Article type
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Abstract
Objectives: to share our experiences, methods and outcomes of three recently undertaken qualitative evidence syntheses, each incorporating a different way of working with framework synthesis.
Methods: our first example of framework synthesis is the approach used within a traditional nine-month review focusing on the experiences of robotic animals within care homes, where the initial framework was created using a logic model based on an understanding of the background literature. The second approach to framework synthesis occurred within a six-week rapid review intended to inform the Independent Review of the Mental Health Act (1983). There was no pre-existing model or theory on which to base the framework, with the limited timeframe prohibiting the creation of a logic model. The research team decided to base their initial framework upon the research objectives and revise this using an iterative process of inductive thematic analysis. Our final example is the use of framework synthesis within a mixed-methods review focusing on improving the experience of care for people with dementia in hospital. Here, framework synthesis was used as a tool for identifying and organizing relevant data within the initial stage of a meta-ethnography approach.
Results: the nature of the findings differed across the three approaches to framework synthesis. Themes arising from the six-week rapid review were less rich than those from the other two approaches, but were very closely aligned with the specific interests of the commissioners of the review. This contrasted with the final output of the meta-ethnography approach in particular, where the results of the initial framework synthesis were used to create a comprehensive record of which papers contributed towards the final themes within the highly interpretative synthesis that reflected the much broader research aims. All three methods allowed the review authors to integrate data from the primary studies into common themes in a way that was highly transparent and replicable and allowed us to hypothesize the possible relationships between the themes arising from each review.
Conclusions: the approach to framework synthesis can be adapted to suit the initial aim and timeframe of the review, the availability of an existing theory or model and the intended purpose of the final results. By choosing an approach that was best suited the context of each review, we were able to ensure that the results met the requirements of key stakeholders and fulfilled our research objectives.
Patient or healthcare consumer involvement: the views of patients or research stakeholders were incorporated within each review. Examples of such involvement include drawing upon their knowledge and experience for the construction of the initial framework or the incorporation of their views on the preliminary findings into the final themes and subthemes.
Methods: our first example of framework synthesis is the approach used within a traditional nine-month review focusing on the experiences of robotic animals within care homes, where the initial framework was created using a logic model based on an understanding of the background literature. The second approach to framework synthesis occurred within a six-week rapid review intended to inform the Independent Review of the Mental Health Act (1983). There was no pre-existing model or theory on which to base the framework, with the limited timeframe prohibiting the creation of a logic model. The research team decided to base their initial framework upon the research objectives and revise this using an iterative process of inductive thematic analysis. Our final example is the use of framework synthesis within a mixed-methods review focusing on improving the experience of care for people with dementia in hospital. Here, framework synthesis was used as a tool for identifying and organizing relevant data within the initial stage of a meta-ethnography approach.
Results: the nature of the findings differed across the three approaches to framework synthesis. Themes arising from the six-week rapid review were less rich than those from the other two approaches, but were very closely aligned with the specific interests of the commissioners of the review. This contrasted with the final output of the meta-ethnography approach in particular, where the results of the initial framework synthesis were used to create a comprehensive record of which papers contributed towards the final themes within the highly interpretative synthesis that reflected the much broader research aims. All three methods allowed the review authors to integrate data from the primary studies into common themes in a way that was highly transparent and replicable and allowed us to hypothesize the possible relationships between the themes arising from each review.
Conclusions: the approach to framework synthesis can be adapted to suit the initial aim and timeframe of the review, the availability of an existing theory or model and the intended purpose of the final results. By choosing an approach that was best suited the context of each review, we were able to ensure that the results met the requirements of key stakeholders and fulfilled our research objectives.
Patient or healthcare consumer involvement: the views of patients or research stakeholders were incorporated within each review. Examples of such involvement include drawing upon their knowledge and experience for the construction of the initial framework or the incorporation of their views on the preliminary findings into the final themes and subthemes.
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