<p>The purpose of this constructivist grounded theory study was to explore women's experiences with endometriosis through diagnosis, treatment, and coping. Conducted using a health geography, medical sociology, and medical anthropology theoretical framework and a constructivist grounded theory methodology, the following research objectives guided this study: (a) document the experiences and consequences of receiving a medical diagnosis of endometriosis from the perspective of a group of women living in Hamilton, Ontario; (b) explore the iterative process the women experienced while seeking relief from the symptoms of endometriosis; (c) interpret the meaning of 'coping' that women on the journey for a reliable diagnosis and effective treatment for endometriosis experienced; and (d) formulate a coherent, middle-range interpretive substantive theory of the women's journey, in order to help others better understand the endometriosis experience from the patient's perspective.</p> <p>Seventy women were interviewed, and the middle-range substantive theory that emerged from this study is grounded in their experiences. The results indicate that the women experienced endometriosis as a journey through constant interaction with the social worlds they had defined through diagnosis, treatment, and ultimately coping. Studying their everyday life experiences and mapping those in the context of their biomedical, personal, and informational social worlds allow for a broader understanding of the varying ways that the women interviewed perceived the treatment processes and their treatment options, made sense of their symptoms, and experienced uncertainty about the influence change could have on their everyday lives. By incorporating their individual experiences and knowledge, their social world and descriptions of these worlds reflect the entirety of the endometriosis experience. Finally, if one examines endometriosis only from the perspective of being diagnosed, treated, and learning to cope with the disease, many facets of the journey are missed. Understanding these individual experiences as a journey, instead of just diagnosis, treatment, and coping, has practical implications for healthcare providers treating endometriosis.</p> / Thesis / Doctor of Philosophy (PhD)

Social Networks are broad set of actors or organizations and relations between them. The recent review of the literature shows that the research has been focused mainly on the effects of social networks on the entrepreneurial process but little attention is being paid to the process of development of social networks during an entrepreneurial process. The present studies highlight the aspects of process through analysing life cycle, teleology, dialectic and evolutionary views of process of development of social networks. This thesis presents ‘Becoming a Networked Entrepreneur’, a substantive theory of process of social network development in Entrepreneurship Literature constructed using Constructivist Grounded Theory approach to study the 13 entrepreneurs of Fast Growing Firms in Lahore, Pakistan. There are three main conceptual domains of this theory: sources of networks and actions of the entrepreneur and Developmental Patterns. The process of becoming a networked entrepreneur involves constant interaction of entrepreneur with the environment where sources of networks enable the entrepreneur to get connected to a network actor. Through studying the process of becoming a networked entrepreneur, the researchers can view the process in an integrated approach which involves the development of networks before starting the venture and interaction of entrepreneur with the environment where these networks are being developed. The process of becoming a networked entrepreneur presents a framework to study the networks and their development along the entrepreneurial venture.

Legal aid programs comprise a robust national infrastructure attempting to alleviate and reduce poverty. Since their proliferation as part of the War on Poverty, these organizations have provided individual civil legal assistance and engaged in collective legal and political strategies to advance systemic change. Starting in the 1980s, however, public policies have been enacted to cut funding and restrict the ability of federally funded legal aid programs to engage in collective and systemic advocacy. As a result, the ability of programs to work alongside low-income communities has been compromised. The histories and core commitments of legal aid and social work are linked. As a profession social work is concerned broadly with efforts to address poverty and specifically with the self-determination and empowerment of those experiencing poverty directly. In this study a constructivist grounded theory design was used to examine the process of collaboration between legal aid attorneys and client community members. The sample for the study included 28 attorneys, client community members, and other stakeholders affiliated with three legal aid programs. Based on 28 interviews and two focus groups with these participants, a conceptual framework entitled Collaborating for Justice in a Legal Aid Context was constructed. Findings suggest that both primary stakeholder groups were motivated to act by the unequal access to advantage in the world around them. Once affiliated with legal aid, they were constrained by scarcity of resources but nonetheless acted creatively to collaborate as well as to enhance collaborative capacity. Collaboration occurred in different timeframes, and this temporal element suggested ways that individuals and organizations can extend and deepen collaboration. Collective activities, informal interaction, and boards and advisory groups all played roles in facilitating collaboration between legal aid programs and their client communities. Through these actions, participants and their affiliated organizations were able to move from circumstances of scarcity to circumstances of generativity and development. Implications for education, practice, and policy are discussed.

Mothers play a vital role in providing healthy food choices for their preschool children. This role has become more complex in the present obesity-producing environment that has contributed to the increasing prevalence of childhood overweight and obesity in Canada. Childhood overweight and obesity is a significant public health issue in Nova Scotia where the percentage is higher than the national average. The purpose of this study was to generate a theoretical understanding of the process in which 18 mothers living within the Cape Breton Regional Municipality engaged while making food choices for their preschool children. Constructivist grounded theory methodology informed by sensitising constructs from symbolic interaction and the socio-environmental health promotion perspective facilitated a multilevel exploration of the factors that affect mothers’ food choice practices for their preschoolers. Data collection took place over 16 months. Thirty-five interviews were completed. Grounded theory methods were used to analyze the data and a substantive theory of how mothers made food choices for their preschool children was co-constructed with the participants. The substantive theory, Persistent Optimizing, consists of three main integrated conceptual categories. In the first conceptual category, Acknowledging Contextual Constraints, mothers acknowledged various individual, interpersonal, and socio-environmental contextual factors that hindered their ability to make intended, healthier food choices for their children. In the second conceptual category, Stretching Boundaries, mothers developed and enacted moderating strategies to lessen the impact of contextual constraints, thereby increasing the number of food choices available to them. In the third conceptual category, Strategic Positioning, mothers developed and enacted a variety of optimizing strategies to get them closer to making the optimal food choice for their children in a given situation. Mothers in this study struggled continuously with varying degrees of success to provide the foods they believed their children needed. The findings suggest that in practice, policy, research, and education, community health nurses must work independently and collaboratively at all levels of influence to facilitate, mediate, and advocate for social, economic, and physical environments that improve mothers’ ability to make food choices that promote their children’s health and reduce their risk of becoming overweight and obese.

Despite nursing’s espoused professional values of caring and social justice, some patients are stigmatized and receive discriminatory nursing care. There is a gap in existing literature about how nurses deal with the tension they experience when personal and professional values collide. The purpose of this study was to generate a substantive theory of the process that nurses use when faced with values tension in clinical practice and how this affects their behaviour. Using constructivist grounded theory methodology informed by symbolic interactionism and critical social theory, the theory of Juggling a Way of Being was co-constructed with data obtained through interviews with registered nurses (n=8) who provide frontline care in an emergency department in Atlantic Canada. The study’s findings revealed a process fraught with tension as nurse participants assimilated internal and external stressors, adjusted the patient-centered/nurse-centered lens according to their interpretation of the situation, and achieved a point of action or inaction. Implications for nursing practice and administration, education and research are discussed.

<p><h1>Abstract</h1></p> <p><strong>Succeeding in Level 1 of a BScN Program: A Grounded Theory Inquiry</strong></p> <p>This research is an inquiry into the journey of student success as experienced by Level 1 nursing students in a BScN program. It is a qualitative study using a constructivist grounded theory methodology that looks at the psychosocial processes that are integral to the nursing student’s experience of Level 1. Fifty 1 to 1 semi-structured interviews were conducted with Level 1and Level 2 nursing students, experienced level 1 faculty and academic advisors (n=46). Participants were asked to define student success, and discuss their experience of success. The constant comparison method and theoretical sampling informed the findings. The result was an emerging substantive theory for student success entitled: <em>Succeeding in Level 1 of a BScN Program (Succeeding Substantive Theory or SST).</em> There are four conceptual processes that make up the <em>SST</em>: Learning, Balancing, Connecting and Becoming. Each concept has several categories that summarize the codes reflected in the data. The <em>SST</em> offers a fresh and novel perspective on student success as it reflects the processes involved in a comprehensive and integrated way. The insights and understanding that result from the <em>SST</em> can be used to direct policy and resources for student success, inform curricular revision, and suggest further research.</p> / Doctor of Philosophy (PhD)

This research project aims to explore service user and mental health social workers’ (MHSW) perspectives and experiences of practice in the area of personality disorder. It seeks to answer three research questions: how service users and MHSWs understand personality disorder, how they understand MHSW practice and how practice in this area might be better informed. The study’s attention to the experiences and perspectives of both groups sets the research within the interpretivist paradigm and relies on a relativist ontology, subjectivist epistemology and inductive, qualitative methodology. The involvement of both groups means that this project makes an original contribution to MHSW research and practice. Constructivist grounded theory (CGT) has been used to generate a conceptual, theoretical analysis. The research was divided into two phases. Phase 1 involved ten semi-structured interviews with ten service users from a community service for people with personality disorder. This data was analysed before Phase 2 began, comprising twelve semi-structured interviews with twelve MHSWs from three regions of England. NVivo 7 was used to analyse the data in and across case. The analysis identified participants’ understanding of personality disorder, mental health social work practice and how this practice might be better informed. The analysis was supplemented by documentary analysis of policies relevant to personality disorder and MHSW. The findings suggest that traumatic experience impacts on the lens through which the person views self and others. Distress can be overwhelming, lead to extreme and unsafe behaviours, which reinforce disconnection from self and others. In supporting a relationship between personality disorder and traumatic experience, this study suggests the relevance of mental health social work (MHSW) to personality disorder. The findings suggest that more humane, empathic responses are required. Practice founded on understanding the impact of traumatic experience and the ways in which the individual might be trying to cope with their distress. The findings reveal the importance of MHSWs’ relational skills and interventions that offer practical support, encouragement and effective liaison with others. Through more caring, protective bonds and broad social supports MHSW might empower individuals’ response to traumatic experience. The findings raise implications for MHSW and mental health professionals more generally. The findings also indicate that practice would be better informed by greater knowledge and understanding of the person and the diagnosis; the provision of feedback to the person; modelling; greater transparency and consistency; support for the person’s social and family network, and more practical support. This project makes an original contribution to knowledge about personality disorder and to MHSW knowledge and practice in this area.

Educational institutions offer transformative opportunities for veterans transitioning from military service. Veteran-specific cultural supports in educational environments offer participation in occupations and development of skills needed to complete educational goals. However, veterans experience complex life circumstances atypical from traditional student culture which influences use of available environmental supports. Currently, the student veteran population is growing following fifteen years of combat and with systematic downsizing of the military. Therefore, rehabilitation professionals and educators must understand the unique experiences which shape veteran life flow during the transition process. This dissertation contains three studies investigating veteran experiences transitioning to postsecondary education. The first study surveyed the attitudes and beliefs of veterans coping with the transition to postsecondary education. Results identified veterans’ preference to using skills learned in the military for solving problems in the transition and reported limited use of university supports made available. A second study examined lived experiences of veterans transitioning and their interactions with traditional students and university supports. Results identified veterans emerge in college culture following a transactive process of sorting through military experiences, building on military skills, and developing new relationships for civilian identity. The final constructivist grounded theory study investigated the individual and collective constructions of veteran transitioning experiences in relation to culture and context. Twelve veterans were theoretically sampled and developed Kawa (River) metaphorical diagrams of their transition experiences. Intensive interviews discussed the meaning ascribed to veterans’ diagrams. Interview data was analyzed with the constant comparison technique until theoretical saturation was achieved. The emergent theory explained student veteran life flow by two major theoretical concepts: seeking understanding and gaining stability to shape life flow in transition from military to student culture. Veterans shared understanding in each cultural environment by socially interacting with others perceived to be reaching out and connecting with veterans. Veterans also performed autonomous actions of gaining stability by using their skills, pinpointing useful resources, and cultivating the growth and expression of personal skills. Both theoretical processes simultaneously, enhanced veteran’s transition to postsecondary education and promoted harmony within veteran life flow over time.

Hearing disclosures of childhood sexual abuse (CSA) is a clinical reality for many therapists. Psychologists within mental health services are working increasingly with clients who have traumatic histories, including the presence of CSA. Recently there has been a drive towards improving services for adult survivors of CSA, with an emphasis on asking health and social care service-users about abuse. Recent research has demonstrated that the experience of talking about CSA in psychological therapy can be a complex experience for client and clinician with varied consequences for both parties. The research into psychologists‟ experiences of CSA disclosure has been limited to surveys of psychologists‟ practice and knowledge and has lacked a scientific approach. This study aimed to expand on the scientific research into CSA disclosure with a Constructivist Grounded Theory approach (CGT). CGT was used to explore psychologists‟ experiences of CSA disclosure from clients in Adult Mental Health. Eight psychologists took part in the current study and were recruited from a large Clinical Psychology service in Scotland. Data was collected through semi-structured interviews. Core categories constructed in this study contributed to a model of psychologists‟ experiences of disclosure in AMH clinical practice. Core categories referred to “Negotiating the Dance of Disclosure” and “Nurturing the Pre-conditions to Disclosure”, which occur in parallel to the therapeutic relationship; whereas “Growing Personally and Professionally” and “Carrying the Weight of the Work” refer to the impact of hearing disclosures and talking about CSA with clients. Research findings are discussed and the implications of this model in relation to theory and areas of development for research and clinical practice are considered.

This bachelor thesis had the aim to investigate how young female students experience their safety situation in their own neighbourhood, around the University of Dar es Salaam in Tanzania. Previous research shows that women tend to feel more fear of crime in public spaces than men, and this feeling is restricting their mobility in time and space. This gender structure is a worldwide phenomenon and is by feminist geographers explained as an expression of the patriarchy. A phenomenological approach was used in this research to gain an understanding of how this gender structure is affecting individual female’s lives. The used method was focus group interviews and two groups were interviewed, with totally seven respondents. The sessions were analysed by using constructivist grounded theory and partly narrative analysis. The interviewees explained that there were certain spaces that they experience as dangerous, foremost dark places without visibility and few people passing. They also stated that places where people had been robbed, raped or kidnapped earlier were more threating. The potential criminal was portrayed as a non-student male, and the male students were described as their potential protectors. The fear was always present in their lives, they felt more or less unsafe in all parts of the campus and even in their homes. This threat restricted their daily mobility in both time and space, and they used different strategies to avoid different types of crimes.