The Theories can be useful to nurse-researchers as guides for conducting research. A theory offers a set of concepts and propositions that can be applied consistently and examined systematically across studies of clinical problems. When appropriate, researchers can use theories as guides across phases of research. When researchers communicate clearly about how they have applied a theory in their studies, others can synthesize evidence more readily across studies where the same theory was used. If scholars understand the conceptual dimensions, antecedents, and consequences of their clinical problems, then they are likely to select theories and methods that are aligned well with their clinical problems. Grounded theory is a research approach that appeals to nurses for several reasons. Grounded theory helps nurses to understand, develop, and utilize real-world knowledge about health concerns.
Initiating and sustaining effective change in healthcare is a continuing challenge, with even the most successful improvements often being difficult to sustain or replicate in other contexts. According to Breckenridge (2019), Key figures in improvement science have emphasized the importance of learning from the psychological, social and structural processes influencing the implementation and maintenance of practice innovations. They have called for researchers to look into the ‘black box’ of quality improvement to learn lessons from both successes and failures. Motivating Change conceptualizes the psychosocial-structural conditions for large-scale, sustained change. By narrowing the gap between extrinsic and intrinsic motivators, and equipping staff with the capacity and opportunity to act on these motivations, it is possible to create self-improving organizations with a systems structure that welcomes change as a means to improvement. The theory adds to and extends the existing evidence base on how to create large-scale sustained change and promotes the shared expertise of those individuals already actively doing improvement work on the ground.
Breckenridge JP, Gray N, Toma M, et al. Motivating Change: a grounded theory of how to achieve large-scale, sustained change, co-created with improvement organisations across the UK. BMJ Open Quality 2019;8:e000553. doi:10.1136/ bmjoq-2018-000553