Title
Qualitative systematic reviews of treatment burden in stroke, heart failure and diabetes - Methodological challenges and solutions Phil Edwards
Date Issued
28 January 2013
Access level
open access
Resource Type
review
Author(s)
Gallacher K.
Jani B.
Morrison D.
Macdonald S.
Blane D.
Erwin P.
May C.R.
Eton D.T.
Smith F.
Batty D.G.
Mair F.S.
Mayo Clinic
Publisher(s)
BioMed Central Ltd.
Abstract
Background: Treatment burden can be defined as the self-care practices that patients with chronic illness must perform to respond to the requirements of their healthcare providers, as well as the impact that these practices have on patient functioning and well being. Increasing levels of treatment burden may lead to suboptimal adherence and negative outcomes. Systematic review of the qualitative literature is a useful method for exploring the patient experience of care, in this case the experience of treatment burden. There is no consensus on methods for qualitative systematic review. This paper describes the methodology used for qualitative systematic reviews of the treatment burdens identified in three different common chronic conditions, using stroke as our exemplar. Methods: Qualitative studies in peer reviewed journals seeking to understand the patient experience of stroke management were sought. Limitations of English language and year of publication 2000 onwards were set. An exhaustive search strategy was employed, consisting of a scoping search, database searches (Scopus, CINAHL, Embase, Medline & PsycINFO) and reference, footnote and citation searching. Papers were screened, data extracted, quality appraised and analysed by two individuals, with a third party for disagreements. Data analysis was carried out using a coding framework underpinned by Normalization Process Theory (NPT). Results: A total of 4364 papers were identified, 54 were included in the review. Of these, 51 (94%) were retrieved from our database search. Methodological issues included: creating an appropriate search strategy; investigating a topic not previously conceptualised; sorting through irrelevant data within papers; the quality appraisal of qualitative research; and the use of NPT as a novel method of data analysis, shown to be a useful method for the purposes of this review. Conclusion: The creation of our search strategy may be of particular interest to other researchers carrying out synthesis of qualitative studies. Importantly, the successful use of NPT to inform a coding frame for data analysis involving qualitative data that describes processes relating to self management highlights the potential of a new method for analyses of qualitative data within systematic reviews.
Volume
13
Issue
1
Language
English
OCDE Knowledge area
Sistema cardiaco, Sistema cardiovascular
Endocrinología, Metabolismo (incluyendo diabetes, hormonas)
Subjects
Scopus EID
2-s2.0-84872801846
PubMed ID
Source
BMC Medical Research Methodology
ISSN of the container
14712288
Sponsor(s)
We would like to acknowledge The International Minimally Disruptive Medicine Workgroup. We would like to thank the Chief Scientist Office Scotland for funding this study. We would like to thank Jane Goodfellow, University of Glasgow, for her help with the design of Figure 1.
Sources of information:
Directorio de Producción Científica
Scopus