Patient-centred care positions patients as active participants, collaborators, and experts in their healthcare and healthcare relationships - a role that adults with High Functioning Autism Spectrum Disorder (HFASD) may find challenging. The purpose of this study was to better understand the perspective and experiences of adults with HFASD in healthcare and healthcare relationships. Twenty-eight North American adults with HFASD responded to four open-ended long-answer questions online, which were analyzed using constant comparison methods within the grounded theory framework. Participants’ positive and negative experiences in healthcare were determined by their interactions with healthcare professionals who were portrayed as knowledgeable and empowering allies, or unknowledgeable and overpowering adversaries. Ultimately, these findings highlight the need for more education and knowledge about HFASD among healthcare professionals, and how it impacts these adults, as well as the need to develop evidence based interventions and tools to support adults with HFASD communication in healthcare. / October 2016

Manitoba has the highest rate of type 2 diabetes in Canada, exceeding other provinces 12-fold. Current literature has suggested that social supports are critical to the promotion and adoption of healthy living in youth living with type 2 diabetes. As such, high quality social support has been perceived as positive and can enhance youths’ resilience against life stressors. Despite this suggestion, there is little evidence on how best to support this population. The purpose of this Masters thesis was to explore the meaning of social support among Manitoban youth living with type 2 diabetes. Guided by a constructivist grounded theory approach, youth identified the following avenues of social support: family, friends, health care professionals, school and programming. Future interventionists should be aware of the vast incongruence in patients’ and physician’s perceptions of health in type 2 diabetes and design interventions accordingly. / February 2017

Clinicians and researchers know that women experience distress related to the diagnosis of and treatment for ovarian cancer. A review of the literature revealed that while there is interest in the topic, distress is inconsistently defined and measured. Women have been reported to have a variety of distress experiences including the challenges of late diagnosis and the treatment regimen, communication difficulties with healthcare providers, and concern about the effect of their diagnosis on their loved ones. Without information directly from women, assumptions predominate about what the experience is like and what they would find helpful from support persons. Women’s perceptions about distress was identified as a gap in the knowledge leading to the present study which asked “What do women with ovarian cancer want their spouse/significant other, family, friends, and healthcare providers to know about their experience of distress during diagnosis and treatment?” A qualitative method, Grounded Theory as outlined by Glaser and Strauss in 1967 was chosen to guide this IRB approved study. Twelve women participated in audiotaped interviews contributing data for analysis using the constant comparative method. Six common themes or subcategories emerged across all the interviews and resulted in a conceptualization of the experience as an “existential assault.” Though individual experience differed, abstraction and conceptualization of the data revealed the common themes as (a) “out of the blue like lightning”; (b) “no stone left unturned”; (c)“knowing what I don’t want to know and not knowing what I want to know”; (d) “watching you, watching me- we are both afraid”; (e) “talking yet not talking, about death”; and (f) “now I have to take care of me.” Participants expressed the need for professional support people who contribute their efforts to cure, but who also listen to the participant’s need to manage and control their own experience and to live in ways that give their life meaning and purpose. The experience of distress for the participants was intensified by the needs of those in their social network (spouse/significant other, family, friends, and healthcare providers) who also experienced distress, at times requiring participants to provide support for those who would be expected to be providing support.

For most of us, thoughts about our own mortality are largely unconscious, an invisible backdrop to our daily living. However, when forced to face a potentially life threatening event, these otherwise underlying thoughts about human transience rise to consciousness. Given the seemingly inherent link between receiving a cancer diagnosis and developing an increased awareness of one’s own mortality, the present study sought to address the following research question, “What are the experiences and processes by which women with gynecologic cancer construct meaning and manage death anxiety in the face of their cancer diagnosis?” Based on an interpretive grounded theory paradigm, 10 women with gynecologic cancer were interviewed to gather rich, nuanced information about the phenomenology of death anxiety in this understudied cancer population. The primary ways in which participants managed the threat of mortality were to engage in certain socially-sanctioned behaviors related to religion, spirituality, family, identity, and social obligations. These activities served a dual purpose by (1) giving participants the opportunity to fight symbolically or literally against death and (2) allowing them to derive a sense of meaning and purpose in life. Findings from this study offer a unique conceptual understanding of the cancer experience. Implications for theory, research, and practice are discussed.

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.

Cette thèse s'inscrit dans le domaine de l’internationalisation de la distribution. Son objectif est d’expliquer les facteurs de succès ou d’échec de la filiale étrangère du distributeur international. L’analyse de la littérature met en évidence l’existence d’une large palette de perspectives théoriques divergentes. Afin de construire un cadre conceptuel cohérent, notre travail se fonde sur un modèle intégré d’origine industrielle combinant les approches SCP (« Structure-Conduct-Performance »), RBV (« Resource-Based-View ») et la théorie des capacités dynamiques de la firme, que nous adaptons aux spécificités de la distribution. Le modèle est construit et présenté à partir du concept central de « compétences-clés », appliqué au distributeur, il s’agit de comprendre de quelle manière les compétences clés de la filiale internationale de distribution influencent ses choix stratégiques et sa performance. Cette recherche nous conduit à clarifier une série de notions ayant un lien étroit avec les compétences-clés. Nous pouvons observer indirectement les « compétences-clés » du distributeur international au travers des activités et capacités distinctives de sa filiale dans un pays donné. Le terrain choisi est la Chine, qui, tant par sa taille que par sa vitesse de développement économique et commercial, représente un véritable laboratoire des transformations à l’oeuvre dans les pays émergents. En termes de méthodologie, nous avons retenu une approche qualitative basée sur la « Grounded Theory ». Les résultats, obtenus par l’analyse des entretiens de vingt un dirigeants de filiale étrangère font apparaître d’une part, que la typologie des compétences-clés de la filiale du distributeur international repose sur deux types de compétences: les compétences de base et les compétences architecturales, d’autre part, le modèle intégré emprunté au domaine industriel est validé dans le domaine de la distribution sachant que les facteurs environnementaux jouent dans ce dernier cas un rôle plus important. / The purpose of this dissertation is to explain the success and failure factors for the foreign subsidiary of an international retailer. However, the existing literature draws on a wide range of divergent theoretical perspectives. In order to build one coherent conceptual framework, our study is based on an integrated model combining the SCP and RBV perspectives and the dynamical capability theory, while indicating the central role of core competences. Since this model was derived from industrial fields, we adapted it into a retailing model in order to understand how the core competences of the international retailer’s foreign subsidiary could influence its strategic choices and performances. This framework was used in a Grounded Theory study aimed at 21 top managers of international retailers in China. Our findings showed that the foreign subsidiary’s core competences for the international retailer could be classified as: component competences and architectural competences. Results from the international retailing fields broadly support the theoretical model borrowed from industrial fields. However, the environmental factors play a more important role in the first field.

Few studies have explored how medical ethics works in practice specifically in terms of the social processes that result in a decision regarding an ethical problem. This is particularly so in the case of children’s intensive care. More than a decade of teaching healthcare ethics to both nurses and doctors prompted a study to examine how ethical problems are resolved in a children’s intensive care unit. This qualitative study addressed this question in a single large children’s intensive care unit in England. The study was guided by grounded theory in examining via individual face to face unstructured and semi-structured interviews what ethical problems were encountered and how they were resolved. Interviews were conducted mainly with doctors and nurses working on an intensive care unit. Two admitting consultant doctors and three parents were also interviewed. The analysis of data gathered in 20 interviews was developed using Strauss and Corbin’s (1998) framework. A theory emerged from the analysis of the data that revealed the most prominent ethical problems in children’s intensive care related to end-of-life situations. Most significant among these was the decision to withdraw life-preserving interventions from a child. The theory outlines a process by which health professionals involved in the care and treatment of a child in intensive care negotiated a consensus on the point at which it was no longer appropriate to continue life-preserving interventions. This consensus was then presented to parents. Parental assent to withdrawal was facilitated, when not immediately forthcoming, by a process of persuasion.

D. Litt. et Phil. / The aim of this study was to develop a comprehensive framework for the rehabilitative needs of female offenders, through the use of Grounded Theory methodology. The framework took the form of a two-axis structure, with axis one encompassing the management of prisons and staff, and axis two dealing with the management and rehabilitation of prisoners. Axis two was conceptualised as a sequence of stages from the start of imprisonment until post-release. The framework is offered as a holistic structure for the development and integration of rehabilitative programmes. The framework is anticipated to assist in obtaining additional funding and support from the business community in order to make rehabilitative programmes available to a greater number of prisoners. The framework may also enable individuals and companies to determine where the specific resources at their disposal could be put to use with the greatest effect.

Wikis have been found to be an easy-to-use, low-cost, and Internet-based technology useful in creating and mobilizing knowledge. Wikis hosted within firms (corporate wikis) have become a popular way for employees to share information and collaborate. Preliminary research suggested that as few as 6% of wiki consumers contributed to the development of wiki pages. Conventional approaches argued that employees judged the costs of participating in wikis (e.g., authoring or changing material, reading messages, following an argument, and posting responses) to exceed the benefits of participating in wikis (e.g., recognition, reputation etc.) - thus many people "lurked" but did not post. Considering that people contemplated perceived benefits with costs of participating in wikis, research emphasized the cognitive aspects of decision-making. The emotional aspects of wiki participation in firms have received little research attention. Yet, research in other fields such as law, economics, and health showed that emotions played a critical role in human decision making, where feelings were shown to outweigh contemplated costs and benefits. For example, Kiviniemi, Voss-Humke, and Siefert (2007) found that positive feelings about exercise resulted in more physical activity whereas positive feelings about food resulted in unhealthy food choices. For Wikipedia, a public wiki, studies suggested that emotion might be an important motivator in participation. The purpose of this research was to study the role of emotion in corporate wiki participation. Since the area of research is new, the contextual details of wikis in an organizational setting made it difficult for a researcher to separate the context from the main effects. A grounded theory approach was needed. Under grounded theory, one starts with the data and builds arguments or theories from the "ground up." This study used a grounded theory methodology to reveal data through interviews, employee journals, observations, wiki statistics, and other documentation. Data were analyzed on a continuum using grounded theory coding to identify codes, categories, concepts, and properties and to recognize relationships among concepts. An exploration of emotion in an organizational context resulted in theories that provided an important beginning to understanding wiki experiences and improving wiki outcomes.

This thesis examines how knowledge management professionals use trust as a component in the creation of knowledge management systems, and what methods they use for building trust. Adopting a grounded theory approach, interviews with 8 knowledge management professionals active in different industries served as the base for an analysis that identified trust to be the single most important common factor in the data. The concept of trust used by the informants was identified as relating to the knowledge management system itself, rather than other users, employees or groups in an organisation. Building trust, the KM-professionals mainly focused on three methods: simple solutions, system superiority, and implementation security. Using these methods, the KM-professionals seek to ensure system trust by creating opportunities for users to obtain positive experiences of using the system, and thereby generate a foundation for a trust-based relationship between the user and the system.