Open Access Correspondence

Meta-ethnography 25 years on: challenges and insights for synthesising a large number of qualitative studies

Francine Toye1*, Kate Seers2, Nick Allcock3, Michelle Briggs4, Eloise Carr5 and Karen Barker16

Author Affiliations

1 Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK

2 Royal College of Nursing Research Institute, Warwick Medical School, University of Warwick, Coventry, UK

3 School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK

4 Institute of Health and Well Being, Leeds Metropolitan University, Leeds, UK

5 Faculty of Nursing, University of Calgary, Alberta, Canada

6 Biomedical Research Unit, Nuffield Department Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK

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BMC Medical Research Methodology 2014, 14:80  doi:10.1186/1471-2288-14-80

Published: 21 June 2014


Studies that systematically search for and synthesise qualitative research are becoming more evident in health care, and they can make an important contribution to patient care. Our team was funded to complete a meta-ethnography of patients’ experience of chronic musculoskeletal pain. It has been 25 years since Noblit and Hare published their core text on meta-ethnography, and the current health research environment brings additional challenges to researchers aiming to synthesise qualitative research. Noblit and Hare propose seven stages of meta-ethnography which take the researcher from formulating a research idea to expressing the findings. These stages are not discrete but form part of an iterative research process. We aimed to build on the methods of Noblit and Hare and explore the challenges of including a large number of qualitative studies into a qualitative systematic review. These challenges hinge upon epistemological and practical issues to be considered alongside expectations about what determines high quality research. This paper describes our method and explores these challenges. Central to our method was the process of collaborative interpretation of concepts and the decision to exclude original material where we could not decipher a concept. We use excerpts from our research team’s reflexive statements to illustrate the development of our methods.