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Exploring Qualitative Research Synthesis

The Role of Patients’ Perspectives in Health Policy Design and Decision Making

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Abstract

Health systems are placing more and more emphasis on the design and delivery of services that are focused on the patient, and there is a growing interest in patient involvement in health policy research and health technology assessment (HTA). Furthermore, there is a growing research interest in eliciting patients’ views, not only on ‘what works’ for patients but also on the need for intervention and on factors influencing the implementation of particular health technologies, their appropriateness and acceptability.

This article focuses on qualitative research synthesis in eliciting patients’ perspectives. Its aim is to bring research closer to policy development and decision making, to facilitate better use of research findings for health and welfare, to generate a body of evidence, and to ensure that effective and appropriate information is used in health policy decision design.

A variety of synthesizing approaches in qualitative research are explored, such as meta-synthesis, meta-summary, meta-ethnography, and meta-study, focusing especially on methodology. Meta-synthesis and meta-ethnography are probably the most frequently cited approaches in qualitative research synthesis and have perhaps the most developed methodology.

The implications of these various synthesizing approaches in relation to health policy and HTA are discussed, and we suggest that meta-synthesis and meta-summary are particularly useful approaches. They have an explicit focus on ‘evidence synthesis’, fairly clear methodologies, and they are designed to not only present interpretations of the findings but also integrate research findings.

Qualitative research synthesis enables researchers to synthesize findings from multiple qualitative studies on patients’ perspectives instead of establishing new, expensive, and perhaps redundant studies that might intrude on the lives of patients. Qualitative research synthesis is highly recommended by decision makers and in health policy research and HTA. In cases where patient assessment is important to overall success, it can provide those responsible for policy and decision making with a broad and varied range of knowledge about patients’ perspectives before they make decisions on the application of health technologies.

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Notes

  1. The term ‘qualitative research’ needs to be used with caution. It encompasses a multitude of research methods, different epistemologies, and theoretical positions. However, we employ the term in this paper because it is in common use.

  2. In the Handbook for Synthesizing Qualitative Research, two chapters address questions of searching, retrieving, and appraisal.[8]

  3. Some authors have presented the construction of research findings as occurring at three levels: first-, second-, and third-order constructs[19] (meta-synthesis[39–41]). First-order constructs refer to how the patients in a qualitative study construct their own understandings and meanings related to the phenomenon under discussion. Second-order constructs refer to the research findings based on the researchers’ interpretation of data. Third-order constructs refer to those research findings generated by assembling a number of second-order constructs to construct third-order interpretations. The third-order interpretations must be consistent with the original results but also extend beyond them. They deal with re-constructions of re-constructions of constructions representing a conceptual development constituting a new and fresh contribution to the literature reviewed.

  4. The techniques and devices of meta-study are detailed in the book Meta-Study of Qualitative Health Research by Paterson et al.[22]

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Acknowledgements

No sources of funding were used to conduct this study or prepare this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Research Unit, Health, Man and Society and National Research Center for Cancer Rehabilitation, Institute of Public Health, Faculty of Health, University of Southern Denmark, JB Winsloewsvej 9B, DK-5000, Odense C, Denmark

    Helle Ploug Hansen

  2. Institute of Public Health — Health Economics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

    Eva Draborg

  3. Secretarian for European Network for HTA (EUnetHTA), National Board of Health, Copenhagen, Denmark

    Finn Børlum Kristensen

  4. Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

    Finn Børlum Kristensen

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  1. Helle Ploug Hansen
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  2. Eva Draborg
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Correspondence to Helle Ploug Hansen.

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Hansen, H.P., Draborg, E. & Kristensen, F.B. Exploring Qualitative Research Synthesis. Patient-Patient-Centered-Outcome-Res 4, 143–152 (2011). https://doi.org/10.2165/11539880-000000000-00000

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