Focus on Qualitative Methods Qualitative Metasynthesis: Issues and Techniques

Department of Women's and Children's Health, School of Nursing, University of North Carolina at Chapel Hill 27599, USA.
Research in Nursing & Health (Impact Factor: 1.27). 09/1997; 20(4):365-71.
Source: PubMed


There has been an accumulation of qualitative studies in recent years, but little cumulation of the understandings gained from them. Qualitative research appears endangered both by efforts to synthesize studies and by the failure to do so. Techniques used have included reciprocal translations of key metaphors and concepts and qualitative and quantitative comparative analyses to produce narrative and theoretical integrations. The major problem yet to be resolved is developing usable and communicable systematic approaches to conducting metasynthesis projects that maintain the integrity of individual studies.

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    • "Sandelowski et al. (p. 366) [20], for example, define qualitative metasynthesis as theories, grand narratives, generalizations, or interpretive translations produced from the integration or comparison of findings from qualitative studies. "
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    ABSTRACT: Pressure on emergency departments (EDs) sometimes results in handover delays for patients who arrive in ambulances, leading to operational disruption to the ambulance service and ED, and poorer patient experience. Some EDs have adopted models of care to provide rapid access for emergency patients to senior clinical staff. We carried out a systematic review of studies describing the operation of a senior clinician-led rapid assessment team in an ED whose purpose was to streamline receiving, treating and discharging patients. We examined research papers published in English 2004-2014, searching eight electronic databases. We used a pre-defined data extraction framework and assessed papers for quality. We used narrative synthesis to analyse and synthesise the data on the characteristics of these models and their impact on patient flow. We identified 628 potentially eligible studies, of which 13 met the inclusion criteria for the review. Most were uncontrolled before and after studies (n=8); two were randomised controlled trials and two were controlled studies. The majority of models shared common characteristics, in addition to being led by senior clinicians: the patient was initially seen by a triage nurse, assessment and treatment occurred simultaneously with triage or followed quickly, and assessment and triage took place within a designated area of the ED. A wide range of outcome measures was collected. All studies which described effects on waiting times reported a reduction, generally across all patient groups. Seven studies reported that patients treated under the model spent less time in the ED between registration and discharge (up to 54% less in one study), with a range of impacts noted on other ED patients. Five studies reported that fewer patients left the ED without being seen. Five studies reported positive feedback from staff. The review suggests that rapid access models in the ED may have benefits for patients, though evidence is still limited. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Emergency Medicine Journal 06/2015; 32(6):e15-6. DOI:10.1136/emermed-2015-204980.12 · 1.84 Impact Factor
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    • "The meta-ethnographic synthesis includes three approaches: (1) reciprocal translation, which entails exploring key concepts from each study and then translating these concepts across studies to explore the cogency and scope of key themes; (2) refutational synthesis, which entails identifying contradictions and dissimilar concepts across studies. The " refutations' are explored to explain these contradictions; and (3) line of arguments, which entails interpreting the concepts across studies to build a general interpretation and theory across studies grounded in the concepts that emerge across studies (Dixon-Woods et al., 2006; Pope et al., 2007; Sandelowski et al., 1997; Thorne et al., 2004). "
    The International Journal of Children s Rights 04/2015; 23(1):109-132.
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    • "Sandelowski et al. (p. 366) [20], for example, define qualitative metasynthesis as theories, grand narratives, generalizations, or interpretive translations produced from the integration or comparison of findings from qualitative studies. "
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    ABSTRACT: Presentations of self-harm to paramedic and emergency staff are increasing, and despite being the first professionals encountered, patients who self-harm report the quality of care and attitudes from these staff are unsatisfactory. Understanding this care may provide opportunities to improve services. The aim of this study is to enhance knowledge building and theory generation in order to develop practice and policy through a metasynthesis of qualitative research relating to perceptions of paramedic and emergency care for people who self-harm. The metasynthesis draws on Evolved Grounded Theory Methodology (EGTM). A search was undertaken of CINAHL®, MEDLINE®, OVID ® and Psych INFO®, and grey literature. Subject headings of 'self-harm' were used alongside key words 'suicide', 'paramedic' 'emergency', 'overdose', 'pre-hospital' mental health, ambulance, perceptions of care, emergency. A total of 1103 papers were retrieved; 12 were finally included. No papers investigated paramedic care for self-harm. The following metaphors emerged: (a) frustration, futility and legitimacy of care; (b) first contact in the pre-hospital environment: talking, immediate and lasting implications of the moral agent; (c) decision making in self-harm: balancing legislation, risk and autonomy; (d) paramedics' perceptions: harnessing professionalism and opportunities to contribute to the care of self-harm. Paramedics are often the first health professional contact following self-harm, yet limited qualitative literature has explored this encounter. Metaphors revealed in this paper highlight challenges in decision making and legislation, also opportunities to improve care through professionalization and tailored education. Copyright © 2015 Elsevier Inc. All rights reserved.
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