Synthesis of quantitative and qualitative research: an example using Critical Interpretive Synthesis.
OBJECTIVE
This paper is a report of a Critical Interpretive Synthesis to synthesize quantitative research, in the form of an effectiveness review and a guideline, with qualitative research to examine the use of morphine to treat cancer-related pain.


BACKGROUND
Critical Interpretive Synthesis is a new method of reviewing, developed from meta-ethnography, which integrates systematic review methodology with a qualitative tradition of enquiry. It has not previously been used specifically to synthesize effectiveness and qualitative literature. Data sources. An existing systematic review of quantitative research and a guideline examining the effectiveness of oral morphine to treat cancer pain were identified. Electronic searches of Medline, CINAHL, Embase, PsychINFO, Health Management Information Consortium database and the Social Science Citation Index to identify qualitative research were carried out in May 2008.


METHODS
Qualitative research papers reporting on the use of morphine to treat cancer pain were identified. The findings of the effectiveness research were used as a framework to guide the translation of findings from qualitative research using an integrative grid. A secondary translation of findings from the qualitative research, not specifically mapped to the effectiveness literature, was guided by the framework.


RESULTS
Nineteen qualitative papers were synthesized with the quantitative effectiveness literature, producing 14 synthetic constructs. These were developed into four synthesizing arguments which drew on patients', carers' and healthcare professionals' interpretations of the meaning and context of the use of morphine to treat cancer pain.


CONCLUSIONS
Critical Interpretive Synthesis can be adapted to synthesize reviews of quantitative research into effectiveness with qualitative research and fits into an existing typology of approaches to synthesizing qualitative and quantitative research.
Flemming
Kate
K
Department of Health Sciences The University of York, UK. kaf1@york.ac.uk
D000701:Analgesics, Opioid / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D009020:Morphine / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement; D036301:Qualitative Research; D012196:Review Literature as Topic
D000701:Analgesics, Opioid; D009020:Morphine