# Prioritizing qualitative meta-synthesis findings in a mixed methods systematic review study: A description of the method

## TL;DR

This paper describes a mixed methods review method that prioritizes qualitative evidence to understand why older patients with chronic conditions are readmitted to hospitals.

## Contribution

The paper introduces a novel sequential mixed methods review approach that prioritizes qualitative synthesis over quantitative data.

## Key findings

- A five-step method was developed to prioritize qualitative evidence in mixed methods reviews.
- The method uses meta-synthesis and thematic analysis to explore psychosocial factors influencing unplanned readmissions.
- Comparing qualitative and quantitative evidence helps build holistic understandings of complex clinical problems.

## Abstract

To describe a sequential mixed methods review method that prioritized synthesized qualitative evidence from primary studies to explain the complexities of older persons with multiple chronic conditions’ unplanned readmission experiences.

Segregated mixed methods review studies frequently prioritize quantitative evidence synthesis to examine the effectiveness of interventions; utilizing qualitative evidence to explain quantitative data. There is a lack of guidance about how to prioritize qualitative evidence.

Five procedural steps were developed to prioritize qualitative evidence synthesis. In Step 1, research questions were developed. In Step 2, databases were searched, studies were mapped to their method (qualitative or quantitative) and appraised. In Step 3, meta-synthesis and applied thematic analysis were used to synthesize extracted qualitative evidence about the psychosocial processes and factors that influenced unplanned readmission. In Step 4, quantitative evidence was synthesized using vote counting to determine the factors influencing unplanned readmission. In Step 5, a matrix was used to compare, determine the agreement between the qualitative and quantitative evidence, juxtapose findings, and uphold validity. Factors were mapped to the model of psychosocial processes and analytic themes.

Prioritizing qualitative evidence synthesis in a mixed methods review study prioritizes participants’ experiences, perspectives, and voices to understand complex clinical problems from participants who experienced the event. Synthesizing and integrating evidence facilitates the construction of holistic new understandings about phenomenon and expands mixed methods systematic review methods.

Prioritizing patients’ perspectives is useful for developing new client-centered interventions, establishing best practices for future reviews, generating theories, and expanding research methods.