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Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care

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  • Campbell, Rona
  • Pound, Pandora
  • Pope, Catherine
  • Britten, Nicky
  • Pill, Roisin
  • Morgan, Myfanwy
  • Donovan, Jenny

Abstract

Interest in how qualitative health research might be used more widely to inform health policy and medical practice is growing. Synthesising findings from individual qualitative studies may be one method but application of conventional systematic review methodology to qualitative research presents significant philosophical and practical challenges. The aim here was to examine the feasibility of synthesising qualitative research using qualitative methodology including a formative evaluation of criteria for assessing the research to be synthesised. Ten qualitative studies of adult patients' perspectives of diabetes were purposefully selected and questions proposed by the critical appraisal skills programme (CASP) adapted and used to assess papers prior to synthesis. Each study was reviewed independently by two experienced social scientists. The level of agreement between reviewers was determined. Three papers were excluded: one because it turned out not to be qualitative research, one because the quality of the empirical work was poor and one because the qualitative findings reported were also recorded in another paper already included. The synthesis, which had two distinct elements, was conducted using the meta-ethnographic method. Firstly, four papers containing typologies of patient responses to diabetes were synthesised. Secondly, six key concepts were identified from all seven papers as being important in enabling a person with diabetes to achieve a balance in their lives and to attain a sense of well-being and control. These included: time and experience, trust in self, a less subservient approach to care providers, strategic non-compliance with medication, effective support from care providers and an acknowledgement that diabetes is serious. None of the studies included in the synthesis referenced any of the early papers nor did they appear to have taken account of or built upon previous findings. This evaluation confirmed that meta-ethnography can lead to a synthesis and extension of qualitative research in a defined field of study. In addition, from it a practical method of qualitative research assessment evolved. This process is promising but requires further testing and evaluation before it could be recommended for more widespread adoption.

Suggested Citation

  • Campbell, Rona & Pound, Pandora & Pope, Catherine & Britten, Nicky & Pill, Roisin & Morgan, Myfanwy & Donovan, Jenny, 2003. "Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care," Social Science & Medicine, Elsevier, vol. 56(4), pages 671-684, February.
  • Handle: RePEc:eee:socmed:v:56:y:2003:i:4:p:671-684
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    Cited by:

    1. Blacklock, C. & Ward, A.M. & Heneghan, C. & Thompson, M., 2014. "Exploring the migration decisions of health workers and trainees from Africa: A meta-ethnographic synthesis," Social Science & Medicine, Elsevier, vol. 100(C), pages 99-106.
    2. Joseph, Gillian M. & Skinner, Mark W. & Yantzi, Nicole M., 2013. "The weather-stains of care: Interpreting the meaning of bad weather for front-line health care workers in rural long-term care," Social Science & Medicine, Elsevier, vol. 91(C), pages 194-201.
    3. Marion Haas & Sandy Fowler, 2006. "A synthesis of qualitative research on cervical cancer screening behaviour: Women?s perceptions of the barriers and motivators to screen and the implications for policy and practice, CHERE Working Pap," Working Papers 2006/7, CHERE, University of Technology, Sydney.
    4. Reid, Bernie & Sinclair, Marlene & Barr, Owen & Dobbs, Frank & Crealey, Grainne, 2009. "A meta-synthesis of pregnant women's decision-making processes with regard to antenatal screening for Down syndrome," Social Science & Medicine, Elsevier, vol. 69(11), pages 1561-1573, December.
    5. Al-Janabi, Hareth & Coast, Joanna & Flynn, Terry N., 2008. "What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up," Social Science & Medicine, Elsevier, vol. 67(1), pages 111-121, July.
    6. Bennion, Amy E. & Shaw, Rachel L. & Gibson, Jonathan M., 2012. "What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research," Social Science & Medicine, Elsevier, vol. 75(6), pages 976-985.
    7. Cabral, Christie & Lucas, Patricia J. & Ingram, Jenny & Hay, Alastair D. & Horwood, Jeremy, 2015. "“It's safer to …” parent consulting and clinician antibiotic prescribing decisions for children with respiratory tract infections: An analysis across four qualitative studies," Social Science & Medicine, Elsevier, vol. 136, pages 156-164.
    8. Lambert, Helen, 2006. "Accounting for EBM: Notions of evidence in medicine," Social Science & Medicine, Elsevier, vol. 62(11), pages 2633-2645, June.
    9. Hansen, Henrik & Trifkovic, Neda, 2013. "Systematic Reviews: Questions, Methods and Usage," MPRA Paper 47993, University Library of Munich, Germany.
    10. McNeil, Ryan & Small, Will, 2014. "‘Safer environment interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs," Social Science & Medicine, Elsevier, vol. 106(C), pages 151-158.
    11. Best, Paul & Manktelow, Roger & Taylor, Brian, 2014. "Online communication, social media and adolescent wellbeing: A systematic narrative review," Children and Youth Services Review, Elsevier, vol. 41(C), pages 27-36.
    12. Sim, Julius & Madden, Sue, 2008. "Illness experience in fibromyalgia syndrome: A metasynthesis of qualitative studies," Social Science & Medicine, Elsevier, vol. 67(1), pages 57-67, July.
    13. Ellis, J. & Boger, E. & Latter, S. & Kennedy, A. & Jones, F. & Foster, C. & Demain, S., 2017. "Conceptualisation of the ‘good’ self-manager: A qualitative investigation of stakeholder views on the self-management of long-term health conditions," Social Science & Medicine, Elsevier, vol. 176(C), pages 25-33.
    14. Malpass, Alice & Shaw, Alison & Sharp, Debbie & Walter, Fiona & Feder, Gene & Ridd, Matthew & Kessler, David, 2009. ""Medication career" or "Moral career"? The two sides of managing antidepressants: A meta-ethnography of patients' experience of antidepressants," Social Science & Medicine, Elsevier, vol. 68(1), pages 154-168, January.
    15. Gaventa, John & Barrett, Gregory, 2012. "Mapping the Outcomes of Citizen Engagement," World Development, Elsevier, vol. 40(12), pages 2399-2410.
    16. Skinner, Mark W. & Yantzi, Nicole M. & Rosenberg, Mark W., 2009. "Neither rain nor hail nor sleet nor snow: Provider perspectives on the challenges of weather for home and community care," Social Science & Medicine, Elsevier, vol. 68(4), pages 682-688, February.

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