Qualitative meta‐synthesis

The question of what do to with a body qualitative study reports on particular topic has attracted many nurses the promise meta-synthesis. Conceptualizing it as potentially analogous quantitative meta-analysis, they feel allure generating conclusive evidence that includes kinds subject and experiential phenomena explicitly written out both population-based clinical measurement studies. However, given complexity diversity inquiries in our discipline beyond, problem synthesis is decidedly different challenge from which comparable studies equivalent quality can be aggregated generated more significant therefore truths. Margarete Sandelowski, wise prolific early nursing meta-synthesist, captured dilemma quite perfectly by posing “How you sum up poem?” (p. 366).1 Many approaches we now think collectively meta-synthesis originated social sciences an attempt move field qualitatively derived understandings “little islands knowledge” 181)2 toward grand sociological theories. Among first adapt idea intellectual projects applied disciplines were educators Noblit Hare,3 whose meta-ethnography created means illuminate evolving interpretations within cross-interrogate each perspective all others. As other health researchers began take 1990s, inspired rapidly increasing enthusiasm for was being promoted among most methodological advancements century, expanding power precision research answer range questions conventional methodologies had proven inadequate.4 In this context, new options introduced into methodology literature, its own slant interpretation, attracting adherents detractors (see Table 1). Their shared aspiration create vehicle form prescribed sequence analytic synthetic maneuvers extant published work through scholars could arrive at overarching or synoptic claims about concern their fields.5 primary aim short paper guide readers become array overall rubric inflated expectations have arisen conflation between cousin secondary temper realistic sensibility around cannot contribute nursing's knowledge base. It essential prospective approach well informed appropriately ask nature bodies material might those questions. Further, genre ongoing scholarly integrity, vital importance there coherent alignment processes conclusions one logically draw it. defining characteristic any systematic review use predetermined structured protocols search, screen, appraise, select summarize findings order narrowly focused question.13, 14 This involves identifying possibly relevant studies, then applying clearly justified exclusion criteria so delimit subset included final analysis (for detailed guidance, I recommend Malterud15 Sandelowski Barroso4). Often hundreds even thousands possible are reduced tiny fraction whole, typically characterized similarity. On basis exercise, made appearance representing entire research, though capture only held common characteristics determined tight web design.16 world, if seeking confirmation efficacy intervention example, rigidity emphasis objectivity makes excellent sense. world meta-synthesis, where often dealing subjectivities human experiences, play havoc logical flow argument respect exists make And despite best efforts procedurally objective, reminds us reviews ultimately “disciplined subjectivity,” inherently partial, situated, reflective moment time.17 various qualitive see tension authors who method critical, reflective, integrative, primarily aggregative. critically interpretive approach, allows scholar unpack peer impact choices, theoretical positionings, contexts, data sets intricate details explain perspectives drawn inquiries, allowing increasingly comprehensive across time space. truly digging deep individual doing thinking, coming appreciation how why presented manner reports. Within style straightforward steps process (such locating report, let alone classifying interpreting integrating them) much complicated (and interesting) than initially anticipated.4 Understandably, requires depth formal disciplinary cultural knowledge, including nuances language signifiers academic communities, able interpret procedural ingredients shaped report.18, 19 Because this, days assumed managed interdisciplinary teams experienced scholars. Over time, however, while bypassing exhaustive time-consuming original dataset placed hands scholars, less prepared intensity kind work. past 2 decades, been explosion claiming orientation, proportion them demonstrating look in-depth envisioned likes Hare.20 these newer follow tightly rigidly formats Cochrane Collaboration evidence-based practice, JBI (formerly known Joanna Briggs Institute), network partners collaborate develop practice guides train reviewers.21 product tends aggregative rather interpretive,22, 23 Bergdahl recently it, “turning rich descriptions thin reductions” 1).24 Based assumption screening weaker better – complete sense meta-analysis variety rely appraisal “checklists” reflect narrow view inquiry ought be. arbitrary decisions supposed features “good” used justify narrowing similar represents entirety legitimate guiding field. such nursing, recognition multiple sources accepted enhance deepen interpretation atypical seems far reasonable does examining lens explore extract potential value. These tensions point and, depending land relation question, should conducted. rules tend indicator. because products review, nomenclature conveys represent privileged (more certain, accurate) contribution may justifiably deserve.25 At worst, expropriate insights hard-earned grounded them, transforming convenient summary format likely attract citations. best, add little available beyond mediocre glean afternoon's reading library.18, 20 opposite end spectrum argue interpretive, inductive, product. Malterud puts “qualitative ambition re-narration” (n.p.)15 Proponents concerned pre-determined rule-following, fetishizing integrity produced Rather, will attentive presence auditable line reasoning leads cross-comparative process.17, 18 For go cataloguing already territory thought, thoughtful informed. not entrée literature insightfully preliminary angle sufficient flexibility allow available.15 From there, set finely-tuned contextual inclusion decisions, tracking logic but also implications result. immerse yourself critical reflection your field, fully come appreciate marvelous “permeable boundaries” issues, whether phenomenon interest evolved over co-existed spoken using languages conceptualizations communities.26 paradox that, although technical “data management” exercise sufficiently naïve disinterested overlook phenomena, becomes apparent when capacity handle messiness concerns bring thought leaders together imaginary creative dialogue capable capturing ways understanding context positionality. Done well, wisdom, factual knowledge. Qualitative currently popularized runs risk relevance meaningful knowledge-building concern, probability significantly misrepresenting value qualitatively-derived illness understanding. Instead relying upon guidelines developed movement strip variation hold tremendous helping understand know, know Nursing long enter complexities, subjectivities, social/political contexts experience. investigating material, hope priority ensure methods justice contributions measure good lies squarely extent advance collective thinking. Sally Thorne, RN, PhD, FAAN, FCAHS, FCAN, Professor School Nursing, University British Columbia Vancouver, Canada, she serves Associate Dean Faculty Applied Science. She Editor-in-Chief journal Inquiry, member Authors-in-Residence Nurse Author & Editor.