Article type
Year
Abstract
Background: The importance of combining qualitative and quantitative data when designing complex interventions for patient benefit is growing in recognition. Methods for systematically synthesising qualitative and quantitative evidence have been developed and are increasingly utilised in health services research.
Objectives: To demonstrate both the validity of a systematic review and narrative synthesis and the application of the results in designing and testing a complex intervention for mental health service users.
Methods: We combined qualitative and quantitative data by conducting a systematic review and narrative synthesis using a multistage literature search aimed at identifying mainstream and grey literature relating to patients' experience of recovery. Three stages were included in the narrative synthesis with tabulation, cross-tabulation, in-depth thematic analysis and vote counting used to develop the preliminary synthesis. Relationships between studies of 1) differing quality and 2) different populations were explored using conceptual and methodological triangulation. We tested the validity of this approach through critical reflection, expert consultation with different stakeholder groups (patients, carers, expert researchers, health care professionals and individuals from black and minority ethnic backgrounds) and patient focus groups. We applied the results of the synthesis to develop a complex intervention.
Results: 97 papers including 87 models of recovery were included in the synthesis. The validation phase suggested that the synthesis was a robust model which captured the experiences of patients. The synthesis has been used to inform development of a standardised measure (INSPIRE) and an intervention and training package for frontline mental health staff (REFOCUS).
Conclusions: Narrative synthesis offers a robust and valid way of synthesising evidence, particularly where qualitative evidence predominates and for topics where patient experience is key. The narrative synthesis has been successfully applied to the design and development of tools currently being evaluated in a multisite cluster randomised controlled trial.
Objectives: To demonstrate both the validity of a systematic review and narrative synthesis and the application of the results in designing and testing a complex intervention for mental health service users.
Methods: We combined qualitative and quantitative data by conducting a systematic review and narrative synthesis using a multistage literature search aimed at identifying mainstream and grey literature relating to patients' experience of recovery. Three stages were included in the narrative synthesis with tabulation, cross-tabulation, in-depth thematic analysis and vote counting used to develop the preliminary synthesis. Relationships between studies of 1) differing quality and 2) different populations were explored using conceptual and methodological triangulation. We tested the validity of this approach through critical reflection, expert consultation with different stakeholder groups (patients, carers, expert researchers, health care professionals and individuals from black and minority ethnic backgrounds) and patient focus groups. We applied the results of the synthesis to develop a complex intervention.
Results: 97 papers including 87 models of recovery were included in the synthesis. The validation phase suggested that the synthesis was a robust model which captured the experiences of patients. The synthesis has been used to inform development of a standardised measure (INSPIRE) and an intervention and training package for frontline mental health staff (REFOCUS).
Conclusions: Narrative synthesis offers a robust and valid way of synthesising evidence, particularly where qualitative evidence predominates and for topics where patient experience is key. The narrative synthesis has been successfully applied to the design and development of tools currently being evaluated in a multisite cluster randomised controlled trial.