Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care.
Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care.
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DOI：
10.1016/s0277-9536(02)00064-3
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发表时间：
2003-02-01
期刊：
影响因子：
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通讯作者：
Donovan, Jenny
中科院分区：
文献类型：
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作者：
Campbell, Rona;Pound, Pandora;Donovan, Jenny
人们对如何更广泛地使用定性健康研究的兴趣来为健康政策和医疗实践增长。从个人定性研究中综合发现可能是一种方法，但是常规系统审查方法在定性研究中的应用提出了重大的哲学和实际挑战。这里的目的是使用定性方法研究合成定性研究的可行性，包括对评估要合成研究的标准的形成性评估。有目的地选择了对成年患者观点的十项定性研究，并在合成之前提出了调整和用于评估论文的关键评估技能计划（CASP）提出的问题。每项研究都由两位经验丰富的社会科学家独立审查。确定了审稿人之间的协议水平。排除了三篇论文：其中之一是因为事实证明不是定性研究，其中之一是因为经验工作的质量很差，而一篇是因为据报道的定性发现也记录在另一篇论文中。该合成具有两个不同的元素，是使用荟萃术方法进行的。首先，合成了四篇包含患者对糖尿病反应类型的论文。其次，从所有七篇论文中都确定了六个关键概念对于使糖尿病患者在生活中达到平衡并获得幸福感和控制感很重要。其中包括：时间和经验，对自我的信任，对护理提供者的越来越少的方法，战略性不合规，护理提供者的有效支持以及对糖尿病是严重的认可。综合中没有任何研究都没有提到任何早期论文，也没有考虑到以前的发现或建立。该评估证实，荟萃术可以在定义的研究领域中导致定性研究的综合和扩展。此外，从中，定性研究评估的一种实用方法也进化了。这个过程是有希望的，但需要进一步的测试和评估，然后才建议采用更广泛的采用。
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.