Publicado

2025-09-01

Cómo seleccionar una metasíntesis cualitativa para la práctica basada en la evidencia en salud

How to select a qualitative meta-synthesis for evidence-based practice in health

Palabras clave:

Investigación cualitativa, salud humana, literatura de revisión, revisión sistemática, práctica basada en la evidencia (es)
Qualitative research, human health, review literature, systematic review, evidence-based practice (en)

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La metasíntesis cualitativa permite interpretar y sintetizar conocimientos para comprender fenómenos, informar la práctica clínica, asesorar políticas y desarrollar teoría. De esta forma, se consolida como una estrategia clave para superar enfoques reduccionistas que distorsionan la realidad.

Objetivo Identificar los aportes metodológicos y prácticos de la metasíntesis cualitativa a la práctica basada en la evidencia.

Método Se realizó una revisión narrativa. La búsqueda abarcó PubMed, Web of Science, Scopus, Google Académico y Connected Papers.

Resultados Se incluyeron 30 artículos en los que se identificaron seis tipos de metasíntesis: metaetnografía, metaestudio, metasíntesis, síntesis interpretativa crítica, síntesis narrativa y meta-síntesis cualitativa.

Conclusión La metasíntesis es un método potente en la práctica basada en la evidencia, permite interpretar críticamente los estudios cualitativos. Cada enfoque responde a distintas necesidades: la metaetnografía y la metasíntesis cualitativa generan nuevas interpretaciones, mientras que el metaestudio y la síntesis interpretativa crítica ofrecen análisis rigurosos. La selección del método adecuado depende del fenómeno de estudio.

 

Qualitative meta-synthesis allows for the interpretation and integration of knowledge to understand phenomena, inform clinical practice, guide policy, and develop theory. In this way, it becomes a key strategy to overcome reductionist approaches that distort reality.

Objective To identify the methodological and practical contributions of qualitative meta-synthesis to evidence-based practice.

Method: A narrative review was conducted. The search covered PubMed, Web of Science, Scopus, Google Scholar, and Connected Papers.

Results Thirty articles were included, identifying six types of meta-synthesis: meta-ethnography, meta-study, meta-synthesis, critical interpretive synthesis, narrative synthesis, and qualitative meta-synthesis.

Conclusion Meta-synthesis is a powerful method in Evidence-Based Practice, enabling critical interpretation of qualitative studies. Each approach responds to different needs: meta-ethnography and qualitative meta-synthesis generate new interpretations, while meta-study and critical interpretive synthesis provide rigorous analyses. The choice of the appropriate method depends on the phenomenon under study.

 

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1. Green J, Thorogood N. Qualitative methods for health research [Internet]. Thousand Oaks, CA: SAGE Publications, 2004. Disponible en: https://tinyurl.com/yyad2ryp.

2. Paterson BL, Thorne SE, Canam C, Jillings C. Meta-study of qualitative health research [Internet]. Thousand Oaks, CA: SAGE Publications; 2001. http://dx.doi.org/10.4135/9781412985017.

3. Morán P, Analidhia N. El uso de la metasíntesis en la investigación. Res non verba (Guayaquil) [Internet]. 2018; 8(2):111–22. Consultado en febrero 2025. Disponible en: https://tinyurl.com/5bkyeerd.

4. Noblit GW, Hare RD. Meta-ethnography [Internet]. Thousand Oaks, CA: SAGE Publications; 1988. http://dx.doi.org/10.4135/9781412985000.

5. Kaboub F. Realistic evaluation. Soc Sci J [Internet]. 2004; 41(1):153–4. http://dx.doi.org/10.1016/j.soscij.2003.10.017.

6. Nye E, Melendez-Torres GJ, Bonell C. Origins, methods and advances in qualitative meta-synthesis. Rev Educ [Internet]. 2016; 4(1):57–79. http://dx.doi.org/10.1002/rev3.3065.

7. González Garrido GB. Experiencias de inclusión educativa de estudiantes universitarios con discapacidad. Metasíntesis. Siglo Cero [Internet]. 2024; 55(4):71–86. http://dx.doi.org/10.14201/scero.31993.

8. Torres-Sanmiguel AF, Carreño-Moreno S, Chaparro-Diaz L. Experiencia de los cuidadores informales en Colombia: Revisión sistemática y metasíntesis. Univ Salud [Internet]. 2023; 26(1):29–40. Disponible en: https://tinyurl.com/y53er5tw.

9. Gutiérrez JPV, Lozano VRR, de la Paz Castillo L. Emotional health of sanitary professionals in COVID-19 contexts: a systematic review and qualitative meta-synthesis. Rev Habanera Cienc Médicas [Internet]. 2024; 23(1):45. Consultado en agosto de 2025. Disponible en: https://tinyurl.com/4sz7hcht.

10. Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD. Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int. 2011; 31(11):1409–17. https://doi.org/10.1007/s00296-011-1999-3.

11. Sandelowski M, Barroso J, Voils CI. Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings. Res Nurs Health [Internet]. 2007; 30(1):99–111. http://dx.doi.org/10.1002/nur.20176.

12. Dixon-Woods M, Cavers D, Agarwal S, Annandale E, Arthur A, Harvey J, et al. Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Med Res Methodol. 2006; 6(1):35. http://dx.doi.org/10.1186/1471-2288-6-35.

13. Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC Methods Programme [Internet]. Lancaster, England: Lancaster University; 2006. http://dx.doi.org/10.13140/2.1.1018.4643.

14. Finfgeld-Connett D. A guide to qualitative meta-synthesis. Routledge; 2018. 15. Sandelowski M, Barroso J. Handbook for synthesizing qualitative research. Springer Publishing Company; 2007.

16. Majid U, Vanstone M. Appraising qualitative research for evidence syntheses: A compendium of quality appraisal tools. Qual Health Res. 2018; 28(13):2115–31. http://dx.doi.org/10.1177/1049732318785358.

17. Glaser B, Strauss A. The discovery of grounded theory: strategies for qualitative research. Mill Valley, CA: Sociology Press; 1967.

18. Corbin JM, Strauss AC. Basics of qualitative research. 3.a ed. [Internet]. Thousand Oaks, CA: SAGE Publications; 2008. http://dx.doi.org/10.4135/9781452230153.

19. Finfgeld-Connett D. Generalizability and transferability of meta-synthesis research findings. J Adv Nurs [Internet]. 2010; 66(2):246–54. http://dx.doi.org/10.1111/j.1365-2648.2009.05250.x.

20. Saldana J. The Coding Manual for qualitative researchers. Thousand Oaks, CA: SAGE Publications Limited; 2021.

21. Huberman AM, Miles MB. Data management and analysis methods. En: Denzin NK, Lincoln YS, editores. Handbook of qualitative research. Sage Publications; 1994. p. 428–44.

22. Miles MB, Huberman AM. Qualitative data analysis: A sourcebook of new methods. Thousand Oaks, CA: SAGE Publications; 1984.

23. Escañuela Sánchez T, Linehan L, O’Donoghue K, Byrne M, Meaney S. Facilitators and barriers to seeking and engaging with antenatal care in high-income countries: A meta-synthesis of qualitative re- search. Health Soc Care Community [Internet]. 2022; 30(6):e3810–28. http://dx.doi.org/10.1111/hsc.14072.

24. Ntshingila N, Downing C, Rathaba DD, Hastings-Tolsma M. COVID-19 and nurse faculty caring: A meta-synthesis. Heliyon. 2024; 10(7):e28472. http://dx.doi.org/10.1016/j.heliyon.2024.e28472.

25. McMahon NE. What shapes local health system actors’ thinking and action on social inequalities in health? A meta-ethnography. Soc Theory Health. 2023; 21(2):119–39. http://dx.doi.org/10.1057/s41285-022-00176-6.

26. Fonseca SMP, Loaiza DPB, García LFG. Breastfeeding in indigenous communities: a meta-ethnography of knowledge and practices. Breastfeed Rev [Internet]. 2024; 32:33–47. Disponible en: https://tinyurl.com/msw8frem.

27. Bansal N, Karlsen S, Sashidharan SP, Cohen R, Chew-Graham CA, Malpass A. Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLoS Med [Internet]. 2022; 19(12):e1004139. http://dx.doi.org/10.1371/journal.pmed.1004139.

28. Price J, Sharma S, Brunet J. Women’s experiences with yoga after a cancer diagnosis: a qualitative meta-synthesis-part I. Syst Rev. 2023; 12(1):176. http://dx.doi.org/10.1186/s13643-023-02350-x.

29. Persson M, Hildingsson I, Hultcrantz M, Kärrman Fredriksson M, Peira N, Silverstein RA, et al. Care and support when a baby is stillborn: A systematic review and an interpretive meta-synthesis of qualitative studies in high-income countries. PLoS One. 2023; 18(8):e0289617. http://dx.doi.org/10.1371/journal.pone.0289617.

30. McCallum KS, Youngblood J, Hayden KA, Brussoni M, Emery C, Bridel W. Children’s knowledge about play-related risk, risk-taking, and injury: A meta-study. Leisure (Waterloo). 2024; 48(4):699–724. http://dx.doi.org/10.1080/14927713.2023.2242859.

31. Crossen W, Wadsworth N, Ronkainen N, Haslett D, Tod D. Identity in elite level disability sport: a systematic review and meta-study of qualitative research. Int Rev Sport Exerc Psychol. 2023; 18(1):289-315. http://dx.doi.org/10.1080/1750984x.2023.2214993.

32. Singh H, Fakembe SP, Brown RK, Cameron JI, Nelson MLA, Kokorelias KM, et al. Stroke experiences and unmet needs of individuals of African descent living in high-income economy countries: A qualitative meta-synthesis. J Racial Ethn Health Disparities [Internet]. 2024; 11(5):2608–26. http://dx.doi.org/10.1007/s40615-023-01725-z.

33. Robstad N, Paulsen A, Vistad I, Hott AC, Hansen Berg K, Øgård-Repål A, et al. Experiences of pain communication in endometriosis: A meta-synthesis. Acta Obstet Gynecol Scand 2025; 104(1):39–54. doi: http://dx.doi.org/10.1111/aogs.14995.

34. Herber OR, Kastaun S, Wilm S, Barroso J. From qualitative meta-summary to qualitative meta-synthesis: Introducing a new situation-specific theory of barriers and facilitators for self-care in patients with heart failure. Qual Health Res [Internet]. 2019; 29(1):96–106. http://dx.doi.org/10.1177/1049732318800290.

35. Yoong SQ, Tan R, Jiang Y. Dyadic relationships between informal caregivers and older adults with chronic heart failure: a systematic review and meta-synthesis. Eur J Cardiovasc Nurs. 2024; 23(8):833–54. http://dx.doi.org/10.1093/eurjcn/zvae093.

36. Ogundipe E, Sælør KT, Biong S, Gonzalez MT. Core dimensions of social inclusion for residents with mental health and/or substance use challenges: A qualitative meta-synthesis. J Psychosoc Rehabil Ment Health. 2024. http://dx.doi.org/10.1007/s40737-024-00415-1.

37. Kuusisto-Gussmann E, Höckelmann C, von der Lühe V, Schmädig R, Baltes M, Stephan A. Patients’ experiences of delirium: A systematic review and meta-summary of qualitative research. J Adv Nurs. 2021; 77(9):3692–706. http://dx.doi.org/10.1111/jan.14865.

38. López Luna JF. La comunicación hospitalaria entre profesionales de la salud y familiares de pacientes hospitalizados: Una revisión integradora. Dilemas Contemp: Educ Política Valores. 2022; 9(2). http://dx.doi.org/10.46377/dilemas.v9i2.3146.

39. Kuchenmüller T, Boeira L, Oliver S, Moat K, El-Jardali F, Barreto J, et al. Domains and processes for institutionalizing evidence-informed health policy-making: a critical interpretive synthesis. Health Res Policy Syst [Internet]. 2022; 20(1):27. http://dx.doi.org/10.1186/s12961-022-00820-7.

40. Sinnott C, Ansari A, Price E, Fisher R, Beech J, Alderwick H, et al. Understanding access to general practice through the lens of candidacy: a critical review of the literature. Br J Gen Pract. 2024; 74(747):e683–94. http://dx.doi.org/10.3399/BJGP.2024.0033.

41. Sayer-Jones K, Sherman KA. Body image concerns in individuals diagnosed with benign gynaecological conditions: scoping review and meta-synthesis. Health Psychol Behav Med. 2021; 9(1):456–79. http://dx.doi.org/10.1080/21642850.2021.1920949.

42. Koehn S, Jones CA, Barber C, Jasper L, Pham A, Lindeman C, et al. Candidacy 2.0 (CC) - an enhanced theory of access to healthcare for chronic conditions: lessons from a critical interpretive synthesis on access to rheumatoid arthritis care. BMC Health Serv Res. 2024; 24(1):986. http://dx.doi.org/10.1186/s12913-024-11438-6.

43. Vivolo M, Owen J, Fisher P. Psychological therapists’ experiences of burnout: A qualitative systematic review and meta-synthesis. Ment Health Prev. 2024; 33(200253):200253. http://dx.doi.org/10.1016/j.mhp.2022.200253.

44. Chung M-L, Widdel M, Kirchhoff J, Sellin J, Jelali M, Geiser F, et al. Risk factors for pressure injuries in adult patients: A narrative synthesis. Int J Environ Res Public Health. 2022; 19(2):761. http://dx.doi.org/10.3390/ijerph19020761.

45. Richardson C, Robb KA, O’Connor RC. A systematic review of suicidal behaviour in men: A narrative synthesis of risk factors. Soc Sci Med. 2021; 276(113831):113831. http://dx.doi.org/10.1016/j.socscimed.2021.113831.

46. Clarke JM, Waring J, Bishop S, Hartley J, Exworthy M, Fulop NJ, et al. The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis. BMC Health Serv Res. 2021; 21(1):260. http://dx.doi.org/10.1186/s12913-021-06272-z.

47. Sutton L, Rowe S, Hammerton G, Billings J. The contribution of organisational factors to vicarious trauma in mental health professionals: a systematic review and narrative synthesis. Eur J Psychotraumatol. 2022; 13(1):2022278. http://dx.doi.org/10.1080/20008198.2021.2022278.

48. Lee S, Lee J. Interaction between healthcare providers and parents of children or adolescents with epilepsy: A qualitative systematic review and meta-synthesis. Epilepsy Behav. 2024; 158(109940):109940. http://dx.doi.org/10.1016/j.yebeh.2024.109940.

49. Ngondwe P, Tefera GM. Barriers and facilitators of access to healthcare among immigrants with disabilities: A qualitative meta-synthesis. Healthcare (Basel). 2025; 13(3):313. http://dx.doi.org/10.3390/healthcare13030313.

50. Weston K, Anbari AB, Bullock L. The work of breastfeeding among women of low socioeconomic status: A qualitative metasynthesis. Glob Qual Nurs Res. 2023; 10:23333936231161130. http://dx.doi.org/10.1177/23333936231161130.

51. Tefera GM, Yu M. Immigrant women’s access to healthcare services in the United States: A qualitative meta-synthesis. J Soc Serv Res. 2022; 48(2):285–99. http://dx.doi.org/10.1080/01488376.2022.2035300.

52. Morton J, Vignato J, Anbari AB. Stigma experienced by perinatal women with opioid dependency in the United States: A qualitative meta-synthesis. West J Nurs Res. 2023; 45(9):843–53. http://dx.doi.org/10.1177/01939459231182495.

53. Bondas T, Hall EOC. A decade of metasynthesis research in health sciences: A meta-method study. Int J Qual Stud Health Well-being. 2007; 2(2):101–13. http://dx.doi.org/10.1080/17482620701251684.

54. Sim J, Mengshoel AM. Metasynthesis: issues of empirical and Theoretical context. Qual Quant. 2023; 57:3339-61. http://dx.doi.org/10.1007/s11135-022-01502-w.

55. Durán Durán MA, Orgambídez Ramos A. La meta-etnografía Reflexiones teóricas y orientaciones prácticas. En: Escobar Fuentes S, Montalbán Peregrín MF, editores. La práctica de la metodología cualitativa. Dykinson; 2024. p. 74–101.

56. Edwards J, Kaimal G. Using meta-synthesis to support application of qualitative methods findings in practice: A discussion of meta-ethnography, narrative synthesis, and critical interpretive synthesis. Arts Psychother. 2016; 51:30–5. http://dx.doi.org/10.1016/j.aip.2016.07.003.

57. Frost J, Garside R, Cooper C, Britten N. Meta-study as diagnostic: Toward content over form in qualitative synthesis. Qual Health Res. 2016; 26(3):307–19. http://dx.doi.org/10.1177/1049732315619381.

58. Ludvigsen MS, Hall EOC, Meyer G, Fegran L, Aagaard H, Uhrenfeldt L. Using Sandelowski and Barroso’s meta-synthesis method in advancing qualitative evidence. Qual Health Res. 2016; 26(3):320–9. http://dx.doi.org/10.1177/1049732315576493.

59. Tong A, Flemming K, McInnes E, Oliver S, Craig J. Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med Res Methodol [Internet]. 2012; 12(1):181. http://dx.doi.org/10.1186/1471-2288-12-181.

60. France EF, Cunningham M, Ring N, Uny I, Duncan EA, Jepson RG, et al. Improving reporting of meta ethnography: The eMERGe reporting guidance. J Adv Nurs. 2019; 75(5):1126–39. http://dx.doi.org/10.1111/jan.13809.

61. Lewin S, Booth A, Glenton C, Munthe-Kaas H, Rashidian A, Wainwright M, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series. Implement Sci. 2018; 13(Suppl 1):2. http://dx.doi.org/10.1186/s13012-017-0688-3.

62. Atalla ADG, El-Ashry AM, Mohamed SMS. The relationship between evidence-based practices’ facilitators and barriers among nurses and their competencies: self-efficacy as a mediator. BMC Nurs. el 2025; 24(1):458. http://dx.doi.org/10.1186/s12912-025-02896-2.

63. Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA. 1992; 268(17):2420–5. http://dx.doi.org/10.1001/jama.1992.03490170092032.

64. Tonelli MR, Shapiro D. Experiential knowledge in clinical medicine: use and justification. Metamedicine. 2020; 41(2–3):67–82. http://dx.doi.org/10.1007/s11017-020-09521-0.

65. Feghali-Restrepo A, Estrada-Mesa DA. Problemas en la práctica clínica: los retos de la medicina basada en la evidencia. Rev Médicas UIS. 2020; 33(1):59–65. http://dx.doi.org/10.18273/revmed.v33n12020007.

66. Martín SR, Martín SR. Metasíntesis, nueva perspectiva de análisis de una crítica intelectual de la investigación sociosanitaria. Enferm Cardiol [Internet]. 2018; (75):19–23. Consultado en agosto 2025. Disponible en: https://tinyurl.com/2ta6yz88.

67. Noyes J, Booth A, Cargo M, Flemming K, Harden A, Harris J, et al. Chapter 21: Qualitative evidence. En: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al., editores. Cochrane Handbook for Systematic Reviews of Interventions version 65 [Internet]. Cochrane; 2024. Disponible en: https://tinyurl.com/4vydnjyd.

68. Martínez Salgado C, compiladora. Por los caminos de la investigación cualitativa: exploraciones narrativas y reflexiones en el ámbito de la salud. 2010. México, DF: Universidad Autónoma Metropolitana, Unidad Xochimilco, División de Ciencias Biológicas y de la Salud; 2010.

69. Korhonen A, Hakulinen-Viitanen T, Jylhä V, Holopainen A. Meta-synthesis and evidence-based health care-a method for systematic review. Scand J Caring Sci. 2013; 27(4):1027–34. http://dx.doi.org/10.1111/scs.12003.

70. Lachal J, Revah-Levy A, Orri M, Moro MR. Metasynthesis: An original method to synthesize qualitative literature in psychiatry. Front Psychiatry [Internet]. 2017; 8:269. http://dx.doi.org/10.3389/fpsyt.2017.00269.

71. Mohammed MA, Moles RJ, Chen TF. Meta-synthesis of qualitative research: the challenges and opportunities. Int J Clin Pharm. 2016; 38(3):695–704. http://dx.doi.org/10.1007/s11096-016-0289-2.

72. Kinn LG, Holgersen H, Ekeland T-J, Davidson L. Metasynthesis and bricolage: an artistic exercise of creating a collage of meaning. Qual Health Res 2013; 23(9):1285–92. http://dx.doi.org/10.1177/1049732313502127.