A strength of substantive grounded theories is that they are modifiable. Yet, little attention is given in the research literature to the evolution of grounded theories through the process of emergent fit. In this article, emergent fit is discussed, and the evolution of the theoretical understanding of relationships with helping systems is provided as an example. In a feminist grounded-theory study of women’s caring, emergent fit with existing inductive research on health care relationships resulted in a framework of negotiating, which includes four strategies: reframing responsibility, becoming an expert, harnessing resources, and taking on more. This explanatory model demonstrates how the use of emergent fit can avoid the generation of isolated theories and contribute to knowledge accumulation by producing a substantive theory with wider applicability.
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References
1.
Anderson, J. , & Elfert, H. (1989). Managing chronic illness in the family: Women as caregivers. Journal of Advanced Nursing, 14, 735-745.
2.
Baker, C. , Norton, S., Young, P., & Ward, S. (1998). An exploration of methodological pluralism in nursing research. Nursing in Research & Health, 21, 545-555.
3.
Benner, P. (1984). From novice to expert. Menlo Park, CA: Addison-Wesley.
4.
Burke, S. , Kauffman, E., Costello, E., & Dillon, M. (1991). Hazardous secrets and reluctantly taking charge: Parenting a child with repeated hospitalizations. Image, 22, 39-45.
5.
Dickoff, J. , & James, P. (1968). A theory of theories: A position paper. Nursing Research, 17, 197-203.
6.
Dixon, D. (1996). Unifying concepts in parents’ experiences with health care providers. Journal of Family Nursing, 2, 111-132.
7.
Estabrooks, C. , Field, P. A., & Morse, J. (1994). Aggregating qualitative findings: An approach to theory development. Qualitative Health Research, 4, 503-511.
8.
French, M. (1985). Beyond power: On women, men, and morals. New York: Summit.
9.
Glaser, B. (1972). Experts versus laymen: A study of the patsy and the subcontractor. Mill Valley, CA: Sociology Press.
10.
Glaser, B. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press.
11.
Glaser, B. (1992). Basics of grounded theory analysis. Mill Valley, CA: Sociology Press.
12.
Glaser, B. , & Strauss, A. (1967). The discovery of grounded theory. Chicago: Aldine.
13.
Hampton, D. (1995). Expertise: The true essence of nursing. Advances in Nursing Science, 17, 15-24.
14.
Jensen, L. , & Allen, M. (1996). Meta-synthesis of qualitative findings. Qualitative Health Research, 6, 555-562.
15.
Kearney, M. (1998). Ready-to-wear: Discovering formal grounded theory. Research in Nursing and Health, 21, 179-186.
16.
Merritt-Gray, M. , & Wuest, J. (1995). Counteracting abuse and breaking free: The process of leaving revealed through women’s voices. Health Care for Women International, 16, 399-412.
17.
Morse, J. (1997). Considering theory derived from qualitative research. In J. Morse (Ed.), Completing a qualitative project: Details and dialogue (pp. 163-189). Thousand Oaks, CA: Sage.
18.
Noblit, G. , & Hare, R. (1988). Meta-ethnography: Synthesizing qualitative studies. Newbury Park, CA: Sage.
19.
Paterson, B. , & Thorne, S. (1997). The developmental evolution of expertise in Type 1 diabetes. Unpublished manuscript.
20.
Paterson, B. , Thorne, S., & Dewis, M. (1998). State of the science: Adapting to and managing diabetes. Image, 30, 57-62.
21.
Sandelowski, M. (1997). Focus on qualitative methods. Qualitative metasynthesis: Issues and techniques. Research in Nursing and Health, 20, 365-371.
22.
Schreiber, R. , Crooks, D., & Stern, P. N. (1997). Qualitative meta-analysis. In J. Morse (Ed.), Completing a qualitative project: Details and dialogue (pp. 311-326). Thousand Oaks, CA: Sage.
23.
Silva, M. , & Sorrell, J. (1992). Testing nursing theory: Critique and philosophical method. Advances in Nursing Science, 14, 12-23.
24.
Stern, P. N. , & Pyles, S. (1986). Using grounded theory methodology to study women’s culturally based decisions about health. In P. N. Stern (Ed.), Women, health, and culture (pp. 1-24). Washington, DC: Hemisphere.
25.
Strauss, A. (1978). Negotiations. San Francisco: Jossey-Bass.
26.
Strauss, A. , & Corbin, J. (1994). Grounded theory methodology: An overview. In N. Denzin & Y. Lincoln (Eds.), Handbook of qualitative research (pp. 273-285). Thousand Oaks, CA: Sage.
27.
Thorne, S. (1990). Navigating troubled waters: Chronic illness experience in health care crisis. Dissertation Abstracts International, 50. (University Microfilms No. AAC91-14014).
28.
Thorne, S. , & Paterson, B. (1998). Shifting images of chronic illness. Image, 20, 173-178.
29.
Thorne, S. , & Robinson, C. (1988). Health care relationships: The chronic illness perspective. Research in Nursing and Health, 11, 293-300.
30.
Thorne, S. , & Robinson, C. (1989). Guarded alliance: Health care relationships in chronic illness. Image, 21, 153-157.
31.
Traustadottir, R. (1991). Women who care: Gender, disability and family life. Journal of Family Issues, 12, 211-228.
32.
Twigg, J. , & Atkin, K. (1995). Carers and services: Factors mediating service provision. Journal of Social Policy, 24, 5-30.
33.
Walker, L. , & Avant, K. (1988). Strategies for theory construction in nursing (2nd ed.). Norwalk, CT: Appleton & Lange.
34.
Wuest, J. (1991). Harmonizing: A North American Indian approach to management of middle ear disease with transcultural nursing implications. Journal of Transcultural Nursing, 3, 5-14.
35.
Wuest, J. (1995). Feminist grounded theory: An exploration of the congruency and tensions between two traditions in knowledge discovery. Qualitative Health Research, 5, 125-137.
36.
Wuest, J. (1997a). Fraying connections of caring women: An exemplar of including difference in the development of explanatory frameworks. Canadian Journal of Nursing Research, 29, 99-116.
37.
Wuest, J. (1997b). Illuminating environmental influences on women’s caring. Journal of Advanced Nursing, 26, 49-58.
38.
Wuest, J. (1998). Setting boundaries: A strategy for precarious ordering of women’s caring demands. Research in Nursing and Health, 21, 39-49.
39.
Wuest, J. (1999). Repatterning care: Women’s proactive management of family caregiving demands. Unpublished manuscript.
40.
Wuest, J. , Ericson, P. K., & Stern, P. N. (1994). Becoming strangers. Journal of Advanced Nursing, 20, 437-443.
41.
Wuest, J. , Ericson, P. K., & Stern, P. N. (1998). Connected and disconnected support: The impact on the caregiving process in Alzheimer’s disease. Unpublished manuscript.
42.
Wuest, J. , & Stern, P. N. (1990a). Childhood otitis media: The family’s endless quest for relief. Issues in Comprehensive Pediatric Nursing, 13, 499-513.
43.
Wuest, J. , & Stern, P. N. (1990b). The impact of fluctuating relationships with the Canadian health care system on family management of otitis media with effusion. Journal of Advanced Nursing, 15, 556-563.
44.
Wuest, J. , & Stern, P. N. (1991). Empowerment in primary health care: The challenge for nurses. Qualitative Health Research, 1, 80-99.
