Objective. Grounded theory (GT) is an established qualitative research method, but few papers have encapsulated the benefits, limits, and basic tenets of doing GTresearch on user and provider experiences of health care services. GT can be used to guide the entire study method, or it can be applied at the data analysis stage only. Methods. We summarize key components of GT and common GT procedures used by qualitative researchers in health care research. We draw on our experience of conducting a GTstudy on amyotrophic lateral sclerosis patients' experiences of health care services. Findings. We discuss why some approaches in GTresearch may work better than others, particularly when the focus of study is hard-to-reach population groups. We highlight the flexibility of procedures in GT to build theory about how people engage with health care services. Conclusion. GT enables researchers to capture and understand health care experiences. GT methods are particularly valuable when the topic of interest has not previously been studied. GT can be applied to bring structure and rigor to the analysis of qualitative data. Key Words. Grounded theory, qualitative research, qualitative interviews, health care experiences Many researchers and research teams that are predominantly quantitative in orientation may find that qualitative methods are needed to answer some or all of the questions they seek to answer in their study. This article seeks to enable such researchers to conduct qualitative research and data analysis with the help of the grounded theory (GT) method, one of the most widely used and established qualitative methods. We give practical advice pertaining to each step of a research project, and we illustrate these with the help of examples from a recent study that we conducted, and also hypothetical examples of research scenarios (the latter are in italics).

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The grounded theory (GT) method is widely applied, yet frequently misunderstood. We outline the main variants of GT and dispel the most common myths associated with GT. We argue that the different variants of GT incorporate a core set of shared procedures that can be put to work by any researcher or team from their chosen ontological and epistemological perspective. This “shared core” of the GT method is articulated as the principles of (1) taking the word “grounded” seriously, (2) capturing and explaining context-related social processes, (3) pursuing theory through engagement with data, and (4) pursuing theory through theoretical sampling. In this article, we have put forward, in a nutshell, a distillation of core principles underpinning existing GT approaches that can aid further engagement with the different variants of GT. We are motivated by the wish to make GT more comprehensible and accessible, especially for researchers who are new to the method.

Theoretical sampling is a key procedure for theory building in the grounded theory method. Confusion about how to employ theoretical sampling in grounded theory can exist among researchers who use or who want to use the grounded theory method. We illustrate how we employed theoretical sampling in diverse grounded theory studies and answer key questions about theoretical sampling in grounded theory. We show how theoretical sampling functions in grounded theory and how it differs from sampling for data generation alone. We demonstrate how induction, retroduction, and abduction operate in grounded theory and how memoing drives theoretical sampling in the pursuit of theory. We explicate how theoretical sampling can contextualize data to build concepts and theory. Finally, we show how theoretical sampling in grounded theory operates in secondary analysis to derive theory that goes beyond the original purpose of data collection.

Loneliness and depression are serious mental health concerns across the spectrum of residential care, from nursing homes to assisted and retirement living. Psychosocial care provided to residents to address these concerns is typically based on a long-standing tradition of 'light' social events, such as games, trips, and social gatherings, planned and implemented by staff. Although these activities provide enjoyment for some, loneliness and depression persist and the lack of resident input perpetuates the stereotype of residents as passive recipients of care. Residents continue to report lack of meaning in their lives, limited opportunities for contribution and frustration with paternalistic communication with staff. Those living with dementia face additional discrimination resulting in a range of unmet needs including lack of autonomy and belonging-both of which are linked with interpersonal violence. Research suggests, however, that programs fostering engagement and peer support provide opportunities for residents to be socially productive and to develop a valued social identity. The purpose of this paper is to offer a re-conceptualization of current practices. We argue that residents represent a largely untapped resource in our attempts to advance the quality of psychosocial care. We propose overturning practices that focus on entertainment and distraction by introducing a new approach that centers on resident contributions and peer support. We offer a model-Resident Engagement and Peer Support (REAP)-for designing interventions that advance residents' social identity, enhance reciprocal relationships and increase social productivity. This model has the potential to revolutionize current psychosocial practice by moving from resident care to resident engagement.

An increased demand for long-term care services coupled with the decreased availability of informal (family) carers in many industrialised countries has led to the employment of growing numbers of 'migrant care workers '. Little is known about this heterogeneous group or of their experience of employment in longterm care. Providing an important insight into a hitherto little researched and poorly understood topic, this article presents the findings of a qualitative study in Ireland that sought greater understanding of migrant carers' experience of care work and of the intra-group differences among them. The findings suggest that some members of the long-term care workforce are more likely to confront obstacles and discrimination than others. The data indicate that the experiences of European, South Asian and African carers are significantly different and that relationships may exist between carers' region of origin and their experience of care work, employment mobility and long-term plans for remaining in the sector. The findings underscore the significance of acknowledging the unique barriers and obstacles faced by particular populations of care workers. A better understanding of the changing demographic profile and needs of both care recipients and their paid (migrant) care-givers is required to ensure that appropriate policy and practical interventions are developed to support both groups.

This article describes and evaluates cash-for-care programmes for older people in four European countries, namely Home-Care Grants in Ireland, Direct Payments in the United Kingdom (England), Service Vouchers in Finland and Personal Budgets in The Netherlands. The purpose is to raise understanding of the background and reasons for the introduction of cash-for-care programmes and their impact on the countries' care regimes. It is argued that while the motives for introducing cashfor-care programmes in the four countries are similar, namely to promote choice and autonomy, to plug gaps in existing provision, to create jobs, and to promote efficiency, cost savings and domiciliary care, the relative importance of these goals varies. Current cash-for-care programmes have comparatively modest coverage as compared with direct service provision and provide no more than an optional, supplementary source of care in three of the studied countries. Cash-for-care schemes have not radically transformed the care regimes in Finland, The Netherlands or the United Kingdom. In Ireland, however, the restricted availability of alternative forms of formal service provision means that the expansion of cash-for-care might shift care provision significantly towards private provision and financing.

BackgroundCaregiver burden affects the physical, psychological and emotional well-being of the caregiver. The purpose of this analysis was to describe an informal caregiver cohort (n = 81), their subjective assessment of burden and difficulties experienced as a result of providing care to people with Amyotrophic Lateral Sclerosis (ALS).MethodsUsing mixed methods of data collection and analysis, we undertook a comprehensive assessment of burden and difficulties associated with informal caregiving in ALS. As part of a semi-structured interview a series of standardised measures were used to assess quality of life, psychological distress and subjective burden, and in an open-ended question caregivers were asked to identify difficult aspects of their caregiving experience.ResultsThe quantitative data show that psychological distress, hours of care provided and lower quality of life, were significant predictors of caregiver burden. From the qualitative data, the caregiving difficulties were thematised around managing the practicalities of the ALS condition, the emotional and psychosocial impact; limitation and restriction, and impact on relationships.ConclusionsThe collection and analysis of quantitative and qualitative data better explores the complexity of caregiver burden in ALS. Understanding the components of burden and the difficulties experienced as a result of caring for someone with ALS allows for better supporting the caregiver, and assessing the impact of burden on the care recipient.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-016-0153-0) contains supplementary material, which is available to authorized users.