Conducting a meta-ethnography of qualitative literature: Lessons learnt
Tóm tắt
Qualitative synthesis has become more commonplace in recent years. Meta-ethnography is one of several methods for synthesising qualitative research and is being used increasingly within health care research. However, many aspects of the steps in the process remain ill-defined. We utilized the seven stages of the synthesis process to synthesise qualitative research on adherence to tuberculosis treatment. In this paper we discuss the methodological and practical challenges faced; of particular note are the methods used in our synthesis, the additional steps that we found useful in clarifying the process, and the key methodological challenges encountered in implementing the meta-ethnographic approach. The challenges included shaping an appropriate question for the synthesis; identifying relevant studies; assessing the quality of the studies; and synthesising findings across a very large number of primary studies from different contexts and research traditions. We offer suggestions that may assist in undertaking meta-ethnographies in the future. Meta-ethnography is a useful method for synthesising qualitative research and for developing models that interpret findings across multiple studies. Despite its growing use in health research, further research is needed to address the wide range of methodological and epistemological questions raised by the approach.
Tài liệu tham khảo
Lloyd Jones M: Application of systematic review methods to qualitative research: practical issues. Journal of Advanced Nursing. 2004, 48 (3): 271-278. 10.1111/j.1365-2648.2004.03196.x.
Mays N: Qualitative research in health care: Assessing quality in qualitative research. British Medical Journal. 2000, 320: 50-52. 10.1136/bmj.320.7226.50.
McEwan MJ: A systematic review of the contribution of qualitative research to the study of quality of life in children and adolescents with epilepsy. Seizure. 2004, 13: 3-14. 10.1016/S1059-1311(03)00081-5.
Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R: Using meta ethnography to synthesise qualitative research: a worked example. J Health Serv Res Policy. 2002, 7: 209-215. 10.1258/135581902320432732.
Mays N, Pope C, Popay J: Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. J Health Serv Res Policy. 2005, 10 (Suppl 1): 6-20. 10.1258/1355819054308576.
Green J: Qualitative methods for health research. 2004, London , Sage
Dixon-Woods M, Agarwal S, Young B, Jones D, Sutton A: Integrative approaches to qualitative and quantitative evidence. 2004
Thomas J: Integrating qualitative research with trials in systematic reviews. British Medical Journal. 2004, 328: 1010-1012. 10.1136/bmj.328.7446.1010.
Harden A, Garcia J, Oliver S, Rees R, Shepherd J, Brunton G, Oakley A: Applying systematic review methods to studies of people's views: an example from public health research. J Epidemiol Community Health. 2004, 58: 794-800.
Barbour RS, Barbour M: Evaluating and synthesising qualitative research: the need to develop a distinctive approach. J Eval Clin Pract. 2003, 9 (2): 179-186. 10.1046/j.1365-2753.2003.00371.x.
Barbour RS: Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?. BMJ. 2001, 322 (7294): 1115-1117. 10.1136/bmj.322.7294.1115.
Noblit GW: Meta-ethnography: synthesizing qualitative studies. 1988, Newbury Park, California , Sage
Campbell R, Pound P, Pope C, Britten N, Pill R, Morgan M, Donovan J: Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care. Soc Sci Med. 2003, 56: 671-684. 10.1016/S0277-9536(02)00064-3.
Pound P, Britten N, Morgan M, Yardley L, Pope C, Daker-White G, Campbell R: Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med. 2005, 61: 133-155. 10.1016/j.socscimed.2004.11.063.
Dixon-Woods M, Shaw RL, Agarwal S, Smith JA: The problem of appraising qualitative research. Qual Saf Health Care. 2004, 13: 223-225. 10.1136/qshc.2003.008714.
Volmink J, Garner P: Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev. 2007, CD003343-4
Munro S: Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Medicine. 2007, 4 (7):
Walsh D: Meta-synthesis method for qualitative research: a literature review. Journal of Advanced Nursing. 2005, 50 (2): 204-211. 10.1111/j.1365-2648.2005.03380.x.
Dixon-Woods M, Fitzpatrick R, Roberts K: Including qualitative research in systematic reviews: opportunities and problems. J Eval Clin Pract. 2000, 7 (2): 125-133. 10.1046/j.1365-2753.2001.00257.x.
Evans D: Database searches for qualitative research. Journal of the Medical Library Association. 2002, 90 (3): 290-293.
Barroso J: The challenges of searching for and retrieving qualitative studies. Western Journal of Nursing Research. 2003, 25: 153-178. 10.1177/0193945902250034.
Booth A: Cochrane or cock-eyed? How should we conduct systematic reviews of qualitative research?. Qualitative Evidence-based conference: Taking a critical stance. 2001, Coventry University
Shaw RL: Finding qualitative research: an evaluation of search strategies. BMC Medical Research Methodology. 2004, 4 (5):
Spencer L: Quality in qualitative evaluation: a framework for assessing research evidence. Government Chief Social Researcher’s Office Occasional Papers Series. 2003, London , Cabinet Office, 2:
Malterud K: Qualitative research: standards, challenges and guidelines. Lancet. 2001, 358: 483-488. 10.1016/S0140-6736(01)05627-6.
Rowan M: Qualitative research articles: information for authors and peer reviewers. Canadian Medical Association Journal. 1997, 157 (10): 1442-1446.
Programme CAS: Critical Appraisal Skills Programme. Ten questions to help you makesense of qualitative research. [http://www.phru.nhs.uk/Doc_Links/Qualitative%20Appraisal%20Tool.pdf]
Sandelowski M, Barroso J: Reading qualitative studies. International Journal of Qualitative Methods. 2002, 11:
Anfara Jnr V: Qualitative Analysis on Stage: Making the Research Process More Public. Educational Researcher. 2002, 31: 28-38. 10.3102/0013189X031007028.
Schutz A: Collected Papers . 1971, The Hague , Martinus Nijhoff, 1: 361-
Smith LK: Patient’s help seeking and delay in cancer presentation: a qualitative synthesis. Lancet. 2005, 366: 825-831. 10.1016/S0140-6736(05)67030-4.
Ritchie J: Qualitative Health Research. 2003, London , Sage
Walter FM: Lay understanding of familial risk of common chronic diseases: a systematic review and synthesis of qualitative research. Annals of Family Medicine. 2004, 2 (6): 583-594. 10.1370/afm.242.
Garner P: Promoting adherence to tuberculosis treatment. Bulletin of the World Health Organization. 2007, 85 (5): 404-406. 10.2471/BLT.06.035568.
Volmink J: Systematic review of randomised controlled trials of strategies to promote adherence to tuberculosis treatment. BMJ. 1997, 315: 1403-1406.
Noyes J: Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative meta-synthesis. Journal of Advanced Nursing. 2007, 57 (3): 227-243. 10.1111/j.1365-2648.2006.04092.x.
Baum F: Researching public health: behind the qualitative-quantitative methodological debate. Social Science and Medicine. 1995, 40 (4): 459-468. 10.1016/0277-9536(94)E0103-Y.
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2288/8/21/prepub