Journal of Health Services Research & Policy > Volume 7, Number 4 > Pp. 209-215

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Original research

Using meta ethnography to synthesise qualitative research: a worked example

Nicky Britten, Rona Campbell, Catherine Pope, Jenny Donovan, Myfanwy Morgan, Roisin Pill

Department of General Practice and Primary Care, King's College, London; Department of Social Medicine, University of Bristol; Department of Social Medicine, University of Bristol; Department of Social Medicine, University of Bristol; Department of Public Health Sciences, King's College, London; Department of General Practice, University of Wales College of Medicine, Cardiff, UK

Objectives: To demonstrate the benefits of applying meta ethnography to the synthesis of qualitative research, by means of a worked example.

Methods: Four papers about lay meanings of medicines were arbitrarily chosen. Noblit and Hare's seven-step process for conducting a meta ethnography was employed: getting started; deciding what is relevant to the initial interest; reading the studies; determining how the studies are related; translating the studies into one another; synthesising translations; and expressing the synthesis.

Results: Six key concepts were identified: adherence/compliance; self-regulation; aversion; alternative coping strategies; sanctions; and selective disclosure. Four second-order interpretations (derived from the chosen papers) were identified, on the basis of which four third-order interpretations (based on the key concepts and second-order interpretations) were constructed. These were all linked together in a line of argument that accounts for patients' medicine-taking behaviour and communication with health professionals in different settings. Third-order interpretations were developed which were not only consistent with the original results but also extended beyond them.

Conclusions: It is possible to use meta ethnography to synthesise the results of qualitative research. The worked example has produced middle-range theories in the form of hypotheses that could be tested by other researchers.

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