The application of Qualitative Descriptive studies (QD) is mostly in healthcare and nursing in order to accurately select the evidence for the studies to make sound conclusions. A systematic review of several articles that followed QD is conducted to see their research objectives, design justification, theoretical/philosophical frameworks, sampling and sample size, data collection and sources, data analysis, and presentation of findings. This systematic review observes the methods followed in the articles that used QD and where they fail to produce insufficient evidence for the readers.
Defining qualitative descriptive studies
Qualitative descriptive research is conducted from a subjective perspective and includes the who, what, and where of events or experiences. The study is quite flexible and its purpose is exploration of naturalistic data, i.e. data that is obtained from records of human activities without the involvement of the researcher.
What is a systematic review?
The word ‘review’ suggests that Systematic Review is like a secondary research performed on already existing research in order to reduce their bias. A clearly formulated research question is answered by synthesising the available evidence- collecting all the data under one cohesive story. This can be done by either qualitative method (summarising all the information by assessing its quality) or by quantitative method (by conducting a meta analysis) or a combination of both.
Use of systematic review in qualitative descriptive studies
The purpose of using a systematic review to analyse qualitative studies is to use methods to select quality evidence to arrive at the conclusion. This is very useful in healthcare because human feedback is required to make crucial decisions. For example, in 2008, Dr Robert Boyle conducted a systematic research to answer the following medical question:
‘What is the effectiveness of probiotics in reducing eczema symptoms and improving quality of life in patients with eczema?’
After a research question is formulated, the researchers know what direction to take during the review. The next step is to make a research plan which is the protocol that the review will follow to reduce bias in information by having a thorough selection criteria.
For QD, the study selection was done according to the following criteria:
- Only research papers that followed QD design method throughout the main text (not just data analysis section)
After identifying the papers, the selected ones go through an assessment using a Critical Appraisal Skills Programme (CASP) which is a set of 10 main questions with some subsets of questions. Some of these questions include:
- Did the researcher justify the research design? Was the recruitment strategy appropriate to the aims of the research?
- Was the form of data clear e.g., tape recordings, video materials, notes, etc.?
- Was there an in-depth description of the analysis process?
Did the researcher discuss the credibility of their findings (e.g., triangulation)
The results of these findings were presented using a table to show how many articles fulfilled this criteria and how many didn’t.
Next stage of the systematic review is to extract data. This involves three people- two to conduct the study independently and the third one to be a mediator. The data to be extracted from each study is its year, study design, sample size, context, research findings, and conclusions. Then this raw data goes through the researcher’s judgement of its quality (good quality study has the least amount of bias), which is assessed through a variety of forms:
- The Registry of Methods and Tools for Evidence-Informed Decision Making
- Grading of Recommendations, Assessment, Development and Evaluations Working Group
For example, the data extraction results for one of the studies is presented like this
Authors, Country: Adams et al. (2014), USA
Research Objectives:
- Explore
- Responses to communication strategies
Design justification:
- (-) Reference
- (-) Rationale (the minus signs show weakness of the method)
Theoretical/philosophical frameworks: Not reported (NR)
Sampling/sample size:
- Purposive sampling/maximum variation
- 32 family members
Data collection and data sources:
- Interviews
- Observations
- Review of daily flow sheet
- Demographics
Data analysis:
- Inductive and deductive qualitative content analysis
- (-) Data saturation
Findings:
Five themes about family members’ perceptions of nursing communication approaches
Once the researchers have the data regarding each study and its quality, they can synthesise the data by either giving a qualitative summary in words or presenting the results in numbers after the meta analysis. For example, one of the findings of the quality appraisal are reported like this.
In the vast majority (90.9%) of the articles, researchers did not explain their involvement and positionality during the process of recruitment and data collection or during data analysis (63.6%)
Finally, all these results are compiled into a report
Final takeaway
Although a systematic review is extremely useful in minimising the bias as they are thorough and transparent, they can be very narrow in their results as compared to the amount of time they consume. Find out what kind of research type is useful for your study and whether you would require a systematic review for it.
