Qualitative synthesis: A guide to conducting a meta-ethnography

Cahill, Mairéad; Robinson, Katie; Pettigrew, Judith; Galvin, Rose; Stanley, Mandy

doi:10.1177/0308022617745016

Cited by 109 publications

(102 citation statements)

References 30 publications

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“…Once you have read through the chosen studies, the next step involves extracting the ‘raw data’ from the studies for the synthesis. The raw data for a meta-ethnographic synthesis are the first and second order constructs [ 29 , 31 ]. The data needs to be extracted from each of the studies, which can be done by using a standardised data extraction form [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…We then scanned the reference lists of relevant articles to identify further relevant literature. We also drew on the results from two recent systematic reviews [ 23 , 29 ]. As such, while the searches conducted for the present article were not systematic, the guide reflects recent methodological recommendations in the wider methodological literature.…”

Section: Methodsmentioning

confidence: 99%

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Meta-ethnography in healthcare research: a guide to using a meta-ethnographic approach for literature synthesis

Sattar

Lawton

Panagioti

et al. 2021

BMC Health Serv Res

133

180

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Background Qualitative synthesis approaches are increasingly used in healthcare research. One of the most commonly utilised approaches is meta-ethnography. This is a systematic approach which synthesises data from multiple studies to enable new insights into patients’ and healthcare professionals’ experiences and perspectives. Meta-ethnographies can provide important theoretical and conceptual contributions and generate evidence for healthcare practice and policy. However, there is currently a lack of clarity and guidance surrounding the data synthesis stages and process. Method This paper aimed to outline a step-by-step method for conducting a meta-ethnography with illustrative examples. Results A practical step-by-step guide for conducting meta-ethnography based on the original seven steps as developed by Noblit & Hare (Meta-ethnography: Synthesizing qualitative studies.,1998) is presented. The stages include getting started, deciding what is relevant to the initial interest, reading the studies, determining how the studies are related, translating the studies into one another, synthesising the translations and expressing the synthesis. We have incorporated adaptations and developments from recent publications. Annotations based on a previous meta-ethnography are provided. These are particularly detailed for stages 4–6, as these are often described as being the most challenging to conduct, but with the most limited amount of guidance available. Conclusion Meta-ethnographic synthesis is an important and increasingly used tool in healthcare research, which can be used to inform policy and practice. The guide presented clarifies how the stages and processes involved in conducting a meta-synthesis can be operationalised.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Meta-ethnography in healthcare research: a guide to using a meta-ethnographic approach for literature synthesis

Sattar

Lawton

Panagioti

et al. 2021

BMC Health Serv Res

133

180

View full text Add to dashboard Cite

show abstract

“…More recent guides to conducting meta-ethnography also remain vague about stage seven. For example, Cahill et al [14], reminds us that Noblit and Hare ask us to consider the audience when writing up the synthesis findings, but Cahill and colleagues do not state what this might or could entail.…”

Section: A Neglected Stage?mentioning

confidence: 99%

“…The term 'translation' is used by Noblit and Hare to describe the process of examining 'how the studies in question relate to each other' in relation to stage 5 and synthesis of those translations at stage 6 [4] (page 39). What translation means in practice in stages 5 and 6 is now well documented [13][14][15][16].…”

Section: A Neglected Stage?mentioning

confidence: 99%

Patient and Public Involvement (PPI) in evidence synthesis: how the PatMed study approached embedding audience responses into the expression of a meta-ethnography

Park

Khan

Stevenson

et al. 2020

BMC Med Res Methodol

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Background: Patient and public involvement (PPI) has become enshrined as an important pillar of health services empirical research, including PPI roles during stages of research development and analysis and co-design approaches. Whilst user participation has been central to qualitative evidence synthesis (QES) for decades, as seen in the Cochrane consumer network and guidelines, meta-ethnography has been slow to incorporate user participation and published examples of this occurring within meta-ethnography are sparse. In this paper, drawing upon our own experience of conducting a meta-ethnography, we focus on what it means in practice to 'express a synthesis' (stage 7). We suggest the methodological importance of 'expression' in Noblit and Hare's seven stage process (Noblit, GW and Hare, RD. Meta-ethnography: synthesizing qualitative studies, 1988) has been overlooked, and in particular, opportunities for PPI user participation within it. Methods: Meta-ethnography comprises a seven-stage process of evidence synthesis. Noblit and Hare describe the final 7th stage of the meta-ethnography process as 'expression of synthesis', emphasizing co-construction of findings with the audience. In a previous study we conducted a meta-ethnography exploring patient and student experience of medical education within primary care contexts. We subsequently presented and discussed initial meta-ethnography findings with PPI (students and patients) in focus groups and interviews. We transcribed patient and student PPI interpretations of synthesis findings. As a research team, we then translated these into our existing meta-ethnography findings. Results: We describe, with examples, the process of involving PPI in stage 7 of meta-ethnography and discuss three methodological implications of incorporating PPI within an interpretative approach to QES: (1) we reflect on the construct hierarchy of user participants' interpretations and consider whether incorporating these additional 1st order, 2nd level constructs implies an additional logic of 3rd order 2nd level constructs of the QES team; (2) we discuss the link between PPI user participation and what Noblit and Hare may have meant by ideas of 'expression' and 'audience' as integral to stage 7; and (3) we link PPI user participation to Noblit and Hare's underlying theory of social explanation, i.e. how expression of the synthesis is underpinned by ideas of translation and that the synthesis must be 'translated in the audience's (user participants) particular language'.

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“…All studies that were included for synthesis were independently critically appraised by two reviewers (LL/MB or LL/PS) using the JBI Checklist for Qualitative Research [25] and discrepancies were resolved through consensus. While quality appraisal is common in meta-ethnography, there is a lack of consensus about how it should be used [26]. We chose not to exclude studies based on quality, but instead, to reflect on which studies contributed more or less to our interpretations.…”

Section: Reading and Relating The Studiesmentioning

confidence: 99%

Experiences of youth with medical complexity and their families during the transition to adulthood: a meta-ethnography

Bird

Carter

et al. 2020

Journal of Transition Medicine

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Youth with medical complexity (YMC) are a small subset of youth who have a combination of severe functional limitations and extensive health service use. As these youth become adults, they are required to transition to adult health, education, and social services. The transition to adult services is especially difficult for YMC due to the sheer number of services that they access. Service disruptions can have profound impacts on YMC and their families, potentially leading to an unsuccessful transition to adulthood. This meta-ethnography aims to synthesize qualitative literature exploring how YMC and their families experience the transition to adulthood and transfer to adult services. An in-depth understanding of youth and family experiences can inform interventions and policies to optimize supports and services to address the needs of this population at risk for unsuccessful transition to adulthood. Using Noblit and Hare’s approach to meta-ethnography, a comprehensive search of Medline, CINAHL, Embase, PsycINFO, Social Sciences Index, and Sociological Abstracts databases, supplemented by hand searching, was conducted to identify relevant studies. Included studies focused on the transition to adulthood or transfer to adult services for YMC, contained a qualitative research component, and had direct quotes from youth or family participants. Studies were critically appraised, and data were analyzed using meta-ethnographic methods of reciprocal translation and line of argument synthesis. Conceptual data from ten studies were synthesized into six overarching constructs: (1) the nature and process of transition, (2) changing relationships, (3) goals and expectations, (4) actions related to transition, (5) making sense of transition, and (6) contextual factors impacting transition. A conceptual model was developed that explains that youth and families experience dynamic interactions between their goals, actions, and relationships, which are bounded and influenced by the nature, process, and context of transition. Despite the tremendous barriers faced during transition, YMC and their families often demonstrate incredible resilience, perseverance, and resourcefulness in the pursuit of their goals. Implications for how the conceptual model can inform practice, policy, and research are shared. These implications include the need to address emotional needs of youth and families, support families in realizing their visions for the future, promote collaboration among stakeholders, and develop policies to incentivize and support providers in implementing current transition guidelines.

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Qualitative synthesis: A guide to conducting a meta-ethnography

Cited by 109 publications

References 30 publications

Meta-ethnography in healthcare research: a guide to using a meta-ethnographic approach for literature synthesis

Meta-ethnography in healthcare research: a guide to using a meta-ethnographic approach for literature synthesis

Patient and Public Involvement (PPI) in evidence synthesis: how the PatMed study approached embedding audience responses into the expression of a meta-ethnography

Experiences of youth with medical complexity and their families during the transition to adulthood: a meta-ethnography

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