Rationale and Standards for the Systematic Review of Qualitative Literature in Health Services Research

Abstract

Despite growing recognition of the need for qualitative methods in health services research, there have been few attempts to define quality standards for assessing the results. This article acknowledges the desirability of a plurality of standards. However, it is argued that three interrelated criteria can be identified as the foundation of good qualitative health research: interpretation of subjective meaning, description of social context, and attention to lay knowledge. These criteria can be examined in relation to different dimensions of any research report, including theoretical basis, sampling strategy, scope of data collection, description of data collected, and concern with generalizability or typicality. But if the concern is with the appropriateness of care and with understanding the factors that shape lay and clinical behavior, then these criteria must form the basis of a hierarchy of qualitative research evidence.

Quality of life after spinal cord injury: a meta-synthesis of qualitative findings

“…24 Therefore, as part of the process of the meta-synthesis, the quality of relevant studies was evaluated using predetermined criteria. 21,30 Krefting 42 observed that 'too frequently, qualitative research is evaluated against criteria appropriate to quantitative research and is found to be lacking'. This is not due to an inherent inadequacy, but rather to the inappropriate imposition of criteria developed for a different form of inquiry.…”

“…30 A number of guidelines exist for evaluating qualitative research. 21,26,36,43,44 However, the procedure for critiquing qualitative research is not one of judging rigid adherence to rules or specific prescriptive criteria, 45,46 but is a process of weighing the various elements of the research in an effort to determine their appropriateness given the purpose and context of the study. 44 Sandelowski et al 25 recommend using very general criteria for quality in evaluating the studies relevant to the systematic review.…”

“…Researchers contend that the most important indicator of quality for papers to be included in a meta-synthesis is clear evidence (through documentation of participants' perspectives) that the themes reported by the original researchers were rooted in the data. 21,24,28,39 Thus, papers were only included in the review if they included participants' words to support the researchers' interpretations (the 'audit trail'), and if they met those guidelines for rigour that are listed below. For the purposes of this review the following criteria were employed to gauge the quality of the studies, and were the guidelines for rigour that underpinned the present study.…”

“…For the purposes of this review the following criteria were employed to gauge the quality of the studies, and were the guidelines for rigour that underpinned the present study. These criteria were formulated with reference to the work of scholars from the qualitative tradition 21,26,36,43 …”

“…4,12,[14][15][16][17][18][19][20] Different research methods generate different types of knowledge 21 and qualitative research can make a valuable contribution to evidence-based healthcare by probing 'taken for granted' and conventional ideas, and exploring the experiences, perspectives and contexts of peoples' lives. 22,23 Accordingly, qualitative methods have been employed in several studies into the experience of life after SCI.…”