Abstract
BackgroundDecision making in health and social care requires robust syntheses of both quantitative and qualitative evidence. Meta-ethnography is a seven-phase methodology for synthesising qualitative studies. Developed in 1988 by sociologists in education Noblit and Hare, meta-ethnography has evolved since its inception; it is now widely used in healthcare research and is gaining popularity in education research. The aim of this article is to provide up-to-date, in-depth guidance on conducting the complex analytic synthesis phases 4 to 6 of meta-ethnography through analysis of the latest methodological evidence.MethodsWe report findings from a methodological systematic review conducted from 2015 to 2016. Fourteen databases and five other online resources were searched. Expansive searches were also conducted resulting in inclusion of 57 publications on meta-ethnography conduct and reporting from a range of academic disciplines published from 1988 to 2016.ResultsCurrent guidance on applying meta-ethnography originates from a small group of researchers using the methodology in a health context. We identified that researchers have operationalised the analysis and synthesis methods of meta-ethnography – determining how studies are related (phase 4), translating studies into one another (phase 5), synthesising translations (phase 6) and line of argument synthesis - to suit their own syntheses resulting in variation in methods and their application. Empirical research is required to compare the impact of different methods of translation and synthesis. Some methods are potentially better at preserving links with the context and meaning of primary studies, a key principle of meta-ethnography. A meta-ethnography can and should include reciprocal and refutational translation and line of argument synthesis, rather than only one of these, to maximise the impact of its outputs.ConclusionThe current work is the first to articulate and differentiate the methodological variations and their application for different purposes and represents a significant advance in the understanding of the methodological application of meta-ethnography.
Highlights
Decision making in health and social care requires robust syntheses of both quantitative and qualitative evidence
Meta-ethnography is suited to producing a new interpretation, model or theory, which goes beyond the findings of the individual studies synthesised, and does not aggregate findings [9]
Meta-ethnography has seven iterative and overlapping phases [9], which we describe with emphasis on the complex analytic synthesis Phases 4 to 6
Summary
Decision making in health and social care requires robust syntheses of both quantitative and qualitative evidence. Meta-ethnography is a seven-phase methodology for synthesising qualitative studies. Noblit and Hare’s [9] meta-ethnography, originally developed for synthesising education ethnographies, is one of the most frequently used and influential methodologies for qualitative evidence synthesis in health and social care research [10,11,12] with a rapidly increasing volume of published meta-ethnographies [10, 12, 13]. Meta-ethnography is theoretically-based drawing on Geertz’s concept of thick description [14] and Turner’s [15] theory of sociological understanding as ‘translation.’ It is unique among qualitative evidence synthesis methodologies in synthesising conceptual data from primary studies and was designed to take into account the unique research contexts in primary studies. Meta-ethnographies have been included in clinical guidelines for asthma management [17, 18], medication adherence [4, 5] and head and neck cancer care [7, 8]
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