6 Evidence Appraisal: Research 1032017). Meta-synthesis is thought of as the qualitative counterpart to meta-
analysis and involves interpreting data rather than aggregating data or produc-
ing a summary statistic (Polit & Beck, 2017). In meta-synthesis, researchers make
systematic decisions on study inclusion criteria and evaluate the study quality.
Both meta-analyses and meta-syntheses use rigorous scientific techniques.
A number of different types of meta-synthesis methods exist. One commonly
used method is meta-ethnography (Noblit & Hare, 1988). Meta-ethnography,
which has its origins in the field of education, involves seven phases that focus on
the translation and interpretation of findings (Polit & Beck, 2017). Other meta-
synthesis methods include qualitative meta-summary, critical interpretive synthe-
sis, grounded formal theory, thematic synthesis, and meta-study (Polit & Beck,
2017). For nurses who lack experience and expertise in critiquing qualitative
studies, meta-syntheses are quite helpful because they aid in not only assessing
the rigor of individual studies but also interpreting findings.
Example: Meta-Synthesis
Flores, Leblanc, and Barroso (2016) conducted a meta-synthesis to understand
the factors that influence how a person with human immunodeficiency virus (HIV)
is linked and retained in care. They synthesized 69 studies that included either
qualitative research studies or the qualitative results from mixed-methods studies.
The meta-synthesis included 2,263 HIV-positive participants and 994 healthcare
providers, family members, or community members. Researchers found three
themes, or influences, for how persons with HIV interact with the care system:
1) the interpersonal stream that includes psychological state upon diagnosis and
informational challenges; 2) the social stream that includes societal experiences
and provider interaction; and 3) the cultural-attitudinal stream including life
demands, quality-of-care experiences, and other structural barriers. The findings
from this meta-synthesis suggest that there are reasons, other than individual level
factors, that link and retain persons with HIV in care. Flores et al. suggested that
changes are needed to address the social and cultural-attitudinal influences.