Iterative design, data collection and analysis

Undertaking repeated cycles of design, data collection and analysis is one of the defining features of the grounded theory approach. Such iteration is enhanced by constant comparative analysis, as described above. The researcher first conducted an in-depth face-to-face interview with the analysis of the interview transcript from a single case. He compared the key issues arising from the data, such as multiple health conditions and family support, with relevant literature. The researcher then proceeded to interview the second man and repeated the entire process of data preparation and analysis. The second transcript was compared with the first and with published literature, to help develop the emergent line of enquiry.

This cyclical process went on until theoretical saturation was achieved, when the research area was theoretically exhausted (Weed, 2009). Theoretical saturation refers to a stage during the grounded theory research process when additional data from the field does not add any new dimensions to the properties of the identified category (Glaser & Strauss, 1967). It is the point at which the core category is fully grounded in data and no more concepts emerge from the additional data (Oktay, 2012). The researcher judged that theoretical saturation had been achieved after he had completed 18 interviews involving families and five with workers from community organisations. In addition, he carried out follow-up phone calls to some participants in order to clarify issues that had emerged during the analyses and had

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not been sufficiently covered in the interviews. This iterative process was designed to develop theoretical sensitivity, as discussed next.

86 2.3.4.3 Theoretical sensitivity

Theoretical sensitivity entails developing a deep understanding of the issues which concern those whose lives are being studied. Although theoretical sensitivity can be enhanced by being immersed in literature and related general knowledge surrounding the phenomenon, it can be compromised if knowledge about previous research stands in the way of ‘hearing’ what the research participants are trying to say (Weed, 2009). Charmaz (2006) maintained that the grounded theory researcher ought to be informed by the literature but should still retain an open mind. Strauss and Corbin (1990), similarly, argued that, although knowledge of the literature is useful, the researcher should remain vigilant to avoid being buried in it at the expense of the participant’s perspectives. The present researcher selectively reviewed the literature so as to update his knowledge about emerging categories such as gender relations, communication with children, reticence about HIV and how HIV affects families. The literature was intended to supplement insights gained from working in the HIV sector both in the UK and in Africa, as well as personal experience of living in families living with diagnosed HIV. For instance, the researcher combined knowledge from published literature concerning HIV-positive status disclosure with his own experience of stigma and concealment in order to help him to understand participant’s own concerns about disclosure to family members.

The researcher’s knowledge about East-African culture contributed to his understanding of what respondents were saying. For example, he was able to contextualise cases of multiple sexual relationships reported by some participants in terms of their membership of polygamous communities in East Africa. To an outsider, Black Africans were ‘known’ for having multiple sexual partners simultaneously (Dodds et al., 2008; Nyindo, 2005; Shannon et al., 2012). To an insider, the trend was mainly common among the individuals from culturally polygamous communities. The researcher also shared common dialects (Swahili and Luo) with some of the participants. This made it easier for those participants to fully express their views in instances when they felt the meaning would be lost in English translation, as illustrated below.

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Robin: So he came and asked me … Koyo omaki koso ango? [Luo – translated to mean you feel cold or what? This expression is used to ask if someone is ill]. You know, in my brain I think I know what he is asking me.

(Robin; 45 years old, HIV-positive for 13 years, lives with wife Harmony; 48 years old, HIV-positive for 14 years, and their 3 children. Have 6 children in total, 4 of whom are Harmony’s late sister’s children)

The above extract illustrates an inquiry into the participants’ HIV status by a relative using figurative language to refer to HIV, illustrating an indirect communication about HIV in the participants’ families even when it was suspected. An outsider might well perceive the enquiry as innocuous small-talk but the researcher’s familiarity with the dialect, and phrases such as cold, slim or wind being used to refer to HIV in their native community, enabled him at times such as this to developed a more nuanced understanding than might have been available to a researcher who did not share the informants’ culture.

As Glaser and Strauss (1967) asserted, theoretical sensitivity grows over time through repeated re-reading and constant comparison, which lead to new insights as the researcher masters a large and increasingly focused range of data. The present researcher developed a better understanding of theorizing and was able to identify key concepts, subcategories and categories as the study progressed, unlike at the beginning when identification of key concepts was a challenge. By the end of data analysis, the researcher was able to identify communication about HIV status as the core category around which other major categories of disclosure, concealment and exposure could be located.