There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses. We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.

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Methods for the thematic synthesis of qualitative research in systematic reviews

Qualitative research most commonly involves the systematic collection, ordering, description and interpretation of textual data generated from talk, observation or documentation. A report of qualitative research should address the following criteria: Clarification and justification; Procedural rigour; Representativeness; Interpretative rigour; Reflexivity and evaluative rigour; and Transferability. Because of the limitations on article length for the Medical Journal of Australia, authors should focus on only a couple of aspects of the research, rather than trying to present a simplified description of multiple aspects.

Quality in qualitative research.

Justice and the Politics of Difference

Sufficient knowledge is available about the definition, details and differences of qualitative content and thematic analysis as two approaches of qualitative descriptive research. However, identifying the main features of theme as the data analysis product and the method of its development remain unclear. The purpose of this study was to describe the meaning of theme and offer a method on theme construction that can be used by qualitative content analysis and thematic analysis researchers in line with the underpinning specific approach to data analysis. This methodological paper comprises an analytical overview of qualitative descriptive research products and the meaning of theme. Also, our practical experiences of qualitative analysis supported by relevant published literature informed the generation of a stage like model of theme construction for qualitative content analysis and thematic analysis. This paper comprises: (i) analytical importance of theme, (ii) meaning of theme, (iii) meaning of category, (iv) theme and category in terms of level of content, and (v) theme development. This paper offers a conceptual clarification and a pragmatic step by step method of theme development that has the capacity of assisting nurse researchers understand how theme is developed. As nursing is a pragmatic discipline, nurse researchers have tried to develop practical findings and devise some way to “do something” with findings to enhance the action and impact of nursing. The application of a precise method of theme development for qualitative descriptive data analysis suggested in this paper helps yield meaningful, credible and practical results for nursing.

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Theme development in qualitative content analysis and thematic analysis

Aim: To produce a framework for the development of a qualitative semi-structured interview
guide.
Background: Rigorous data collection procedures fundamentally influence the results of
studies. The semi-structured interview is a common data collection method, but
methodological research on the development of a semi-structured interview guide is sparse.
Design: Systematic methodological review.
Data Sources: We searched PubMed, CINAHL, Scopus and Web of Science for
methodological papers on semi-structured interview guides from October 2004 - September
2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected ten
papers.
Review methods: We analysed the data using the qualitative content analysis method.
Results: Our analysis resulted in new synthesized knowledge on the development of a semistructured
interview guide, including five phases: 1) identifying the prerequisites for using
semi-structured interviews; 2) retrieving and using previous knowledge; 3) formulating the preliminary semi-structured interview guide; 4) pilot testing the guide; and 5) presenting the
complete semi-structured interview guide.
Conclusion: Rigorous development of a qualitative semi-structured interview guide
contributes to the objectivity and trustworthiness of studies and makes the results more
plausible. Researchers should consider using this five-step process to develop a semistructured
interview guide and justify the decisions made during it.

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Systematic methodological review: developing a framework for a qualitative semi-structured interview guide

Generating best evidence from qualitative research: the role of data analysis

A hierarchy of evidence for assessing qualitative health research

Objectives: To describe the proportion of women reporting time is a barrier to healthy eating and physical activity, the characteristics of these women and the perceived causes of time pressure, and to examine associations between perceptions of time as a barrier and consumption of fruit, vegetables and fast food, and physical activity. Design: A cross-sectional survey of food intake, physical activity and perceived causes of time pressure. Setting: A randomly selected community sample. Subjects: A sample of 1580 women self-reported their food intake and their perceptions of the causes of time pressure in relation to healthy eating. An additional 1521 women self-reported their leisure-time physical activity and their perceptions of the causes of time pressure in relation to physical activity. Results: Time pressure was reported as a barrier to healthy eating by 41% of the women and as a barrier to physical activity by 73%. Those who reported time pressure as a barrier to healthy eating were significantly less likely to meet fruit, vegetable and physical activity recommendations, and more likely to eat fast food more frequently. Conclusions: Women reporting time pressure as a barrier to healthy eating and physical activity are less likely to meet recommendations than are women who do not see time pressure as a barrier. Further research is required to understand the perception of time pressure issues among women and devise strategies to improve women’s food and physical activity behaviours.

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Is the perception of time pressure a barrier to healthy eating and physical activity among women

https://eprints.utas.edu.au/2672/1/Gibbs_et_al_Sampling_paper_ANZJPH.pdf

What have sampling and data collection got to do with good qualitative research

Objective: To compare the weight status of women and children living in socioeconomically disadvantaged rural and urban neighbourhoods in Victoria. Design, setting and participants: Cross-sectional study of data collected between August 2007 and July 2008 as part of the Resilience for Eating and Activity Despite Inequality (READI) study. Women aged 18–45 years living in 40 rural and 40 urban socioeconomically disadvantaged Victorian areas were surveyed by postal questionnaire. Data from a subset of their children aged 5–12 years were also analysed. Weight and height were self-reported for women and measured for children. Main outcome measures: Women’s weight status based on body mass index (BMI): underweight; healthy; overweight; or obese Class I, II or III; children’s weight status based on International Obesity Taskforce BMI cut-off points. Results: Of 11 940 women randomly selected, 4934 (41%) replied to a postal invitation to participate. After exclusions for various reasons, data were available on 3879 women and 636 of their children. Twenty-four per cent of urban and 26% of rural women were classified as overweight; a further 19% of urban and 23% of rural women were classified as obese. Twenty per cent of both urban and rural children were classified as overweight; a further 10% of urban and rural children were classified as obese. In crude analyses, rural women had higher odds of Class I and II obesity (odds ratio [OR], 1.34 and 1.72, respectively) compared with urban women. After adjusting for sociodemographic factors (age, number of children, country of birth, education level, employment status and marital status), there was no difference between urban and rural women in odds of overweight or obesity Class I, II or III. No significant urban–rural difference in odds of overweight/obesity was evident among children. Conclusions: The higher prevalence of obesity in rural women compared with urban women was largely explained by individual-level sociodemographic factors, such as age, number of children, country of birth, education level, employment status and marital status. This suggests that higher obesity levels among women in rural areas may be attributable to the sociodemographic composition of these areas.

Nicky Welch

Papers

Generating best evidence from qualitative research: the role of data analysis

A hierarchy of evidence for assessing qualitative health research

Is the perception of time pressure a barrier to healthy eating and physical activity among women

What have sampling and data collection got to do with good qualitative research

Urban-rural comparison of weight status among women and children living in socioeconomically disadvantaged neighbourhoods.