Background
Phase | Noblit and Hare’s description |
---|---|
Phase 1: Getting started | ‘Identifying an intellectual interest that qualitative research might inform’ ([15], p.26). The focus of the synthesis may be revised through reading interpretive qualitative studies. |
Phase 2: Deciding what is relevant to the initial interest | Study selection should be ‘driven by some substantive interest derived from comparison of any given set of studies’ ([15], p.28). Searches for studies need not be exhaustive: ‘unless there is a substantive reason for an exhaustive search, generalizing from all studies of a particular setting yields trite conclusions’ ([15], p.28). |
Phase 3: Reading the studies | The repeated reading of studies and noting of metaphors with close attention to details in the studies and what they tell you about your area of interest ([15], p.28). |
Phase 4: Determining how the studies are related | Noblit and Hare recommended that reviewers create ‘a list of key metaphors, phrases, ideas and/or concepts (and their relations) used in each account, and [to] juxtapose them’ ([15], p.28) in order to make an initial assumption about how the studies relate to one another. This informs the type of synthesis that will be carried out – a reciprocal or refutational translation or line of argument synthesis. |
Phase 5: Translating the studies into one another | The metaphors and/or concepts in each account and their interactions are compared or ‘translated’ within and across accounts while retaining the structure of relationships between central metaphors/concepts within accounts. The translations taken together are ‘one level of meta-ethnographic synthesis’ ([15], p.28). These are systematic comparisons and reciprocal translation is key to a meta-ethnography. |
Phase 6: Synthesising translations | If there are many translations from phase 5 these can be compared with one another to see if there are common types of translations or if some translations or concepts can encompass those from other studies. ‘In these cases, a second level of synthesis is possible, analyzing types of competing interpretations and translating them into each other’ ([15], p.28) to reach new interpretations/conceptual understandings. |
Phase 7: Expressing the synthesis | Tailoring the communication of the synthesis to the intended audience’s culture and language so that it is intelligible and meaningful to them - ‘the written synthesis is only one possible form’ ([15], p.29). |
Methods
Data sources and search strategy
Inclusion criteria and screening of papers
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in the title and/or abstract have described their approach as meta-ethnography or as using the approach of Noblit and Hare [15] and report a synthesis of qualitative research studies
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on a topic with a health or health care focus including those not carried out in a health care setting
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published between January 2012 and the search date of 16 December 2013
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published in the English language
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published in a peer-reviewed journal.
Data extraction and analysis
Results and discussion
Characteristics of papers
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the reviewers had synthesised published primary qualitative studies
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they had used an interpretive not an aggregative approach
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reviewers had re-interpreted and synthesised conceptual data (even if they also synthesised some participant quotes or other descriptive data from primary studies)
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reviewers had conducted a process which resembled translation (phase 5) as described by Noblit and Hare [15]
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reviewers had intended to reach a new interpretation even if it was not possible for them to achieve this.
Citation of seminal meta-ethnography methodological texts
Paper | Noblit & Hare [15] | Britten et al. [17] | Campbell et al. [16] | Atkins et al. [20] | Malpass et al. [6] | Campbell et al. [19] |
---|---|---|---|---|---|---|
S1. | ✓ | ✓ | - | - | ✓ | - |
S2. | ✓ | ✓ | - | - | - | - |
S3. | ✓ | - | - | - | - | - |
S4. | ✓ | - | ✓ | ✓ | - | - |
S5. | ✓ | - | - | - | ✓ | - |
S6. | ✓ | - | - | - | - | - |
S7. | ✓ | - | ✓ | - | - | ✓ |
S8. | ✓ | ✓ | ✓ | - | - | - |
S9. | ✓ | - | - | - | - | ✓ |
S10. | ✓ | - | - | ✓ | - | - |
S11. | ✓ | ✓ | ✓ | - | ✓ | ✓ |
S12. | ✓ | - | - | - | - | - |
S13. | ✓ | ✓ | ✓ | - | ✓ | - |
S14. | ✓ | - | - | - | - | ✓ |
S15. | ✓ | - | ✓ | ✓ | - | - |
S16. | ✓ | - | - | - | - | - |
S17. | ✓ | ✓ | ✓ | - | - | - |
S18. | ✓ | - | - | - | - | - |
S19. | ✓ | - | ✓ | - | - | - |
S20. | ✓ | ✓ | ✓ | ✓ | ✓ | - |
S21. | ✓ | - | - | - | - | - |
S22 | ✓ | - | - | - | - | ✓ |
S23. | ✓ | - | - | - | - | - |
S24. | ✓ | - | - | ✓ | - | ✓ |
S25. | ✓ | - | - | ✓ | - | ✓ |
S26. | ✓ | - | - | ✓ | - | - |
S27. | ✓ | - | - | - | - | - |
S28. | ✓ | ✓ | ✓ | - | ✓ | - |
S29. | ✓ | ✓ | - | - | ✓ | - |
S30. | ✓ | - | - | - | - | - |
S31. | ✓ | ✓ | - | ✓ | - | - |
S32. | ✓ | - | - | - | - | - |