Generating or developing grounded theory: methods to understand health and illness.

Grounded theory is a qualitative research methodology that aims to explain social phenomena, e.g. why particular motivations or patterns of behaviour occur, at a conceptual level. Developed in the 1960s by Glaser and Strauss, the methodology has been reinterpreted by Strauss and Corbin in more recent times, resulting in different schools of thought. Differences arise from different philosophical perspectives concerning knowledge (epistemology) and the nature of reality (ontology), demanding that researchers make clear theoretical choices at the commencement of their research when choosing this methodology. Compared to other qualitative methods it has ability to achieve understanding of, rather than simply describing, a social phenomenon. Achieving understanding however, requires theoretical sampling to choose interviewees that can contribute most to the research and understanding of the phenomenon, and constant comparison of interviews to evaluate the same event or process in different settings or situations. Sampling continues until conceptual saturation is reached, i.e. when no new concepts emerge from the data. Data analysis focusses on categorising data (finding the main elements of what is occurring and why), and describing those categories in terms of properties (conceptual characteristics that define the category and give meaning) and dimensions (the variations within properties which produce specificity and range). Ultimately a core category which theoretically explains how all other categories are linked together is developed from the data. While achieving theoretical abstraction in the core category, it should be logical and capture all of the variation within the data. Theory development requires understanding of the methodology not just working through a set of procedures. This article provides a basic overview, set in the literature surrounding grounded theory, for those wanting to increase their understanding and quality of research output.

Hospital employees' perceptions of fairness and job satisfaction at a time of transformational change.

Objective This study examines the relationships between job satisfaction and organisational justice during a time of transformational change. Methods Data collection occurred immediately before a major regional hospital's move to a greenfield site. Existing measures of job satisfaction and organisational justice were used. Data were analysed (n=316) using descriptive, correlation and regression methods together with interactions between predictor variables. Results Correlation coefficients for satisfaction and organisational justice variables were high and significant at the P<0.001 level. Results of a robust regression model (adjusted R(2)=0.568) showed all three components of organisational justice contributed significantly to employee job satisfaction. Interactions between the predictor variables showed that job satisfaction increased as the interactions between the predictor variables increased. Conclusions The finding that even at a time of transformational change staff perceptions of fair treatment will in the main result in high job satisfaction extends the literature in this area. In addition, it was found that increasing rewards for staff who perceive low levels of organisational justice does not increase satisfaction as much as for staff who perceive high levels of fairness. If people feel negative about their role, but feel they are well paid, they probably still have negative feelings overall. What is known about the topic? Despite much research highlighting the importance of job satisfaction and organisational justice in healthcare, no research has examined the influence of transformational change, such as a healthcare organisational relocation, on these factors. What does this paper add? The research adds to academic literature relating to job satisfaction and organisational justice. It highlights the importance of organisational justice in influencing the job satisfaction of staff. What are the implications for practitioners? Financial rewards do not necessarily motivate staff but low rewards do demotivate. Shortages of health professionals are often linked to a lack of job satisfaction, and recruitment and retention strategies are often based on salary.

A grounded exploration of the dimensions of managerial capability: A preliminary study of top Australian pharmacist owner-managers.

BACKGROUND: Australian community pharmacies are experiencing challenges, including government prescription pricing reform and a dramatically increasing competitive environment. Enacting appropriate responsive actions requires capable pharmacy managers. 'Capability' implies managing effectively in the present, but with unknown or emerging contexts and with new problems. A conceptual understanding of managerial capability as practiced by pharmacist owner-managers is unavailable in the literature. OBJECTIVES: This research aimed to address the question: How can we understand managerial capability in relation to effective community pharmacy management? The study's objective was to develop preliminary theoretical departure points for continuing research responding to the research question. METHODS: The objective was approached by exploring how 5 top Australian pharmacy owner-managers accomplish the management of their businesses in a changing business environment. Qualitative research methods were employed to develop a social process perspective of how the managers enact their management practices. In-depth semi-structured life-world interviews were undertaken as the major method of data collection. Interview text thematic analysis was carried out identifying rich conceptual properties and dimensions, which 'dimensionalized' 3 key integrated categories. RESULTS: The findings show how the managers are immersed in their business, managerial and personal practices in a holistic and relational manner. Managerial processes, reported through three conceptual categories, their properties and dimensions, reveal the highly situational nature of the reality the managers were experiencing, including their need to express their personal/professional identity. The properties and dimensions of the category 'learning generatively' in particular, reveal how the pharmacy owner-managers shape their business activities and their emerging context as time passes. CONCLUSIONS: The preliminary interpretive view of managerial capability describes the phenomenon as an emergent human accomplishment rather than a possessed ability. This social process perspective enables the inclusion of context with time. The study acts as a formative departure point for continuing research of pharmacist managerial capability which seeks to better understand the linkage between 'knowing' and 'doing'.

Researching pharmacist managerial capability: philosophical perspectives and paradigms of inquiry.

In successful community pharmacy business enterprises suitably responsive actions to meet ever-increasing change require capable pharmacy managers who readily learn and adapt. Capability as a concept is generally understood to be the ability of a manager to identify and act to solve unfamiliar problems in unfamiliar situations. Capability is characterized by adaptability and flexibility. However, different understandings of the concept 'capability' and what it means to be 'capable' are indirect and incomplete. This paper aims to clarify current theories regarding the concept of 'capability' at the level of the individual, and through this to make more explicit what is known about the phenomenon, but more particularly, how we know what we know. The analysis includes the concept of 'competence' because explanations of capability include competence, and the two concepts are not clearly separated in the literature. By probing the epistemological origins of current theory concerning both concepts, the limiting taken for granted assumptions are revealed. Assumptions about context and time, and the psychological theory through which individuals are assumed to perceive, know and learn, are illuminated. The analysis, in connection with the literature, shows how the interpretive philosophic research approach may reveal a different and useful theoretical perspective for explaining capability as a dynamic performance. It is suggested that such a perspective may narrow the gap between the theory of capability and its practice. The interpretive perspective holds potential to reveal how capability, as performed by successful community pharmacy managers, might be further researched and strengthened. This paper supports the challenging suggestion that pharmacy social research needs to rebalance the dominance of purely empirical research by exploring interpretive methodologies to better understand human actions and relations in the context of pharmacy.

How best practices are copied, transferred, or translated between health care facilities: A conceptual framework.

INTRODUCTION: In spite of significant investment in quality programs and activities, there is a persistent struggle to achieve quality outcomes and performance improvements within the constraints and support of sociopolitical parsimonies. Equally, such constraints have intensified the need to better understand the best practice methods for achieving quality improvements in health care organizations over time.This study proposes a conceptual framework to assist with strategies for the copying, transferring, and/or translation of best practice between different health care facilities. PURPOSE: Applying a deductive logic, the conceptual framework was developed by blending selected theoretical lenses drawn from the knowledge management and organizational learning literatures. FINDINGS: The proposed framework highlighted that (a) major constraints need to be addressed to turn best practices into everyday practices and (b) double-loop learning is an adequate learning mode to copy and to transfer best practices and deuteron learning mode is a more suitable learning mode for translating best practice. We also found that, in complex organizations, copying, transferring, and translating new knowledge is more difficult than in smaller, less complex organizations. We also posit that knowledge translation cannot happen without transfer and copy, and transfer cannot happen without copy of best practices. Hence, an integration of all three learning processes is required for knowledge translation (copy best practice-transfer knowledge about best practice-translation of best practice into new context). In addition, the higher the level of complexity of the organization, the more best practice is tacit oriented and, in this case, the higher the level of K&L capabilities are required to successfully copy, transfer, and/or translate best practices between organizations. PRACTICE IMPLICATIONS: The approach provides a framework for assessing organizational context and capabilities to guide copy/transfer/translation of best practices. A roadmap is provided to assist managers and practitioners to select appropriate learning modes for building success and positive systemic change.