The use of meta-synthesis in cardiovascular nursing research

Guidelines for critiquing systematic reviews and meta-syntheses are presented in Polit and Beck's (2008) most recent research text. These have been loosely used to review the two study examples. Although the study by Lefler and Bondy (2004) is titled a meta-synthesis, it is clearly an integrative review and, thus, helps to illustrate the similarities and differences between these two approaches. The Paterson study (2001) suffers, as many qualitative reports do, from a restriction on length, making it difficult to completely assess all aspects of the study. Having said this, the purpose of Paterson's study could have been stated more clearly and the search strategy and inclusion/exclusion criteria could have been more explicit. In both reviews, issues of quality appraisal should have been dealt with in more detail, or reasons for not undertaking a quality appraisal discussed. While Paterson discusses at length the "state of the knowledge" in meta-synthesis, her description of the actual analysis done was very brief. Neither of the studies specifically addressed issues of rigour and Lefler and Bondy only briefly discussed study limitations. No limitations were discussed in the Paterson paper (2001). There are limitations to all research studies and it is important to interpret a study's findings while acknowledging how the limitations affect their interpretation. Lefler and Bondy identify three types of factors that may delay treatment-seeking in women who have had a myocardial infarction and have suggested further research that should be undertaken. Paterson (2001) has proposed a model of chronic illness that can assist nurses in supporting patients with chronic illness. Two studies of potential interest to cardiovascular nurses have been used to illustrate a relatively new research method -- meta-synthesis. Although there are still many methodological questions, the body of knowledge about meta-synthesis is sufficiently developed and documented to permit both novice and experienced researchers to undertake one. Meta-synthesis is an important way of making the large body of qualitative nursing research available to practising nurses and policymakers, as well as generating higher levels of understanding about phenomena of interest to nursing science.