Theoretical sampling is a hallmark of grounded theory methodology, and yet there is little guidance available for researchers on how to implement this process. A review of recently published grounded theory studies in Qualitative Health Research revealed that researchers often indicate that they use theoretical sampling to choose new participants, to modify interview guides, or to add data sources as a study progresses, but few describe how theoretical sampling is implemented in response to emergent findings. In this article, two issues that arose relative to theoretical sampling in an ongoing grounded theory study are discussed. A theoretical sampling guide that was developed by the authors' research team to facilitate systematic decision making and to enhance the audit trail relative to theoretical sampling is described, and an example of how the guide was used to develop a category is presented.

Stress is an inevitable part of life and is especially pervasive in the lives of nursing students. Identifying the predictors of stress as well as coping strategies used can allow for the implementation of appropriate coping interventions to assist in the management of stress in nursing students. Mixed methods research that has been undertaken to gain an understanding about student stress, especially juxtaposing generic versus accelerated nursing students could not be identified. (1) Identify predictors of stress between accelerated and generic Baccalaureate Nursing (BSN) students; and (2) Describe stressors and coping strategies used by accelerated students in comparison with generic students. Embedded mixed methods study. Accelerated and generic BSN third- and fourth-year nursing students at two Midwestern universities. 210 participants: accelerated (n=75) and generic (n=135). A questionnaire packet, including demographics, history of depression, the Perceived Stress Questionnaire, Rosenberg Self-Esteem Scale, Multidimensional Scale of Perceived Social Support, and open-ended questions were administered to students at the end of a class. Simultaneous multiple regression was used to examine predictors of stress. Content analysis was used to analyze qualitative data. Predictors of stress for both the accelerated and generic groups included history of depression, year in the program, emotional support, and self-esteem. Fear of failure and clinical incompetence, problematic relationships, and time management issues were identified as major stressors. Coping strategies used by both groups included positive thinking and social support. Senior students with a history of depression, low self-esteem, and little social support were more likely to experience high levels of stress. This gives educators the potential to identify at risk students and establish stress reduction programs. Encouraging students to use individualized coping strategies will be beneficial.

Childhood sexual abuse is a prevalent social and health care problem. The processes by which individuals heal from childhood sexual abuse are not clearly understood. The purpose of this study was to develop a theoretical model to describe how adults heal from childhood sexual abuse. Community recruitment for an ongoing broader project on sexual violence throughout the lifespan, referred to as the Sexual Violence Study, yielded a subsample of 48 women and 47 men who had experienced childhood sexual abuse. During semistructured, open-ended interviews, they were asked to describe their experiences with healing from childhood sexual abuse and other victimization throughout their lives. Constructivist grounded theory methods were used with these data to develop constructs and hypotheses about healing. For the Sexual Violence Study, frameworks were developed to describe the participants' life patterns, parenting experiences, disclosures about sexual violence, spirituality, and altruism. Several analytic techniques were used to synthesize the findings of these frameworks to develop an overarching theoretical model that describes healing from childhood sexual abuse. The model includes four stages of healing, five domains of functioning, and six enabling factors that facilitate movement from one stage to the next. The findings indicate that healing is a complex and dynamic trajectory. The model can be used to alert clinicians to a variety of processes and enabling factors that facilitate healing in several domains and to guide discussions on important issues related to healing from childhood sexual abuse.

Nursing students are valuable human resources. Detection of potential depression among nursing students is crucial since depression can lead to low productivity, minimized quality of life, and suicidal ideas. Identifying factors affecting depression among students can help nursing educators to find ways to decrease depression. The purpose of this study was to examine rates of depression and the associations between depression and stress, emotional support, and self-esteem among baccalaureate nursing students in Thailand. This correlational, cross-sectional study recruited 331 baccalaureate Thai nursing students. Students completed three instruments that had been translated into Thai: The Center for Epidemiology Studies Depression Scale, Perceived Stress Questionnaire, and Rosenberg Self-Esteem Scale. Another instrument created in Thai was used to measure emotional support. Results revealed that, when using the standard definition, 50.1% of the students were depressed. Stress was positively related to depression, whereas emotional support and self-esteem were negatively related to depression.

Objective: to describe the use of the Mixed Methods Appraisal Tool to appraise and to strengthen the methodological rigor of mixed methods studies in nursing. Method: a theoretical essay was used to describe the application of Mixed Methods Appraisal Tool to support the development and assessment of mixed methods research in nursing. Four mixed methods articles in nursing were purposely chosen and evaluated based on the Mixed Methods Appraisal Tool criteria. Results: Mixed Methods Appraisal Tool is a tool for evaluating primary mixed methods studies based on five evaluation criteria: 1) justification for adopting mixed methods methodology; 2) integration between the quantitative and qualitative components; 3) interpretation of integrated findings of quantitative and qualitative data; 4) presentation of divergences between quantitative and qualitative results; and 5) compliance with the methodological rigor of each individual approach in mixed methods research. Conclusion: Mixed Methods Appraisal Tool is an instrumental resource that can be used to appraise mixed methods research and strengthen the methodological rigor in planning and conducting future mixed studies in nursing research.