systematic literature review in education

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How-to conduct a systematic literature review: A quick guide for computer science research

Angela carrera-rivera.

a Faculty of Engineering, Mondragon University

William Ochoa

Felix larrinaga.

b Design Innovation Center(DBZ), Mondragon University

Associated Data

• No data was used for the research described in the article.

Performing a literature review is a critical first step in research to understanding the state-of-the-art and identifying gaps and challenges in the field. A systematic literature review is a method which sets out a series of steps to methodically organize the review. In this paper, we present a guide designed for researchers and in particular early-stage researchers in the computer-science field. The contribution of the article is the following:

• • Clearly defined strategies to follow for a systematic literature review in computer science research, and
• • Algorithmic method to tackle a systematic literature review.

Graphical abstract

Specifications table

Method details

A Systematic Literature Review (SLR) is a research methodology to collect, identify, and critically analyze the available research studies (e.g., articles, conference proceedings, books, dissertations) through a systematic procedure [12] . An SLR updates the reader with current literature about a subject [6] . The goal is to review critical points of current knowledge on a topic about research questions to suggest areas for further examination [5] . Defining an “Initial Idea” or interest in a subject to be studied is the first step before starting the SLR. An early search of the relevant literature can help determine whether the topic is too broad to adequately cover in the time frame and whether it is necessary to narrow the focus. Reading some articles can assist in setting the direction for a formal review., and formulating a potential research question (e.g., how is semantics involved in Industry 4.0?) can further facilitate this process. Once the focus has been established, an SLR can be undertaken to find more specific studies related to the variables in this question. Although there are multiple approaches for performing an SLR ( [5] , [26] , [27] ), this work aims to provide a step-by-step and practical guide while citing useful examples for computer-science research. The methodology presented in this paper comprises two main phases: “Planning” described in section 2, and “Conducting” described in section 3, following the depiction of the graphical abstract.

Defining the protocol is the first step of an SLR since it describes the procedures involved in the review and acts as a log of the activities to be performed. Obtaining opinions from peers while developing the protocol, is encouraged to ensure the review's consistency and validity, and helps identify when modifications are necessary [20] . One final goal of the protocol is to ensure the replicability of the review.

Define PICOC and synonyms

The PICOC (Population, Intervention, Comparison, Outcome, and Context) criteria break down the SLR's objectives into searchable keywords and help formulate research questions [ 27 ]. PICOC is widely used in the medical and social sciences fields to encourage researchers to consider the components of the research questions [14] . Kitchenham & Charters [6] compiled the list of PICOC elements and their corresponding terms in computer science, as presented in Table 1 , which includes keywords derived from the PICOC elements. From that point on, it is essential to think of synonyms or “alike” terms that later can be used for building queries in the selected digital libraries. For instance, the keyword “context awareness” can also be linked to “context-aware”.

Planning Step 1 “Defining PICOC keywords and synonyms”.

Formulate research questions

Clearly defined research question(s) are the key elements which set the focus for study identification and data extraction [21] . These questions are formulated based on the PICOC criteria as presented in the example in Table 2 (PICOC keywords are underlined).

Research questions examples.

Select digital library sources

The validity of a study will depend on the proper selection of a database since it must adequately cover the area under investigation [19] . The Web of Science (WoS) is an international and multidisciplinary tool for accessing literature in science, technology, biomedicine, and other disciplines. Scopus is a database that today indexes 40,562 peer-reviewed journals, compared to 24,831 for WoS. Thus, Scopus is currently the largest existing multidisciplinary database. However, it may also be necessary to include sources relevant to computer science, such as EI Compendex, IEEE Xplore, and ACM. Table 3 compares the area of expertise of a selection of databases.

Planning Step 3 “Select digital libraries”. Description of digital libraries in computer science and software engineering.

Define inclusion and exclusion criteria

Authors should define the inclusion and exclusion criteria before conducting the review to prevent bias, although these can be adjusted later, if necessary. The selection of primary studies will depend on these criteria. Articles are included or excluded in this first selection based on abstract and primary bibliographic data. When unsure, the article is skimmed to further decide the relevance for the review. Table 4 sets out some criteria types with descriptions and examples.

Planning Step 4 “Define inclusion and exclusion criteria”. Examples of criteria type.

Define the Quality Assessment (QA) checklist

Assessing the quality of an article requires an artifact which describes how to perform a detailed assessment. A typical quality assessment is a checklist that contains multiple factors to evaluate. A numerical scale is used to assess the criteria and quantify the QA [22] . Zhou et al. [25] presented a detailed description of assessment criteria in software engineering, classified into four main aspects of study quality: Reporting, Rigor, Credibility, and Relevance. Each of these criteria can be evaluated using, for instance, a Likert-type scale [17] , as shown in Table 5 . It is essential to select the same scale for all criteria established on the quality assessment.

Planning Step 5 “Define QA assessment checklist”. Examples of QA scales and questions.

Define the “Data Extraction” form

The data extraction form represents the information necessary to answer the research questions established for the review. Synthesizing the articles is a crucial step when conducting research. Ramesh et al. [15] presented a classification scheme for computer science research, based on topics, research methods, and levels of analysis that can be used to categorize the articles selected. Classification methods and fields to consider when conducting a review are presented in Table 6 .

Planning Step 6 “Define data extraction form”. Examples of fields.

The data extraction must be relevant to the research questions, and the relationship to each of the questions should be included in the form. Kitchenham & Charters [6] presented more pertinent data that can be captured, such as conclusions, recommendations, strengths, and weaknesses. Although the data extraction form can be updated if more information is needed, this should be treated with caution since it can be time-consuming. It can therefore be helpful to first have a general background in the research topic to determine better data extraction criteria.

After defining the protocol, conducting the review requires following each of the steps previously described. Using tools can help simplify the performance of this task. Standard tools such as Excel or Google sheets allow multiple researchers to work collaboratively. Another online tool specifically designed for performing SLRs is Parsif.al 1 . This tool allows researchers, especially in the context of software engineering, to define goals and objectives, import articles using BibTeX files, eliminate duplicates, define selection criteria, and generate reports.

Build digital library search strings

Search strings are built considering the PICOC elements and synonyms to execute the search in each database library. A search string should separate the synonyms with the boolean operator OR. In comparison, the PICOC elements are separated with parentheses and the boolean operator AND. An example is presented next:

(“Smart Manufacturing” OR “Digital Manufacturing” OR “Smart Factory”) AND (“Business Process Management” OR “BPEL” OR “BPM” OR “BPMN”) AND (“Semantic Web” OR “Ontology” OR “Semantic” OR “Semantic Web Service”) AND (“Framework” OR “Extension” OR “Plugin” OR “Tool”

Gather studies

Databases that feature advanced searches enable researchers to perform search queries based on titles, abstracts, and keywords, as well as for years or areas of research. Fig. 1 presents the example of an advanced search in Scopus, using titles, abstracts, and keywords (TITLE-ABS-KEY). Most of the databases allow the use of logical operators (i.e., AND, OR). In the example, the search is for “BIG DATA” and “USER EXPERIENCE” or “UX” as a synonym.

Example of Advanced search on Scopus.

In general, bibliometric data of articles can be exported from the databases as a comma-separated-value file (CSV) or BibTeX file, which is helpful for data extraction and quantitative and qualitative analysis. In addition, researchers should take advantage of reference-management software such as Zotero, Mendeley, Endnote, or Jabref, which import bibliographic information onto the software easily.

Study Selection and Refinement

The first step in this stage is to identify any duplicates that appear in the different searches in the selected databases. Some automatic procedures, tools like Excel formulas, or programming languages (i.e., Python) can be convenient here.

In the second step, articles are included or excluded according to the selection criteria, mainly by reading titles and abstracts. Finally, the quality is assessed using the predefined scale. Fig. 2 shows an example of an article QA evaluation in Parsif.al, using a simple scale. In this scenario, the scoring procedure is the following YES= 1, PARTIALLY= 0.5, and NO or UNKNOWN = 0 . A cut-off score should be defined to filter those articles that do not pass the QA. The QA will require a light review of the full text of the article.

Performing quality assessment (QA) in Parsif.al.

Data extraction

Those articles that pass the study selection are then thoroughly and critically read. Next, the researcher completes the information required using the “data extraction” form, as illustrated in Fig. 3 , in this scenario using Parsif.al tool.

Example of data extraction form using Parsif.al.

The information required (study characteristics and findings) from each included study must be acquired and documented through careful reading. Data extraction is valuable, especially if the data requires manipulation or assumptions and inferences. Thus, information can be synthesized from the extracted data for qualitative or quantitative analysis [16] . This documentation supports clarity, precise reporting, and the ability to scrutinize and replicate the examination.

Analysis and Report

The analysis phase examines the synthesized data and extracts meaningful information from the selected articles [10] . There are two main goals in this phase.

The first goal is to analyze the literature in terms of leading authors, journals, countries, and organizations. Furthermore, it helps identify correlations among topic s . Even when not mandatory, this activity can be constructive for researchers to position their work, find trends, and find collaboration opportunities. Next, data from the selected articles can be analyzed using bibliometric analysis (BA). BA summarizes large amounts of bibliometric data to present the state of intellectual structure and emerging trends in a topic or field of research [4] . Table 7 sets out some of the most common bibliometric analysis representations.

Techniques for bibliometric analysis and examples.

Several tools can perform this type of analysis, such as Excel and Google Sheets for statistical graphs or using programming languages such as Python that has available multiple  data visualization libraries (i.e. Matplotlib, Seaborn). Cluster maps based on bibliographic data(i.e keywords, authors) can be developed in VosViewer which makes it easy to identify clusters of related items [18] . In Fig. 4 , node size is representative of the number of papers related to the keyword, and lines represent the links among keyword terms.

[1] Keyword co-relationship analysis using clusterization in vos viewer.

This second and most important goal is to answer the formulated research questions, which should include a quantitative and qualitative analysis. The quantitative analysis can make use of data categorized, labelled, or coded in the extraction form (see Section 1.6). This data can be transformed into numerical values to perform statistical analysis. One of the most widely employed method is frequency analysis, which shows the recurrence of an event, and can also represent the percental distribution of the population (i.e., percentage by technology type, frequency of use of different frameworks, etc.). Q ualitative analysis includes the narration of the results, the discussion indicating the way forward in future research work, and inferring a conclusion.

Finally, the literature review report should state the protocol to ensure others researchers can replicate the process and understand how the analysis was performed. In the protocol, it is essential to present the inclusion and exclusion criteria, quality assessment, and rationality beyond these aspects.

The presentation and reporting of results will depend on the structure of the review given by the researchers conducting the SLR, there is no one answer. This structure should tie the studies together into key themes, characteristics, or subgroups [ 28 ].

SLR can be an extensive and demanding task, however the results are beneficial in providing a comprehensive overview of the available evidence on a given topic. For this reason, researchers should keep in mind that the entire process of the SLR is tailored to answer the research question(s). This article has detailed a practical guide with the essential steps to conducting an SLR in the context of computer science and software engineering while citing multiple helpful examples and tools. It is envisaged that this method will assist researchers, and particularly early-stage researchers, in following an algorithmic approach to fulfill this task. Finally, a quick checklist is presented in Appendix A as a companion of this article.

CRediT author statement

Angela Carrera-Rivera: Conceptualization, Methodology, Writing-Original. William Ochoa-Agurto : Methodology, Writing-Original. Felix Larrinaga : Reviewing and Supervision Ganix Lasa: Reviewing and Supervision.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgments

Funding : This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie Grant No. 814078.

Carrera-Rivera, A., Larrinaga, F., & Lasa, G. (2022). Context-awareness for the design of Smart-product service systems: Literature review. Computers in Industry, 142, 103730.

1 https://parsif.al/

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How can education systems improve? A systematic literature review

• Published: 07 April 2022
• Volume 24 , pages 479–499, ( 2023 )

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• Ignacio Barrenechea   ORCID: orcid.org/0000-0002-4673-3862 1 ,
• Jason Beech 2 &
• Axel Rivas 1  

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Understanding what contributes to improving a system will help us tackle the problems in education systems that usually fail disproportionately in providing quality education for all, especially for the most disadvantage sectors of the population. This paper presents the results of a qualitative systematic literature review aimed at providing a comprehensive overview of what education research can say about the factors that promote education systems’ improvement. This literature is emerging as a topic of empirical research that merges comparative education and school effectiveness studies as standardized assessments make it possible to compare results across systems and time. To examine and synthesize the papers included in this review we followed a thematic analysis approach. We identify, analyze, and report patterns in the papers included in this systematic review. From the coding process, four drivers for system improvement emerged: (1) system-wide approaches; (2) human capital; (3) governance and macro–micro level bridges; and (4) availability of resources.

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Barrenechea, I., Beech, J. & Rivas, A. How can education systems improve? A systematic literature review. J Educ Change 24 , 479–499 (2023). https://doi.org/10.1007/s10833-022-09453-7

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Chapter 1: Introduction

Learning objectives.

At the conclusion of this chapter, you will be able to:

• Identify the purpose of the literature review in  the research process
• Distinguish between different types of literature reviews

1.1 What is a Literature Review?

Pick up nearly any book on research methods and you will find a description of a literature review.  At a basic level, the term implies a survey of factual or nonfiction books, articles, and other documents published on a particular subject.  Definitions may be similar across the disciplines, with new types and definitions continuing to emerge.  Generally speaking, a literature review is a:

• “comprehensive background of the literature within the interested topic area…” ( O’Gorman & MacIntosh, 2015, p. 31 ).
• “critical component of the research process that provides an in-depth analysis of recently published research findings in specifically identified areas of interest.” ( House, 2018, p. 109 ).
• “written document that presents a logically argued case founded on a comprehensive understanding of the current state of knowledge about a topic of study” ( Machi & McEvoy,  2012, p. 4 ).

As a foundation for knowledge advancement in every discipline, it is an important element of any research project.  At the graduate or doctoral level, the literature review is an essential feature of thesis and dissertation, as well as grant proposal writing.  That is to say, “A substantive, thorough, sophisticated literature review is a precondition for doing substantive, thorough, sophisticated research…A researcher cannot perform significant research without first understanding the literature in the field.” ( Boote & Beile, 2005, p. 3 ).  It is by this means, that a researcher demonstrates familiarity with a body of knowledge and thereby establishes credibility with a reader.  An advanced-level literature review shows how prior research is linked to a new project, summarizing and synthesizing what is known while identifying gaps in the knowledge base, facilitating theory development, closing areas where enough research already exists, and uncovering areas where more research is needed. ( Webster & Watson, 2002, p. xiii )

A graduate-level literature review is a compilation of the most significant previously published research on your topic. Unlike an annotated bibliography or a research paper you may have written as an undergraduate, your literature review will outline, evaluate and synthesize relevant research and relate those sources to your own thesis or research question. It is much more than a summary of all the related literature.

It is a type of writing that demonstrate the importance of your research by defining the main ideas and the relationship between them. A good literature review lays the foundation for the importance of your stated problem and research question.

Literature reviews:

• define a concept
• map the research terrain or scope
• systemize relationships between concepts
• identify gaps in the literature ( Rocco & Plathotnik, 2009, p. 128 )

The purpose of a literature review is to demonstrate that your research question  is meaningful. Additionally, you may review the literature of different disciplines to find deeper meaning and understanding of your topic. It is especially important to consider other disciplines when you do not find much on your topic in one discipline. You will need to search the cognate literature before claiming there is “little previous research” on your topic.

Well developed literature reviews involve numerous steps and activities. The literature review is an iterative process because you will do at least two of them: a preliminary search to learn what has been published in your area and whether there is sufficient support in the literature for moving ahead with your subject. After this first exploration, you will conduct a deeper dive into the literature to learn everything you can about the topic and its related issues.

Literature Review Tutorial

1.2 Literature Review Basics

An effective literature review must:

• Methodologically analyze and synthesize quality literature on a topic
• Provide a firm foundation to a topic or research area
• Provide a firm foundation for the selection of a research methodology
• Demonstrate that the proposed research contributes something new to the overall body of knowledge of advances the research field’s knowledge base. ( Levy & Ellis, 2006 ).

All literature reviews, whether they are qualitative, quantitative or both, will at some point:

• Introduce the topic and define its key terms
• Establish the importance of the topic
• Provide an overview of the amount of available literature and its types (for example: theoretical, statistical, speculative)
• Identify gaps in the literature
• Point out consistent finding across studies
• Arrive at a synthesis that organizes what is known about a topic
• Discusses possible implications and directions for future research

1.3 Types of Literature Reviews

There are many different types of literature reviews, however there are some shared characteristics or features.  Remember a comprehensive literature review is, at its most fundamental level, an original work based on an extensive critical examination and synthesis of the relevant literature on a topic. As a study of the research on a particular topic, it is arranged by key themes or findings, which may lead up to or link to the  research question.  In some cases, the research question will drive the type of literature review that is undertaken.

The following section includes brief descriptions of the terms used to describe different literature review types with examples of each.   The included citations are open access, Creative Commons licensed or copyright-restricted.

1.3.1 Types of Review

1.3.1.1 conceptual.

Guided by an understanding of basic issues rather than a research methodology. You are looking for key factors, concepts or variables and the presumed relationship between them. The goal of the conceptual literature review is to categorize and describe concepts relevant to your study or topic and outline a relationship between them. You will include relevant theory and empirical research.

Examples of a Conceptual Review:

• Education : The formality of learning science in everyday life: A conceptual literature review. ( Dohn, 2010 ).
• Education : Are we asking the right questions? A conceptual review of the educational development literature in higher education. ( Amundsen & Wilson, 2012 ).

1.3.1.2 Empirical

An empirical literature review collects, creates, arranges, and analyzes numeric data reflecting the frequency of themes, topics, authors and/or methods found in existing literature. Empirical literature reviews present their summaries in quantifiable terms using descriptive and inferential statistics.

Examples of an Empirical Review:

• Nursing : False-positive findings in Cochrane meta-analyses with and without application of trial sequential analysis: An empirical review. ( Imberger, Thorlund, Gluud, & Wettersley, 2016 ).
• Education : Impediments of e-learning adoption in higher learning institutions of Tanzania: An empirical review ( Mwakyusa & Mwalyagile, 2016 ).

1.3.1.3 Exploratory

Unlike a synoptic literature review, the purpose here is to provide a broad approach to the topic area. The aim is breadth rather than depth and to get a general feel for the size of the topic area. A graduate student might do an exploratory review of the literature before beginning a synoptic, or more comprehensive one.

Examples of an Exploratory Review:

• Education : University research management: An exploratory literature review. ( Schuetzenmeister, 2010 ).
• Education : An exploratory review of design principles in constructivist gaming learning environments. ( Rosario & Widmeyer, 2009 ).

1.3.1.4 Focused

A type of literature review limited to a single aspect of previous research, such as methodology. A focused literature review generally will describe the implications of choosing a particular element of past research, such as methodology in terms of data collection, analysis and interpretation.

Examples of a Focused Review:

• Nursing : Clinical inertia in the management of type 2 diabetes mellitus: A focused literature review. ( Khunti, Davies, & Khunti, 2015 ).
• Education : Language awareness: Genre awareness-a focused review of the literature. ( Stainton, 1992 ).

1.3.1.5 Integrative

Critiques past research and draws overall conclusions from the body of literature at a specified point in time. Reviews, critiques, and synthesizes representative literature on a topic in an integrated way. Most integrative reviews are intended to address mature topics or  emerging topics. May require the author to adopt a guiding theory, a set of competing models, or a point of view about a topic.  For more description of integrative reviews, see Whittemore & Knafl (2005).

Examples of an Integrative Review:

• Nursing : Interprofessional teamwork and collaboration between community health workers and healthcare teams: An integrative review. ( Franklin,  Bernhardt, Lopez, Long-Middleton, & Davis, 2015 ).
• Education : Exploring the gap between teacher certification and permanent employment in Ontario: An integrative literature review. ( Brock & Ryan, 2016 ).

1.3.1.6 Meta-analysis

A subset of a  systematic review, that takes findings from several studies on the same subject and analyzes them using standardized statistical procedures to pool together data. Integrates findings from a large body of quantitative findings to enhance understanding, draw conclusions, and detect patterns and relationships. Gather data from many different, independent studies that look at the same research question and assess similar outcome measures. Data is combined and re-analyzed, providing a greater statistical power than any single study alone. It’s important to note that not every systematic review includes a meta-analysis but a meta-analysis can’t exist without a systematic review of the literature.

Examples of a Meta-Analysis:

• Education : Efficacy of the cooperative learning method on mathematics achievement and attitude: A meta-analysis research. ( Capar & Tarim, 2015 ).
• Nursing : A meta-analysis of the effects of non-traditional teaching methods on the critical thinking abilities of nursing students. ( Lee, Lee, Gong, Bae, & Choi, 2016 ).
• Education : Gender differences in student attitudes toward science: A meta-analysis of the literature from 1970 to 1991. ( Weinburgh, 1995 ).

1.3.1.7 Narrative/Traditional

An overview of research on a particular topic that critiques and summarizes a body of literature. Typically broad in focus. Relevant past research is selected and synthesized into a coherent discussion. Methodologies, findings and limits of the existing body of knowledge are discussed in narrative form. Sometimes also referred to as a traditional literature review. Requires a sufficiently focused research question. The process may be subject to bias that supports the researcher’s own work.

Examples of a Narrative/Traditional Review:

• Nursing : Family carers providing support to a person dying in the home setting: A narrative literature review. ( Morris, King, Turner, & Payne, 2015 ).
• Education : Adventure education and Outward Bound: Out-of-class experiences that make a lasting difference. ( Hattie, Marsh, Neill, & Richards, 1997 ).
• Education : Good quality discussion is necessary but not sufficient in asynchronous tuition: A brief narrative review of the literature. ( Fear & Erikson-Brown, 2014 ).
• Nursing : Outcomes of physician job satisfaction: A narrative review, implications, and directions for future research. ( Williams & Skinner, 2003 ).

1.3.1.8 Realist

Aspecific type of literature review that is theory-driven and interpretative and is intended to explain the outcomes of a complex intervention program(s).

Examples of a Realist Review:

• Nursing : Lean thinking in healthcare: A realist review of the literature. ( Mazzacato, Savage, Brommels, 2010 ).
• Education : Unravelling quality culture in higher education: A realist review. ( Bendermacher, Egbrink, Wolfhagen, & Dolmans, 2017 ).

1.3.1.9 Scoping

Tend to be non-systematic and focus on breadth of coverage conducted on a topic rather than depth. Utilize a wide range of materials; may not evaluate the quality of the studies as much as count the number. One means of understanding existing literature. Aims to identify nature and extent of research; preliminary assessment of size and scope of available research on topic. May include research in progress.

Examples of a Scoping Review:

• Nursing : Organizational interventions improving access to community-based primary health care for vulnerable populations: A scoping review. ( Khanassov, Pluye, Descoteaux, Haggerty,  Russell, Gunn, & Levesque, 2016 ).
• Education : Interdisciplinary doctoral research supervision: A scoping review. ( Vanstone, Hibbert, Kinsella, McKenzie, Pitman, & Lingard, 2013 ).
• Nursing : A scoping review of the literature on the abolition of user fees in health care services in Africa. ( Ridde, & Morestin, 2011 ).

1.3.1.10 Synoptic

Unlike an exploratory review, the purpose is to provide a concise but accurate overview of all material that appears to be relevant to a chosen topic. Both content and methodological material is included. The review should aim to be both descriptive and evaluative. Summarizes previous studies while also showing how the body of literature could be extended and improved in terms of content and method by identifying gaps.

Examples of a Synoptic Review:

• Education : Theoretical framework for educational assessment: A synoptic review. ( Ghaicha, 2016 ).
• Education : School effects research: A synoptic review of past efforts and some suggestions for the future. ( Cuttance, 1981 ).

1.3.1.11 Systematic Review

A rigorous review that follows a strict methodology designed with a presupposed selection of literature reviewed.  Undertaken to clarify the state of existing research, the evidence, and possible implications that can be drawn from that.  Using comprehensive and exhaustive searching of the published and unpublished literature, searching various databases, reports, and grey literature.  Transparent and reproducible in reporting details of time frame, search and methods to minimize bias.  Must include a team of at least 2-3 and includes the critical appraisal of the literature.  For more description of systematic reviews, including links to protocols, checklists, workflow processes, and structure see “ A Young Researcher’s Guide to a Systematic Review “.

Examples of a Systematic Review:

• Education : The potentials of using cloud computing in schools: A systematic literature review ( Hartmann, Braae, Pedersen, & Khalid, 2017 )
• Nursing : Is butter back? A systematic review and meta-analysis of butter consumption and risk of cardiovascular disease, diabetes, and total mortality. ( Pimpin, Wu, Haskelberg, Del Gobbo, & Mozaffarian, 2016 ).
• Education : The use of research to improve professional practice: a systematic review of the literature. ( Hemsley-Brown & Sharp, 2003 ).
• Nursing : Using computers to self-manage type 2 diabetes. ( Pal, Eastwood, Michie, Farmer, Barnard, Peacock, Wood, Inniss, & Murray, 2013 ).

1.3.1.12 Umbrella/Overview of Reviews

Compiles evidence from multiple systematic reviews into one document. Focuses on broad condition or problem for which there are competing interventions and highlights reviews that address those interventions and their effects. Often used in recommendations for practice.

Examples of an Umbrella/Overview Review:

• Education : Reflective practice in healthcare education: An umbrella review. ( Fragknos, 2016 ).
• Nursing : Systematic reviews of psychosocial interventions for autism: an umbrella review. ( Seida, Ospina, Karkhaneh, Hartling, Smith, & Clark, 2009 ).

For a brief discussion see “ Not all literature reviews are the same ” (Thomson, 2013).

1.4 Why do a Literature Review?

The purpose of the literature review is the same regardless of the topic or research method. It tests your own research question against what is already known about the subject.

1.4.1 First – It’s part of the whole. Omission of a literature review chapter or section in a graduate-level project represents a serious void or absence of critical element in the research process.

The outcome of your review is expected to demonstrate that you:

• can systematically explore the research in your topic area
• can read and critically analyze the literature in your discipline and then use it appropriately to advance your own work
• have sufficient knowledge in the topic to undertake further investigation

1.4.2 Second – It’s good for you!

• You improve your skills as a researcher
• You become familiar with the discourse of your discipline and learn how to be a scholar in your field
• You learn through writing your ideas and finding your voice in your subject area
• You define, redefine and clarify your research question for yourself in the process

1.4.3 Third – It’s good for your reader. Your reader expects you to have done the hard work of gathering, evaluating and synthesizes the literature.  When you do a literature review you:

• Set the context for the topic and present its significance
• Identify what’s important to know about your topic – including individual material, prior research, publications, organizations and authors.
• Demonstrate relationships among prior research
• Establish limitations of existing knowledge
• Analyze trends in the topic’s treatment and gaps in the literature

1.4.4 Why do a literature review?

• To locate gaps in the literature of your discipline
• To avoid reinventing the wheel
• To carry on where others have already been
• To identify other people working in the same field
• To increase your breadth of knowledge in your subject area
• To find the seminal works in your field
• To provide intellectual context for your own work
• To acknowledge opposing viewpoints
• To put your work in perspective
• To demonstrate you can discover and retrieve previous work in the area

1.5 Common Literature Review Errors

Graduate-level literature reviews are more than a summary of the publications you find on a topic.  As you have seen in this brief introduction, literature reviews are a very specific type of research, analysis, and writing.  We will explore these topics more in the next chapters.  Some things to keep in mind as you begin your own research and writing are ways to avoid the most common errors seen in the first attempt at a literature review.  For a quick review of some of the pitfalls and challenges a new researcher faces when he/she begins work, see “ Get Ready: Academic Writing, General Pitfalls and (oh yes) Getting Started! ”.

As you begin your own graduate-level literature review, try to avoid these common mistakes:

• Accepts another researcher’s finding as valid without evaluating methodology and data
• Contrary findings and alternative interpretations are not considered or mentioned
• Findings are not clearly related to one’s own study, or findings are too general
• Insufficient time allowed to define best search strategies and writing
• Isolated statistical results are simply reported rather than synthesizing the results
• Problems with selecting and using most relevant keywords, subject headings and descriptors
• Relies too heavily on secondary sources
• Search methods are not recorded or reported for transparency
• Summarizes rather than synthesizes articles

In conclusion, the purpose of a literature review is three-fold:

• to survey the current state of knowledge or evidence in the area of inquiry,
• to identify key authors, articles, theories, and findings in that area, and
• to identify gaps in knowledge in that research area.

A literature review is commonly done today using computerized keyword searches in online databases, often working with a trained librarian or information expert. Keywords can be combined using the Boolean operators, “and”, “or” and sometimes “not”  to narrow down or expand the search results. Once a list of articles is generated from the keyword and subject heading search, the researcher must then manually browse through each title and abstract, to determine the suitability of that article before a full-text article is obtained for the research question.

Literature reviews should be reasonably complete, and not restricted to a few journals, a few years, or a specific methodology or research design. Reviewed articles may be summarized in the form of tables, and can be further structured using organizing frameworks such as a concept matrix.

A well-conducted literature review should indicate whether the initial research questions have already been addressed in the literature, whether there are newer or more interesting research questions available, and whether the original research questions should be modified or changed in light of findings of the literature review.

The review can also provide some intuitions or potential answers to the questions of interest and/or help identify theories that have previously been used to address similar questions and may provide evidence to inform policy or decision-making. ( Bhattacherjee, 2012 ).

Read Abstract 1.  Refer to Types of Literature Reviews.  What type of literature review do you think this study is and why?  See the Answer Key for the correct response.

Nursing : To describe evidence of international literature on the safe care of the hospitalised child after the World Alliance for Patient Safety and list contributions of the general theoretical framework of patient safety for paediatric nursing.

An integrative literature review between 2004 and 2015 using the databases PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and Wiley Online Library, and the descriptors Safety or Patient safety, Hospitalised child, Paediatric nursing, and Nursing care.

Thirty-two articles were analysed, most of which were from North American, with a descriptive approach. The quality of the recorded information in the medical records, the use of checklists, and the training of health workers contribute to safe care in paediatric nursing and improve the medication process and partnerships with parents.

General information available on patient safety should be incorporated in paediatric nursing care. ( Wegner, Silva, Peres, Bandeira, Frantz, Botene, & Predebon, 2017 ).

Read Abstract 2.  Refer to Types of Literature Reviews.  What type of lit review do you think this study is and why?  See the Answer Key for the correct response.

Education : The focus of this paper centers around timing associated with early childhood education programs and interventions using meta-analytic methods. At any given assessment age, a child’s current age equals starting age, plus duration of program, plus years since program ended. Variability in assessment ages across the studies should enable everyone to identify the separate effects of all three time-related components. The project is a meta-analysis of evaluation studies of early childhood education programs conducted in the United States and its territories between 1960 and 2007. The population of interest is children enrolled in early childhood education programs between the ages of 0 and 5 and their control-group counterparts. Since the data come from a meta-analysis, the population for this study is drawn from many different studies with diverse samples. Given the preliminary nature of their analysis, the authors cannot offer conclusions at this point. ( Duncan, Leak, Li, Magnuson, Schindler, & Yoshikawa, 2011 ).

Test Yourself

See Answer Key for the correct responses.

The purpose of a graduate-level literature review is to summarize in as many words as possible everything that is known about my topic.

A literature review is significant because in the process of doing one, the researcher learns to read and critically assess the literature of a discipline and then uses it appropriately to advance his/her own research.

Read the following abstract and choose the correct type of literature review it represents.

Nursing: E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users’ health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance) and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. (J ankowski, Brożek, Lawson, Skoczyński, & Zejda, 2017 ).

• Meta-analysis
• Exploratory

Education: In this review, Mary Vorsino writes that she is interested in keeping the potential influences of women pragmatists of Dewey’s day in mind while presenting modern feminist re readings of Dewey. She wishes to construct a narrowly-focused and succinct literature review of thinkers who have donned a feminist lens to analyze Dewey’s approaches to education, learning, and democracy and to employ Dewey’s works in theorizing on gender and education and on gender in society. This article first explores Dewey as both an ally and a problematic figure in feminist literature and then investigates the broader sphere of feminist pragmatism and two central themes within it: (1) valuing diversity, and diverse experiences; and (2) problematizing fixed truths. ( Vorsino, 2015 ).

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How to Conduct a Literature Review in Educational Research

Introduction.

In the context of educational research, a literature review is a comprehensive summary and analysis of existing literature on a specific topic or research question.

Conducting a literature review before starting a research study is crucial as it helps researchers understand the current state of knowledge in their field.

The importance of a literature review lies in its ability to provide a theoretical framework, identify gaps in the existing literature, and guide the direction of the research.

The objectives of this blog post are to explain the steps involved in conducting a literature review in educational research, highlight common challenges, and provide tips for a successful review process.

Understanding the purpose of a literature review

Main goals of a literature review in educational research.

A literature review serves as a foundation for educational research.

Its main goals are to synthesize existing knowledge, evaluate relevant studies, and contextualize new research.

This process helps researchers understand what has already been discovered and where further investigation is needed.

Firstly, a literature review aims to provide a comprehensive overview of current research on a topic.

It summarizes key findings, methodologies, and theoretical approaches.

By doing so, it offers insights into what the field already knows, ensuring that new research builds on established knowledge.

How a literature review helps in identifying gaps in the existing body of knowledge

Secondly, a literature review is crucial for identifying gaps in the existing body of knowledge.

Researchers can pinpoint areas where information is incomplete or outdated.

By highlighting these gaps, the review guides future research efforts to address unanswered questions or explore under-researched areas.

This step is essential for advancing the field and ensuring that new studies contribute meaningful insights.

Role of a literature review in shaping research questions

Lastly, a literature review plays a significant role in shaping research questions.

By reviewing existing studies, researchers can refine their questions to align with the current state of knowledge.

This alignment ensures that new research addresses relevant issues and contributes to ongoing scholarly conversations.

It helps in formulating precise, researchable questions that can lead to impactful findings.

In summary, understanding the purpose of a literature review involves recognizing its role in summarizing existing research, identifying gaps, and shaping research questions.

This process is fundamental for conducting rigorous and relevant educational research.

Read: Educational Research and Social Justice: Key Insights

Choosing the right sources

Importance of selecting relevant sources.

• It is crucial to choose sources that directly relate to the research topic.
• Relevant sources provide the basis for a strong and solid literature review.
• Selecting appropriate sources ensures the credibility and validity of the study.

Examples of commonly used sources in educational research

• Peer-reviewed journals: These publications undergo rigorous review by experts.
• Books: Authoritative texts provide in-depth information on a specific subject.
• Conference papers: Present recent research findings and discussions in the field.

Determining the credibility and reliability of sources

• Check the author’s credentials and expertise in the subject matter.
• Examine the publication date to ensure the information is current.
• Verify the source’s reputation within the academic community for reliability.

In fact, choosing the right sources for a literature review in educational research is fundamental to the success of the study.

By selecting relevant sources such as peer-reviewed journals , books, and conference papers, researchers can ensure the credibility and reliability of their work.

It is essential to critically evaluate sources to determine their trustworthiness and relevance to the research topic.

Organizing the literature review

When conducting a literature review in educational research, it is crucial to organize the information in a structured and coherent manner.

This section will discuss different methods of organizing a literature review, provide tips on how to structure it effectively, and explain the importance of maintaining a clear and coherent flow of ideas in the review.

Methods of organizing a literature review:

• Thematic approach: One method of organizing a literature review is by themes or topics. This approach involves grouping studies based on common themes or ideas that emerge from the literature.
• Chronological order: Another method is organizing the review chronologically, where studies are arranged based on the publication date. This approach can help show the evolution of research on a specific topic over time.
• Theoretical framework: Organizing the literature review based on theoretical frameworks is another effective method. This approach involves grouping studies according to the theoretical perspectives they align with.

Tips on structuring the literature review effectively

• Start with an introduction: Begin the literature review with an introduction that provides context for the research topic and outlines the purpose of the review.
• Organize the review logically: Ensure that the review is organized logically, moving from general information to more specific details, and using transitions to guide the reader through the review.
• Include critical analysis: Integrate critical analysis of the literature throughout the review, discussing the strengths, weaknesses, and gaps in the existing research.
• Conclude with a summary: End the literature review with a summary that highlights the key findings, implications for future research, and potential areas for further study.

Importance of maintaining a clear and coherent flow of ideas

It is essential to maintain a clear and coherent flow of ideas in the literature review to ensure that the reader can follow the argument and understand the connections between different studies.

The following points highlight the importance of maintaining this flow:

• Enhances readability: A well-structured literature review makes it easier for the reader to navigate the information and understand the key points being discussed.
• Facilitates understanding: By maintaining a logical flow of ideas, the reader can better grasp the main arguments and concepts presented in the review.
• Highlights connections: A coherent flow of ideas allows the reader to see the connections between different studies, theories, and arguments, providing a comprehensive understanding of the research topic.
• Strengthens the argument: When ideas are presented in a clear and coherent manner, it strengthens the overall argument of the literature review and enhances its impact.

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Conducting a comprehensive search

A thorough literature review starts with a comprehensive search for relevant sources.

Begin by defining your research question clearly.

This will guide your search and help identify key topics.

Strategies for conducting a thorough search for relevant literature

Use a systematic approach to find relevant literature.

Start with broad searches to get an overview of the topic.

Gradually narrow your focus to more specific aspects.

Use academic databases, library catalogs, and reference lists.

Evaluate each source for relevance and quality.

Keep track of your search results and organize them systematically.

How to use keywords and search terms effectively

Develop a list of keywords and search terms related to your research topic.

Use synonyms and related terms to expand your search.

Apply Boolean operators like AND, OR, and NOT to refine results.

For example, use “AND” to combine different concepts and “OR” to include synonyms.

Experiment with different combinations to find the most relevant literature.

Tips on utilizing online databases and library resources

Leverage online databases such as PubMed, Google Scholar, and ERIC for academic articles.

These databases offer advanced search features and filters.

Use library resources to access books, journals, and dissertations.

Many libraries provide access to subscription-based databases and interlibrary loans.

Consult a librarian for additional assistance and guidance.

By following these strategies, you will enhance the quality and depth of your literature review.

Conducting a comprehensive search ensures you cover all relevant research, providing a solid foundation for your study.

Read: Ethnographic Research in Education: An Overview

Analyzing and synthesizing the literature

Analyzing and synthesizing the findings from the literature is a crucial step in conducting a literature review in educational research.

The process of analyzing and synthesizing the findings from the literature

One of the first steps in this process is to carefully read and summarize the key points, arguments, and methodologies used in each study.

• Identify key themes: Look for recurring themes or ideas in the literature that provide insights into the research topic.
• Identify trends: Consider any patterns or trends that emerge across different studies or sources.
• Identify patterns: Pay attention to any similarities or differences in the findings or methodologies used by researchers.

By identifying these key elements, you can begin to synthesize the literature by drawing connections between different studies and sources.

Importance of critically evaluating the literature and drawing connections between different sources

Critically evaluate the literature by considering the strengths and limitations of each study, as well as the credibility and relevance of the sources.

• Look for gaps: Identify any gaps in the research where further investigation is needed to fill in missing information.
• Draw connections: Analyze how different studies relate to one another and how they contribute to the overall understanding of the research topic.
• Synthesize findings: Summarize the key findings and insights from the literature to highlight the most important information for your research.

By critically evaluating and synthesizing the literature, you can provide a comprehensive overview of the existing research in the field and identify areas for future study and research.

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Avoiding plagiarism

When conducting a literature review in educational research, it is crucial to avoid plagiarism by properly citing sources.

Plagiarism is a serious offense that can lead to academic consequences.

Here are some important points to consider:

Importance of properly citing sources in a literature review

• Properly citing sources shows respect for the original authors.
• It gives credit to the researchers whose work you are building on.
• It allows readers to verify the information you present in your review.
• It helps to avoid accusations of academic dishonesty.

Common pitfalls to avoid, such as copying verbatim text without proper attribution

• Copying and pasting text from a source without quotation marks and proper citation is plagiarism.
• Paraphrasing without giving credit to the original author is also considered plagiarism.
• Rephrasing sentences while keeping the same structure and meaning is not enough to avoid plagiarism.
• Using someone else’s ideas or arguments without acknowledging them is unethical.

Tips on how to summarize, paraphrase, and reference sources appropriately

• When summarizing a source, focus on the main ideas and key points without copying the original text.
• Paraphrase by putting the information into your own words while maintaining the original meaning.
• Always provide a citation when paraphrasing or summarizing someone else’s work.
• Use quotation marks for direct quotes and include the author’s name, publication year, and page number in the citation.

By following these guidelines and being diligent in citing your sources, you can ensure that your literature review is free of plagiarism and maintains academic integrity.

Writing the literature review

Step-by-step guide on how to write a literature review in educational research.

When it comes to writing a literature review in educational research, it is essential to follow a systematic approach to ensure that your review is well-organized, comprehensive, and insightful.

Here is a step-by-step guide on how to write a literature review in educational research:

• Define your research question: Begin by clearly defining the research question or topic that your literature review will address. This will help you stay focused and ensure that your review is relevant.
• Conduct a comprehensive literature search: Use academic databases, journals, books, and other reputable sources to gather relevant literature on your topic. Make sure to keep track of the sources you find for future referencing.
• Analyze and evaluate the literature: As you review the literature, critically analyze and evaluate each source. Look for common themes, trends, and gaps in the existing research that you can address in your review.
• Organize your sources: Create an outline or a matrix to organize the sources you have collected. Group them based on key themes or topics to make it easier to write the review.
• Write the review: Start by introducing the topic and its relevance to educational research. Then, present the key findings of each source, analyze the data, and discuss the implications for your research question.
• Conclude the review: Summarize the main points of your review, discuss the implications of the findings, and suggest future research directions. Make sure to leave your readers with a clear understanding of the significance of your work.
• Revise and edit: Take the time to revise and edit your literature review to ensure that it is well-structured, coherent, and free of errors. This step is crucial in producing a high-quality review.

Essential components of a literature review

A well-written literature review in educational research typically consists of three main components:

• Introduction: This section introduces the research topic, provides context for the review, and outlines the scope and objectives of the review.
• Body: The body of the review includes a critical analysis of the sources, discussion of key findings, comparison of different studies, and identification of gaps in the literature.
• Conclusion: The conclusion summarizes the main points of the review, highlights the implications of the findings, and suggests future research directions in the field.

Tips on structuring the review and formatting citations

When structuring your literature review, consider the following tips to ensure that it is well-organized and follows the required style guide:

• Use clear headings and subheadings: Organize your review into clear sections with headings and subheadings to guide the reader through the content.
• Follow the required citation style: Whether it is APA, MLA, Chicago, or another style guide, make sure to format your citations and references according to the specified guidelines.
• Include in-text citations: Cite your sources within the text using the appropriate format to acknowledge the authors and avoid plagiarism.
• Create a reference list: Include a list of all the sources cited in your review at the end of the document, following the formatting rules of the citation style guide.

By following these guidelines and tips, you can write a well-structured and comprehensive literature review in educational research that contributes valuable insights to the field.

Conducting a literature review in educational research is crucial for several reasons.

It helps researchers identify gaps in existing knowledge and provides a solid foundation for their own research studies.

By synthesizing relevant literature, researchers can build a strong theoretical framework and gain a deeper understanding of the research topic.

Additionally, a literature review allows researchers to critically evaluate previous studies, which can help them avoid potential pitfalls and design more rigorous research studies.

The importance of conducting a literature review cannot be overstated, as it lays the groundwork for successful research projects and ensures that researchers are informed by the latest developments in their field.

By following the tips and strategies outlined in this blog post, readers can enhance the quality of their research and make meaningful contributions to the field of educational research.

It is essential for researchers to take the time to conduct a thorough literature review and integrate findings from existing studies into their own work.

By doing so, researchers can build on the knowledge base in their field and contribute to the advancement of educational research.

We encourage readers to put these tips and strategies into practice for their own research studies.

A well-conducted literature review is a cornerstone of high-quality research and is essential for producing valuable insights and contributing to the scholarly conversation in educational research.

By following the steps outlined in this blog post, researchers can conduct comprehensive literature reviews that support the validity and significance of their research findings.

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  The Journal of Informatics Journal / The Journal of Informatics / Vol. 4 No. 1 (2024) / Articles (function() { function async_load(){ var s = document.createElement('script'); s.type = 'text/javascript'; s.async = true; var theUrl = 'https://www.journalquality.info/journalquality/ratings/2408-www-ajol-info-tji'; s.src = theUrl + ( theUrl.indexOf("?") >= 0 ? "&" : "?") + 'ref=' + encodeURIComponent(window.location.href); var embedder = document.getElementById('jpps-embedder-ajol-tji'); embedder.parentNode.insertBefore(s, embedder); } if (window.attachEvent) window.attachEvent('onload', async_load); else window.addEventListener('load', async_load, false); })();  

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This work is licensed under a Creative Commons Attribution 4.0 International License .

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Difficulties in learning the data structures course: literature review, adam basigie mtaho, leonard james mselle.

Data structures is a highly demanding course for computer science students, often associated with high cognitive load and consequently,  high failure and dropout rates. This study aimed to identify the primary causes of difficulties in learning data structures  course, as reported in the computer science education literature. The study employed a mixed approach. Quantitative analysis methods utilized descriptive statistics, while qualitative analysis involved a systematic literature review method. A total of 99 research publications  were searched from digital libraries and used in this study, with 42 papers designated for systematic reviews and analysis after meeting  selection criteria. The findings reveal that students in computer science education face several difficulties in learning data structures,  stemming from the inherent complexity of the subject, teaching methodologies employed, and individual learner characteristics such as  poor student background knowledge and low student motivation. Based on these findings, the study recommends the adoption of new  teaching strategies to address the encountered difficulties and enhance the learning experience for students learning data structures.  

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Journal Identifiers

• Open access
• Published: 19 August 2024

Self-injury and suicide among people living with HIV/AIDS in China: a systematic review and meta-analysis

• Xiao-Ping Huang 1 ,
• Zhi-Qiang Li 2 ,
• Wei-Zhang 3 ,
• Xue-Min Feng 1 ,
• Xi-Cheng Wang 3 &
• Zhong-Liang Jiang 3  

BMC Public Health volume  24 , Article number:  2248 ( 2024 ) Cite this article

Metrics details

The prevalence of self-injury and suicide is higher than the general population of people living with HIV/AIDS (PLWHA). However, the results reported in existing studies are highly variable in China. The purpose of this systematic review and meta-analysis was to synthesize the currently available high-quality evidence to explore the prevalence and influence factors of self-injury and suicide among PLWHA in China.

We retrieve literature written in Chinese and English through databases such as PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, WanFang Database, and CQVIP from inception to 1 September 2022. Sata 16.0 software was used for analysis.

A total of 28 studies were included with a sample size of 1,433,971 and had a satisfactory quality score of ≥ 5. The prevalence among PLWHA in China were 30% for suicidal ideation (SI), 5% for suicide attempt (SA), 8% for suicide plan (SP), 7% for attempted suicide (AS), and 3‰ for completed suicide. High stigma (OR = 2.94, 95%CI: 1.90 − 4.57), depression (OR, 3.17; 95%CI, 2.20 − 4.57), anxiety (OR, 3.06; 95%CI, 2.23 − 4.20), low self-esteem (OR, 3.82, 95%CI, 2.22 − 6.57), high HIV related stress (OR, 2.53; 95%CI, 1.36 − 4.72), and unemployment (OR, 2.50; 95%CI, 1.51 − 4.15) are risk factors for SI; high social support (OR, 0.61; 95%CI, 0.44 − 0.84) and spouse infected with HIV (OR, 0.39; 95%CI, 0.21 − 0.74) are protective factors for SI; depression (OR, 1.62; 95%CI, 1.24 − 2.13), high aggression (OR, 4.66; 95%CI, 2.59 − 8.39), and more negative life events (OR, 2.51; 95%CI, 1.47 − 4.29) are risk factors for AS; high level of education (OR, 1.31; 95%CI, 1.21 − 1.43) is risk factor for CS.

Figures indicate that approximately one-third of PLWHA had suicidal ideation, and three out of 1,000 completed suicide in China. Positive events are protective factors for self-injury and suicide among PLWHA, while negative events are risk factors. This suggests that psychosocial support and risk assessment should be integrated into the care of PLWHA.

Peer Review reports

Self-injurious thoughts and behaviors (SITBs) remain a significant public health issue globally, a concern that has persisted since Emile Durkheim published ‘Le Suicide’ in 1897. These behaviors encompass suicide ideation, suicide attempt, suicide plan, completed suicide, and nonsuicidal self-injury (NSSI). Currently, nearly 800,000 people die from suicide each year worldwide [ 1 ], with China accounting for approximately 15% of these deaths [ 2 ].

The WHO estimates that approximately 38.4 million people were living with HIV/AIDS globally at the end of 2021 [ 3 ]. With the advent of antiviral therapy, the cumulative survival rate of people living with HIV/AIDS (PLWHA) has significantly increased. Thanks to the joint efforts of the United Nations Programme on HIV and AIDS and the WHO, HIV infection has been effectively controlled. However, the psychosocial burden has not been effectively relieved. An analysis of data from more than 185,000 adults living with HIV worldwide by Pennsylvania State University College of Medicine found that PLWHA not only are more likely to experience suicidal ideation than the general population, but they are also 100 times more likely to die by suicide [ 4 ].

Among the available studies on SITBs in PLWHA, suicidal ideation has garnered the most attention. A meta-analysis encompassing 32,818 individuals from 15 countries reported a prevalence of suicidal ideation among PLWHA at 20.9% [ 5 ]. In China, the prevalence of suicidal ideation varies widely, ranging from 5.9 to 54.23% [ 6 , 7 ]. For instance, in 2019, separate studies conducted in Guangzhou and Jiangxi reported different prevalences (17.4% vs. 40%), attributed to geographical differences [ 8 , 9 ].

Suicide does not happen suddenly; but rather is a synergistic process involving biological, behavioral, and social factors. However, the exact etiology of suicide remains unclear, as it varies across different ages, personalities, and circumstances. Numerous factors, such as HIV-related stigma, depression, low self-esteem, and previous psychiatric history, have been identified as contributing to the heightened risk of self-injury or suicide among PLWHA compared to the general population [ 10 , 11 , 12 ]. Whereas, some contrary results have been observed. For instance, it is generally believed that the probability of self-injury or suicide is higher in adolescents than in other age groups [ 11 , 13 ], but others have shown that the risk of suicide increases with age [ 14 , 15 ].

While several studies have reported the prevalence and influencing factors of self-injury or suicide among PLWHA in China, they are influenced to a certain extent by the limitations of various research methods, resulting in significant inconsistencies and variations. Hence, the current systematic review and meta-analysis aims to explore the pooled prevalence and influencing factors of self-injury or suicide among PLWHA in China. This endeavor will complement the existing evidence base, and assist policy makers and public health service providers in developing rational and effective prevention and interventions.

The study protocol has been registered in PROSPERO (CRD42022356641) and conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines.

Search strategy

We conducted a comprehensive search of Chinese and English literature published from the inception of each database up to September 1, 2022. English databases included Medline (via PubMed), Embase, Web of Science and Cochrane Library; Chinese databases included the Chinese biomedical literature service system (SinoMed), China National Knowledge Infrastructure (CNKI), WanFang Database, and China Science and Technology Journal Database (CQVIP), which hosts the most comprehensive collection of Chinese academic journals and provides access to a vast number of full-text articles. Medical Subject Headings and Entry Terms were used in combination, employing Boolean logical operators to combine search terms. Key terms included HIV, acquired immunodeficiency syndrome, self-injurious behavior, suicide, and geographical location within mainland China, Hong Kong, Macau and Taiwan. A detailed search strategy is outlined in Additional Table  1 . Each retrieval step was performed by two researchers (XP.H. and ZQ.L.) independently. In case of disagreement between the two researchers, a third party (Senior researcher, XC.W.), who oversaw the search strategy, will participate in discussion and resolve the inconsistencies.

Selection criteria and data extraction

Literature screening and data extraction were carried out independently by two researchers (XP.H. and ZQ.L.) according to predefined inclusion and exclusion criteria. Articles included in the final analysis met the following criteria: (1) study subjects were Chinese PLWHA; (2) the study focused on the prevalence or influencing factors of self-injury or suicide, and reported odds ratios (OR) and 95% confidence intervals (95%CI) for these factors; and (3) the study design was cross-sectional, case-control, or cohort. Exclusion criteria were as follows: (1) sample size < 30; (2) abstracts, reviews, conference literature, or case report; (3) full text unavailable, incomplete information, or the data cannot be extracted; and (4) duplicate publications.

A standardized information extraction table was created. Two researchers (XP.H. and ZQ.L.) independently extracted all data, which were cross-checked for consistency. Disagreements were resolved through discussion or with the involvement of a third researcher (Senior researcher, XC.W.). Data collection included: author, year of publication, study type, region, sample size, male proportion, mean or median age, prevalence, and influencing factors (Additional Table  2 ).

Quality assessment

The article’s quality was independently assessed by two researchers (W.Z. and XM.F.). Case-control and cohort studies were evaluted using the Newcastle-Ottawa Scale (NOS) [ 16 , 17 ], while cross-sectional studies were assessed using the observational study evaluation criteria [ 18 ] recommended by the Agency for Healthcare Research and Quality (AHRQ) to gauge bias risk (Additional Table  2 ). A total score of five or higher indicates satisfactory quality.

Statistical analysis

Stata 16.0 software was used for analysis. Meta-analysis data included prevalence, OR and, 95%CI. Prevalence of self-injury and suicide was calculated by dividing the number of screen-positive participants by the total sample size and multiplying by 100. OR = 1 indicated no association, OR > 1 indicated a risk factor. Study heterogeneity was assessed using I-squared (I 2 ) values and Q test; I 2  > 50% indicated substantial heterogeneity [ 19 ], using a random effects model [ 20 ]. Sensitivity analyses were conducted using a study-by-study exclusion approach; univariate meta-regression and subgroup analysis based on study subject characteristics to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots for rough qualitative analysis and Egger test for quantitatively assessment, with p  < 0.05 indicating statistically significant publication bias.

Search results

The literature selection process is depicted in the PRISMA flow chart (Fig.  1 ). A total of 949 articles were retrieved from the database, comprising 407 English and 542 Chinese. After removing 215 duplicates and reviewing titles, abstracts and full texts according to the inclusion and exclusion criteria, 28 studies were finally included [ 6 , 7 , 8 , 9 , 14 , 15 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. These comprised 16 English-language and 12 Chinese-language literatures, totaling 1,433,971 cases.

PRISMA flow chart of the study

Characteristics of studies

Among the final 28 included studies, there were 4 cohort studies, 3 case-control studies, and 21 cross-sectional studies. Half of these studies were published between 2011 and 2020, with 57.14% published in English. The majority (92.86%) were conducted in mainland China, and the primary assessment tool used was CIDI (57.14%) (Table  1 ). Every study received a quality score of at least 5, indicating satisfactory quality (Additional Table  3 ). Suicidal ideation was the primary focus in 29% of these studies, with 23 studies relating to it. Only 4 studies examined completed suicide specifically (Fig.  2 ).

Distribution of research topics. Note SI, suicidal ideation; SA, suicide attempt; SP, suicide plan; AS, attempted suicide; CS, completed suicide

Pooled prevalence of suicide in PLWHA

The pooled prevalence of suicidal ideation in PLWHA was 30% (Fig.  3 ), suicide attempt, suicide plan, attempted suicide, and completed suicide were 5%, 8%, 7%, and 3‰, respectively (Additional Fig.  1 ). The data of completed suicide were merged as a percentage and presented as a thousandth rate.

We performed meta-regression with sample size, year of publication, region, mean or median age, and male proportion as variables to explore the possible sources of heterogeneity. The results showed that the pooled prevalence of suicidal ideation in PLWHA was statistically different in sample size > 400 ( z = -2.39, p  = 0.017). Subgroup analysis revealed a higher prevalence of suicidal ideation in studies with sample sizes < 400 compared to those with sample sizes ≥ 400 (34% vs. 26%), but not the source of heterogeneity. Significant difference was also found in the pooled prevalence of suicide attempt ( z = -4.56, p  < 0.001) and attempted suicide ( z = -6.41, p  < 0.001) based on male proportion, subgroup analysis identified male proportion as a source of heterogeneity. Regarding completed suicide, there were statistically significant differences based on region ( z  = 4.48, p  < 0.001) and male proportion ( z  = 5.45, p  < 0.001). Subgroup analysis showed that while region and male proportion were not the source of heterogeneity, but may be factors that modulate heterogeneity. (Additional Fig.  2 )

Forest plots of Suicide Ideation in PLWHA

Influence factor of suicide in PLWHA

A total of 16 studies covered influencing factors related to suicide ideation, with 2 studies focusing on attempted suicide, and 2 on completed suicide. Meta-analysis showed that among PLWHA, high stigma (OR, 2.94; 95%CI, 1.90 − 4.57), depression (OR, 3.17; 95%CI, 2.20 − 4.57), anxiety (OR, 3.06; 95%CI, 2.23 − 4.20), low self-esteem (OR, 3.82; 95%CI, 2.22 − 6.57), high HIV related stress (OR, 2.53; 95%CI, 1.36 − 4.72), and unemployment (OR, 2.50; 95%CI, 1.51 − 4.15) are risk factors for suicide ideation; while high social support (OR, 0.61; 95%CI, 0.44 − 0.84) and spouse infected with HIV (OR, 0.39; 95%CI, 0.21 − 0.74) are protective factors against suicide ideation. Depression (OR, 1.62; 95%CI, 1.24 − 2.13), high aggression (OR, 4.66; 95%CI, 2.59 − 8.39), and more negative life events (OR, 2.51; 95%CI, 1.47 − 4.29) are risk factors for attempted suicide. Elder (OR = 1.40, 95%CI: 0.81 − 2.40) and high level of education (OR = 1.31, 95%CI: 1.21 − 1.43) are risk factors for completed suicide (Table  2 ).

Sensitivity analysis

Sensitivity analysis results of the pooled prevalence showed that except for completed suicide (the results are somewhat unreliable) (Fig.  4 ), there was no significant change after deleting any of the references, and the results were stable (Additional Fig.  3 ). The results of the sensitivity analysis of influencing factors for suicidal ideation also showed good stability (Table  3 ).

Sensitivity analysis of pooling prevalence of Completed Suicide in PLWHA

Publication bias

The funnel plot results for indicators with more than 10 studies, such as the prevalence of suicidal ideation and its influencing factor depression, suggested potential publication bias(Fig.  5 ). However, Egger test results demonstrated that prevalence of suicidal ideation ( t  = 1.59, p  = 0.127), suicide attempt ( t  = 2.81, p  = 0.067), suicide plan ( t  = 2.05, p  = 0.110), attempted suicide ( t  = 2.33, p  = 0.068), and completed suicide ( t = -0.05, p  = 0.961) had no publication bias. Egger test results of the influencing factors of suicidal ideation indicated that anxiety ( t  = 1.72, p  = 0.228) and high stigma ( t = -0.86, p  = 0.438) had no publication bias; depression ( t  = 2.44, p  = 0.041) and high social support ( t = -4.47, p  = 0.046) may have publication bias.

Funnel plot of prevalence of SI in PLWHA

Owing to social discrimination and prejudice, stigma, and economic burden, PLWHA experience significant psychological pressure, often leading to anxiety, depression, and sleep disorders [ 43 ]. These mental health challenges can have profound negative effects and may even result in extreme behaviors [ 44 ]. Research indicates that the prevalence of self-injury and suicide among PLWHA is higher compared to the general population [ 45 ], with approximately 20% of PLWHA engaging in deliberate self-harm [ 46 ]. Among women diagnosed with HIV, 26% have reported suicide attempt [ 47 ]. Although, studies have shown that the prevalence of suicidal ideation among PLWHA is around 35%, and identified depression, perceived discrimination, low social support, anxiety, and low self-esteem as risk factors [ 48 ], there remains significant variability and inconsistency in reported findings across these primary studies.

A total of 28 studies were included in this meta-analysis, all with quality assessments above 5, and a combined sample size of 1,433,971. To a certain extent, it shows the current prevalence and influencing factors of suicide in PLWHA in China. Some of the included studies were highly heterogeneous (I 2 , 0 − 98.8%), with a certain degree of publication bias.

Meta-analysis revealed that the prevalence of suicidal ideation among PLWHA in China was 30%, which is lower than the findings reported by LiuY et al. [ 48 ]. This difference may be attributed to variations in the characteristics of the included population, sample size, and study types. The incidence of suicide attempt was 5%, lower than the 7.1% reported by Gizachew KD et al. [ 49 ] and similar to the 4.23% reported by ZhangY et al. [ 50 ], which may be influenced by different countries and study subjects. Suicide plan were reported at 8%, higher than that reported by RuFX et al. [ 51 ], likely due to differences in research subjects and retrieval strategies. The prevalence of attempted suicide, completed suicide were 7% and 3‰, respectively, is similar to the findings of TsaiY et al. [ 52 ]. Variations may stem from differences in countries, search strategies, and study years.

High stigma, depression, anxiety, low self-esteem, high HIV related stress, and unemployment were identified as risk factors for suicidal ideation among PLWHA. This could be due to behavioral changes and psychosocial factors mediated after HIV diagnosis [ 53 ]. Conversely, high social support and spouse infected with HIV were protective factors for suicidal ideation in PLWHA, this could be attributed to the heightened psychological stress from stigma experienced by PLWHA compared to the general population, necessitating increased social support and comfort from partners [ 54 ]. Depression, high aggression, and experiencing more negative life events were considered as risk factors for attempted suicide among PLWHA. The accumulation of negative life events alongside HIV infection likely acts as stressors leading to depression and heightened aggression. Individuals with high aggression are reported to be 3 − 4 times more likely to attempt suicide compared to those with lower aggression levels [ 55 ]. Older age and higher levels of education are risk factors for completed suicide among PLWHA. Increased age often correlates with declining physical function and feelings of loneliness, which may contribute to suicide among the elderly [ 56 ]. This underscores the importance of integrating psychological and social support into the diagnosis, treatment, and prevention systems for PLWHA to mitigate their psychological burden and mental health challenges, thereby preventing suicides.

We conducted subgroup analysis based on sample size, revealing the highest prevalence (34%) of suicidal ideation among studies with sample sizes < 400, and the lowest prevalence (26%) among those with sample sizes ≥ 400. This difference may be explained by the phenomenon where sample correlations converge to population values as sample size increases, whereas smaller samples may exhibit instability [ 57 ]. Furthermore, subgroup analysis indicated lower prevalence of suicide attempt and attempted suicide in studies with a higher proportion of men, possibly due to greater stress tolerance observed in men compared to women [ 36 ]. For instance, the incidence of repeated self-injury among Chinese adolescents is approximately 22.1%, with woman being 1.5 times more likely to repeat self-injury compared to men [ 58 ]. While in studies of WangW et al. [ 33 ] and WangXL et al. [ 34 ], did not find significant gender differences.

Furthermore, YangZJ et al. [ 39 ] pointed out that age > 30 years old was a protective factor for suicidal ideation in PLWHA, whereas other studies on the contrary believed that this age group may increase suicidal ideation risk by 2.5 times [ 15 ]. Similarly, WangW et al. [ 15 ] identified higher education levels as protective against suicidal ideation among PLWHA, but studies by LauJTF et al. [ 24 ] and YangZJ et al. [ 39 ] found no significant differences in suicidal ideation distribution based on educational attainment. These discrepancies highlight the need for further research and exploration. Living alone appears to influence suicidal ideation development in China, particularly among the elderly, although there is limited literature specifically addressing this factor in PLWHA [ 30 ], warranting additional investigation. However, there is relatively scant research on risk factor for suicide attempt, suicide plan, attempted suicide and completed suicide among PLWHA in China. This scarcity may be attributed to improved HIV diagnosis and detection capabilities following the implementation of China’s AIDS prevention and control policies, such as the “Four Frees and One Care” initiative. These policies have enhanced timely treatment and reduced the economic burden on families affected by HIV, thereby alleviating mental pressures and potentially lowering suicide incidence [ 59 ].

In the PLWHA population in China, research on self-injury is limited and receives relatively little attention. In Anhui, China, PLWHA who were paid to donate blood had a self-injury probability approximately 2.8 times higher than the general population [ 6 ]. Additionally, about 31% of AIDS patients in compulsory wards experience self-injurious behavior [ 60 ]. However, these findings alone are insufficient to fully understand the prevalence of self-injury among PLWHA in China. The hidden nature of self-injury, reluctance of individuals to report such behaviors, and inadequate detection contribute to underreporting [ 61 ]. Furthermore, clinical healthcare providers often lack necessary professional training, leading to insufficient assessment and attention towards self-injurious behaviors. Another contributing factor is the lack of a strict unified concept of self-injury and suicide, with varying perspectives among different disciplines and scholars. Studies have noted confusion and difficulty in distinguishing between self-injury and suicide attempt [ 62 , 63 ], which further limits research in this area. Hence, Chinese scholars are urged to prioritize research on self-injury among PLWHA, exploring potential social, psychological, and biological factors affecting this group. Timely interventions are crucial to interrupting the progression from self-injury to suicide in this population.

SITBs significantly impact PLWHA, their families, and communities. In this systematic review and meta-analysis of high-quality evidence, we found that the prevalence of self-injury and suicide among Chinese PLWHA is relatively high, and its influencing factors can be summarised into three categories, namely, the individual’s psychological adjustment ability, family and social support, and the living environment’s tolerance of AIDS. Given the above findings, we believe that to improve the current situation, we should do the following: Firstly, correctly guiding PLWHA to accept their condition is crucial to enhancing their psychological adjustment. Encouraging them to join AIDS support groups, learn the basics of AIDS, and share their experiences with other patients can eliminate misunderstandings and fears of the disease, and reduce the sense of loneliness and helplessness. Secondly, encouraging participation in social activities and volunteerism can mitigate social isolation, boost self-esteem, and foster a stronger sense of social identity and support. Thirdly, combating stigma and discrimination through education and community initiatives is essential. Promoting greater social inclusion and support networks for PLWHA can reduce their vulnerability to SITBs. Finally, enhancing healthcare professionals’ training in identifying and managing mental health issues among PLWHA is crucial. This will improve early detection and targeted intervention for high-risk individuals, ensuring timely support and care. By implementing these strategies, we can improve the well-being and mental health outcomes for PLWHA in China.

This study has several limitations. Firstly, the sample size of the included studies varied from 85 to 763,287, and there were many diagnostic tools used, including BSSI, CIDI, SIOSS, SCID-I/P, ICD-10, BDI and BSRS-5, etc., which showed significant differences among the studies. Secondly, sample representation, participants’ basic characteristics, and differences in study areas may be the factors that affect the results. Moreover, the types of literature included in this study were cross-sectional, case-control and cohort studies, which may be limited in the strength of the argument. To overcome these limitations, we conducted a meta-analysis to explore the sources of heterogeneity among the results. Moving forward, there is a need for future studies with large sample sizes, minimal baseline heterogeneity, balanced demographic characteristics, and multi-center collaboration to further investigate the incidence and influencing factors of self-injury and suicide among PLWHA in China. This will provide objective, evidence-based data to guide healthcare providers in formulating and implementing effective interventions.

Conclusions

Figures indicate that approximately one-third of PLWHA experience suicidal ideation, and three out of every 1,000 completed suicide in China. Positive factors such as high social support and self-esteem serve as protective factors against self-injury and suicide among PLWHA. Conversely, negative factors including high stigma, depression, anxiety, low self-esteem, high HIV-related stress, unemployment, high aggression, and exposure to negative life events are associated with increased risk. These findings underscore the importance of integrating psychosocial support and comprehensive risk assessment into the care of PLWHA.

Data availability

All extracted data are published studies, the original data are available in the paper, and the data are not blocked or restricted. Supplementary data to this article can be found online. Additional data will be available upon requests to Xiaoping Huang ([email protected]).

Abbreviations

People living with HIV/AIDS

Chinese includes Chinese biomedical literature service system

China National Knowledge Infrastructure

China Science and Technology Journal Database

Suicidal ideation

Suicide attempt

Suicide plan

Attempted suicide

Completed suicide

Odds ratios

95% confidence intervals

Self-injurious thoughts and behaviors

Nonsuicidal self-injury

World Health Organization

Newcastle-Ottawa Scale

Agency for Healthcare Research and Quality

International Classification of Diseases 10th edition

Comprehensive International Diagnostic Interview

Beck Depression Inventory

The five-item Brief Symptom Rating Scale

Self-rating Idea of Suicide Scale

Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition

Beck Scale for Suiciden Ideation

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Supported by the Yunnan Provincial Health Commission Research Project: Yunnan Provincial Clinical Center for Infectious Diseases, the National Science and Technology Major Projects of the “13th Five-Year Plan” (2017ZX10202101), the Yunnan Provincial Clinical Research Center for Infectious Diseases (AIDS) of the Major Science and Technology Project of Yunnan Provincial Department of Science and Technology (202102AA310005).

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All authors reviewed and approved the study. XP.H. : Methodology, literature search, data collection and analysis, Writing - Original draft preparation; ZQ.L. : literature search, data collection and analysis; W.Z. : duplicate assessment of study bias; XM. F. : literature search, data collection and analysis; XC.W. : Methodology, Supervision, Writing - Review and editing, Funding; ZL.J. : Supervision, Writing - Review, Funding.

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Huang, XP., Li, ZQ., Wei-Zhang et al. Self-injury and suicide among people living with HIV/AIDS in China: a systematic review and meta-analysis. BMC Public Health 24 , 2248 (2024). https://doi.org/10.1186/s12889-024-19444-3

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DOI : https://doi.org/10.1186/s12889-024-19444-3

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