A Methodological Framework for Integrating Phenomenology and Grounded Theory in Health Professions Research: Insights From Medical Radiation Science

Abstract

Qualitative methodologies, particularly phenomenology and grounded theory, are crucial for generating knowledge relevant to the advancement of evidence-based healthcare. Phenomenology focuses on understanding lived experiences, while grounded theory aims to develop explanatory theories of the processes that shape these experiences. However, methodological evolution has resulted in blurred boundaries and confusion between these two methodologies, potentially leading to inappropriate integration, known as method slurring. This methodological review addresses these issues by examining how phenomenology and grounded theory can be appropriately integrated and by providing a clear description of their philosophical boundaries. Both phenomenology and grounded theory have adaptations that align with key research paradigms: post-positivism, interpretivism, and constructivism. Three specific integrated designs are proposed in this work, based on methodological complementarity. (1) In post-positivism, Husserl’s descriptive phenomenology and Glaser’s classical grounded theory align through a shared requirement to suspend researcher’s preconceptions to achieve objectivity. (2) In interpretivism, Heidegger’s interpretive phenomenology aligns with Strauss and Corbin’s grounded theory. This alignment stems from their shared methodological requirement that objectivity through bracketing may not be feasible. Thus, research within this paradigm applies reflexivity and memoing to understand participants’ subjective experiences. Additionally, both approaches acknowledge that researchers participate in the interpretive process. (3) In constructivism, Gadamer’s ontological “fusion of horizons” and Charmaz’s co-construction are harmonised as a methodological practice for creating theoretical knowledge. These congruent designs can be implemented using sequential, convergent, or iterative integration pathways. Employing a methodologically complementary and philosophically congruent integrated approach, exemplified by studying burnout and coping strategies in medical radiation practitioners, enhances data triangulation and methodological rigour. Researchers should be mindful of the philosophical underpinnings of the chosen adaptations to ensure alignment with the research paradigm and to avoid methodological slurring, thereby producing rigorous and relevant outcomes.

Introduction

Qualitative methodologies represent specific theoretical and philosophical frameworks used to examine phenomena within real-world contexts (Creswell & Poth, 2018). The findings of such studies are essential to the advancement of evidence-based healthcare (Bleiker et al., 2019), and for medical radiation science, qualitative research is vital for examining concepts such as cultural dynamics, professionalism, regulatory frameworks, health and illness, management, and education, among other aspects of practice, often from a first-person perspective (i.e., from patients and practitioners). Whilst there are various qualitative methodologies available to researchers, the choice of research methods i.e., data collection, analysis, and reporting, must be well justified (Holloway & Wheeler, 2003). They should also demonstrate how the chosen methodology was used to effectively refine the initial research questions and best facilitate the generation of relevant results.

Medical radiation science is an allied health profession using sophisticated imaging and therapeutic equipment for the diagnosis and treatment of injuries and diseases. It includes the disciplines of diagnostic radiography, radiation therapy, and nuclear medicine. A recent work by Ago, Kilgour and Smith (2025) found that phenomenology and grounded theory are two of the most common qualitative methodologies used in medical radiation science research. Phenomenology examines participants’ lived experience to better understand the phenomenon occurring (Burns & Peacock, 2019; Munhall, 2012; van Manen, 2016). Whilst, in contrast, grounded theory involves analysing and examining the actions, processes, or interactions underpinning participants’ lived experiences to develop a theory (Charmaz, 2006; Corbin & Strauss, 2015; Denzin & Lincoln, 2018).

It has been noted that examination of concepts in medical radiation science requires an approach that considers participants’ feelings and behaviours (i.e., lived experiences, which aligns with phenomenology) and cultures (i.e., evolving processes, which relates to grounded theory) (Hammick, 1995). Thus, utilising an integrated methodology of phenomenology and grounded theory approaches can be used for holistic examination of complex, underexplored clinical concepts (Wilson & Hutchinson, 1991) to generate relevant meaningful theories, which for medical radiation science, may help to develop “our unique profession-specific knowledge” (Bolderston, 2014, p. 202). The advantages of this integrated design include enhanced data triangulation (Annells, 2006; Wilson & Hutchinson, 1991) by allowing researchers to address different, yet related, dimensions of a complex phenomenon within the same study (e.g., using a single data source to understand burnout and coping strategies in medical radiation practitioners). This improves study rigour, relevance, and practicality of the qualitative findings made, and ultimately, facilitates the development of meaningful theories to support evidence-based patient care (Annells, 2006).

However, methodological evolution and adaptations have contributed to the blurring of boundaries between phenomenology and grounded theory (Starks & Brown Trinidad, 2007; Urcia, 2021). This blurring results in overlap and confusion amongst researchers, especially for novices (Green, 2014; Singh & Estefan, 2018; Starks & Brown Trinidad, 2007; Urcia, 2021), and is evident in medical radiation science literature. Inconsistencies and inaccuracies in the choice of methodological approaches and alignment with the aims of the studies are well reported (Metsala & Fridell, 2018), and in addition, 35.7% of researchers fail to specify the qualitative approach employed (Ago, Kilgour, & Smith, 2025). This confusion can also result in ‘method slurring’, whereby researchers combine different methodologies or theoretical underpinnings within a single study, without providing a clear rationale, thus reducing coherence and rigour (Baker et al., 1992).

To best understand the usefulness of integrating phenomenology and grounded theory methodologies as an appropriate qualitative approach, it is useful to highlight this with an example. Therefore, if one wanted to research a medical radiation practitioners’ (i) lived experiences of workplace burnout and (ii) their adopted coping strategies, then for (i) a phenomenological approach that ‘makes meaning/sense’ of the participant’s lived experiences regarding burnout is best suited. However, for (ii), a grounded theory approach allows the researcher to examine the adopted coping strategies and underlying processes involved, and therefore, to develop an explanatory theoretical description or interpretation of the participant’s behaviour, actions, processes, and/or interactions.

Therefore, based on the current research issues described (i.e., blurred boundaries in adaptations and potential method slurring), this review aims to provide a clear description of philosophical boundaries and methodological congruence between phenomenology and grounded theory, and examine how both can be appropriately integrated within one study. This is intended to help researchers avoid inappropriate integration of philosophically and methodologically different approaches and to improve the rigour and application of qualitative findings to support evidence-based practice.

Methods and Literature Search

A narrative review was conducted to synthesise the evidence supporting the effective integration of phenomenology and grounded theory in medical radiation science research. This approach was selected because the extensive philosophical dimensions and blurred boundaries of phenomenology and grounded theory required a flexible means of evidence synthesis to trace the history and development of their adaptations (Green et al., 2006).

A literature search was performed in June 2025 across PubMed, Scopus, and CINAHL databases. The search strategy included keywords such as “qualitative research”, “phenomenology”, “grounded theory”, “healthcare”, and “health profession*”. These were combined with Boolean operators (OR/AND). The included articles were (i) peer-reviewed journal articles and conference proceedings that (ii) examined the philosophical dimensions of phenomenology and/or grounded theory. Additionally, (iii) articles that combined features of both approaches in one study were included. Moreover, (iv) only articles published in the English language were included. There were no limitations to the date of publication. Articles that did not examine the philosophical foundations of phenomenology or grounded theory and non-English language articles were excluded. Table 1 provides a glossary of key terms.

Table 1.

Glossary of Key Terms (Bryant, 2017; Charmaz, 2006, 2014)

Glossary of Key Terms
Axial coding aims to bring together ‘fractured data’ by specifying characteristics of a category and how they relate to the central phenomenon.
Bracketing (Epoché): A descriptive phenomenological strategy in which researchers attempt to suspend all preconceived assumptions, perceptions, and biases about the studied phenomenon and assume a tabula rasa (blank slate) position to achieve objectivism. This technique is required by Husserl’s descriptive phenomenology and Glaser’s classical grounded theory.
Categorical coding: A process of organising individual codes into higher-level conceptual categories that represent broader patterns in the data. It aims to structure early idea obtained from open coding into more meaningful groupings (i.e., categories).
Constant comparative method: This is a grounded theory strategy where data are continuously compared with emerging categories and previous data to refine and develop theoretical insights.
Focused coding: This is a later stage grounded theory analysis technique that requires higher level of abstraction than open coding. It requires the researcher to compare initial codes in order to select those with higher analytic power or determine a new code that captures a number of initial codes.
Fusion of horizons: A process specific to Gadamer’s hermeneutic phenomenology that describes the merging of the researcher’s and participants’ perspectives to shape the meaning of the phenomenon and create shared understanding.
Hermeneutic circle: A circular analytical process used in Gadamer’s hermeneutic phenomenology, involving pre-understanding and complete interpretation of lived experiences. It involves continuous reading of transcripts (moving inside the parts of the data) to identify the evolving understanding of the hidden meaning (moving outside the whole) (see part-whole analysis).
Line-by-line coding: An open coding technique where each line of data is coded to ensure close engagement with data and help prevent the premature influence of researcher preconceptions, thus supporting analytic openness.
Memoing: A process used in grounded theory, particularly Charmaz’s constructivist approach, that involves documenting the researcher’s perceptions, biases, emerging insights, and interpretations in reflective journals. Identical to reflexivity.
Method slurring: Inappropriate integration of philosophically different methodological approaches in one study. This reduces coherence and rigour.
Open coding is the initial stage of grounded theory analysis where data are examined line-by-line to identify discrete concepts, actions, and meanings. The aim is to produce useable and useful abstractions.
Part-whole analysis: A hermeneutic method where understanding is developed through continuous movement between individual parts of the data and the entire phenomenon. It reflects the belief that full meaning can only emerge through interpretation of both the details and the whole context simultaneously.
Reflexivity: Involves the use of reflective journaling to document the researcher’s self-awareness and critical reflection on how their assumptions, background, and role influence the research process and interpretations. It is identical to memoing in grounded theory.
Selective coding: This is the end-stage coding process in grounded theory involving the identification of a core category, a central theme that logically integrates and explains all other categories developed in earlier coding stages (i.e., open and axial coding). The purpose is to weave categories into a coherent storyline that explains the phenomenon.
Theoretical coding: This is a grounded theory analysis process where relationships between categories are refined and conceptualised to construct an explanatory theory.
Transcendental I: A state of bias-free assumption in descriptive phenomenology achieved through bracketing that helps the researcher to understand the studied phenomenon by descriptive means.
Unknowing: A process used in interpretive and hermeneutic phenomenology to manage researcher bias, whereby researchers intentionally acknowledge their preconceptions and use journaling to set them aside “to the best of their ability”, and to remain open to the subjective experience of each participant. Unknowing encourages researchers to listen without imposing preconceived judgements on participants’ accounts.

Reflexivity and Researcher Positioning

The research team identifies as insiders within the medical radiation science discipline. This allows for a holistic and nuanced examination of the complex, profession-specific concepts discussed in this framework. JLA is a final-year doctoral student with foundational experience in qualitative methodology and a clinical background in medical radiation science. To ensure interpretive clarity and mitigate the risks of method slurring, JLA was mentored by AK, an experienced qualitative researcher serving as the primary supervisor. AK also shares a professional background in medical radiation science, providing a consistent insider perspective during the analytical process. CLS is an experienced academic with a professional background in nuclear chemistry and served as a joint primary supervisor. This inclusion provides a vital technical and scientific dimension that reflects the human-technical nature of medical radiation science, ensuring that the developed frameworks remain grounded in both the human experience and the sophisticated technological realities of the discipline.

Results and Discussion

Summary of Included Studies

Twenty-five articles were included in this review, with a publication date ranging from 1967 to 2025. These articles focused on phenomenology (n=7), grounded theory (n=10), both phenomenology and grounded theory (n=5), and paradigmatic and theoretical definitions that inform phenomenology and grounded theory (n=3). The included articles clarify the philosophical basis of phenomenology and grounded theory, distinguishing between Husserlian transcendental phenomenology, Heideggerian/Gadamerian hermeneutic phenomenology, and varying adaptations of grounded theory, including Glaser’s post-positivism and Charmaz’s constructivism.

In terms of methodological integration, Wilson and Hutchinson (1991) explored the triangulation of Heideggerian hermeneutics and grounded theory, while Baker et al. (1992) discussed the risks of “method slurring” when these two are combined without adequate consideration of their philosophical and/or methodological congruence. Building on these studies, Urcia (2021) provided an overview of adaptations to assist researchers in selecting the appropriate methodology to help avoid methodological slurring/messes.

Table 2 provides a summary of the included studies, highlighting author details and year of publication, study type, methodological focus, key philosophical position, key insight, and relevance to methodological integration. Other relevant articles used in discussing the findings have been included in the reference list.

Table 2.

Summary of Included Studies

Author(s), year	Study type	Methodology focus	Key philosophical position	Insight	Relevance to integration
Rodriguez and Smith (2018)	Review/Empirical	Phenomenology (van Manen/Interpretative Phenomenological Analysis (IPA))	Hermeneutic Phenomenology: Focuses on lived experience through life-world existentials (temporality, spatiality).	Summarises key differences between Husserlian and Heideggerian traditions.	Differentiates between descriptive objectivity and interpretive co-creation.
Baker et al. (1992)	Methodological paper	Mixed/Integration critique	Paradigmatic Distinction: Differentiates between the psychological focus of phenomenology and sociological social processes in grounded theory.	Defines and critiques method slurring, where strategies are combined without philosophical clarity.	Critiques sloppy integration as potentially eroding methodological rigour.
Burns and Peacock (2019)	Methodological paper	Phenomenology (Interpretive)	Hermeneutic Ontology: Rooted in Heideggerian Dasein and “being-in-the-world”.	Compares nursing-specific adaptations by Benner, Munhall, and Conroy.	Discusses the impossibility of bracketing in interpretive designs.
Burns et al. (2022)	Methodological paper	Mixed/Integration discussion	Constructivist: Compares constructivist grounded theory and interpretive phenomenology as philosophically non-contradictory.	Maps the evolutionary overview of grounded theory and Phenomenology across paradigms.	Supports methodological complementarity in health research.
Bynum and Varpio (2018)	Methodological paper	Phenomenology (Hermeneutic)	Interpretivism: Focuses on clinical reasoning through the hermeneutic circle.	Defines core principles of hermeneutic phenomenology in medical education.	Clarifies how “pre-understanding” replaces bracketing in interpretive work.
Charmaz (2014)	Methodological paper	Grounded theory (Constructivist)	Constructivist: Assumes multiple, fluid realities where meaning is co-created between researcher and participants.	Establishes methods like line-by-line coding and theoretical coding.	Establishes the modern constructivist path that allows for iterative integration.
Charmaz and Thornberg (2021)	Methodological paper	Grounded theory (Quality)	Critical Constructivist: Seeks diverse perspectives and transparency through reflexivity.	Provides a 13-point checklist for maintaining quality in grounded theory studies	Argues that grounded theory is a nodal point for debating significant qualitative issues.
Charmaz (2006)	Methodological paper (Book)	Grounded theory (Comprehensive)	Pragmatist/Interactionist: Roots grounded theory in sociology and pragmatist philosophy.	Extensive guide on memo-writing, coding, and theory reconstruction	Provides the systematic “methodological pillar” for integration.
Gadamer (1975)	Conceptual paper (Book)	Phenomenology (Gadamerian)	Hermeneutic Ontology: Understanding as the “fusion of horizons” and a move toward dialogue.	Explains the hermeneutic circle and the priority of the question.	Essential philosophical foundation for the “constructive lens.”
Giorgi (2012)	Methodological paper	Phenomenology (Husserlian)	Transcendental Phenomenology: Uses psychological reduction to describe consciousness as such, avoiding interpretation.	Clarifies the descriptive phenomenological psychological method.	Highlights the incompatibility of descriptive methods with interpretive or constructivist turns.
Glaser (2002)	Methodological paper	Grounded theory (Classic)	Post-positivist: Theory is “discovered” and conceptualised from emergent social patterns.	Emphasises conceptualisation over description.	Represents the “descriptive lens” requirement for objective theory discovery.
Glaser and Strauss (1967)	Methodological paper (Book)	Grounded theory (Foundational)	Post-positivist/Critical Realist: Theory is “discovered” from a reality independent of the researcher.	Establishes the constant comparative method and theoretical sampling.	The primary origin of the grounded theory “methodological pillar.” Provides the foundational logic for all subsequent grounded theory adaptations.
Kouam Arthur William (2024)	Conceptual paper	Mixed/Paradigm navigation	Interpretivist/Constructivist: Differentiates paradigms based on subjective vs. socially constructed reality.	Clarifies distinctions in research design and data analysis for social sciences.	Guides effective selection of paradigms based on philosophical stance.
Mackey (2005)	Methodological paper	Phenomenology (Heideggerian)	Hermeneutic Ontology: Focuses on the “meaning of Being-in-the-world” (Dasein) and the situatedness of human existence.	Provides methodological insights into pre-understanding and the hermeneutic circle.	Supports the shift from epistemological questions (Husserl) to ontological ones (Heidegger).
Mills et al. (2006a)	Methodological paper	Grounded theory (Reflexivity)	Constructivist: Advocates for equalising power dynamics between researcher and participant.	Identifies memoing as a reflective tool for abstract thinking.	Promotes reflexivity as a means to achieve methodological congruence.
Mills et al. (2006b)	Methodological paper	Grounded theory (Constructivist)	Constructivist: Denies the existence of objective truth independent of human history.	Maps the spiral of methodological development from Glaser to Charmaz.	Justifies the use of the constructivist paradigm for rigorous research.
Reay et al. (2016)	Empirical qualitative study	Grounded theory (Classic)	Post-positivist/Interpretivist: Adapts classic grounded theory for fluid environments like triage nursing.	Illustrates the process of theoretical sensitivity and memo-writing.	Argues that classic grounded theory can adapt to different epistemological perspectives.
​	Methodological paper	Mixed/Integration discussion	Interpretivist Constructivism: Rejects objective universal reality in favour of flexible, participant-driven inquiry.	Synthesises literature on linking interpretivism and constructivism for nursing research.	Supports the use of temporal, tentative designs to ground research in participant realities.
Urcia (2021)	Review	Mixed/Integration discussion	Compartmentalised Paradigms: Maps adaptations into post-positivism, interpretivism, and constructivism.	Provides a comprehensive overview of adaptations to avoid “methodological messes/slurring.”	Offers guidelines for selecting specific adaptations based on researcher worldview.
Varpio and MacLeod (2020)	Conceptual paper	Mixed/Paradigm navigation	Paradigmatic Logic: Distinguishes objectivist deductive and subjectivist inductive research logics.	Clarifies the language of research, defining theory, theoretical frameworks, and conceptual frameworks.	Illustrates how research design changes based on the chosen paradigm.
Alsaigh and Coyne (2021)	Methodological paper	Hermeneutic Phenomenology (Gadamerian)	Hermeneutic Ontology: Focused on the “fusion of horizons,” the “hermeneutic circle,” and the role of “pre-understandings”.	Provides a step-by-step strategy for data analysis to ensure rigour for novice researchers.	Offers a structured framework to facilitate deep interpretive analysis while remaining faithful to complex philosophical tenets.
Annells (2006)	Methodological paper	Mixed/Integration Discussion (phenomenology & grounded theory)	Constructivist Paradigm: Adheres to a relativist ontology and a transactional/subjectivist epistemology.	Cautions that integration requires approaches to share the same ontological foundation to avoid a loss of integrity.	Supports “turning the prism” via methodological triangulation to gain different but vital types of understanding.
Cutcliffe (2000)	Methodological paper	Grounded Theory (sampling, creativity, and reflexivity)	Symbolic Interactionism: Assumes reality is constructed through symbols and human interaction.	Argues for the liberation of researcher creativity and tacit knowledge as integral to the inductive process.	Emphasises “precision” and “mindfulness” to avoid unintentional “method slurring” and increase inquiry quality.
Singh and Estefan (2018)	Methodological development	Grounded Theory (Glaser vs. Strauss & Corbin vs. Charmaz)	Constructivist-Interpretivist (Charmaz): Reality is a function of interpretation and co-construction.	Compares philosophical underpinnings to help researchers select the approach that fits their position and field.	Supports Charmaz’s approach for “embedded” researchers who value personal and professional experiences as aid to knowing.
Wilson and Hutchinson (1991)	Methodological paper	Triangulation of Heideggerian hermeneutics and Grounded Theory	Hermeneutic Ontology (Heidegger) and Symbolic Interactionism. Merges the ontological study of “Being” with the sociological study of active human creators in their world.	Illustrates the concept of “turning the prism” to gain different outcomes from one study; distinguishes between “knowing how” (hermeneutics) and “knowing that” (grounded theory).	Directly supports methodological complementarity by showing how hermeneutics provides rich detail while grounded theory offers a conceptual framework for practice.

Factors to Consider When Selecting a Research Methodology

The Role of the Research Paradigm

Scientific research is guided by philosophical assumptions held by the researcher or the research group, and includes ideas, beliefs, values etc., that influence their worldview and interpretation of reality. This is termed a research paradigm (Varpio & MacLeod, 2020), which guides the research process, including the context-specific inquiry chosen (Maksimović & Evtimov, 2023; Park et al., 2020). Therefore, understanding of research paradigms (Dawadi et al., 2021) and their associated theoretical frameworks (Assalahi, 2015; Maksimović & Evtimov, 2023) can facilitate improved methodological decision making. Research paradigms include positivism, post-positivism, interpretivism, and constructivism (see Table 3) (Creswell & Poth, 2018; Denzin & Lincoln, 2018). However, this list is not exhaustive.

Table 3.

Paradigmatic Adaptations of Phenomenology and Grounded Theory

Paradigm	Post-positivism		Interpretivism		Constructivism
Adaptations	Husserl descriptive phenomenology	Glaser’s classical grounded theory	Heidegger’s interpretive phenomenology	Strauss and Corbin’s grounded theory	Gadamer’s hermeneutic phenomenology	Charmaz’s constructivist grounded theory
Key feature	Reality can be critically examined through an objective description of the participant’s lived experiences (Carman, 2006).	Reality exists in the world and can be objectively observed to generate theory (Urcia, 2021).	Multiple realities exist, and that it is impossible to achieve an unbiased perspective of knowledge or meaning (Burns et al., 2022).	Multiple realities exist (Strauss & Corbin, 2015).	The researcher’s assumptions and experiences integrated with participants’ continuous feedback are essential in developing meanings from data (Urcia, 2021).	Co-construction, involving the researcher’s preconceived notions and disciplinary background and their continuous partnership/interaction with participants aid the development of theoretical knowledge (Charmaz, 2014; Charmaz et al., 2018).
Ontological stance	Critical realist ontology (i.e.,truth is probable through a critical examination of the context of social realities) (Creswell & Poth, 2018)		Relativist ontology (i.e.,a worldview where multiple realities exist) (Lincoln et al., 2018; Urcia, 2021).		Relativist ontology (i.e.,a worldview where multiple realities exist) (Creswell & Poth, 2018; Lincoln et al., 2018)
Epistemological stance	Modified objectivist epistemology (i.e.,truth can be achieved through minimal interactions with research participants, and without losing the objectivity in identifying cause-effect mechanisms (Creswell & Poth, 2018; Lincoln et al., 2018).		Subjectivist epistemology (i.e.,truth and meaning are shared subjectively among people) (Creswell & Poth, 2018; Urcia, 2021).		Social constructivism (i.e.,reality should be co-constructed by the researcher and participants) (Creswell & Poth, 2018; Lincoln et al., 2018)
Methodological/philosophical underpinning	Husserlian phenomenologists need to ensure unprejudiced investigation of the phenomenon without the influence of the researcher’s preconceptions (Giorgi, 2009; van Manen, 2016)	Assumes that “the data speaks for itself” (i.e.,truth evolves from data) (Reay et al., 2016, p. 27).	Phenomenological reduction, through bracketing, is impractical, and that individuals rely on their experiences and biases to subjectively influence the interpretation of knowledge (Burns et al., 2022)	Strauss and Corbin argued that Glaser’s objectivism is unachievable (Urcia, 2021), and emphasises that knowledge and theory can be developed from the subjective experiences of both the researcher and participants (Rieger, 2019).	Co-construction is required to foster understanding in Gadamer’s hermeneutic phenomenological inquiry (Mackey, 2005).	Requires researchers and participants to co-create knowledge/theory that is grounded in the experiences of both (Charmaz et al., 2018; Mills et al., 2006a), and captures the influence of relativist ontology and constructivist epistemology.
Strategies used to achieve methodological requirements	Husserl used phenomenological reduction through epoché or bracketing (a state where researcher suspends all preconceived assumptions, perceptions, and biases about the studied phenomenon and assumes a tabula rasa position) to achieve objectivism (Liamputtong, 2019; Neubauer et al., 2019).	Classic grounded theorists separate themselves from the data and research the participants to uncover an unbiased theory (Charmaz & Thornberg, 2021; Keane, 2014).	Interpretive phenomenologists use ‘unknowing’ and/or reflexivity to acknowledge their preconceptions and biases. These are achieved through journaling (Bynum & Varpio, 2018; Munhall, 1994). Unknowing helps the researcher to remain open to the subjective experience of each participant (Munhall, 2012).	The researcher is expected to be aware of the influence of their own perceptions and biases, and document these in reflective journals, a process known as memoing, and emphasises the relevance of open coding (Burns et al., 2022; Charmaz, 2014)	Like interpretive phenomenology, researchers use reflective journals to achieve unknowing and/or reflexivity (Bynum & Varpio, 2018; Munhall, 2012).	Like Strauss and Corbin’s grounded theory, Charmazian grounded theorists are expected to recognise how their preconceptions and biases may influence theory generation. Memoing, through reflective journals, is a useful strategy (Burns et al., 2022; Charmaz, 2014)

Positivists assume that reality is disciplined, rational, and logical, and knowledge is measured without human interactions (Creswell & Creswell, 2018). They attempt to establish cause-effect relationships to understand objective reality (Creswell & Creswell, 2018). Thus, hey are mostly used in quantitative studies (Giddings & Grant, 2006; Maksimović & Evtimov, 2023) to test and explain hypotheses (Liamputtong, 2019). However, during the modernist phase (1950–1970), there was a shift away from positivism to post-positivism (Denzin & Lincoln, 2018), which follows positivist principles but permits minimal interaction between the researcher and research participants (Maksimović & Evtimov, 2023; Taylor & Medina, 2013) with interest focusing on objective description of participants’ lived experiences (Table 3).

The 21st century has seen a rise in research within the interpretivist paradigm, which focuses on how people understand and give meaning to their subjective experiences (Creswell & Creswell, 2018). This makes its application essentially relevant to healthcare as it allows health professionals to adopt flexible, participant-centred approaches to examine and understand their subjective experiences (Tanlaka & Aryal, 2025). It asserts that there are multiple interpretations of reality, truth, and knowledge, and that the world should be understood from the perspective of each individual (Liamputtong, 2019). Lastly, there is constructivism, which is often used interchangeably with interpretivism. However, constructivism emphasises the social influence and knowledge co-creation to describe how an individual’s interactions, experiences, and contexts shape their beliefs and understandings (Kouam Arthur William, 2024).

Philosophical Elements of a Research Paradigm

Within any scientific discipline, there exists the basic paradigm of the science, including its concepts, knowledge, and theoretical base, and the methodologies for advancing the science (Donaldson & Crowley, 2004). Therefore, this paradigm shapes the research conducted, and includes four key philosophical elements:

(i) Ontology, which refers to a researcher’s worldview on nature, truth, and reality (Park et al., 2020; Rodriguez & Smith, 2018);

(ii) Epistemology, which is concerned with how we acquire/uncover knowledge (i.e.,truth and reality) (Creswell & Poth, 2018; Lincoln et al., 2018);

(iii) Methodology, which is the systematic processes used to conduct scientific inquiry, with the aim of gaining knowledge about the research problem being investigated (Metsala & Fridell, 2018). Methodology influences the methods (Guraya et al., 2023), which includes strategies for participant recruitment, data collection, analysis, assumptions made, study limitations, and strategies used to manage these limitations (Kivunja & Kuyini, 2017); and,

(iv) Axiology, which describes how a researcher’s personal values, beliefs, and experiences influences their philosophical approach ( Corcoran et al., 2022) to make the right decisions and/or to remain unbiased throughout the research process (Guraya et al., 2023).

The Possibility for Integrating Phenomenology and Grounded Theory in One Study

Methodological rigour requires researchers to (i) select a methodology that aligns with their philosophical assumptions, the study objectives, the current evidence base within the area of study, and the expected outcome (Starks & Brown Trinidad, 2007), and (ii) follow systematic and self-reflective approaches to data collection, analysis, and interpretation (Mays & Pope, 2002) to ensure credible, transferable, confirmable, and dependable outcomes (Ahmed, 2024; Anney, 2014).

However, whilst rigour is essential in qualitative research, flexibility around the research process is equally important, and can promote the relevance of the study through effective exploration of the inherent and context-specific challenges (Fade & Swift, 2011; Kressmann & Mueller-Seeger, 2025) as they arise (i.e., as the experiences of the participants are revealed). This may necessitate modifying the research questions based on the evolving realities. In turn, this simultaneously drives the study’s rigour due to the requirement for continuous self-reflection on the researcher’s positionality (Agee, 2009).

Similarly, flexibility is also important when selecting a methodology that examines different concepts, as was highlighted in the earlier example of workplace burnout among medical radiation practitioners, and their various coping strategies. These concepts warranted different methodologies; thus, they require the integration of different, but philosophically similar, qualitative approaches to achieve their goals and maintain research rigour. Notably, Ayton (2023) suggests that grounded theory lends itself well to integration with other qualitative methodologies, such as phenomenology, provided one is careful to avoid methodological slurring (Annells, 2006) by considering the philosophical evolution and/or adaptations of both approaches. Therefore, the next section will examine how philosophical adaptions in phenomenological and grounded theory approaches can aid their integration to avoid such slurring, whilst ensuring rigorous and relevant evidence is produced for medical radiation practice.

Philosophical Adaptations in Phenomenological and Grounded Theory Approaches

As discussed earlier, phenomenological approaches aim to understand human behaviour and the meaning individuals make of their own experiences (Neubauer et al., 2019; Teherani et al., 2015), and to note, the initial phenomenology approach—Husserlian descriptive phenomenology—has undergone many adaptions. For example, Heidegger’s interpretive phenomenology resulted in many interpretive adaptations (Urcia, 2021), such as the phenomenological adaptations of Smith (1996) and Munhall (1994). Ago, Kilgour and Smith (2025) reported that 23.2% of phenomenological research in medical radiation science involves approaches that align with Husserl’s descriptive phenomenology (e.g., Giorgi (2009, 2012)), while 52.2% involve approaches that align with Heidegger’s interpretive phenomenology. Further adaptations include Gadamer’s hermeneutic phenomenology which extends Heidegger’s interpretive phenomenology to include an artful interpretation to understand the lived experiences of humans (Alsaigh & Coyne, 2021).

In contrast, grounded theory seeks to generate explanatory theoretical representation of human behaviour from the perspective of those who have experienced the phenomenon (Creswell & Creswell, 2018; Keane, 2014). Similar to phenomenology, grounded theory has evolved to include adaptations, such as the Glaserian approach or classic grounded theory, Strauss and Corbin’s approach, and Charmaz’s constructivist grounded theory (Berthelsen et al., 2017; Keane, 2014; Wuest, 2012). However, all adaptations believe in symbolic interactionism (Wuest, 2012), whereby reality is symbolically constructed and interpreted through ongoing interactions among individuals within asocial networks (Cutcliffe, 2000; Wuest, 2012), and that the patterns of participants’ interpretation of a phenomenon can be accepted as reasonable knowledge for theory generation (Urcia, 2021). This theory is described as an analytic schema that explains the foundational social processes underlying a phenomenon (Wilson & Hutchinson, 1991).

To understand the similarities between the various adaptations, a careful examination of the various paradigms within which they fall, and associated ontologies, epistemologies, and methodologies is required (Urcia, 2021). In this review, three adaptations of phenomenology (Husserl’s descriptive phenomenology, Heidegger’s interpretive phenomenology, and Gadamer’s hermeneutic phenomenology) will be examined. Similarly, three adaptations of grounded theory (Glaser’s classic grounded theory, Strauss and Corbin’s grounded theory, and Charmaz’s constructivist grounded theory) will also be examined. Table 3 provides key features and methodological requirements of the various adaptations.

The Relationship Between Paradigms and Philosophical Elements

To achieve a methodologically rigorous inquiry, there must be correlation between the researcher’s ontological stance, epistemological approach, the chosen methodologies, and axiological stance (Bleiker et al., 2019). Table 3 shows the relationship between three different paradigms and three philosophical elements (i.e., ontology, epistemology, and methodology). As axiology describes the researcher’s value judgement, it is not included in this comparison. In addition, Table 3 presents some key features, methodological requirements, and strategies used to achieve these requirements in the various phenomenology and grounded theory adaptations.

Similarities and Differences in Methods: Sampling, Data Collection and Analysis Strategies

Methods are strategies and techniques for sampling, collecting, and analysing data (Ago, Kilgour, & Smith, 2025; Urcia, 2021), and are influenced by the philosophical foundations of a specific methodological adaptation (Richards & Morse, 2013). Therefore, this section will provide a careful examination of the research methods (i.e., sampling, data collection and analysis) associated with the various paradigmatic adaptations will help researchers to select methodologically congruent strategies and prevent method slurring.

Sampling and Sample Size

All adaptations of phenomenology and grounded theory employ purposive sampling to recruit participants with rich and varying experiences of the phenomenon under examination (Creswell & Poth, 2018; Urcia, 2021), and there is no prescribed sample size, as this is dependent on the study objectives (Urcia, 2021). In general, the sample sizes for both phenomenology and grounded theory are lower than quantitative studies (Ago, Kilgour, & Smith, 2025; Urcia, 2021), with phenomenological studies typically smaller compared to grounded theory (Ago, Kilgour, & Smith, 2025; Creswell & Poth, 2018). This is likely due to the in-depth exploration of participants’ lived experiences required by phenomenological studies, rather than broad generalisability employed by grounded theory (Giorgi, 2009; Smith et al., 2009; van Manen, 2016). Additionally, unlike grounded theory, phenomenology is less strict on data saturation (Giorgi, 2009; Smith et al., 2009), which requires researchers to continuously recruit new participants to a point where no significant new information is obtained (Creswell & Creswell, 2018).

Data Collection and Analysis

There are differences in the data collection and analysis processes for the various adaptations of phenomenology and grounded theory. However, blurred boundaries in philosophical adaptions have resulted in large similarities in the methods of data collection and analysis. For instance, phenomenological data collection includes semi-structured interviews and focus groups (Ago, Kilgour, & Smith, 2025), with various pattern-based analysis approaches to generate meaning (Patton, 2002). Similarly, all grounded theory adaptations utilise interviews, focus groups, and observations (Keane, 2014; Mruck & Mey, 2019), and theory-generating analysis strategies through different coding approaches (Charmaz, 2014; Urcia, 2021; Wuest, 2012).

Of note, data collection and analysis are concurrent in both phenomenology and grounded theory studies. However, as phenomenological researchers seek to create meaning out of the data collected, it is imperative that any adopted analytic strategy must align with the philosophical underpinnings of the chosen phenomenological approach. For example, Husserlian phenomenological analysis requires the use of recognised descriptive approaches of phenomenological data analysis, whereby the researcher must bracket their own preconceptions to achieve a pure description of the participants’ lived experiences (Giorgi, 2009; Wirihana et al., 2018). Whilst analysis of interpretive or hermeneutic phenomenological data involves searching for meaningful interpretations that reflect various aspects of the lived experiences (Creswell & Poth, 2018), and includes the interpretive phenomenological analysis (Smith et al., 2009; Smith & Osborn, 2015) and Gadamer’s hermeneutic circle (Creswell & Creswell, 2018; Gadamer, 1975). Specific to Gadamer’s hermeneutic phenomenology is knowledge co-construction between the researcher and the participants (Burns & Peacock, 2019), whereby the researcher undergoes a circular process of pre-understanding and complete interpretation of the lived experiences (Creswell & Creswell, 2018; Gadamer, 1975). This part-whole analysis (Gadamer, 1975) is achieved by continuously reading the transcripts (i.e., moving inside the parts) to identify the evolving understanding of the hidden meaning (i.e., moving outside the whole) of existence (Burns & Peacock, 2019; Stratton-Maher, 2022). It is also recommended for interpretive or hermeneutic phenomenological researchers to verify with participants the accuracy of the interpretation of their lived experiences (Munhall, 2012).

In contrast, grounded theorists contrast data, categories, concepts, and theoretical claims to produce knowledge (Charmaz, 2014; Strauss & Corbin, 2015). Data analysis in Glaserian grounded theory involves an objective approach to open and selective coding (Rieger, 2019). In contrast, data analysis in Strauss and Corbin’s interpretive approach to grounded theory involves categorical coding (i.e.,open coding), detailed additional categories (i.e., axial coding), selective/intersecting categories, and theoretical coding (Strauss & Corbin, 2015). Charmaz’s constructivist grounded theory requires researchers to engage in reflexive practices through memoing, which is identical to reflexivity as is used in interpretive or hermeneutic phenomenology. In addition to open, axial, and selective coding, constructivist grounded theory analysis involves line-by-line conceptual coding and focused coding to synthesise large datasets through back-and-forth movement between data and conceptualisation (Ayton, 2023; Charmaz & Thornberg, 2021), which is similar to Gadamer’s hermeneutic (part-whole) analysis.

Framework for Phenomenology-Grounded Theory Designs

The discussion above highlights that while phenomenology and grounded theory originate from distinct philosophical traditions, there exists some degree of methodological congruence in the different adaptations which may support their integration within a single study. For example previous studies (Burns et al., 2022; Lincoln et al., 2018) emphasised the strong alignment and methodological similarities between interpretive/hermeneutic phenomenology and constructivist grounded theory. Also, Lincoln et al. (2018) argue that these two methodological adaptations are not philosophically contradictory, thus supporting their potential for integration. However, it is important for researchers to carefully consider the purpose/objectives of the research, the nature of the research questions, and the level at which integration is being enacted (i.e., philosophical, methodological, or procedural).

Accordingly, three different phenomenology-grounded theory designs are proposed: (i) a descriptive design, which integrates Husserl’s descriptive phenomenology and Glaser’s grounded theory; (ii) an interpretive design, which integrates Heidegger’s interpretive phenomenology and Strauss and Corbin’s grounded theory approach; and (iii) a constructive design, which integrates Gadamer’s hermeneutic phenomenology and Charmaz’s constructivist grounded theory (Figure 1).

Figure 1.

Framework for phenomenology-grounded theory designs

Ensuring Methodological Complementarity to Overcome Method Slurring

In order to avoid method slurring, any attempt to combine different qualitative methodologies should ensure that (i) the paradigmatic adaptions and philosophical underpinnings of the methodologies involved, and/or (ii) the philosophical paradigm driving the inquiry are congruent (Annells, 2006). Although this framework proposes integrated designs, it is important to acknowledge the radical ontological and epistemological incompatibilities that may exist (Annells, 2006; Wilson & Hutchinson, 1991). For example, reducing complex phenomenological philosophies to mere research techniques ignores their conceptual depth and risks method slurring. Consequently, the frameworks proposed are established on methodological complementarity and are applicable to different but complementary research questions. For example, in studying burnout and coping strategies among medical radiation practitioners, phenomenology may be used to understand participants’ lived experience while grounded theory allows for the development of theories that help to understand adopted coping strategies and underlying processes.

As a result, to ensure paradigmatic congruence and avoid method slurring, this integrated framework synthesises the distinct strengths of both traditions. Philosophically, the integration is rooted in phenomenological principles (including epoché/bracketing, pre-understanding, Dasein, hermeneutic circle, fusion of horizons, and artful interpretation) to capture the nuance of human experience (Alsaigh & Coyne, 2021). Methodologically, the integration draws on grounded theory principles (including memoing, line-by-line coding, focused coding, constant comparison, and theoretical coding) to provide a systematic structure for theory generation (Charmaz, 2014). These allow the researcher to progressively generate deeper interpretations of lived experiences while systematically constructing theories that explain underlying social processes.

Again, using the exemplar study of “medical radiation practitioners’ experiences with burnout and adopted coping strategies”, the next sections explain how the proposed phenomenology-grounded theory designs can provide rigorous and relevant results to advance clinical practice.

Descriptive Phenomenology-Grounded Theory Design

This design brings together Husserl’s descriptive phenomenology and Glaser’s classical grounded theory at the level of analytic procedure, particularly in their shared emphasis on maintaining openness to data (Keane, 2014; Neubauer et al., 2019)). Both approaches advocate strategies that seek to minimise the influence of researcher assumptions. In Husserl’s descriptive phenomenology, this is achieved through epoché (Neubauer et al., 2019), whereas Glasser’s grounded theory requires the researcher to avoid forcing the data to allow for emergent theories (Glaser, 2002; Glaser & Strauss, 1967). Consequently, integration should focus on this methodological complementarity rather than philosophical alignment. Of note, Husserl’s descriptive phenomenology is grounded in transcendental framework concerned with accessing the essences of experience. Transcendental framework requires the researcher to separate themselves from the world including their own physical being to reach the state of the transcendental I (see Glossary of key terms) to understand phenomena by descriptive means (Neubauer et al., 2019). In contrast, Glasser’s classical grounded theory is rooted in post-positivist orientation aimed at generating explanatory theories (Glaser, 2002; Glaser & Strauss, 1967).

Studying Burnout and Coping Strategies Through Descriptive Phenomenology-Grounded Theory

To align this study with post-positivism it must be ensured that the researcher’s objectivity is maintained. This is achieved through phenomenological reduction and bracketing, which allows the researchers to examine the participants’ experiences with burnout. The emerging categories and theory are then developed through open coding, ensuring the final theory of coping is emergent and grounded in the participants’ descriptive accounts, thus upholding the underpinning philosophy of “the data speaks for itself”.

To ensure qualitative quality, the researcher should first describe the essential features of burnout experienced by participants and subsequently develop an explanatory account of underlying factors resulting in burnout and coping processes.

Interpretive Phenomenology-Grounded Theory Design

This design reflects a form of interpretive engagement, drawing on Heidegger’s interpretive phenomenology and Strauss and Corbin’s grounded theory. Both approaches recognise that the researcher plays an active role in meaning-making and that bracketing may not be feasible (Burns et al., 2022; Urcia, 2021). However, Heidegger situates interpretation as an ontological condition of “being-in-the-world” (Dasein) (Annells, 1996), whereas Strauss and Corbin approach interpretation as a methodological and analytic process informed by pragmatism and symbolic interactionism (Urcia, 2021). Therefore, their congruence lies in methodological complementarity (i.e., acknowledgement of researcher involvement), rather than philosophical congruence.

Studying Burnout and Coping Strategies Through Interpretive Phenomenology-Grounded Theory

To align this study with interpretivism, it must acknowledge the existence of multiple subjective realities. Consequently, it requires researchers to continuously reflect on their experiences and understanding of burnout and therefore contextualise the interpretation of the subjective experience. The grounded theory component, influenced by Strauss and Corbin, employs structured coding (i.e., axial and selective coding) to relate the identified conditions (e.g., high workload in an emergency department) to the practitioners’ coping practices. This will result in a contextualised interpretation of burnout and the conditional process of coping.

Hermeneutic Phenomenology-Constructivist Grounded Theory Design

Both Gadamer’s hermeneutic phenomenology and Charmaz’s constructivist grounded theory acknowledge that understanding emerges through interaction and that the researcher’s perspective is integral to the interpretive process. However, there are philosophical differences. Gadamer’s hermeneutic phenomenology recognises understanding as a historically situated, ontological event that requires fusion of horizons (Debesay et al., 2008; Dowling, 2007; Gadamer, 1975). In contrast, Charmaz’s constructivist grounded theory recognises co-construction as a methodological practice (Charmaz, 2006, 2014). Consequently, this design should be conceptualised as a dialogue between a philosophical account of understanding (the phenomenological component) and a methodological framework for constructing explanatory theories to enhance meaning-making.

Studying Burnout and Coping Strategies Through Constructive Phenomenology-Grounded Theory

To align this study with constructivism, it must utilise a highly collaborative approach that emphasises knowledge co-creation between the researcher and participants. Gadamer’s hermeneutic phenomenology allows the researcher to engage in the fusion of horizons through the hermeneutic circle to interpret how the meaning of burnout is co-created through dialogue and historical understanding. This deep, co-created meaning then informs the Charmazian grounded theory process of line-by-line conceptual coding and focused coding. The constructive phenomenology-grounded theory explores how shared meanings and social processes shape coping behaviours, allowing the researcher to develop a socially constructed theory of coping grounded in both the participants’ accounts and the researcher’s reflections.

Table 4 provides a holistic assessment of phenomenology-grounded theory designs and their methodological approaches to examining medical radiation practitioners’ experiences with burnout and coping strategies.

Table 4.

Methodological Application of Phenomenology-Grounded Theory in Examining Burnout and Coping Strategies in Medical Radiation Practitioners

Element	Husserl’s phenomenology + Glaser’s grounded theory	Heidegger’s phenomenology + strauss and Corbin’s grounded theory	Gadamer’s hermeneutic phenomenology + Charmaz’s constructivist grounded theory
Ontology	Critical realism: burnout and coping have real causal mechanisms that may manifest differently across different medical radiation practice contexts/settings. However, these contexts share many common underlying features that can be examined through the lived experiences of research participants.	Existential ontology and relativism: burnout and coping are context-specific and shaped by being-in-the world (i.e.,differ by sub-disciplines of medical radiation practice). The researcher examines how these context-specific experiences relate to the underlying social processes by analysing practitioners’ subjective account to uncover the condition of burnout, interactions, and consequences that inform coping mechanisms.	Hermeneutic ontology and social relativism: burnout and coping are socially constructed from interactions within interprofessional teams, patient care, professional demands and culture, etc.). Gadamer’s hermeneutic phenomenology enables the researcher to interpret how meaning of burnout is co-created through dialogue and historical understanding. When combined with Charmaz’s constructivist grounded theory, this enables exploration of how shared meanings and social processes shape coping behaviours, allowing for the development of a theory.
Epistemology	Modified objectivism: The researcher brackets preconceptions to access participants’ pure experiences with burnout and coping (Husserl’s phenomenology), while also aiming to discover meaningful patterns and theoretical insights that emerge inductively from the data (Glaser’s grounded theory).	Subjectivism: The researcher acknowledges that understanding of burnout and associated coping mechanisms is shaped by their own pre-conceptions (Heidegger’s interpretive phenomenology) and actively seeks to interpret participants’ meaning making by identifying conditions, actions, and consequences through theoretically informed coding (Strauss and Corbin’s grounded theory).	Constructivism: Knowledge is co-constructed through interpretive interaction between the researcher and participants, with the researcher leveraging on their preconceptions and engaging in fusion of horizons to shape the meaning of burnout as experienced by medical radiation practitioners (Gadamer’s hermeneutic phenomenology). Co-construction of these meanings, shaped by social, contextual and relational processes that influences burnout and coping, helps the researcher to develop a theory about the phenomenon.
Aim	To discover the essence of burnout and develop an emergent, objective theory of coping.	To understand medical radiation practitioners’ lived experiences of burnout and examine the conditions and consequences of coping mechanisms.	To understand how social interactions affect medical radiation practitioners’ lived experiences of burnout and examine the conditions and consequences of coping mechanisms.
Data collection (with examples)	Semi-structured interviews and focus groups to examine essential structures of the participants’ experiences.	Semi-structured interviews and focus groups combined with field notes (or reflective journals) to capture contextual and individual interpretation of burnout as experienced by medical radiation practitioners.	Semi-structured interviews and focus groups combined with field notes (or reflective journals) focused on knowledge co-construction between the researcher and participants to capture social and contextual interpretation of burnout as experienced by medical radiation practitioners.
Data analysis	Researcher begins with phenomenological reduction and applies open coding to build emerging categories and theory.	Researcher engages in reflexivity (journaling or memoing) followed by axial and selective coding to relate conditions to coping practices.	Hermeneutic interpretation through fusion of horizon (hermeneutic circle) informs line-by-line conceptual coding grounded in mutual understanding and social meaning.
Role of researcher and participants	The researcher brackets/suspends preconceptions about burnout and underlying processes. Meaning is developed purely from participants’ descriptive experiences.	The researcher reflects on their past experiences and understanding of burnout and the underlying processes to contextualised interpretation of burnout and coping mechanisms.	Researcher and participants co-create the meaning of burnout and coping mechanism used by understanding the contextual and social processes that influence it.
Outcome	The essential meaning of burnout and emergent theory on coping grounded in participants’ account.	Contextualised interpretation of burnout and conditional processes of coping.	Co-constructed understanding of burnout and socially constructed theory of coping grounded in both the participants’ accounts and the researcher’s reflections.

Integration Pathways for Applying Phenomenology-Grounded Theory Designs

Integrating phenomenology and grounded theory in one study may be achieved through three proposed approaches: (1) sequential integration, (2) convergent integration, and (3) iterative integration. In 1991, Wilson and Hutchinson first suggested the use of phenomenology and grounded theory as an integrated approach in qualitative health research (Wilson & Hutchinson, 1991), especially in situations where the researcher is an insider (for example, a medical radiation practitioner examining professional concepts). They suggested that the integration should be done sequentially, i.e., phenomenology, followed by grounded theory or vice versa, depending on the intended outcome. In 2006, Merilyn followed Wilson and Hutchinson’s (1991) sequential approach for nursing research (Annells, 2006), with the findings of the first component informing the design or analysis of the second. For example, phenomenology can be used to explore participants’ lived experiences of working patterns among medical radiation practitioners followed by grounded theory examination of how poor work-life balance contributes to burnout within the profession (Allan et al., 2025).

Alternatively, the convergent integration of phenomenology and grounded theory conducts both methodologies in parallel (Razali & Abu Bakar, 2023) and utilises the same data, but applies different analytical lenses, and merging the findings during interpretation. Of note, this approach has only been used in software engineering (Razali & Abu Bakar, 2023) but may be applicable to healthcare research. For example, using a convergent integrated approach, phenomenology can be used to explore the lived experience of diagnostic radiographers when transitioning to non-emergency imaging settings, enabling the researcher to uncover the intrinsic meaning behind their professional decisions, while grounded theory can provide a data-driven understanding of how factors, such as high workloads, burnout, and time constraints, influenced participants’ decision to move away from emergency medical imaging settings. The grounded theory approach can also enhance our understanding of the factors or processes that could influence their return to emergency settings.

The third pathway is an iterative integration of phenomenology and grounded theory, which requires the researcher to move back-and-forth between phenomenological and grounded theory principles during data collection, analysis, and interpretation. This approach may be best applied to complex, underexplored, or evolving concepts. For instance, a recent study that explored how organisational challenges affect wellbeing in nuclear medicine technologists with a focus on participants’ lived experiences with burnout, professionalism, and pragmaticism (Shields et al., 2024), would have benefitted from a phenomenology-grounded theory integration. Indeed, the authors emphasised that their “iterative study … [of the] poorly explored phenomenon” (p.623) combined symbolic interactionism (a grounded theory principle) with double hermeneutics (a phenomenological principle (Smith et al., 2009)). Figure 2 demonstrates the three integration pathways of phenomenology-grounded theory designs in health professions research.

Figure 2.

Phenomenology-grounded theory integration pathways (created in https://BioRender.com)

Recommendations for Enhancing the Use of Phenomenology-Grounded Theory Designs

Integrating phenomenology and grounded theory methodologies within one study is not well established in the literature. Issues arise from methodological slurring (Baker et al., 1992; Urcia, 2021) (Figure 1) and integrated phenomenology-grounded theory designs are time consuming in terms of data collection and analysis, and also require the researcher to be knowledgeable in the philosophies of both methodologies (Wilson & Hutchinson, 1991).

Consequently, researchers, especially novices, seeking to use any of the designs proposed (Figure 1) should be mindful of the philosophical underpinnings of the chosen adaptations. This requires ensuring that the integrated methodology aligns with the researcher’s ontological and epistemological stances regarding the phenomenon under investigation, and ensures congruence in the methodological choices and the philosophical assumptions guiding the inquiry (Mills et al., 2006b; Urcia, 2021). It is also important for the novice researcher to seek mentorship from an experienced qualitative researcher (Wilson & Hutchinson, 1991). These strategies will enhance both methodological rigour and relevance of the outcome.

Limitations and Strengths

This was a preliminary conceptual review rather than a comprehensive evidence synthesis, and whilst it provided an in-depth evaluation of the methodological adaptations discussed, replicability may be an issue, as the literature was purposively selected to explore key philosophical and methodological features of phenomenology and grounded theory. Additionally, the inclusion of only a couple of health professions’ literature (Annells, 2006; Wilson & Hutchinson, 1991) means that further research is needed to validate the proposed integrative frameworks. Moreover, researchers should be aware of possible methodological slurring, challenges in data analysis and interpretation, and time constraints associated with the phenomenology-grounded theory approaches.

Conclusion

Phenomenology and grounded theory methodologies have evolved since they were first described (Denzin & Lincoln, 2018; Lincoln et al., 2018) and alignment of adaptions with post-positivism, interpretivism, and constructivism, has resulted in similarities in the methodological principles guiding them. For example, both the Husserlian phenomenology and Glaserian grounded theory require researchers to set aside their preconceptions to produce pure descriptions or theories of the participants’ lived experiences. Similarly, Gadamer’s hermeneutic phenomenology and Charmaz’s constructivist grounded theory both agree with the valid use of the researcher’s experiences to shape the interpretation of participants’ lived experience, and to continuously reflect on these experiences to co-construct knowledge with the participants.

In this review, burnout among medical radiation practitioners was used as an example to explain how adaptations of phenomenology and grounded theory can be integrated to produce rigorous and relevant results to inform clinical practice (Table 4). These integrations can be undertaken sequentially, convergently, or iteratively (Figure 2) depending on the intended outcome.

However, regardless of these similarities and their potential integration, it is important to note that phenomenology and grounded theory serve different purposes. As such, authors need to ensure that for their chosen approach, whether any of the integrated approaches described in this review or as a stand-alone methodology, aligns with the research questions or objectives and the paradigmatic principle guiding their research. In addition, researchers seeking to use any of the integrated designs should ensure the chosen approaches are methodologically complementary and/or philosophically congruent with each other and with the overall research paradigm to avoid methodological/method slurring.