Abstract:
OBJECTIVES:To demonstrate the benefits of applying meta ethnography to the synthesis of qualitative research, by means of a worked example. METHODS:Four papers about lay meanings of medicines were arbitrarily chosen. Noblit and Hare's seven-step process for conducting a meta ethnography was employed: getting started; deciding what is relevant to the initial interest; reading the studies; determining how the studies are related; translating the studies into one another; synthesising translations; and expressing the synthesis. RESULTS:Six key concepts were identified: adherence/compliance; self-regulation; aversion; alternative coping strategies; sanctions; and selective disclosure. Four second-order interpretations (derived from the chosen papers) were identified, on the basis of which four third-order interpretations (based on the key concepts and second-order interpretations) were constructed. These were all linked together in a line of argument that accounts for patients' medicine-taking behaviour and communication with health professionals in different settings. Third-order interpretations were developed which were not only consistent with the original results but also extended beyond them. CONCLUSIONS:It is possible to use meta ethnography to synthesise the results of qualitative research. The worked example has produced middle-range theories in the form of hypotheses that could be tested by other researchers.
journal_name
J Health Serv Res Policyjournal_title
Journal of health services research & policyauthors
Britten N,Campbell R,Pope C,Donovan J,Morgan M,Pill Rdoi
10.1258/135581902320432732subject
Has Abstractpub_date
2002-10-01 00:00:00pages
209-15issue
4eissn
1355-8196issn
1758-1060journal_volume
7pub_type
杂志文章abstract:OBJECTIVE:Cost-utility analysis is gaining importance as a tool for setting priorities in health care. The approach requires quality-of-life weights on a scale from 0.00 (corresponding to death) to 1.00 (corresponding to perfect health). Different methods and perspectives of the evaluators tend to give different result...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/135581904322716111
更新日期:2004-01-01 00:00:00
abstract::Patients are increasingly using the internet to access information on health care and services, as well as writing reviews of their own experiences. With patient choice increasing in many health systems, payers, purchasers and providers are attempting to take control of this trend by designing and managing their own p...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010010
更新日期:2011-04-01 00:00:00
abstract::The National Health Service (NHS) in England is not only a commissioner and provider of health care to the sick, but also offers certainty and peace of mind to all citizens--even those who do not use the health service in any year. However, due to the recent dominance of cost-effectiveness and cost-utility analysis as...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.009024
更新日期:2010-07-01 00:00:00
abstract::Evidence-based medicine (EBM) and evidence-based decision-making (EBDM) were intended to revolutionize health care and health policy. Thus far they have not. A great deal of research has demonstrated the persistent ubiquity of error in health care, wide and unjustifiable variations in practice and the minimal impact o...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907781543094
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVES:Randomized controlled trials are important for evaluating health care interventions, but recruitment can be difficult. Studies of potential participants' perspectives on trial participation are accumulating, but their collective contribution is not obvious. In 2007, we conducted a meta-ethnographic synthesis...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/1355819613483126
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To explore some of the impacts of star performance ratings in acute hospital trusts in England. METHODS:A multiple case study design was used which incorporated purposeful sampling of 'low' and 'high' performing trusts using the star rating system. In each case study site, data collection comprised semi-stru...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960501000106
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To explain recent rapid audited change in the uptake of locally implemented, evidence-based clinical guidelines for asthma and angina in primary care. METHODS:A case study of primary care in two matched, adjacent districts in Northern England, focusing on a stratified random sample of 49 general practitioner...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581903322029494
更新日期:2003-07-01 00:00:00
abstract::People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969700200206
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The assessment of any health care intervention should consider both risks and benefits and take patients' preferences about these into account. The study reported in this paper aimed to elicit patient valuations of health states relevant to assessment of the prevention of stroke by warfarin antic...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/1355819011927288
更新日期:2001-04-01 00:00:00
abstract::'Knowledge transfer' has become established as shorthand for a wide variety of activities linking the production of academic knowledge to the potential use of such knowledge in non-academic environments. While welcoming the attention now being paid to non-academic applications of social research, we contend that terms...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008055
更新日期:2008-07-01 00:00:00
abstract::'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical app...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819616660581
更新日期:2016-10-01 00:00:00
abstract::Continuity of care is concerned with the quality of care over time. There are two important perspectives on this. Traditionally, continuity of care is idealized in the patient's experience of a 'continuous caring relationship' with an identified health care professional. For providers in vertically integrated systems ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906778476490
更新日期:2006-10-01 00:00:00
abstract::In most jurisdictions, public policy regarding assisted death has not advanced beyond simple prohibition. However, this issue is increasingly likely to reach the policy agenda. Policy-makers may be tempted to turn for guidance to the three places in the world with developed policy or legislation: the Netherlands; the ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969900400409
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness and cost of obtaining consent for review of medical records within the passively observed non-intervention arm of a cluster randomized controlled trial, 'Comparison Arm for ProtecT'. METHODS:Two hundred and thirty men, who had been notified to the trial by cancer registries as h...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008085
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of a risk factor checklist and training video for general practitioners in reducing inter-practice variation and improving the appropriateness of referrals (assessed by their positive predictive value or PPV) of patients with suspected otitis media with effusion (OME or 'glue ear') to ...
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1258/1355819011927387
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:The United States Government's Medicaid expansion policy has important implications for health centres, since a large proportion of health centre patients are Medicaid enrollees. The objective of this study was to compare primary care utilization and clinical quality performance between health centres in Med...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819618788592
更新日期:2019-01-01 00:00:00
abstract::This essay considers some limitations of programme theory evaluation in relation to healthcare policies. This approach, which seeks to surface 'programme theories' or construct 'logic models', is often unable to account for empirical observations of policy implementation in real-world contexts. I argue that this failu...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819618779614
更新日期:2018-10-01 00:00:00
abstract::Health services research must continually address the question: Under what conditions may data not collected specifically for research, such as primary medical data, be re-used for research without compromising the privacy of the data-subjects? For secondary use of data in research there are basically three options. O...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581903766468800
更新日期:2003-07-01 00:00:00
abstract::The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insure...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819616664374
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:To evaluate whether the Clinical Priority Assessment Criteria (CPAC), used to prioritise access to elective surgery, was associated with: (a) patients' access to surgery in practice; (b) patients' level of need; and (c) patients' ability to benefit from surgery. Patients' perceptions of the 'booking system' ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581902320176322
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Scholarship cites health care managers (HCMs) as not using research evidence in their management practice. The purpose of this review was to evaluate the effectiveness of interventions to enhance HCMs use of research evidence in practice. METHODS:We carried out a systematic review and focus groups to valida...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/1355819618786764
更新日期:2019-01-01 00:00:00
abstract:AIMS:To evaluate the extent to which structural variation between English general practices is accounted for at higher organisational levels in the National Health Service (NHS). METHODS:We analysed data for 11 structural characteristics of all general practices in England. These included characteristics of general pr...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581903321466058
更新日期:2003-04-01 00:00:00
abstract::Almost everything you know about heroin addiction is wrong. Not only is it wrong, but it is obviously wrong. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and contrary t...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008022
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVES:To estimate the costs and potential efficiency gains of changing the frequency of clinic appointments and drug dispensing arrangements for stable HIV patients compared to the costs of hospital pharmacy dispensing and home delivery. METHODS:We estimated the annual costs per patient (HIV clinic visits and eit...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819613508176
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:The introduction of an internal market in the British National Health Service (NHS) has highlighted the importance of developing appropriate, valid and timely measures of hospital activity, both for the purposes of specifying and monitoring contracts and for evaluating the success of the NHS reforms in gener...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969600100104
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:To identify factors that explain patient satisfaction with general practice physicians and hence that may drive patients' choice of practice. METHODS:Logistic regression analysis of English National Health Service national patient survey data is used to identify the aspects of general practice care that are...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2007.007055
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Access to cardiac treatments has been documented to vary with patients' age. It is unknown whether these variations reflect patients' treatment preferences. We aimed to investigate patients' preferences for cardiology treatments and develop a Patients' Preferences Questionnaire. METHODS:Semi-structured inte...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008012
更新日期:2008-10-01 00:00:00
abstract::This paper analyses likely implications of two recent European Court rulings on the provision of health care across borders within the European Union. We argue that the two cases have fundamental implications for the provision of health services as free access to care across borders conflicts with the principle of sub...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960000500408
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS). METHODS:Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819614527439
更新日期:2014-07-01 00:00:00
abstract::Health services researchers have an important role to play in helping health care systems around the world provide high quality, affordable services. However, gaps between the best evidence and current practice suggest that researchers need to work in new ways. The production of research that meets the needs and prior...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819617714815
更新日期:2017-10-01 00:00:00