The synthesis of qualitative research and evidence-based nursing
- Kate Flemming, RGN, MSc
- University of York York, UK
Readers of Evidence-Based Nursing will be familiar with “review articles.” They are among the most common types of research abstracted for the journal, and although systematic reviews of randomised controlled trials (RCTs) predominantly feature in the Treatment section, reviews that address questions of assessment, causation, quality improvement, prognosis, and quality assessment have also been abstracted. Reviews of qualitative research have been abstracted less frequently—7 times since the journal began in 1998.
Qualitative research is an important component of the evidence base for nursing. Almost one quarter of all abstracts published in Evidence-Based Nursing (n = 205) have been primary qualitative research articles, and they have examined several areas of nursing practice. Like quantitative researchers, qualitative researchers have become interested in synthesising qualitative research in order to develop new cumulative knowledge.1 This notebook will explore how syntheses of qualitative research may contribute to the practice of evidence-based nursing.
Systematic reviews and meta-analyses of RCTs are at the top of the hierarchy for providing evidence of the effectiveness of interventions. This is because all individual trials have limitations, such as low statistical power, researcher or expert bias, and contextual variability.2 Similarly, single qualitative studies can be heavily influenced by specific issues of context and generalisability. By synthesising qualitative research, these difficulties can potentially be overcome.
THE DEVELOPMENT OF THE SCIENCE OF THE SYNTHESIS OF QUALITATIVE RESEARCH
Several methodological approaches have been developed to synthesise qualitative research over the past 2 decades. Some have been adapted from methods used to analyse primary qualitative research, whereas others have been specifically developed for this purpose.3
Qualitative synthesis is being promoted by a number of organisations based on the recognition that providing health care involves complex, multifactorial decisions that require a range of evidence. Qualitative synthesis complements the “rationalist” model of synthesis provided by traditional systematic review methods.4 One such organisation is the Cochrane Qualitative …