N U R SI N G T H E O R Y A N D C O N C E PT D E V E L O P M E N T O R A N A L Y SI S

Triangulation of qualitative approaches: hermeneutical phenomenology

and grounded theory
Merilyn Annells PhD RN
Professor of Community Nursing, La Trobe University, RDNS Helen Macpherson Smith Institute of Community Health,
St Kilda, Victoria, Australia

Accepted for publication 24 March 2006

Correspondence: ANNELLS M. (2006) Journal of Advanced Nursing 56(1), 55–61

Merilyn Annells, Triangulation of qualitative approaches: hermeneutical phenomenology and
La Trobe University, grounded theory
RDNS Helen Macpherson Smith Institute of
Aim. In this paper, suggestions are offered about the appropriate use of hermeneutic
Community Health,
phenomenology and grounded theory in one study.
31 Alma Rd,
St Kilda,
Background. As an alternative to selecting only one qualitative research approach to
Victoria, illuminate a topic of interest about which little is known, two qualitative approaches
3182, could be used in a study. Fear of ‘method slurring’ may prevent this alternative being
Australia. used. Occasionally, however, credible qualitative researchers have advocated using
E-mail: m.annells@latrobe.edu.au various research approaches in one study, for example using hermeneutical
phenomenology and grounded theory in triangulation. However, if pursuing this
doi: 10.1111/j.1365-2648.2006.03979.x
direction, several advances in thinking about using qualitative research approaches
should be considered.
Discussion. An experience is presented of deciding to use grounded theory and
hermeneutic phenomenology in one study. Cautions, practical considerations and
alternative options are offered for using these approaches in one study, and the
implications of some other possible ways to ‘triangulate’ qualitative approaches are
discussed.
Conclusion. Different research approaches can be creatively and successfully used in
one study if there has been adequate consideration of vital factors that determine if
there is a good ‘fit’ of the approaches not only with the research problem and
question, but also with each other, while also maintaining the integrity of each
approach.

Keywords: grounded theory, hermeneutics, nursing, phenomenology, qualitative

approaches, research methods, triangulation

commonly used single approaches to qualitative health

Introduction
It is common for nurse researchers planning qualitative
research into a complex human phenomenon about which
little is known to feel a need to reduce possible choices of
research approach to just one type, with narrowing of the aim
and related research question in order to be consistent with
the product that can be obtained through using the approach.
Sometimes researchers may feel torn between selecting
phenomenology or grounded theory; these are the most
research (McKibbon & Gadd 2004). This conflict arises
especially when both the meaning of the lived experience and
understanding of social actions and interactions can provide
useful guidance for clinical practice.
Perhaps, the most salient published suggestion about an
alternative approach was offered by Wilson and Hutchinson
(1991), who advocated use of phenomenology and grounded
theory in two distinct phases when researching a complex
phenomenon about which there is a dearth of knowledge,

 2006 The Author. Journal compilation  2006 Blackwell Publishing Ltd 55

M. Annells
and when the phenomenology is hermeneutical in style. They
claimed that this enabled ‘turning the prism’ (p. 274) to view
the phenomenon, and that this design provided ‘the breadth
and depth needed in nursing science’ (p. 275). Their
observation was that those who use grounded theory or
hermeneutic phenomenology ‘share a commitment to a
qualitative, naturalistic, contextual, historic, intersubjective
methodology to understand human responses and experien-
ces from a variety of perspectives as they are transformed
over time’ (p. 267). In their opinion, grounded theory can
inform practical intervention and further research, whilst
‘The rich and insightful detail of hermeneutics provides a
depth of personal understanding that creates a dialogue and a
beginning for a conversation’ (p. 275). However, they
emphasized that when using both approaches in a study to
seek different outcomes illuminating ‘clinical realities that
elude alternative approaches’ (p. 263), it is vital to maintain
the integrity of each approach – not only through separate
data collection, but also through use of different interview
styles and data analysis processes.
Researchers contemplating this suggestion might be con-
cerned about the oft-cited warning in the seminal work of
Baker et al. (1992) to avoid the ‘method slurring’ that could
occur when grounded theory and phenomenology are
entwined in a study. However, this is not relevant to Wilson
and Hutchinson’s (1991) suggestion as there would be two
discrete phases of research, with two products. Stern (1994,
p. 219) affirms this when stating that Wilson and Hutchin-
son’s (1991) proposed two-phase study combined grounded
theory and phenomenology ‘to great advantage’ without
making the mistake of aiming for a hybrid product. Coffey
and Atkinson (1996, p. 14), whilst emphatically rejecting a
summing or aggregating of alternative understandings from
‘vulgar triangulation’ when applying varying research
approaches in one study, do accept use of different approa-
ches if the resulting product/s juxtapose understandings that
acknowledge the complexity of the phenomenon studied.
Using grounded theory and phenomenology enables that sort
of juxtaposition.
The juxtaposition of understandings is acceptable in
research in this postmodern era, but how acceptable is using
two qualitative approaches in the one study? According to
Denzin and Lincoln (2000, p. 1061), qualitative research is
moving into a ‘seventh moment’ that is likely to feature
‘interpretive bricoleurs’ for whom ‘invention is not only the
child of necessity, it is the demand of restless art’ and
qualitative approaches ‘become the ‘‘invention’’, and the
telling of the tales – the representation – becomes the art’.
When considering the 1991 proposal of Wilson and
Hutchinson, it is vital to recognize that this was formulated
56  2006 The Author. Journal compilation  2006 Blackwell Publishing Ltd
probably prior to the ‘fifth moment’ of qualitative research,
and progression in thinking about qualitative research needs
to guide evaluation of their suggestion. Presented below is an
experience of systematically considering this matter when
planning a study.
An example
The aim of the study was to research how flatus affected
people receiving nursing care. Having reviewed the literature,
I realized that there was an almost complete absence of
research about this phenomenon. This is not surprising as the
social processes involved when flatus has affected a patient
are not readily considered in the clinical world of nursing. As
grounded theory provides understandings of people’s actions
and beliefs about a health phenomenon, including social
processes, and was recognized in the planning stage as being
useful when seeking to explain relationships between con-
cepts to form a substantive theory, this research approach
seemed useful to address the study aim. Increasingly, how-
ever, I became aware that the impact of flatus on patients
was a complex human phenomenon and that there was a
need to illuminate more than relevant social processes to
adequately address the problem. As hermeneutical phenom-
enology focuses on comprehension or the meaning of text/
action, the need to use hermeneutic phenomenology to
understand possible meanings of situations and experiences
pertaining to flatus impacting on patients, became clear.
When trawling the qualitative methodology literature to
seek guidance about this dilemma, I found the 1991 proposal
of Wilson and Hutchinson and some limited discussion about
their proposal. This added impetus to my tentative plan not
only to develop a substantive grounded theory focussing on
nurse–patient actions and interaction, but also to inquire
about possible meanings of the experience to give broader
understanding of an existential nature. That is, I wanted to
interpret stories about experiencing the phenomenon, not
only for intrinsic gains when the resulting product promoted
an empathetic vicarious response in the reader, but also to
motivate application of the substantive grounded theory in
nursing practice.
A constraint
I was wary in the planning stage of the study about using
these two qualitative research approaches because of two
major issues arising from contemporary qualitative research
methodology concerns. The first was that the approach
needed to be applied in a manner congruent with the
philosophical paradigm about inquiry underpinning the
Nursing theory and concept development or analysis
study. The second issue arose directly from the first: namely,
if using two different qualitative research approaches, it
would be necessary to ensure that both were congruent with
that philosophical paradigm and hence with each other.
Needing to identify paradigmatic stance about qualitative
research arose as a concern around the fifth moment of
qualitative research (Guba & Lincoln 1994); nursing research
methodologists began emphasizing this need around then as
exampled by Benoliel (1996), a pioneering grounded theorist,
who stressed the importance of being aware of the relation-
ship between a chosen research approach and ‘underlying
assumptions about the nature of reality’ and a ‘particular
philosophy’ (p. 417).
My philosophical belief in relativist ontology, transac-
tional/subjectivist epistemology, and need for a hermeneuti-
cal/dialectical methodology when conducting social research
placed that perspective in a constructivist paradigm, as
identified by Lincoln and Guba (2000). Therefore, both
research approaches to be applied needed to be congruent
with constructivism and this required evaluation of how this
matched the suggestions of Wilson and Hutchinson (1991).
Evaluation of Wilson and Hutchinson’s (1991) discussion
of grounded theory suggested it reflected the positivist
philosophy of classic (or Glaserian) grounded theory (Glaser
& Strauss 1967, Glaser 1978, 1992, 1998, 1999) based on
realist ontology with a received view of knowledge.
Contrastingly, Wilson and Hutchinson (1991) made state-
ments about Heideggerian phenomenology that reflected
relativism and a perceived view of knowledge, such as when
directing the researcher to be ‘a partner with the informant’
as ‘they work together to produce the interview’ (p. 270).
This is understandable as an evaluation of the ontological
roots and basis of hermeneutic phenomenology, including
Heideggerian and Gadamerian forms, identifies relativist
ontology and a comfortable fit to a constructivist paradigm
(Annells 1996a, 1999). This is congruent with discernible
relativist ontology underpinning hermeneutic phenomenol-
ogy, as was widely accepted by the fifth moment of
qualitative research (e.g. Ray 1994, Koch 1995, Grenz
1996). The problem is, though, that this is at odds with a
neopositivist form of grounded theory, the classic (or
‘Glaserian mode’) suggested for application by Wilson and
Hutchinson (1991). Consequently, in their article there are
non-harmonizing views about the role of the inquirer being to
generate text (a perceived view of knowledge) in the
hermeneutical phenomenology phase, contrasted to collecting
data (a received view of knowledge) for the grounded theory
phase (Wilson & Hutchinson 1991, p. 270).
Further complicating matters were some statements by
Wilson and Hutchinson (1991) about hermeneutic phenom-
 2006 The Author. Journal compilation  2006 Blackwell Publishing Ltd
Triangulation of qualitative approaches
enology that seem to be aligned to realism, such as the
statements that this approach aims to ‘unveil the shared
common practices’ (p. 268), ‘accurately describe and inter-
pret participant’s meaning’s’ (p. 268), ‘get the story straight’
(p. 270), and ‘discover meaning’ (p. 271).
Wilson and Hutchinson (1991) did not discuss the need for
research to be ontologically congruent with the inquirer’s
belief about the nature of reality, which always has meth-
odological consequences. Neither did they address any need
for the two approaches to be ontologically congruent, or
alternatively seek to justify how research approaches can be
used in a study when ontologically variant about research, as
their suggested combination of approaches somewhat seem to
be. Their philosophical discussion about the two approaches
commenced one step too late – that of epistemology rather
than ontology. It is important to note, however, that their
proposal was formulated prior to the issue of the philosoph-
ical congruency of paradigm of inquiry becoming widely
accepted as necessary in major qualitative research methodo-
logy forums; thus, it is understandable for that time to be
recommending research approaches that have different
ontological roots.
The question then was ‘What should I do in my research?’
First, the preferred type of grounded theory to be applied was
a modified mode of grounded theory, the ‘Straussian’ mode
(Strauss & Corbin 1990, 1994, 1998), as this has a
discernible slant to relativist ontology (a perceived view of
knowledge) and so was congruent with a constructivist
perspective to qualitative research, which was the philoso-
phical stance underpinning my intended study. As major
works about grounded theory do not make explicit the
‘relationships among assumptions, taken-for-granted pre-
mises, and technical and analytic procedures’ (Benoliel
1996, p. 413), others, including me (Annells 1996b,
1997a,b, 2003) have sought to clarify and disseminate
possible ontological roots, epistemological consequences
and subsequent methodological positions. I have argued that
Strauss and Corbin’s (1990, 1994, 1998) mode of grounded
theory exhibits a leaning toward the constructivist paradigm
of research, although still reflecting some aspects of positivist
thought and language. This issue has been debated (e.g.
Charmaz 2000, Hall & Callery 2001, Heath & Cowley
2004) but, whether this mode of grounded theory is leaning
toward constructivism or not, it can be applied in a
constructivist way, as has been explained amongst sugges-
tions for five major options in grounded theory modes
(Annells 1997b).
Although critical hermeneutical phenomenology is also
possible, hermeneutical phenomenology (underpinned by the
tradition of philosophical hermeneutics) can be used in the
57
M. Annells
constructivist paradigm of research, as mentioned previously.
The form of hermeneutic phenomenology I selected for my
study was Gadamerian, as I consider Gadamer’s philosoph-
ical ideas (Gadamer 1975, 1976, 1987) to be well-reasoned
and justified.
The decision
Table 1 lists elements of the mode of grounded theory I used
for the first phase of the study, and also elements of the form
of hermeneutical phenomenology applied for the second
phase. Each phase had separate objectives, and a different
sample was used for each phase because of the traditionally
differing sampling strategies required by the two research
approaches. It should be noted that I applied a slightly altered
version of Strauss and Corbin (1990, 1994, 1998) mode of
grounded theory. Because of the need for congruency with
constructivism, the approaches were applied in different
modes/forms to those proposed by Wilson and Hutchinson;
therefore, Table 1 is a modified version of a table presented
by Wilson and Hutchinson (1991, p. 226).
However, there were three other ways in which my use of
the two approaches varied from the suggestions of Wilson
and Hutchinson (1991): added use of reflexivity, both
approaches keeping the dialogue open about the resultant
Table 1 Comparison of a constructivist version of grounded theory and hermeneutical phenomenology with a Gadamerian influence (adapted
from Wilson & Hutchinson 1991, p. 266)
Grounded theory (Strauss and Corbin mode in influence)
Derived from Strauss’s action theory with an emphasis on
social interaction and social processes related to a
phenomenon
Relativist ontology foundation and in the constructivist
paradigm of research
Considers structural conditions and consequences
Focuses on actors attempting to manage the course of the
phenomenon
Theoretical framework evolves during the research
A modification of an established method
Theoretical sampling of incidents and situations with sampling
continuing until constructed categories are saturated
Data generation through interviews, observations, and
document analysis, as appropriate to the phenomenon
Constant-comparative data analysis
Writing clarifies the theory and reflexivity is encouraged
through memo writing
Aiming for understanding to inform praxis
Product is a substantive grounded construct-as-theory
58
constructions (not just the hermeneutic phenomenology), and
rejection of realist notions of validity. These variations were
derived from a postmodern position about research. More-
over, I needed to apply more time and effort for the grounded
theory phase, but Wilson and Hutchinson (1991) were silent
on that matter.
Conclusion
Recommendations
Using grounded theory and hermeneutical phenomenology in
two distinct phases in the study was a positive and productive
experience. My opinion based on this experience is that the
two products can be complementary for gaining vital but
different types of understandings that could be useful for best
practice about a phenomenon central to a problem or a
curiosity. Therefore, I recommend using this kind of triangu-
lation to research a phenomenon when ‘turning the prism’ can
be an advantage. Not only is a phenomenon interpreted
according to the possible social processes that occur about the
phenomenon, but understanding is enhanced about possible
meanings of existential human experience of the phenomenon.
In this era, gratitude is due to Wilson and Hutchinson
(1991) for initially suggesting use of the two approaches, and
Hermeneutical phenomenology (Gadamerian in influence)
Derived from Gadamerian hermeneutics emphasising the
possible existential meaning of an experienced phenomenon
Relativist ontology foundation and in the constructivist
paradigm of research
Considers linguisticity of understanding, temporality and
historicality
Considers the phenomenon in the everyday awareness of the
person
Interpretive scheme of hermeneutic philosophical ideas as
found appropriate
Research process personally chosen
Purposive text sources aiming to have sufficient text to provide
richness and variation
Conversations are sufficient for text generation, text being
more than a transcript of the conversation
Retrospective text interpretation
Involves writing and thinking, including reflexivity through
journal writing
Aiming for an empathetic vicarious response and
understanding to inform praxis
Product is a synthesis of interpreted possible meanings
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Nursing theory and concept development or analysis
What is already known about this topic
• Grounded theory and hermeneutic phenomenology can
be used in two separate sections of a study.
• Triangulation (both theoretical and methodological)
and mixed approach designs are increasingly accepted
in nursing and health-focussed research.
What this paper adds
• Forms of grounded theory and hermeneutic phenome-
nology used together in a study need to arise from the
same ontological foundation, whether this is linked to a
perceived view of knowledge or to a received view of
knowledge.
• Fundamental philosophical issues and related research
processes to assist in selection of forms of grounded
theory and hermeneutic phenomenology for use in one
study.
• Potential creative ways of varying research approaches
in a study, including enablers and constraints.
there are a number of elements in their discussion about the
suggestion that remain imperative, including:
• the differing foci of the approaches;
• each approach needs to have separate integrity, yielding
different outcomes;
• understanding both approaches to be committed to re-
search that is naturalistic, contextual, historicist and
intersubjective;
• nature and purpose of the literature review;
• that separate generation of text should occur for each ap-
proach;
• that hermeneutical phenomenology has no ‘method’ as it is
mainly a thinking and writing activity, and that interpreted
understanding/s can be presented in many different ways;
• that disadvantages include the time required for text gen-
eration/interpretation, and the need to be ‘well-versed’ in
both approaches, or to have access to mentors.
Although not a necessity, I recommend that grounded
theory be engaged for the first of the two phases. Therefore,
the understandings constructed from that phase will benefi-
cially broaden the inquirer’s horizon about the phenomenon
when later engaging in the hermeneutical phenomenology
phase.
I also recommend caution to ensure that the forms of the
two approaches used arise from the same ontological
foundation about research, whether that is a perceived or a
received view of knowledge. For instance, if following Wilson
 2006 The Author. Journal compilation  2006 Blackwell Publishing Ltd
Triangulation of qualitative approaches
and Hutchinson’s (1991) suggestion about grounded theory
(the positivist classic mode of the approach), then the other
phase should use a form of phenomenology which is
ontologically realist or critical realist, have an objectivist or
modified objectivist epistemology, and a suitable methodo-
logy – such as Husserlian phenomenology (Husserl 1982) or
phenomenology from the perspective of Merleau-Ponty
(1974, 1989) or van Manen (1990, 2002). Other alternatives
might be to use both approaches, congruent with relativistic
ontology as in Table 1, or to use a mode of grounded theory
in a critical theory paradigm of research coupled with a
critical hermeneutical research approach.
Unless the two approaches are founded on the same
ontology about research, the study will suffer loss of integrity
from lack of harmony between:
• fit of the inquirer’s ontological basis for epistemological
and methodological decisions with that of the selected
modes/forms of the approaches;
• congruent justifications for research processes;
• selection of research quality criteria suitable for both
phases;
• pivotal need for the research products to satisfy one overall
curiosity or help address one specific problem.
Without this harmony, the inquirer may be frustrated by
incommensurability of the two approaches, becoming lost in
multiple fractures which would inevitably occur when trying
to do the research.
Other possibilities
In this era, which values both theoretical and methodological
triangulation in research (Risjord et al. 2002, Ammenwerth
et al. 2003, Kushner & Morrow 2003), it would also be
possible to turn the prism further by using a third qualitative
research approach through which to view the phenomenon of
interest, such as applying ethnography to explore cultural
aspects.
It would also be possible to apply either grounded theory
or phenomenology in conjunction with other approaches. For
example, using grounded theory simultaneously with apply-
ing action research develop best practice models, with the
developing grounded theory illuminating aspects of model
development in the second and third action cycles. Keeping
grounded theory processes separate from the action research
would be vital and probably be best achieved by use of
separate research personnel. There would be the same sample
of incidents and situations, but with the grounded theory
section of the study inquiring only about those that are
theoretically sampled as relevant – grounded theory samples
incidences and situations, not people per se. Therefore,
59
M. Annells
preservation of the theoretical sampling principle for groun-
ded theory could occur with this design and usual sampling
strategies required for each approach be maintained.
Strauss and Corbin (1994, p. 283) predicted that adapta-
tion of the grounded theory approach ‘will include combining
it with other methodologies (hermeneutical, phenomenolog-
ical, for instance)’. It is not clear if this is meant to be two
entirely discrete phases, as proposed by Wilson and Hut-
chinson (1991), or a closer fusion.
A revolutionary possibility of pursuing a closer fusion
could be one set of data collection and analysis for
constructing a grounded theory, but with attention in data
collection also to exploring the meaning of experience
phenomenologically; then data would be reinterpreted in a
discrete, separate phase – that is, two foci of data collection,
but with analysis quite separate. This is different from using
different theories in different ‘readings of data’ to construct
different products (e.g. Honan et al. 2000), as data collection
would then have two separate foci. However, such a study
would have to justify diverting from separate sampling
techniques, a commonly believed ‘immutable law’ about
comparison of grounded theory and phenomenology research
processes.
New ideas are emerging about both mixed research
approach design and challenging of supposed immutable
laws about research approaches. For instance, Wimpenny
and Gass (2000) have explored whether there is an intrinsic
difference between interviewing in phenomenology and
grounded theory, and conclude that purpose is the core
issue. The avoidance of ‘method slurring’ is being challenged
by writers such as Johnson et al. (2001), with their advocacy
of ‘British pluralism’.
One other possibility about mixed research approaches
design is that in a primarily quantitative study grounded
theory and/or phenomenology can be applied to ‘turn the
prism’, but philosophical issues need to influence choice of
versions of approaches used. When planning a combination
of naturalistic and quantitative research approaches, poten-
tial tension between the underlying ontology of each needs to
be considered, as realized and assessed in a study by
Johnstone (2004). In addition to congruent philosophical
underpinnings about what is inquiry for modes of research
approaches used, a parallel recommendation is to ensure
congruency of approaches/s with the researcher’s philosoph-
ical perspective about research.
In conclusion, when contemplating methodological trian-
gulation and mixed approach design in this seventh moment
of qualitative research, new dialogue is likely to emerge
amongst methodological adherents about what paradigms
mean and related issues, such as the trusting of results
60  2006 The Author. Journal compilation  2006 Blackwell Publishing Ltd
(Lincoln & Denzin 2000). These debates will continue, and
so it is wise to stay tuned to advances in thinking about these
matters.
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