A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain

Abstract Background Each year over five million people develop chronic non-malignant pain and can experience healthcare as an adversarial struggle. The aims of this study were: (1) to bring together qualitative evidence syntheses that explore patients’ experience of living with chronic non-malignant...

Full description

Bibliographic Details
Main Authors: Fran Toye, Kate Seers, Erin Hannink, Karen Barker
Format: Article
Language:English
Published: BMC 2017-08-01
Series:BMC Medical Research Methodology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12874-017-0392-7
id doaj-dd2800069b314cc0b8348a613457cb82
record_format Article
spelling doaj-dd2800069b314cc0b8348a613457cb822020-11-24T20:55:58ZengBMCBMC Medical Research Methodology1471-22882017-08-0117111110.1186/s12874-017-0392-7A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant painFran Toye0Kate Seers1Erin Hannink2Karen Barker3Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation TrustRoyal College of Nursing Research Institute, Warwick Medical School, University of WarwickNuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation TrustNuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation TrustAbstract Background Each year over five million people develop chronic non-malignant pain and can experience healthcare as an adversarial struggle. The aims of this study were: (1) to bring together qualitative evidence syntheses that explore patients’ experience of living with chronic non-malignant pain and develop conceptual understanding of what it is like to live with chronic non-malignant pain for improved healthcare; (2) to undertake the first mega-ethnography of qualitative evidence syntheses using the methods of meta-ethnography. Methods We used the seven stages of meta-ethnography refined for large studies. The innovation of mega-ethnography is to use conceptual findings from qualitative evidence syntheses as primary data. We searched 7 bibliographic databases from inception until February 2016 to identify qualitative evidence syntheses that explored patients’ experience of living with chronic non-malignant pain. Results We identified 82 potential studies from 556 titles, screened 34 full text articles and included 11 qualitative evidence syntheses synthesising a total of 187 qualitative studies reporting more than 5000 international participants living with chronic pain. We abstracted concepts into 7 conceptual categories: (1) my life is impoverished and confined; (2) struggling against my body to be me; (3) the quest for the diagnostic ‘holy grail’; (4) lost personal credibility; (5) trying to keep up appearances; (6) need to be treated with dignity; and (7) deciding to end the quest for the grail is not easy. Each conceptual category was supported by at least 7 of the 11 qualitative evidence syntheses. Conclusions This is the first mega-ethnography, or synthesis of qualitative evidence syntheses using the methods of meta-ethnography. Findings help us to understand that the decision to end the quest for a diagnosis can leave patients feeling vulnerable and this may contribute to the adversarial nature of the clinical encounter. This knowledge demonstrates that treating a patient with a sense that they are worthy of care and hearing their story is not an adjunct to, but integral to health care.http://link.springer.com/article/10.1186/s12874-017-0392-7Qualitative researchQualitative evidence synthesisPainPatient experienceSystematic reviewMeta-ethnography
collection DOAJ
language English
format Article
sources DOAJ
author Fran Toye
Kate Seers
Erin Hannink
Karen Barker
spellingShingle Fran Toye
Kate Seers
Erin Hannink
Karen Barker
A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain
BMC Medical Research Methodology
Qualitative research
Qualitative evidence synthesis
Pain
Patient experience
Systematic review
Meta-ethnography
author_facet Fran Toye
Kate Seers
Erin Hannink
Karen Barker
author_sort Fran Toye
title A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain
title_short A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain
title_full A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain
title_fullStr A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain
title_full_unstemmed A mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain
title_sort mega-ethnography of eleven qualitative evidence syntheses exploring the experience of living with chronic non-malignant pain
publisher BMC
series BMC Medical Research Methodology
issn 1471-2288
publishDate 2017-08-01
description Abstract Background Each year over five million people develop chronic non-malignant pain and can experience healthcare as an adversarial struggle. The aims of this study were: (1) to bring together qualitative evidence syntheses that explore patients’ experience of living with chronic non-malignant pain and develop conceptual understanding of what it is like to live with chronic non-malignant pain for improved healthcare; (2) to undertake the first mega-ethnography of qualitative evidence syntheses using the methods of meta-ethnography. Methods We used the seven stages of meta-ethnography refined for large studies. The innovation of mega-ethnography is to use conceptual findings from qualitative evidence syntheses as primary data. We searched 7 bibliographic databases from inception until February 2016 to identify qualitative evidence syntheses that explored patients’ experience of living with chronic non-malignant pain. Results We identified 82 potential studies from 556 titles, screened 34 full text articles and included 11 qualitative evidence syntheses synthesising a total of 187 qualitative studies reporting more than 5000 international participants living with chronic pain. We abstracted concepts into 7 conceptual categories: (1) my life is impoverished and confined; (2) struggling against my body to be me; (3) the quest for the diagnostic ‘holy grail’; (4) lost personal credibility; (5) trying to keep up appearances; (6) need to be treated with dignity; and (7) deciding to end the quest for the grail is not easy. Each conceptual category was supported by at least 7 of the 11 qualitative evidence syntheses. Conclusions This is the first mega-ethnography, or synthesis of qualitative evidence syntheses using the methods of meta-ethnography. Findings help us to understand that the decision to end the quest for a diagnosis can leave patients feeling vulnerable and this may contribute to the adversarial nature of the clinical encounter. This knowledge demonstrates that treating a patient with a sense that they are worthy of care and hearing their story is not an adjunct to, but integral to health care.
topic Qualitative research
Qualitative evidence synthesis
Pain
Patient experience
Systematic review
Meta-ethnography
url http://link.springer.com/article/10.1186/s12874-017-0392-7
work_keys_str_mv AT frantoye amegaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
AT kateseers amegaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
AT erinhannink amegaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
AT karenbarker amegaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
AT frantoye megaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
AT kateseers megaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
AT erinhannink megaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
AT karenbarker megaethnographyofelevenqualitativeevidencesynthesesexploringtheexperienceoflivingwithchronicnonmalignantpain
_version_ 1716791281179426816