Evidence-Based Practice for Nurses

the perspective of the author’s analysis. Possible uses of
the concept should be presented, including definitions
and descriptions found in all types of literature. Related
and interchangeable concepts may also be described. This
further assists in clarifying the concept being studied.
After this, the author can state specific characteristics of
the concept, known as defining attributes. Antecedents,
or conditions that must precede the concept, are also
presented. For example, a person must have functioning neurons to feel pain.
Next, the consequences, or outcomes, of the concept should be discussed.

The most interesting part of the concept analysis is the presentation of various
cases. In the pain example, one case describes pain, another may describe itching,
and yet another may describe pleasure. These cases represent, almost represent,
and do not represent the concept. Critiquing the rigor with which the author has
approached the concept analysis report is of utmost importance in determining
the contribution of the report to evidence. When the author has carefully and
thoughtfully followed the concept analysis steps, the results and implications for
practice and research can contribute to the development of evidence.

Although qualitative findings are considered lower-level evidence, they
do provide the patient perspective for EBP. Meta-synthesis is the analysis of
a group of qualitative studies. Finfgeld (2003) noted the goal is “to produce
a new and integrative interpretation of findings that is more substantive than
those resulting from individual investigations” (p. 894). Meta-synthesis involves
breaking down findings, examining them, discovering essential features, and
finally transforming the essential features into a new, integrated whole.

The Second S: Syntheses

Syntheses integrate various pieces of evidence to present a whole depiction of
a phenomenon. A systematic review is a common type of synthesis found in
nursing. It is a rigorously conducted process of obtaining and reviewing the
literature to answer pre-established theoretical or practice questions. The word
systematic is the key to understanding the nature and intent of a systematic
review. According to the Encarta dictionary, systematic means “done methodi-
cally or carried out in a methodological and organized manner.”

FYI

Within the 5 Ss are several types of evidence,

including case studies, concept analyses,

meta-syntheses, systematic reviews, tradi-

tional literature reviews, integrative reviews,

meta-analyses, practice guidelines, and

abstracts.

Read a concept analysis article on a concept that is of interest to you. How does the report

increase your understanding of the concept? Describe how the concept analysis report helped

you clarify the “edges” of the concept.

CRITICAL THINKING EXERCISE 12-2

KEY TERMS

meta-synthesis: A

systematic review

that contains only

qualitative studies; a

scholarly paper that

combines results

from qualitative

studies

systematic review:

A rigorous and

systematic synthesis

of research findings

about a clinical

problem

12.1 The Pyramid of the 5 Ss 313