A discursive analysis of contemporary literature examining qualitative research findings in evidence-based health care.

Abstract

The systematic review has become the ‘gold standard’ of evidence. Historically the systematic review has focused on effectiveness and as such the aggregation of results from randomised controlled trials. However health care questions are often complex requiring different research approaches to yield appropriate answers. It is acknowledged that not all research questions are amenable to the results of RCTS and as such there is now a shift towards understanding the need to incorporate research findings that acknowledge social and cultural concerns. This shift has resulted in an increased use of qualitative research findings as evidence and more specifically the systematic review of qualitative research findings. While still a relatively new area of research, the methods surrounding qualitative systematic review are fast developing. To date there are many views and debates on how this type of research should be performed. In order to gain a deeper level of understanding of these positions a discursive analysis informed by Foucault was undertaken on contemporary literature. Incorporating Foucault’s archaeological and genealogical aspects to analysis three distinct discursive formations related to the incorporation of qualitative systematic review into evidence-based practice is revealed. History of the present: a voice silenced examines the discourses surrounding the evidence-based revolution lack of reference to incorporating qualitative research findings. Rise of the silenced voice examines the discourses around positioning qualitative research findings into evidence-based practice. The final formation, Building Blocks to systematic review examines all the discourses surrounding the elements of conducting a qualitative systematic review. Finally the researcher concludes that all approaches to synthesising qualitative research are useful and have a place within health care but only reviews that follow the Five Stages of Systematic Review can be given the label of being a ‘systematic review’. Only those methods that detail an explicit, well defined question, perform a comprehensive search for research, critically assess the quality of research papers, extract and aggregate the findings of the included research papers can be given the label of being a qualitative systematic review.