Table Of ContentSystematic Synthesis of Qualitative Research
POCKET GUIDES TO
SOCIAL WORK RESEARCH METHODS
Series Editor
Tony Tripodi, DSW
Professor Emeritus, Ohio State University
Determining Sample Size Strategies to Approximate Random
Balancing Power, Precision, and Practicality Sampling and Assignment
Patrick Dattalo Patrick Dattalo
Preparing Research Articles Analyzing Single System Design Data
Bruce A. Thyer William R. Nugent
Systematic Reviews and Meta-Analysis Survival Analysis
Julia H. Littell, Jacqueline Corcoran, Shenyang Guo
and Vijayan Pillai The Dissertation
Historical Research From Beginning to End
Elizabeth Ann Danto Peter Lyons and Howard J. Doueck
Confi rmatory Factor Analysis Cross-Cultural Research
Donna Harrington Jorge Delva, Paula Allen-Meares, and
Sandra L. Momper
Randomized Controlled Trials
Secondary Data Analysis
Design and Implementation for
Thomas P. Vartanian
Community-Based Psychosocial
Interventions Narrative Inquiry
Phyllis Solomon, Mary M. Cavanaugh, Kathleen Wells
and Jeffrey Draine Structural Equation Modeling
Needs Assessment Natasha K. Bowen and Shenyang Guo
David Royse, Michele Staton-Tindall, Finding and Evaluating Evidence
Karen Badger, and J. Matthew Webster Systematic Reviews and
Multiple Regression with Discrete Evidence-Based Practice
Dependent Variables Denise E. Bronson and Tamara S. Davis
John G. Orme and Terri Combs-Orme Policy Creation and Evaluation
Developing Cross-Cultural Measurement Understanding Welfare Reform
Thanh V. Tran in the United States
Richard Hoefer
Intervention Research
Grounded Theory
Developing Social Programs
Julianne S. Oktay
Mark W. Fraser, Jack M. Richman,
Maeda J. Galinsky, and Steven H. Day Quasi-Experimental
Research Designs
Developing and Validating Rapid
Bruce A. Thyer
Assessment Instruments
Neil Abell, David W. Springer, Systematic Synthesis of
and Akihito Kamata Qualitative Research
Michael Saini and Aron Shlonsky
Clinical Data-Mining
Integrating Practice and Research
Irwin Epstein
MICHAEL SAINI
ARON SHLONSKY
Systematic Synthesis
of Qualitative Research
1
1
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____________________________________________
Library of Congress Cataloging-in-Publication Data
Saini, Michael.
Systematic synthesis of qualitative research / Michael Saini, Aron Shlonsky.
p. cm. — (Pocket guides to social work research methods)
Includes bibliographical references and index.
ISBN 978-0-19-538721-6 (pbk. : alk. paper) 1. Social service—Research—
Methodology. 2. Qualitative research—Methodology. I. Shlonsky, Aron. II. Title.
HV11.S266 2012
001.4’2—dc23
2011036240
____________________________________________
1 3 5 7 9 8 6 4 2
Typeset in Minion
Printed on acid-free paper
Printed in the United States of America
Contents
Preface vii
Acknowledgments xiii
Part I. The Integration of Qualitative Research within Evidence Based Practice
1 Evolution of Qualitative Synthesis within Systematic Reviews 5
2 Methods for Aggregating, Integrating, and Interpreting
Qualitative Research 23
3 Overview of Mixed-Method Systematic Review Designs 50
4 Clarifying Methodological Issues: A Way Forward 64
Part II. A Systematic Approach for Qualitative Synthesis
5 Systematic Synthesis of Qualitative Research 73
6 Searching and Screening Qualitative Studies 90
7 Appraising the Evidence of Qualitative Studies 112
Part III. Qualitative Synthesis as Evidence for Social Work Practice and Policy
8 Reporting Systematic Qualitative Synthesis 143
9 Future Directions for Social Work Practice and Policy 157
vi Contents
Appendix A. Systematic Information Retrieval Coding Sheet 167
Appendix B. Qualitative Research Quality Checklist 169
Glossary 175
References 182
Index 204
Preface
“ What works in child welfare” (Kluger, Alexander, & Curtis, 2000).
“What works for troubled children,” (Buchanan & Ritchie, 2004). “What
works for parents with learning disabilities” (McGaw, 2000). These titles
refl ect an interest in what is effective in social work policy and practice
and are part of a growing body of literature aimed at improving out-
comes for clients receiving services from social workers and others in the
helping professions and understanding the systems that impede or facili-
tate the delivery of these services.
N otwithstanding this expressed interest in harnessing evidence for
effective social work practice and policy and a simultaneous, parallel
growth of quantitative and qualitative evidence relevant to social work,
there remains a lack of attention paid to building a cumulative body of
evidence to inform social work practice and policy. This means that it is
diffi cult to identify gaps in knowledge so that new research questions can
be asked that are relevant to the experiences of populations served by
social work. For clinicians, the challenge of including the best available
evidence within practice decisions with clients is overwhelming given the
ever-increasing volume of studies on specifi c areas of social work practice.
Social workers often have little time and insuffi cient resources to ade-
quately make sense of the best available evidence needed to guide practice.
Literature reviews can only go so far and are notoriously biased. Without
systematic summaries of individual studies, the task of making sense of
the evidence, both within and across studies, is a daunting endeavor.
viii Preface
Systematic reviews are designed to deal with this very problem and
are an integral part of evidence-based practice. They can be thought of as
an overarching approach for the review of evidence and are generally
understood to include a set of preformulated questions, comprehensive
methods for searching and locating primary studies, a transparent
method for appraising quality, and explicit procedures for synthesizing
included studies. Although not typically included in the discourse of sys-
tematic reviews and evidence-based practice, knowledge gained from
qualitative research can not only describe elements of interventions that
“work,” but can also be helpful in answering questions about why inter-
ventions work (or do not work) and the infl uence these interventions
may have (or do not have) on clients that the interventions are meant to
target. As important as “Did it work?” type of questions, qualitative stud-
ies might ask: How do people experience the intervention? Why might an
intervention work, for whom, and in what circumstances? What aspects
of the intervention are valued and why is this so? What system level fac-
tors contribute to the successful implementation of an intervention?
What conditions create potential barriers for recruitment and participa-
tion in an intervention? Within the context of evidence-based practice,
qualitative research can also be the primary source of data to answer
questions that do not focus solely on social services’ effi cacy or effective-
ness (Gough & Elbourne, 2002) but, instead, focus on the richly described
perceptions of clients and the contextual considerations that infl uence
the delivery of services including: the perceived needs of clients; clients’
experiences of services; the presence of program champions or leaders;
the operation and resources for services; the cultural appropriateness,
relevance, and sensitivity of services; aspects related to training; and the
presence or absence of collaboration among partners in supporting the
services.
Arguments are often made about the contingent nature of evidence
gleaned from synthesis of qualitative studies and the current lack of con-
sensus about the veracity of some of its aspects. And yet, despite these
hesitations, qualitative synthesis can be included within the family of sys-
tematic reviews as a unique method for answering research questions, as
well a method that compliments and enhances other systematic review
methods. Systematic synthesis is an important technique and, used suit-
ably, can deepen our understanding of the contextual dimensions of
social work practice, and can help to move qualitative synthesis out of
Preface ix
the shadow of quantitative synthesis (i.e., meta-analysis). Moreover,
qualitative synthesis provides impetus to the creation of methods that are
transparent, consistent, and rigorous, regardless of the systematic review
method, and helps to distinguish qualitative synthesis from other types
of reviews of the literature.
PURPOSE OF THE BOOK
This book aims to provide graduate students, social work researchers,
and practitioners with current standards, philosophical debates, and
methods for understanding and conducting systematic qualitative syn-
thesis. An overview of the range of qualitative synthesis methods avail-
able is provided so that readers may choose a method that is most
consistent with the important questions they are asking, which will, ulti-
mately, better inform practice and policy decisions relevant to social
work. In doing so, we also introduce and explain the terminology found
within this emerging fi eld of research to provide a clear roadmap for
those inclined to pursue this challenging, yet rewarding method of
inquiry.
L ike others who have considered these issues (Dixon-Woods, Bonas,
Booth, et al., 2006; Paterson, Thorne, Canam, & Jillings, 2001; Pope,
Mays, & Popay, 2007; Sandelowski & Barroso, 2007), we are not naïve to
the challenges involved in articulating systematic methods for synthesiz-
ing qualitative studies. We acknowledge the risk that presenting an
approach for qualitative synthesis poses. We may overemphasize meth-
ods over substance and readers might perceive that we are prescribing a
single method. Moreover, the philosophical differences between, say,
a post-positivist grounded theory study and a critical–realist ethno-
graphic study cannot be ignored. Both are qualitative studies, yet how
can they be compared? Indeed, this is what makes a quantitative system-
atic review much easier because there is just one philosophical tradition
to contend with: post-positivism. Quantitative meta-reviews compare
fi ndings generated by different designs and statistical techniques, but, for
the most part, each study enacts the same basic post-positivist assump-
tions (e.g., that differences between people can be observed, aggregated,
interpreted, and generalized).
