However, policy makers and other review users also posed questions about intervention need, appropriateness and acceptability, and factors influencing intervention implementation.
Noblit and Hare 7 describe two broad types of qualitative syntheses. An increasing number of meta-synthesis papers are appearing in the nursing and midwifery literature.
The text which was taken from the report of the primary study is on the left and codes were created inductively to capture the meaning and content of each sentence. Many of the newer methods being developed have much in common with meta-ethnography, as originally described by Noblit and Hare, and often state explicitly that they are drawing on this work.
Received Apr 17; Accepted Jul The picture that is presented aims to be distorted neither by biases in the review process nor by biases in the primary research which the review contains [ 7 - 10 ]. This paper identifies the particular issues that relate especially to reviewing qualitative research systematically and then to describing the activity of thematic synthesis in detail.
Qualitative research, it is often proposed, is not generalisable and is specific to a particular context, time and group of participants. There is a growing interest in meta-synthesis as a technique for generating new insights and understanding from qualitative health care research. In the words of Margarete Sandelowski, "metasyntheses are integrations that are more than the sum of parts, in that they offer novel interpretations of findings.
Failing to do this can undermine the statistical models that underpin the analysis and bias the results.
Thematic synthesis has three stages: Free Kate Seers Correspondence to: When electronic versions were not available, the results sections were either re-typed or scanned in using a flat-bed or pen scanner.
Conclusion We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Methods We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research.
However, Doyle [[ 39 ], p] states that, "like meta-analysis, meta-ethnography utilizes multiple empirical studies but, unlike meta-analysis, the sample is purposive rather than exhaustive because the purpose is interpretive explanation and not prediction".
Examples from the literature indicate that some aspects of the technique are not yet fully established. Qualitative research and systematic reviews The act of seeking to synthesise qualitative research means stepping into more complex and contested territory than is the case when only RCTs are included in a review.
We now move to a description of the methods we used in our example systematic review. This was described by Noblit and Hare 7 and has recently been identified as the most widely cited method used in qualitative synthesis 6. While this paper has the traditional structure for reporting the results of a research project, the detailed methods e.
This type of review uses rigorous and explicit methods to bring together the results of primary research in order to provide reliable answers to particular questions [ 3 - 6 ].
We were also concerned about imposing the a priori framework implied by our review questions onto study findings without allowing for the possibility that a different or modified framework may be a better fit. These are serious concerns which it is not the purpose of this paper to contest.
Systematic review methods are well-developed for certain types of research, such as randomised controlled trials RCTs.
Interventions that were in line with these suggestions tended to be more effective.
Abstract Background There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. The earliest published work that we know of that deals with methods for synthesising qualitative research was written in by Noblit and Hare [ 31 ].
This problem is easily addressed when a statistical meta-analysis is being conducted: So a qualitative synthesis is a developing area. A line of argument is built up; having compared studies, what can now be said—are there new concepts or a new understanding leading to a new theory, only apparent when you have looked at key concepts from the studies and how they might be connected.
We take the view that the quality of qualitative research should be assessed to avoid drawing unreliable conclusions. In our example review we assessed our studies according to 12 criteria, which were derived from existing sets of criteria proposed for assessing the quality of qualitative research [ 46 - 49 ], principles of good practice for conducting social research with children [ 50 ], and whether studies employed appropriate methods for addressing our review questions.
One type of interpretive qualitative synthesis is meta-ethnography.qualitative research, nine distinct methods of synthesis were identified.
These are: meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, framework synthesis and ecological triangulation. The conceptual frameworks for each method are summarised below.
• Newton JD. How does the general public view posthumous organ donation? A meta-synthesis of the qualitative literature.
BMC Public Health. ; • Noblit GW, Hare RD. Meta-ethnography: Synthesizing qualitative studies. Sage, • Park YA, Gretzel U. Success factors for destination marketing web sites: A qualitative meta-analysis.
FINDINGS: Meta-synthesis attempts to integrate results from a number of different but inter-related qualitative studies. The technique has an interpretive, rather than aggregating, intent, in contrast to meta-analysis of quantitative studies.
A qualitative synthesis (sometimes called a qualitative systematic review) systematically searches for research on a topic, and draws the findings from individual studies together.
Although systematic reviews of quantitative data are well established, for qualitative research, this is a fairly new field, and methods are still developing.
Qualitative metasynthesis is an intentional and coherent approach to analyzing data across qualitative studies.
It is a process that enables researchers to identify a specific research question and then search for, select, appraise, summarize, and combine qualitative evidence to address the research question.
A meta-synthesis exercise was undertaken, and this informed reflection and critique of the method.
Meta-synthesis attempts to integrate results from a number of different but inter-related qualitative studies. The technique has an interpretive, rather than aggregating, intent.Download