Synthesising Qualitative Studies: There is growing consensus that the needs, preferences and experiences of patients and the public should be taken into account in developing and evaluating new interventions. One way of ensuring that the views and experiences of the public can be incorporated into research, policy and practice is through identifying and bringing together (synthesising) the relevant research evidence from individual qualitative studies.
While the results from one qualitative study may be difficult to generalise, a syntheses of all the relevant qualitative studies can identify a range of common themes as well as any divergent views. Unlike methods for the synthesis of intervention studies (e.g. Cochrane reviews) there is no single method to the identification and synthesis of health (-related) qualitative research.
Four methods have been most widely used and are described briefly below:
Meta-ethnography is currently the most commonly used method . Meta-ethnography involves seven steps which, by bringing together findings from individual interpretive accounts, produces a new interpretation of the data. It involves both induction and interpretation, and thus follows a similar approach to the methods of qualitative data analysis used in the studies being synthesised.
Thematic synthesis is often (but not exclusively) used for analysing qualitative data alongside quantitative data synthesis. Initially developed by researchers from the EPPI-Centre, it addresses questions around “what works,” primarily in relation to health promotion interventions. This method develops analytical themes through descriptive synthesis and finding of explanations relevant to a particular review question.
Meta-study involves critical interpretation of existing qualitative research. Before synthesis can take place and a new interpretation obtained, three analytical phases are completed—”meta-theory, meta-method, and meta-data analysis”. These phases, equating to the analysis of theory, analysis of methods, and the analysis of findings , can be conducted concurrently to “provide a unique angle of vision from which to deconstruct and interpret” a body of qualitative literature. Once these analytical processes have been completed, meta-synthesis “brings back together ideas that have been taken apart,” creating a new interpretation of the phenomenon under investigation
Meta-summary uses “quantitatively oriented aggregation of qualitative findings that are themselves topical or thematic summaries or surveys of data”. Such summaries can be conducted on their own, or in association with more traditional qualitative synthesis, and can include qualitative and quantitative descriptive findings.
Example:
The views of young people in the UK about obesity, body size, shape and weight: a systematic review.
This systematic review aimed to examine recent UK research findings where young people aged from 12-18 provided views about their own body sizes or about the body sizes of others.
A total of 30 studies were included. Three main themes were identified:
- General perceptions about different body sizes and society’s responses to them (It’s on your conscience all the time);
- Overweight young people’s beliefs about influences on size and experiences related to their size (If I had the choice, I wouldn’t be this size); and
- Overweight young people’s experiences of trying to lose and maintain weight and their suggestions for action (Make sure, even when it’s hard, you’ve got people there).
Young people discussed larger body sizes in overwhelmingly social terms. An overweight body size was to be avoided for social, rather than health reasons. Young women and men identified ideals consistently for their own bodies that were very different for the two sexes.
Implications for intervention/service development and delivery: The findings suggest that there is a need for those who develop weight reduction initiatives to recognise the physical, psychological and social constraints faced by young participants; and to consider how they can reduce stigma
Implications for policy: To consider the full range of factors that contribute to obesity, especially those that are social or environmental in nature, and provide opportunities for young people to engage in positive healthy behaviours , and to involve diverse groups of children in the development and evaluation of initiatives.
Related:
Ruth Jepson recently ran a two day event on synthesising qualitative research for the Scottish Graduate School of Social Science.
Further reading:
Ring N, Ritchie K, Mandava L, Jepson R. A guide to synthesising qualitative research for researchers undertaking health technology assessments and systematic reviews. 2010.
Ring N, Jepson R, Ritchie K: Methods of synthesising qualitative research for health technology assessment. Int J Technol Assess Health Care 2011, 27:384-390.
