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Realist synthesis: illustrating the method for implementation research
Jo Rycroft-Malone1, Brendan McCormack, Alison M Hutchinson
1School of Healthcare Sciences, Bangor University, Fron Heulog, Ffriddoedd Road, Bangor, UK. j.rycroft-malone@bangor.ac.uk
Implementation Science : IS
|April 21, 2012
Summary
This paper details a realist synthesis methodology for understanding how interventions enable evidence-informed healthcare. It highlights the approach
Area of Science:
- Health Services Research
- Evidence Synthesis
- Healthcare Interventions
Background:
- Realist synthesis is an emerging evidence review approach focusing on intervention mechanisms.
- Few published examples exist, creating a need for methodological guidance.
- This paper addresses this gap by detailing a realist review process.
Purpose of the Study:
- To describe the process of conducting a realist review and synthesis.
- To answer: 'what interventions and strategies are effective in enabling evidence-informed healthcare?'
- To consider the strengths and challenges of realist review.
Main Methods:
- Defined review scope through concept mining and framework formulation.
- Searched, scrutinized, extracted, and synthesized evidence.
- Developed a narrative including hypotheses based on extracted data.
Main Results:
- Developed an outcome-focused theoretical framework for evidence-informed healthcare.
- Tailored review questions to four theory/intervention areas.
- Included 52 papers in the 'change agency' theory area, with data extraction and synthesis.
Conclusions:
- Realist synthesis is suitable for complex interventions, considering context and outcomes.
- The approach offers pragmatic conclusions compared to other systematic reviews.
- This methodology facilitates systematic and transparent literature synthesis.
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