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Meta-Study of Qualitative Health Research: A practical guide to meta-analysis and meta-synthesis
Barbara L Paterson, Sally E Thorne, Connie Canam, Carol Jillings
ISBN: 0-7619241-5-9 2001 162 pages Thousand Oaks, California: Sage
Sally Borbasi
Practice Development, School of Nursing and Midwifery, Flinders University, SA
This is a book that sets out the structure and processes of an emerging new method in qualitative research called meta-study. It is the 3rd volume in a series of nursing research texts that explore method and comes with a seal of approval from Margarete Sandelowski. The book is written by a group of senior academics from the School of Nursing at the University of British Columbia all of whom have an interest in qualitative research and chronic illness. In the text the reader is taken through step-by-step directions on how to conduct a meta-study-described as a 'discrete and distinct approach to new inquiry based on a critical interpretation of existing qualitative research' (p.2) and designed to, 'transform the accumulated findings of a generation of qualitative researchers in nursing and health care from a collection of small studies into a legitimate body of knowledge' (p.133). The authors' work on the meta-study of chronic illness is used extensively throughout the book by way of example.
The roots of meta-study lie in the social sciences. As an approach to research, meta-study is explained as involving 'analysis of the theory, methods and findings of qualitative research and the synthesis of these insights into new ways of thinking about a phenomenon' (p.1). The book comprises eight chapters. An introduction elucidates the fundamental tenets of the approach and describes a framework for its application. The second chapter articulates what is required in setting up a meta-study with some useful tips drawn from the authors' immediate experience. The next chapter describes the research process starting with how one retrieves and assesses primary research reports. It then deals with criteria for inclusion and exclusion and how one systematically appraises the reported research for inclusion in the study while continually seeking to ensure rigour. This chapter leads on to the next step of the process known as meta-data-analysis.
Meta-data-analysis is described as a systematic means for 'comparative analysis of research findings of primary research studies conducted by a variety of researchers' (p.55). Discovering this process not as straightforward as it might at first have appeared; the authors provide first hand knowledge of the technique. The chapter begins with explanation of the steps required in selection of an analytic approach to the task and how to manage data. Drawing on their chronic illness meta-study the contextual nature of primary research data is emphasised. The authors point out that 'data are shaped methodologically and theoretically by the researcher's theoretical orientation and research design and historically and socio-culturally by what was happening at the time of the research' (p.62). Contextual analysis therefore can reveal 'shifting trends' (p.67) that can be used as a basis for articulating new theories and challenging dominant intellectual traditions (p.133). The chapter concludes with a caveat to remain analytically honest when rendering visible, analysing and interpreting other people's research.
Chapters five and six explore meta-method and meta-theory respectively. Meta-method involves the study of the epistemological soundness of existing research as well as the ways that methodological applications may influence the findings generated (p.71). Meta-theory is described as a creative and systematic means of analysing theory and its effects on research within a specific field (p.107). Both of these steps are designed to deconstruct text in order to identify and challenge assumptions and influences brought about through methodological and/or theoretical predispositions. In the case of meta-method a means is offered to introduce new interpretations and techniques to qualitative research approaches and it adds to an understanding of the methodological complexities inherent in exploring health and illness phenomena (p.90). Meta-theory on the other hand, allows us to better understand why we think the way we do and what alternate ways of thinking might be possible and to seek alternative explanations. Further, it uncovers the social, political and philosophical implications to the theoretical claims researchers make (p.108) especially those that may only become apparent through the influence of time and space.
Chapter seven draws together the three analytic steps of meta-study and describes how they each contribute to meta-synthesis: the stage at which new theory is synthesised. In considering how meta-synthesis is shaped by the larger context of the meta-study project the chapter articulates the importance/purpose of the analytic processes and how they allow for the possibility through synthesis of a 'richer, deeper and more multifaceted way of theorising about a phenomenon' (p.119). Chapter eight examines quality issues and the need for rigorous standards in conducting meta-study. Criteria to measure quality are discussed along with sections on dissemination of results; challenging traditional practices and future directions. The authors acknowledge that meta-study is an up-and-coming method, yet its potential to extend the power of qualitative research is too great to ignore and a challenge is thrown to readers to embrace such work.
In conclusion, I found this book intelligible and useful. The text provides excellent insight into an approach that appears to offer exciting possibilities for qualitative researchers from any discipline. The authors take a practical 'how to' approach to the text and yet their work is entirely scholarly, underpinned by a thorough command of the theoretical and methodological intricacies of qualitative research. This text will be essential reading for those wishing to conduct or know more about meta-study. It will also be useful to people wanting to know more about qualitative research in general because while it is essentially a book about meta-study it is also a book about qualitative research and what is more, it provides new direction. While meta-study is not for the faint-hearted due to its processes being time-consuming, lengthy and requiring a certain level of scholarship I shall be recommending the book to my higher degree students as it will certainly augment their knowledge of the area. It may well be a method that more advanced students and academics with a common field of interest would attempt in groups. In my opinion this book should be on the shelves of all academics serious about qualitative work and readily available for students/others from their institutional libraries.
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