findings were consistent with other findings in the stroke literature at the time,
adding credibility to her work. Although Folden’s work added much to nursing
knowledge about stroke, the published articles stopped short of proposing a
complete theory with assumptions and relational statements.
Using the same population, stroke survivors, Mauk, who published earlier as
Easton, sought to answer the question: What is the process of stroke recovery?
(Easton, 1999a). From her research, a grounded theory emerged for poststroke
recovery that was labeled the poststroke journey: from agonizing to owning.
Mauk used writings and videotapes from stroke survivors to identify concepts
and generate a theory. She then conducted face-to-face interviews with 18
stroke survivors to refine the theory. The end result of this grounded theory
research showed that stroke survivors reported six major phases in the process
of recovery: agonizing, fantasizing, realizing, blending, framing, and owning
(Mauk, 2001, 2006). Nursing interventions targeted to each phase of recovery
are being developed and explored but have yet to be tested.
More recently, Gallagher (2011) developed a grounded theory that focused on
the emotional process of stroke recovery. In a sample of nine stroke survivors,
she found three key themes related to emotional recovery: “1) recognizing that
stroke will not go away, 2) choosing to work on recovery, 3) working on being
normal” (p. 24). Interestingly, many of these themes are similar to what Mauk
found in examining the overall process of stroke recovery.
These three studies illustrate that grounded theory can be used by nurses to
explore a phenomenon about which little is known. In the previous examples,
the process of stroke recovery was one that had to be discovered from survivors
themselves. Theories can be used to develop practice guidelines. By listening
to, documenting, and explaining the process that patients go through, nurses
can provide better care because they are sensitized to patients’ situations.Ethnographic Research:
Understanding Culture
Spradley (1979), considered to be a leading expert in ethnography, defined the
method as “the work of describing a culture” (p. 3). He further stated that instead
of just studying people, ethnography involves learning from people. Spradley
(1980) suggested three basic aspects of human experience that researchers
needed to discover: cultural behavior (what people do), cultural knowledge
(what people know), and cultural artifacts (what people make and use). “The
goal of inquiry is rounded, not segmented understanding. It is comprehensive
in intent” (Hughes, 1992, p. 443). Ethnographic research involves studying
groups and making collective observations. It is the method of choice for
studying cultures.236 CHAPTER 9 Qualitative Designs: Using Words to Provide Evidence