The overall aim of this study was to contribute to the development of metasynthesis through an analysis of the challenges involved. The study grew out of the critique of qualitative metaresearch raised by current developers of metamethodologies. Different views on the application of methodologies have emerged in the literature, contributing to confusion and ambiguity concerning the challenging questions of what, why, how, and who in metasynthesis research, which might increase the risk of misunderstanding. The roots of metasynthesis research are seen as multifaceted and influencing the development of the methods in different directions. The primary worth of metasynthesis is theoretical and/or methodological development (synthesis) combined with the potential for reflection: going beyond and behind the studies (meta). Metasynthesis research has also the potential to raise questions of research collaboration, culture, and language.
Aagaard, H. , & Hall, E. O. C. (in press). Mothers' experiences of having a preterm infant in the neonatal care unit: A meta-synthesis . Journal of Pediatric Nursing.
2.
Angen, M. J. (2000). Evaluating interpretive inquiry: Reviewing the validity debate and opening the dialogue . Qualitative Health Research, 10, 378-395 .
3.
Barbour, R. S. (2001). Checklists for improving rigour in qualitative research: A case of the tail wagging the dog . British Medical Journal, 32, 1115-1117 .
4.
Barroso, J. , Gollop, C. J. , Sandelowski, M. , Meynell, J. , Pearce, P. F. , & Collonis, L. J. (2003). The challenges of searching for and retrieving qualitative studies . Western Journal of Nursing Research, 25, 153-178 .
5.
Beck, C. (2002a). Mothering multiples: A metasynthesis of qualitative research . MCN: American Journal of Maternal Child Nursing, 27, 214-221 .
6.
Beck, C. (2002b). Postpartum depression: A metasynthesis . Qualitative Health Research, 12, 453-472 .
7.
Bondas, T. (2000). Att vara med barn: En vårdvetenskaplig studie av kvinnors upplevelser under perinatal tid [To be with child: A study of women's lived experiences from a caring science perspective]. Åbo, Sweden: Åbo Akademi . (In Swedish, English summary)
8.
Bondas, T. (2003). Caritative leadership: Ministering to the patients . Nursing Administration Quarterly, 27, 249-255 .
9.
Bondas, T. (2005). To be with child: A heuristic synthesis in maternal care. In R. E. Balin (Ed.),Trends in midwifery research (pp. 119-136). New York: Nova Science .
10.
Bondas, T. , Berg, M. , Hall, E. O. C. , Lundgren, I. , Brinchmann, B. S. , & Vehviläinen-Julkunen, K. (2004). Metasynthesis as an approach in a Nordic collaboratory research program in childbearing . Paper presented at the Third Nordic Interdisciplinary Conference on Qualitative Methods in the Service of Health, Aarhus University, Denmark (Abstracts p. 28).
11.
Bondas, T. , & Hall, E. O. C. (2006). Meta questions in metasynthesis research: Paper presented at the Fourth Nordic Interdisciplinary Conference on Qualitative Methods in the Service of Health, Växjö University, Sweden . International Journal of Qualitative Studies on Health and Well-Being, 1(Suppl. 1), 13-32 .
12.
Campbell, R. , Pound, P. , Pope, C. , Britten, N. , Pill, R. , & Morgan, M. (2003). Evaluating: Meta-ethnography: A synthesis of qualitative research on lay experiences of diabetes and diabetes care . Social Science and Medicine, 56, 671-684 .
13.
Conn,V. S. , Isaramalai, S.-A. , Rath, S. , Jantarakupt, P. , Wadhawan, R. , & Dash, Y. (2003). Beyond MEDLINE for literature searches . Image: Journal of Nursing Scholarship, 35, 177-182 .
14.
Conn, V. S. , Valentine, J. C. , Cooper, H. M. , & Rantz, M. (2003). Grey literature in meta-analyses . Nursing Research, 52, 256-261 .
15.
Cooper, H. (1988). Synthesizing research. Thousand Oaks, CA: Sage .
16.
Edwards, A. , Elwyn, G. , Hood, K. , & Rollnick, S. (2000). Judging the “weight of evidence” in systematic reviews: Introducing rigour into the qualitative overview stage by assessing Signal and Noise . Journal of Evaluation in Clinical Practice, 6, 177-184 .
17.
Estabrooks, C. A. , Field, P. A. , & Morse, J. M. (1994). Aggregating qualitative findings: An approach to theory development . Qualitative Health Research, 4, 503-511 .
18.
Evans, D. , & Pearson, A. (2001). Systematic reviews: Gatekeepers of nursing knowledge . Journal of Clinical Nursing, 10, 593-599 .
19.
Finfgeld, D. L. (1999). Courage as a process of pushing beyond the struggle . Qualitative Health Research, 9, 803-814 .
20.
Finfgeld, D. L. (2003). Metasynthesis: The state of the art-so far . Qualitative Health Research, 13, 893-904 .
21.
Glaser, B. G. , & Strauss, A. S. (1967). The discovery of grounded theory. Chicago: Aldine .
22.
Glass, G. V. , McGraw, B. , & Smith, M. L. (1981). Meta-analysis in social research. Beverly Hills, CA: Sage .
23.
Hall, E. O. C. (1997). Four generations of nurse theorists in the U.S. An overview of their questions and answers . Vård i Norden, 17(2), 15-23 .
24.
Hall, E. O. C. (2006). When a newborn or small child is critically ill: Nurses', parents'and grandparents'experiences and dynamics in family-centred care. Aarhus: Aarhus University, Institute of Public Health, Department of Nursing Science, Faculty of Health Sciences, Denmark .
25.
Heaton, J. (2004). Reworking qualitative data. London: Sage .
26.
Jensen, L. A. , & Allen, M. N. (1994). A synthesis of qualitative research on wellness-illness . Qualitative Health Research, 4, 349-369 .
27.
Jensen, L. A. , & Allen, M. N. (1996). Meta-synthesis of qualitative findings . Qualitative Health Research, 6, 553-560 .
28.
Kearney, M. H. (1998a). Ready-to-wear: Discovering grounded formal theory . Research in Nursing and Health, 21, 179-186 .
29.
Kearney, M. H. (1998b). Truthful self-nurturing: A grounded formal theory of women's addiction recovery . Qualitative Health Research, 8, 495-512 .
30.
Kearney, M. H. (2001). New directions in grounded formal theory. In R. Schreiber & P. N. Stern (Eds.),Using grounded theory in nursing (pp. 227-246). New York: Springer .
31.
Kirkevold, M. (1997). Integrative nursing research–An important strategy to further development of nursing science and nursing practice . Journal of Advanced Nursing, 25, 977-984 .
32.
Kvale, S. (1996). Interviews: An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage .
33.
McCormick, J. , Rodney, P. , & Varcoe, C. (2003). Reinterpretations across studies: An approach to meta-analysis . Qualitative Health Research, 13, 933-944 .
34.
Morse, J. M. (1997). Considering theory derived from qualitative research. In J. M. Morse (Ed.),Completing a qualitative project: Details and dialogue (pp. 163-188). Thousand Oaks, CA: Sage .
35.
Morse, J. M. (2001a). Qualitative significance [Editorial] . Qualitative Health Research, 14, 151-152 .
36.
Morse, J. M. (2001b). Qualitative verification: Building evidence by extending basic findings. In J. Morse , J. Swanson , & A. Kuzel (Eds.),The nature of qualitative evidence (pp. 203-220). Thousand Oaks, CA: Sage .
37.
Morse, J. , Swanson, J. , & Kuzel, A. (Eds.). (2001). The nature of qualitative evidence. Thousand Oaks, CA: Sage .
38.
Noblit, G. W. , & Hare, R. D. (1988). Meta ethnography: Synthesizing qualitative studies. Newbury Park, CA: Sage .
39.
Paterson, B. L. (2001). The shifting perspectives model of chronic illness . Image: Journal of Nursing Scholarship, 33, 21-26 .
40.
Paterson, B. L. , Canam, C. , Joachim, G. , & Thorne, S. (2003). Embedded assumptions in qualitative studies of fatigue . Western Journal of Nursing Research, 25, 119-133 .
41.
Paterson, B. L. , & Thorne, S. (1998). An innovative approach to qualitative research synthesis (Abstract 107). Workshop presented at the Fourth Qualitative Health Research Conference, Vancouver, Canada.
42.
Paterson, B. L. , & Thorne, S. (2003). The potential of meta-synthesis for nursing care effectiveness research . Canadian Journal of Nursing Research, 35, 39-43 .
43.
Paterson, B. L. , Thorne, S. E. , Canam, C. , & Jillings, C. (2001). Meta-study of qualitative health research. A practical guide to meta-analysis and meta-synthesis. Thousand Oaks, CA: Sage .
44.
Ritzer, G. (1992). Metatheorizing in sociology: Explaining the coming of age. In G. Ritzer (Ed.),Metatheorizing (pp. 7-26). Newbury Park, CA: Sage .
45.
Sandelowski, M. , & Barroso, J. (2002a). Finding the findings in qualitative studies . Image: Journal of Nursing Scholarship, 34, 213-220 .
46.
Sandelowski, M. , & Barroso, J. (2002b). Reading qualitative studies . International Journal of Qualitative Methods, 1(1), Article 5. Retrieved September 1, 2006, from http://www.ualberta.ca/ĩijqm/
47.
Sandelowski, M. , & Barroso, J. (2003a). Classifying the findings in qualitative studies . Qualitative Health Research, 7, 905-923 .
48.
Sandelowski, M. , & Barroso, J. (2003b). Creating meta-summaries of qualitative findings . Nursing Research, 52, 226-231 .
49.
Sandelowski, M. , & Barroso, J. (2003c). Motherhood in the context of maternal HIV infection . Research in Nursing and Health, 26, 470-482 .
50.
Sandelowski, M. , & Barroso, J. (2003d). Toward a metasynthesis of qualitative findings on motherhood in HIV-positive women . Research in Nursing and Health, 26, 153-170 .
51.
Sandelowski, M. , Docherty, S. , & Emden, C. (1997). Qualitative metasynthesis: Issues and techniques . Research in Nursing and Health, 20, 365-371 .
52.
Schreiber, R. , Crooks, D. , & Stern, P. N. (1989). Qualitative meta-analysis. In J. M. Morse (Ed.),Qualitative nursing research: A contemporary dialogue (pp. 311-327). London: Sage .
53.
Sherwood, G. D. (1997). Metasynthesis of qualitative analysis of caring . Advances in Nursing Science, 3(1), 32-42 .
54.
Sherwood, G. D. (1999). Meta-synthesis: Merging qualitative studies to develop nursing knowledge . International Journal for Human Caring, 3, 37-42 .
55.
Thorne, S. (1994). Secondary analysis in qualitative research: Issues and implications. In J. M. Morse (Ed.),Critical issues in qualitative research methods (pp. 263-279). London: Sage .
56.
Thorne, S. (1998). Ethical and representational issues in qualitative secondary analysis . Qualitative Health Research, 8, 547-555 .
57.
Thorne, S. , Jensen, L. , Kearney, M. H. , Noblit, G. , & Sandelowski, M. (2004). Qualitative metasynthesis: Reflections on methodological orientation and ideological agenda . Qualitative Health Research, 14, 1342-1365 .
58.
Thorne, S. , Joachim, G. , Paterson, B. , & Canam, C. (2002). Influence of the research frame on qualitatively derived health science knowledge . International Journal of Qualitative Methods, 1(1), Article 1. Retrieved September 1, 2006, from http://www.ualberta.ca/ĩiqm/backissues/1_1Final/html/thorneeng.html
59.
Thorne, S. , & Paterson, B. (2002). Two decades of insider research: What we know and don't know about chronic illness experience . Annual Review of Nursing Research, 18, 3-25 .
60.
Thorne, S. , Paterson, B. , Acorn, S. , Canam, C. , Joachim, G. , & Jillings, C. (2002). Chronic illness experience: Insights from a metastudy . Qualitative Health Research, 12, 437-452 .
61.
Zhao, S. (1991). Metatheory, metamethod, meta-data-analysis: What, why, and how?Sociological Perspectives, 34, 377-390 .
62.
Terese Bondas, PhD, RN Docent, is a professor and research leader at the University College of Borås, Sweden.
63.
Elisabeth O. C. Hall, PhD, RN, is an associate professor at Aarhus University, Denmark.
