with international distribution indexed in SCOPUS, and to increase the quality of specialized Hispanic journals, in order to favor scientific dissemination on the subject in Spanish.