A Guide to Qualitative Meta-synthesis

Deborah Finfgeld-Connett

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9780815380627
• eBook ISBN: 9781351212779
• Topic: Psychology
• Subtopic: Research & Methodology in Psychology
• Index: Psychology

A Guide to Qualitative Meta-synthesis provides accessible guidelines for conducting all phases of theory-generating meta-synthesis research, including data collection, analysis, and theory generation. It is a research methodology that is designed to generate evidence-based theory by extracting, analyzing, and synthesizing qualitative findings from across published investigations. These theories provide scaffolding that can be used by health-care providers and other professionals to make context-based decisions and implement situation-specific actions.

Theory-generating meta-synthesis methods stem from the qualitative research paradigm, especially grounded theory. Systematic and rigorous methods are used to identify topically related research reports that provide qualitative findings for analysis. The subsequent analysis of the data goes beyond merely reorganizing and recategorizing research findings. Newly synthesized concepts are developed, and the dynamic relationships among them are fully articulated. The validity of the resultant theory is ensured based on theoretical, methodological, and researcher triangulation; unbiased data collection and sampling strategies; inductive-deductive data analysis and synthesis strategies; and continuous reflexivity.

Meta-synthesis-generated theories are highly important in environments where the use of normalized algorithms, guidelines, and protocols are on the rise. The types of theories discussed in this book will help service providers customize standardized tools so that the most effective evidence-based, yet individualized, interventions can be implemented.

1
Introduction to Theory-Generating Meta-Synthesis Research

Deborah Finfgeld-Connett

Theory-generating meta-synthesis research is discussed in this chapter, including how it differs from primary qualitative research and other types of Meta-synthesis investigations. The research method is briefly described along with ways in which resultant theories can be used to guide individualized patient care.

Meta-synthesis-generated Theories

Theories offer frameworks for understanding the world in which we live, and they range from being very abstract (e.g., systems theories) to being quite specific (e.g., pharmacodynamics of insulin therapy). Meta-synthesis-generated theories fall in the middle of this vast continuum. As such, they are broad enough to be generalizable and yet focused enough to be contextually relevant. Due to both their generalizability and their contextual relevancy, they have the potential to guide decision-making and action in real-world situations (e.g., see the theory of intimate partner violence and its resolution among Native Americans ([Finfgeld-Connett, 2015] in Appendix 3).

Meta-synthesis-generated theories explicate processes, which are comprised of concepts and the dynamic relationships among them. Concepts (e.g., intimate partner violence [IPV] among Native Americans) and their dynamic relationships (e.g., the relationship between the erosion of Native American culture and the incidence of IPV) are well defined phenomena that are developed by analyzing and synthesizing qualitative research findings from across a representative sample of topically relevant research reports (Finfgeld-Connett, 2015).

Background of Meta-synthesis Research

Many quantitative and qualitative systematic review methods have been developed to maximize the understanding and use of findings from primary research, and scholars are struggling to clearly define and differentiate them. As of 2009, Grant and Booth identified 14 such methods, which vary in terms of purpose and the types of evidence that are analyzed (e.g., qualitative findings, quantitative findings, or both). Since 2009, several qualitative synthesis methods have been refined; however, questions remain regarding how these investigations should be conducted (Tricco et al., 2016). This is due in part to the fact that methods from across multiple qualitative synthesis methodologies are often amalgamated to conduct a single investigation (Paterson, 2012). To diminish this confusion, the purpose of this handbook is to explicate a methodology for synthesizing findings from across primary qualitative research reports to generate theory.

Since the early 1980s, when contemporary qualitative research methods were formalized, countless primary qualitative research investigations have been conducted. Although findings from these investigations have enhanced our knowledge of contextually specific phenomena and processes, these isolated findings have had limited impact on practice (Finfgeld-Connett, 2010). In the late 1980s, qualitative researchers recognized this problem, and the first Meta-synthesis methods were developed to synthesize isolated qualitative research findings across studies to make them more meaningful and generalizable (e.g., Noblit & Hare, 1988). Currently, the need to rigorously synthesize qualitative research findings is growing, because the number of primary qualitative investigations is proliferating, and there is an increased demand for contextually rich generalizable findings to help guide evidence-based practice (Finfgeld-Connett, 2010).

Overview of Several Types of Meta-syntheses

Several methods for conducting meta-syntheses exist, which are referred to as meta-ethnography, meta-study, meta-summary, qualitative research synthesis, qualitative meta-aggregation, and so forth (see Table 1.1). Meta-ethnography was developed first, and the purpose of this approach is to synthesize qualitative findings across investigations to create new holistic interpretations (Noblit & Hare, 1988). The purpose of meta-study methods is to analyze theories, methods, and findings across primary qualitative investigations (Paterson, Thorne, Canam, & Jillings, 2001), whereas, the thrust of qualitative research synthesis is to generate conceptual translations across qualitative investigations (Major & Savin-Baden, 2010). Finally, the aim of qualitative meta-aggregation and meta-summary is to sum up and distill information to draw conclusions (Joanna Briggs Institute, 2014; Sandelowski & Barroso, 2007).

Two other methods for synthesizing qualitative research findings are available; however, raw data are not limited to qualitative findings. Realist reviews include quantitative research findings and conceptual and critical literature (Pawson, 2006), and critical interpretive syntheses incorporate quantitative research findings

Table 1.1 Methods for Synthesizing Isolated Qualitative Findings: Distinguishing Attributes and Examples

(Dixon-Woods et al., 2006). Given the variety of research questions and the raw data that are involved in these types of investigations, the data analysis methods tend to be emergent and somewhat unique to each study.

An underlying assumption of the meta-syntheses discussed so far is that they are comprehensive standalone studies. This contrasts with qualitative syntheses that are primarily intended to be adjuncts or extensions of quantitative meta-analyses. In these instances, findings from across quantitative studies are analyzed to identify statistically significant results (Polit & Beck, 2017), and findings from qualitative syntheses are used to texturize them (e.g., Cochrane [Noyes et al., 2015]).

The Meta-synthesis methodology that is outlined in this handbook is meant to result in findings that are fully meaningful on their own. Unlike other approaches, however, the primary objective of this approach is to generate theory. Consistent with this goal, the methods outlined in this text are based on grounded theory, which is an inductive research methodology that involves theoretical sampling, rigorous data analysis and synthesis, and the development of a process model (Corbin & Strauss, 2008). Process models are particularly important to health-care practitioners because step-by-step assessment, action, and reassessment are fundamental to enhancing the mental and physical well-being of patients.

Methodological Labeling

Prior to focusing on theory-generating Meta-synthesis, methodological labeling needs to be briefly addressed. As suggested in column 1 of Table 1.1, confusion abounds (Britten, Garside, Pope, Frost, & Cooper, 2017; Thorne, 2017); and the body of work relating to theory-generating Meta-synthesis is no exception. Over time, researchers have used terms such as Meta-synthesis, meta-interpretation, and qualitative systematic review. This inconsistency is regrettable; however, it reflects the emergent nature of the research genre. It also reflects progressive efforts to label research methods so that readers and reviewers will understand them and support their use (Cheek, 2017). With a few exceptions (e.g., Appendices 2, 3, and 4), the term that is used in the remainder of this text is theory-generating Meta-synthesis. For purposes of readability, it is occasionally shortened to Meta-synthesis.

Overview of Theory-Generating Meta-synthesis Research Process

Theory-generating Meta-synthesis research is positioned within the qualitative research paradigm, and it is based on grounded theory methods (Corbin & Strauss, 2008). In keeping with this paradigmatic and methodological orientation, theory-generating Meta-synthesis research is founded on the assumption that theory can be inductively generated from qualitative data. In this case, data consist of qualitative findings that have been extracted from published research reports. The research process is iterative, and theory emerges as data analysis and synthesis progress over time (Finfgeld-Connett, 2010, 2014b).

Theory-generating Meta-synthesis investigations are conducted by analyzing and synthesizing published qualitative research findings (i.e., raw data) from across multiple primary qualitative or multi-method studies. Results go beyond the aggregation and summation of existing findings to constitute newly synthesized theory that has the potential to underpin decision-making and action (Finfgeld-Connett, 2010).

Comparison of Theory-Generating Meta-synthesis Methods and Primary Qualitative Research

In addition to understanding the similarities and differences among Meta-synthesis research methods, it is also important to understand the similarities and differences between primary qualitative research and theory-generating Meta-synthesis (see Table 1.2).

Table 1.2 Comparison of Primary Qualitative Research and Theory-Generating Meta-synthesis Research

Elements of Research	Primary Qualitative Research	Theory-Generating Meta-synthesis Research
Research Theoretical Framework	Grounded theory, phenomenology, ethnography, etc.	Grounded theory
Purpose	Describe, explore, or understand phenomena or generate theory with limited generalizability beyond the study sample	Generate process theory that is generalizable (i.e., transferable) beyond the study sample
Research Questions	Relate to describing, exploring, or understanding phenomena/concepts	Relate to explicating antecedents, attributes, and outcomes of process theory
Hypotheses	Continually developed and adapted throughout data collection and analysis	Continually developed and adapted throughout data collection and analy...

Table of contents

• Cover
• Title
• Copyright
• CONTENTS
• Preface
• Acknowledgement
• 1 Introduction to Theory-Generating Meta-synthesis Research
• 2 Research Purpose, Topic, Questions, and Hypotheses
• 3 Data Collection and Sampling
• 4 Data Extraction, Analysis, and Theory Generation
• 5 Writing Up the Results
• 6 Looking Ahead
• Glossary
• Appendix 1 Examples of Theory-Generating Meta-synthesis Investigations
• Appendix 2 Perceived Competency and Resolution of Homelessness Among Women with Substance Abuse Problems
• Appendix 3 Qualitative Systematic Review of Intimate Partner Violence Among Native Americans
• Appendix 4 Intimate Partner Violence and Its Resolution Among Mexican Americans
• Appendix 5 Critical Appraisal Skills Programme (CASP)
• Index