example of literature review for nursing research

Nursing: Literature Review

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Good Place to Start: Citation Databases

Interdisciplinary Citation Databases:

A good place to start your research  is to search a research citation database to view the scope of literature available on your topic.

TIP #1: SEED ARTICLE Begin your research with a "seed article" - an article that strongly supports your research topic.  Then use a citation database to follow the studies published by finding articles which have cited that article, either because they support it or because they disagree with it.

TIP #2: SNOWBALLING Snowballing is the process where researchers will begin with a select number of articles they have identified relevant/strongly supports their topic and then search each articles' references reviewing the studies cited to determine if they are relevant to your research.

BONUS POINTS: This process also helps identify key highly cited authors within a topic to help establish the "experts" in the field.

Begin by constructing a focused research question to help you then convert it into an effective search strategy.

• Identify keywords or synonyms
• Type of study/resources
• Which database(s) to search
• Asking a Good Question (PICO)
• PICO - AHRQ
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• What Is a PICOT Question?

Seminal Works: Search Key Indexing/Citation Databases

• Google Scholar
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TIP – How to Locate Seminal Works

• DO NOT: Limit by date range or you might overlook the seminal works
• DO: Look at highly cited references (Seminal articles are frequently referred to “cited” in the research)
• DO: Search citation databases like Scopus, Web of Science and Google Scholar

Web Resources

What is a literature review?

A literature review is a comprehensive and up-to-date overview of published information on a subject area. Conducting a literature review demands a careful examination of a body of literature that has been published that helps answer your research question (See PICO). Literature reviewed includes scholarly journals, scholarly books, authoritative databases, primary sources and grey literature.

A literature review attempts to answer the following:

• What is known about the subject?
• What is the chronology of knowledge about my subject?
• Are there any gaps in the literature?
• Is there a consensus/debate on issues?
• Create a clear research question/statement
• Define the scope of the review include limitations (i.e. gender, age, location, nationality...)
• Search existing literature including classic works on your topic and grey literature
• Evaluate results and the evidence (Avoid discounting information that contradicts your research)
• Track and organize references
• How to conduct an effective literature search.
• Social Work Literature Review Guidelines (OWL Purdue Online Writing Lab)

What is PICO?

The PICO model can help you formulate a good clinical question. Sometimes it's referred to as PICO-T, containing an optional 5th factor. 

Search Example

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Literature Review Overview

What is a Literature Review? Why Are They Important?

A literature review is important because it presents the "state of the science" or accumulated knowledge on a specific topic. It summarizes, analyzes, and compares the available research, reporting study strengths and weaknesses, results, gaps in the research, conclusions, and authors’ interpretations.

Tips and techniques for conducting a literature review are described more fully in the subsequent boxes:

• Literature review steps
• Strategies for organizing the information for your review
• Literature reviews sections
• In-depth resources to assist in writing a literature review
• Templates to start your review
• Literature review examples

Literature Review Steps

Graphic used with permission: Torres, E. Librarian, Hawai'i Pacific University

1. Choose a topic and define your research question

• Try to choose a topic of interest. You will be working with this subject for several weeks to months.
• Ideas for topics can be found by scanning medical news sources (e.g MedPage Today), journals / magazines, work experiences, interesting patient cases, or family or personal health issues.
• Do a bit of background reading on topic ideas to familiarize yourself with terminology and issues. Note the words and terms that are used.
• Develop a focused research question using PICO(T) or other framework (FINER, SPICE, etc - there are many options) to help guide you.
• Run a few sample database searches to make sure your research question is not too broad or too narrow.
• If possible, discuss your topic with your professor. 

2. Determine the scope of your review

The scope of your review will be determined by your professor during your program. Check your assignment requirements for parameters for the Literature Review.

• How many studies will you need to include?
• How many years should it cover? (usually 5-7 depending on the professor)
• For the nurses, are you required to limit to nursing literature?

3. Develop a search plan

• Determine which databases to search. This will depend on your topic. If you are not sure, check your program specific library website (Physician Asst / Nursing / Health Services Admin) for recommendations.
• Create an initial search string using the main concepts from your research (PICO, etc) question. Include synonyms and related words connected by Boolean operators
• Contact your librarian for assistance, if needed.

4. Conduct searches and find relevant literature

• Keep notes as you search - tracking keywords and search strings used in each database in order to avoid wasting time duplicating a search that has already been tried
• Read abstracts and write down new terms to search as you find them
• Check MeSH or other subject headings listed in relevant articles for additional search terms
• Scan author provided keywords if available
• Check the references of relevant articles looking for other useful articles (ancestry searching)
• Check articles that have cited your relevant article for more useful articles (descendancy searching). Both PubMed and CINAHL offer Cited By links
• Revise the search to broaden or narrow your topic focus as you peruse the available literature
• Conducting a literature search is a repetitive process. Searches can be revised and re-run multiple times during the process.
• Track the citations for your relevant articles in a software citation manager such as RefWorks, Zotero, or Mendeley

5. Review the literature

• Read the full articles. Do not rely solely on the abstracts. Authors frequently cannot include all results within the confines of an abstract. Exclude articles that do not address your research question.
• While reading, note research findings relevant to your project and summarize. Are the findings conflicting? There are matrices available than can help with organization. See the Organizing Information box below.
• Critique / evaluate the quality of the articles, and record your findings in your matrix or summary table. Tools are available to prompt you what to look for. (See Resources for Appraising a Research Study box on the HSA, Nursing , and PA guides )
• You may need to revise your search and re-run it based on your findings.

6. Organize and synthesize

• Compile the findings and analysis from each resource into a single narrative.
• Using an outline can be helpful. Start broad, addressing the overall findings and then narrow, discussing each resource and how it relates to your question and to the other resources.
• Cite as you write to keep sources organized.
• Write in structured paragraphs using topic sentences and transition words to draw connections, comparisons, and contrasts.
• Don't present one study after another, but rather relate one study's findings to another. Speak to how the studies are connected and how they relate to your work.

Organizing Information

Options to assist in organizing sources and information :

1. Synthesis Matrix

• helps provide overview of the literature
• information from individual sources is entered into a grid to enable writers to discern patterns and themes
• article summary, analysis, or results
• thoughts, reflections, or issues
• each reference gets its own row
• mind maps, concept maps, flowcharts
• at top of page record PICO or research question
• record major concepts / themes from literature
• list concepts that branch out from major concepts underneath - keep going downward hierarchically, until most specific ideas are recorded
• enclose concepts in circles and connect the concept with lines - add brief explanation as needed

3. Summary Table

• information is recorded in a grid to help with recall and sorting information when writing
• allows comparing and contrasting individual studies easily
• purpose of study
• methodology (study population, data collection tool)

Efron, S. E., & Ravid, R. (2019). Writing the literature review : A practical guide . Guilford Press.

Literature Review Sections

• Lit reviews can be part of a larger paper / research study or they can be the focus of the paper
• Lit reviews focus on research studies to provide evidence
• New topics may not have much that has been published

* The sections included may depend on the purpose of the literature review (standalone paper or section within a research paper)

Standalone Literature Review (aka Narrative Review):

• presents your topic or PICO question
• includes the why of the literature review and your goals for the review.
• provides background for your the topic and previews the key points
• Narrative Reviews: tmay not have an explanation of methods.
• include where the search was conducted (which databases) what subject terms or keywords were used, and any limits or filters that were applied and why - this will help others re-create the search
• describe how studies were analyzed for inclusion or exclusion
• review the purpose and answer the research question
• thematically - using recurring themes in the literature
• chronologically - present the development of the topic over time
• methodological - compare and contrast findings based on various methodologies used to research the topic (e.g. qualitative vs quantitative, etc.)
• theoretical - organized content based on various theories
• provide an overview of the main points of each source then synthesize the findings into a coherent summary of the whole
• present common themes among the studies
• compare and contrast the various study results
• interpret the results and address the implications of the findings
• do the results support the original hypothesis or conflict with it
• provide your own analysis and interpretation (eg. discuss the significance of findings; evaluate the strengths and weaknesses of the studies, noting any problems)
• discuss common and unusual patterns and offer explanations
•  stay away from opinions, personal biases and unsupported recommendations
• summarize the key findings and relate them back to your PICO/research question
• note gaps in the research and suggest areas for further research
• this section should not contain "new" information that had not been previously discussed in one of the sections above
• provide a list of all the studies and other sources used in proper APA 7

Literature Review as Part of a Research Study Manuscript:

• Compares the study with other research and includes how a study fills a gap in the research.
• Focus on the body of the review which includes the synthesized Findings and Discussion

Literature Reviews vs Systematic Reviews

Systematic Reviews are NOT the same as a Literature Review:

Literature Reviews:

• Literature reviews may or may not follow strict systematic methods to find, select, and analyze articles, but rather they selectively and broadly review the literature on a topic
• Research included in a Literature Review can be "cherry-picked" and therefore, can be very subjective

Systematic Reviews:

• Systemic reviews are designed to provide a comprehensive summary of the evidence for a focused research question
• rigorous and strictly structured, using standardized reporting guidelines (e.g. PRISMA, see link below)
• uses exhaustive, systematic searches of all relevant databases
• best practice dictates search strategies are peer reviewed
• uses predetermined study inclusion and exclusion criteria in order to minimize bias
• aims to capture and synthesize all literature (including unpublished research - grey literature) that meet the predefined criteria on a focused topic resulting in high quality evidence

Literature Review Examples

• Breastfeeding initiation and support: A literature review of what women value and the impact of early discharge (2017). Women and Birth : Journal of the Australian College of Midwives
• Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: A literature review (2017). Journal of Racial and Ethnic Health Disparities

• Vitamin D deficiency in individuals with a spinal cord injury: A literature review (2017). Spinal Cord

Resources for Writing a Literature Review

These sources have been used in developing this guide.

Resources Used on This Page

Aveyard, H. (2010). Doing a literature review in health and social care : A practical guide . McGraw-Hill Education.

Purdue Online Writing Lab. (n.d.). Writing a literature review . Purdue University. https://owl.purdue.edu/owl/research_and_citation/conducting_research/writing_a_literature_review.html

Torres, E. (2021, October 21). Nursing - graduate studies research guide: Literature review. Hawai'i Pacific University Libraries. Retrieved January 27, 2022, from https://hpu.libguides.com/c.php?g=543891&p=3727230

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What is a Literature Review?

Key questions for a literature review, examples of literature reviews, useful links, evidence matrix for literature reviews.

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The Scholarly Conversation

A literature review provides an overview of previous research on a topic that critically evaluates, classifies, and compares what has already been published on a particular topic. It allows the author to synthesize and place into context the research and scholarly literature relevant to the topic. It helps map the different approaches to a given question and reveals patterns. It forms the foundation for the author’s subsequent research and justifies the significance of the new investigation.

A literature review can be a short introductory section of a research article or a report or policy paper that focuses on recent research. Or, in the case of dissertations, theses, and review articles, it can be an extensive review of all relevant research.

• The format is usually a bibliographic essay; sources are briefly cited within the body of the essay, with full bibliographic citations at the end.
• The introduction should define the topic and set the context for the literature review. It will include the author's perspective or point of view on the topic, how they have defined the scope of the topic (including what's not included), and how the review will be organized. It can point out overall trends, conflicts in methodology or conclusions, and gaps in the research.
• In the body of the review, the author should organize the research into major topics and subtopics. These groupings may be by subject, (e.g., globalization of clothing manufacturing), type of research (e.g., case studies), methodology (e.g., qualitative), genre, chronology, or other common characteristics. Within these groups, the author can then discuss the merits of each article and analyze and compare the importance of each article to similar ones.
• The conclusion will summarize the main findings, make clear how this review of the literature supports (or not) the research to follow, and may point the direction for further research.
• The list of references will include full citations for all of the items mentioned in the literature review.

A literature review should try to answer questions such as

• Who are the key researchers on this topic?
• What has been the focus of the research efforts so far and what is the current status?
• How have certain studies built on prior studies? Where are the connections? Are there new interpretations of the research?
• Have there been any controversies or debate about the research? Is there consensus? Are there any contradictions?
• Which areas have been identified as needing further research? Have any pathways been suggested?
• How will your topic uniquely contribute to this body of knowledge?
• Which methodologies have researchers used and which appear to be the most productive?
• What sources of information or data were identified that might be useful to you?
• How does your particular topic fit into the larger context of what has already been done?
• How has the research that has already been done help frame your current investigation ?

Example of a literature review at the beginning of an article: Forbes, C. C., Blanchard, C. M., Mummery, W. K., & Courneya, K. S. (2015, March). Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors . Oncology Nursing Forum, 42(2), 118+. Retrieved from http://go.galegroup.com.sonoma.idm.oclc.org/ps/i.do?p=HRCA&sw=w&u=sonomacsu&v=2.1&it=r&id=GALE%7CA422059606&asid=27e45873fddc413ac1bebbc129f7649c Example of a comprehensive review of the literature: Wilson, J. L. (2016). An exploration of bullying behaviours in nursing: a review of the literature.   British Journal Of Nursing ,  25 (6), 303-306. For additional examples, see:

Galvan, J., Galvan, M., & ProQuest. (2017). Writing literature reviews: A guide for students of the social and behavioral sciences (Seventh ed.). [Electronic book]

Pan, M., & Lopez, M. (2008). Preparing literature reviews: Qualitative and quantitative approaches (3rd ed.). Glendale, CA: Pyrczak Pub. [ Q180.55.E9 P36 2008]

• Write a Literature Review (UCSC)
• Literature Reviews (Purdue)
• Literature Reviews: overview (UNC)
• Review of Literature (UW-Madison)

The  Evidence Matrix  can help you  organize your research  before writing your lit review.  Use it to  identify patterns  and commonalities in the articles you have found--similar methodologies ?  common  theoretical frameworks ? It helps you make sure that all your major concepts covered. It also helps you see how your research fits into the context  of the overall topic.

• Evidence Matrix Special thanks to Dr. Cindy Stearns, SSU Sociology Dept, for permission to use this Matrix as an example.
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What is a Literature Review?

A literature review is an essay that surveys, summarizes, links together, and assesses research in a given field. It surveys the literature by reviewing a large body of work on a subject; it summarizes by noting the main conclusions and findings of the research; it links together works in the literature by showing how the information fits into the overall academic discussion and how the information relates to one another; it assesses the literature by noting areas of weakness, expansion, and contention. This is the essentials of literature review construction by discussing the major sectional elements, their purpose, how they are constructed, and how they all fit together.

All literature reviews have major sections:

• Introduction: that indicates the general state of the literature on a given topic;
• Methodology: an overview of how, where, and what subject terms used to conducted your search so it may be reproducable
• Findings: a summary of the major findings in that field;
• Discussion: a general progression from wider studies to smaller, more specifically-focused studies;
• Conclusion: for each major section that again notes the overall state of the research, albeit with a focus on the major synthesized conclusions, problems in the research, and even possible avenues of further research.

In Literature Reviews, it is Not Appropriate to:

• State your own opinions on the subject (unless you have evidence to support such claims).  
• State what you think nurses should do (unless you have evidence to support such claims).
• Provide long descriptive accounts of your subject with no reference to research studies.
• Provide numerous definitions, signs/symptoms, treatment and complications of a particular illness without focusing on research studies to provide evidence and the primary purpose of the literature review.
• Discuss research studies in isolation from each other.

Remember, a literature review is not a book report. A literature review is focus, succinct, organized, and is free of personal beliefs or unsubstantiated tidbits.

• Types of Literature Reviews A detailed explanation of the different types of reviews and required citation retrieval numbers

Outline of a Literture Review

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Nursing: How to Write a Literature Review

Traditional or narrative literature review, other types of literature reviews.

• Ten Simple Rules for Writing a Literature Review
• How to Write a Literature Review
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For more help on this topic, please contact our Research Help Desk: [email protected] or 781-768-7303. Stay up-to-date on our current hours . Note: all hours are EST.

This Guide was created by Carolyn Swidrak (retired).

This guide addresses how to prepare a traditional or narrative literature review. 

Why is a literature review important?

“The primary purpose of a literature review is to summarize evidence on a topic – to sum up what is known and what is not known . ” ( Polit & Beck, 2018, p. 107)

Polit, D.F., & Beck, C.T. (2018). Essentials of nursing research: Appraising evidence for nursing practice. (9th ed.). Philadelphia: Wolters Kluwer

A traditional or narrative review is one type of review.  Others include:

• systematic review
• integrative review
• scoping review

For more information on various types of reviews:

• A typology of reviews: an analysis of 14 review types and associated methodologies Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26(2), 91-108. doi:10.1111/j.1471-1842.2009.00848.x
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Nursing - Graduate Studies Research Guide

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Featured Ebook

A literature review is an essay or part of an essay that summarizes and analyzes research in a particular discipline. It assess the literature by reviewing a large body of studies on a given subject matter. It summarizes by pointing out the main findings, linking together the numerous studies and explaining how they fit into the overall academic discussion on that subject. It critically analyzes the literature by pointing out the areas of weakness, expansion, and contention. 

Literature Review Sections:

• Introduction: indicates the general state of the literature on a given subject.
• Methodology: states  where (databases), how (what subject terms used on searches), and what (parameters of studies that were included); so others may recreate the searches and explain the reasoning behind the selection of those studies.
• Findings: summary of the major findings in that subject.
• Discussion: a general progression from broader studies to more focused studies.
• Conclusion: for each major section that again notes the overall state of the research, albeit with a focus on the major synthesized conclusions, problems in the research, and even possible avenues for further research.
• References: a list of all the studies using proper citation style. 

Literature Review Tips:

• Beware of stating your own opinions or personal recommendations (unless you have evidence to support such claims).
• Provide proper references to research studies.
• Focus on research studies to provide evidence and the primary purpose of the literature review.
• Connect research studies with the overall conversation on the subject.
• Have a search strategy planner and log to keep you focused.

Literature reviews are not a book reports or commentaries; make sure to stay focused, organized, and free of personal biases or unsubstantiated recommendations.

Literature Review Examples:

• Lemetti, T., Stolt, M., Rickard, N., & Suhonen, R. (2015). Collaboration between hospital and primary care nurses: a literature review. International Nursing Review , 62 (2), 248-266. doi:10.1111/inr.12147  

1. Choose a topic and define your research question.

Your literature review should be guided by a focus research question.   Consider PICO and FINER criteria for developing a research question.

• Make sure your research question is not too broad or too narrow. Do a couple of pre-searches to see what information is out there and determine if it is a manageable topic.
• Identify the main concepts of your research question and write down terms that are related to them. Keep a list of  terms that you can use when searching.
• If possible, discuss your topic with your professor. 

2. Decide on the scope of your review.

Check with your assignment requirements and your professor for parameters of the Literature Review.

• How many studies are you considering?
• How comprehensive will your literature review be?
• How many years should it cover? 

3. Select appropriate databases to search.

Make a list of the databases you will search. 

• Don't forget to look at books, dissertations or other specialized databases .
• Contact your librarian to make sure you are not missing any vital databases for that topic.

4. Conduct searches and find relevant literature.

As you are searching in databases is important to keep track and notes as you uncover information.

• Read the abstracts of research studies carefully instead of just downloading articles that have good titles.
• Write down the searches you conduct in each database so that you may duplicate or avoid unsuccessful searches again.
• Look at the bibliographies and references of research studies you find to locate others .
• Look for subject terms or MeSH terms that are associated with the  research studies you find and use those terms in more searches.
• Use a citation manager such as Zotero or Endnote Basic to keep track of your research citations.

5. Review the literature. 

As you are reading the full articles ask the following questions when assessing studies:

• What is the research question of the study?
• Who are the author(s)? What are their credentials and how are they viewed in their field?
• Has this study been cited?; if so, how has it been analyzed?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.  Does the research seem to be complete?  What further questions does it raise?
• Are there any conflicting studies; if so why?

Throughout the process keep careful notes of your searches and findings so it is easier to put it together when it comes to the writing part.

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What are Systematic Reviews? (3 minutes, 24 second YouTube Video)

Systematic Literature Reviews: Steps & Resources

These steps for conducting a systematic literature review are listed below . 

Also see subpages for more information about:

• The different types of literature reviews, including systematic reviews and other evidence synthesis methods
• Tools & Tutorials

Literature Review & Systematic Review Steps

• Develop a Focused Question
• Scope the Literature  (Initial Search)
• Refine & Expand the Search
• Limit the Results
• Download Citations
• Abstract & Analyze
• Create Flow Diagram
• Synthesize & Report Results

1. Develop a Focused   Question 

Consider the PICO Format: Population/Problem, Intervention, Comparison, Outcome

Focus on defining the Population or Problem and Intervention (don't narrow by Comparison or Outcome just yet!)

"What are the effects of the Pilates method for patients with low back pain?"

Tools & Additional Resources:

• PICO Question Help
• Stillwell, Susan B., DNP, RN, CNE; Fineout-Overholt, Ellen, PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek, PhD, RN, CPNP/PMHNP, FNAP, FAAN; Williamson, Kathleen M., PhD, RN Evidence-Based Practice, Step by Step: Asking the Clinical Question, AJN The American Journal of Nursing : March 2010 - Volume 110 - Issue 3 - p 58-61 doi: 10.1097/01.NAJ.0000368959.11129.79

2. Scope the Literature

A "scoping search" investigates the breadth and/or depth of the initial question or may identify a gap in the literature. 

Eligible studies may be located by searching in:

• Background sources (books, point-of-care tools)
• Article databases
• Trial registries
• Grey literature
• Cited references
• Reference lists

When searching, if possible, translate terms to controlled vocabulary of the database. Use text word searching when necessary.

Use Boolean operators to connect search terms:

• Combine separate concepts with AND  (resulting in a narrower search)
• Connecting synonyms with OR  (resulting in an expanded search)

Search:  pilates AND ("low back pain"  OR  backache )

Video Tutorials - Translating PICO Questions into Search Queries

• Translate Your PICO Into a Search in PubMed (YouTube, Carrie Price, 5:11) 
• Translate Your PICO Into a Search in CINAHL (YouTube, Carrie Price, 4:56)

3. Refine & Expand Your Search

Expand your search strategy with synonymous search terms harvested from:

• database thesauri
• reference lists
• relevant studies

Example: 

(pilates OR exercise movement techniques) AND ("low back pain" OR backache* OR sciatica OR lumbago OR spondylosis)

As you develop a final, reproducible strategy for each database, save your strategies in a:

• a personal database account (e.g., MyNCBI for PubMed)
• Log in with your NYU credentials
• Open and "Make a Copy" to create your own tracker for your literature search strategies

4. Limit Your Results

Use database filters to limit your results based on your defined inclusion/exclusion criteria.  In addition to relying on the databases' categorical filters, you may also need to manually screen results.  

• Limit to Article type, e.g.,:  "randomized controlled trial" OR multicenter study
• Limit by publication years, age groups, language, etc.

NOTE: Many databases allow you to filter to "Full Text Only".  This filter is  not recommended . It excludes articles if their full text is not available in that particular database (CINAHL, PubMed, etc), but if the article is relevant, it is important that you are able to read its title and abstract, regardless of 'full text' status. The full text is likely to be accessible through another source (a different database, or Interlibrary Loan).  

• Filters in PubMed
• CINAHL Advanced Searching Tutorial

5. Download Citations

Selected citations and/or entire sets of search results can be downloaded from the database into a citation management tool. If you are conducting a systematic review that will require reporting according to PRISMA standards, a citation manager can help you keep track of the number of articles that came from each database, as well as the number of duplicate records.

In Zotero, you can create a Collection for the combined results set, and sub-collections for the results from each database you search.  You can then use Zotero's 'Duplicate Items" function to find and merge duplicate records.

• Citation Managers - General Guide

6. Abstract and Analyze

• Migrate citations to data collection/extraction tool
• Screen Title/Abstracts for inclusion/exclusion
• Screen and appraise full text for relevance, methods, 
• Resolve disagreements by consensus

Covidence is a web-based tool that enables you to work with a team to screen titles/abstracts and full text for inclusion in your review, as well as extract data from the included studies.

• Covidence Support
• Critical Appraisal Tools
• Data Extraction Tools

7. Create Flow Diagram

The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow diagram is a visual representation of the flow of records through different phases of a systematic review.  It depicts the number of records identified, included and excluded.  It is best used in conjunction with the PRISMA checklist .

Example from: Stotz, S. A., McNealy, K., Begay, R. L., DeSanto, K., Manson, S. M., & Moore, K. R. (2021). Multi-level diabetes prevention and treatment interventions for Native people in the USA and Canada: A scoping review. Current Diabetes Reports, 2 (11), 46. https://doi.org/10.1007/s11892-021-01414-3

• PRISMA Flow Diagram Generator (ShinyApp.io, Haddaway et al. )
• PRISMA Diagram Templates  (Word and PDF)
• Make a copy of the file to fill out the template
• Image can be downloaded as PDF, PNG, JPG, or SVG
• Covidence generates a PRISMA diagram that is automatically updated as records move through the review phases

8. Synthesize & Report Results

There are a number of reporting guideline available to guide the synthesis and reporting of results in systematic literature reviews.

It is common to organize findings in a matrix, also known as a Table of Evidence (ToE).

• Reporting Guidelines for Systematic Reviews
• Download a sample template of a health sciences review matrix  (GoogleSheets)

Steps modified from: 

Cook, D. A., & West, C. P. (2012). Conducting systematic reviews in medical education: a stepwise approach.   Medical Education , 46 (10), 943–952.

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Doctorate of Nursing Practice (DNP) Project Resources

What type of review, how to conduct a review, find articles, evaluating articles, full text access tool.

• How to Get Full Articles
• How to Read a Scientific Paper
• Matrix Template & Example
• Research Instruments
• Organize Your Research
• Statistics + Data Analysis
• Writing & Publishing

Researchers, academics and librarians all use various terms to describe different types of literature reviews. Indeed there is often inconsistency between the ways the types are discussed. Here are a couple of simple explanations.

The image below describes common review types in terms of speed, detail, risk of bias and comprehensiveness:

"Schematic of the main differences between the types of literature review" by Brennan, M. L., Arlt, S. P., Belshaw, Z., Buckley, L., Corah, L., Doit, H., Fajt, V. R., Grindlay, D., Moberly, H. K., Morrow, L. D., Stavisky, J., & White, C. (2020). Critically Appraised Topics (CATs) in veterinary medicine: Applying evidence in clinical practice. Frontiers in Veterinary Science, 7 , 314. https://doi.org/10.3389/fvets.2020.00314 is licensed under CC BY 3.0

The table below has been adapted from a widely used typology of fourteen types of reviews, (Grant & Booth, 2009).  Here are four of the most common types:

For a more detailed list of review types, see:

Grant, M.J. & Booth, A. (2009).  A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26 (2), 91-108.  DOI: 10.1111/j.1471-1842.2009.00848.x

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) outlines standards of practice completing a systematic review to ensure consistency and high-quality results.

• PRISMA 2020 Explanations
• PRISMA 2020 Checklist
• PRISMA 2020 Flow Diagram
• PRISMA Flow Diagram Generator
• PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews

Techniques from the PRISMA process can also be used with other types of reviews to have a systematic process for searching and evaluating results.

• Article Evaluation Handout Key questions to evaluate each section of original research studies (RCTs, cohort studies, etc)

LibKey Nomad is a browser extension that connects you with articles that are library-licensed or open access. LibKey Nomad is available for Google Chrome, Firefox, Safari, Microsoft Edge, Brave, and Vivaldi.

Here is a short demonstration of how it works:

When using LibKey Nomad, you will automatically be directed to the best available version of an article so you don't need to search in multiple places. When the full text of an article is not available, you will be provided with options to request the article through  Interlibrary Loan (ILL).

LibKey Nomad does not require you to create a personal account. It does not track users or hold credentials, and it is only active when you are on the web page of a scholarly publisher or database.  

Getting Started

• Install the LibKey Nomad extension for your browser of choice. (Note: A user account is  not  required to use the extension.)
• Search for and select "James Madison University" from the list of institutions. See images below.
• When you are on publisher websites, Wikipedia, PubMed, and more, you can l ook for the LibKey Nomad button to download PDFs.

Publisher Websites

When you're browsing publisher sites and other web pages, LibKey Nomad provides a link to download the PDF of an article available through the JMU Libraries. It is not necessary to first connect through the JMU Libraries website. If the full text of the article is not available through the JMU Libraries subscriptions, an "Access Options" button will appear, and you will see options for requesting the article through ILL. See example in the image below.

LibKey Nomad also works with Wikipedia. When you're viewing the list of references for an entry, a "Download PDF" button will appear after the citations, if the full text of the article is available from JMU Libraries. An "Article Link" button may appear for citations that are from sources that do not support linking directly to the PDF. For articles not available from JMU Libraries, an "Access Options..." button will appear that provides options for requesting the articles through ILL. See example in the image below.

When you're searching PubMed, LibKey Nomad shows options for downloading a PDF, linking to an article, or additional access options. You can also view the cover images of the journals that articles appear in. LibKey Nomad also provides a link to the complete issue of a journal. Click "View Complete Issue" to browse the table of contents for the issue in which an article appears, helping you find similar articles from the same publication. See example in the image below.

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Nursing and Midwifery

• Accessing NHS resources
• Journals, Databases and Critical Thinking

What is a literature review?

Choosing a topic, developing your search strategy, carrying out your search, saving and documenting your search, formulating a research question, critical appraisal tools.

• Go to LibrarySearch This link opens in a new window

So you have been asked to complete a literature review, but what is a literature review?

A literature review is a piece of research which aims to address a specific research question. It is a comprehensive summary and analysis of existing literature. The literature itself should be the main topic of discussion in your review. You want the results and themes to speak for themselves to avoid any bias.

The first step is to decide on a topic. Here are some elements to consider when deciding upon a topic:

• Choose a topic which you are interested in, you will be looking at a lot of research surrounding that area so you want to ensure it is something that interests you. 
• Draw on your own experiences, think about your placement or your workplace.
• Think about why the topic is worth investigating.  

Once you have decided on a topic, it is a good practice to carry out an initial scoping search.

This requires you to do a quick search using  LibrarySearch  or  Google Scholar  to ensure that there is research on your topic. This is a preliminary step to your search to check what literature is available before deciding on your question. 

The research question framework elements can also be used as keywords.

• Think about who the population/ sample group. Are you looking for a particular age group, ethnicity, cultural background, gender, health issue etc.
• What is the intervention/issue you want to know more about? This could be a particular type of medication, education, therapeutic technique etc. 
• Do you have a particular context in mind? This could relate to a community setting, hospital, ward etc. 

It is important to remember that databases will only ever search for the exact term you put in, so don't panic if you are not getting the results you hoped for. Think about alternative words that could be used for each keyword to build upon your search. 

Build your search by thinking about about synonyms, specialist language, spellings, acronyms, abbreviations for each keyword that you have.

Inclusion & Exclusion Criteria

Your inclusion and exclusion criteria is also an important step in the literature review process. It allows you to be transparent in how you have  ended up with your final articles. 

Your inclusion/exclusion criteria is completely dependent on your chosen topic. Use your inclusion and exclusion criteria to select your articles, it is important not to cherry pick but to have a reason as to why you have selected that particular article. 

• Search Planning Template Use this template to plan your search strategy.

Once you have thought about your keywords and alternative keywords, it is time to think about how to combine them to form your search strategy. Boolean operators instruct the database how your terms should interact with one another. 

Boolean Operators

• OR can be used to combine your keywords and alternative terms. For example "Social Media OR Twitter". When using OR we are informing the database to bring articles continuing either of those terms as they are both relevant so we don't mind which appears in our article. 
• AND can be used to combine two or more concepts. For example "Social Media AND Anxiety". When using AND we are informing the database that we need both of the terms in our article in order for it to be relevant.
• Truncation can be used when there are multiple possible word endings. For example Nurs* will find Nurse, Nurses and Nursing. 
• Double quotation marks can be used to allow for phrase searching. This means that if you have two or more words that belong together as a phrase the database will search for that exact phrase rather than words separately.  For example "Social Media"

Don't forget the more ORs you use the broader your search becomes, the more ANDs you use the narrower your search becomes. 

One of the databases you will be using is EBSCOHost Research Databases. This is a platform which searches through multiple databases so allows for a comprehensive search. The short video below covers how to access and use EBSCO. 

A reference management software will save you a lot of time especially when you are looking at lots of different articles. 

We provide support for EndNote and Mendeley. The video below covers how to install and use Mendeley. 

Consider using a research question framework. A framework will ensure that your question is specific and answerable.

There are different frameworks available depending on what type of research you are interested in.

Population - Who is the question focussed on? This could relate to staff, patients, an age group, an ethnicity etc.

Intervention - What is the question focussed on? This could be a certain type of medication, therapeutic technique etc. 

Comparison/Context - This may be with our without the intervention or it may be concerned with the context for example where is the setting of your question? The hospital, ward, community etc?

Outcome - What do you hope to accomplish or improve etc.

Sample - as this is qualitative research sample is preferred over patient so that it is not generalised. 

Phenomenon of Interest - reasons for behaviour, attitudes, beliefs and decisions.

Design - the form of research used. 

Evaluation - the outcomes.

Research type -qualitative, quantitative or mixed methods.  

All frameworks help you to be specific, but don't worry if your question doesn't fit exactly into a framework. 

There are many critical appraisal tools or books you can use to assess the credibility of a research paper but these are a few we would recommend in the library. Your tutor may be able to advise you of others or some that are more suitable for your topic.

Critical Appraisal Skills Programme (CASP)

CASP is a well-known critical appraisal website that has checklists for a wide variety of study types. You will see it frequently used by practitioners.

Understanding Health Research

This is a brand-new, interactive resource that guides you through appraising a research paper, highlighting key areas you should consider when appraising evidence.

Greenhalgh, T. (2014) How to read a paper: The basics of evidence-based medicine . 5 th edn. Chichester: Wiley

Greenhalgh’s book is a classic in critical appraisal. Whilst you don’t need to read this book cover-to-cover, it can be useful to refer to its specific chapters on how to assess different types of research papers. We have copies available in the library!

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Graduate Nursing

• Electronic Resources
• Finding Books
• Professional Organizations
• CRAAP Method
• APA Guide 7th Edition

Literature Review

• Copyright and Plagiarism

How to Search

Need more articles, but can't seem to find the right ones? Try these techniques!

Backwards searching: Once you find a relevant article, check the reference list at the end of the article. This will help you find other pertinent articles. 

Forward searching : Once you find a relevant article, look at whether it has been cited in more-recent research. If a researcher cited it, it is likely that their paper will also relate to your topic. ResearchGate is a community for students and researchers. It lists where each of their publications have been cited, if at all. This can be found under the "citations" tab that pops up when you click on any publication. 

When stuck, ask yourself, "What else is related to my topic?"

Get creative! You might find useful literature that you did not initially anticipate.

Fonseca, M. (2013, November 4) 5 tips to write a great literature review. https://www.editage.com/insights/5-tips-to-write-a-great-literature-review?refer=scroll-to-1-article&refer-type=article

What is a Literature Review?

"A literature review is a critical summary of all the published works on a particular topic" (Fonseca, 2013). A literature review provides background for your paper by quickly bringing the reader up-to-date on relevant findings, controversies, and dilemmas. It is the author's chance to "set the scene" and demonstrate why their topic is of interest to academia. In your literature review, you will describe "where your project comes from and how it fits in with existing knowledge" (Lloyd, 2017-2018). Further, you will provide "an argument for why your project makes a valuable contribution" (Lloyd, 2017-2018).

References: 

Lloyd, C.(2017-2018). Literature reviews for sociology senior theses . [PowerPoint Slides]. https://socthesis.fas.harvard.edu/files/socseniorthesis/files/pres-litreview.pdf

Step One: Define Your Research Question

What are you trying to determine for your literature review? What specifically do you want to learn more about? Choose a topic that you are genuinely interested in. Next, conduct a broad search on it. Determine what trending and popular research is available, then narrow your topic down. You can refine it by one or more of the following:

• Geographic location
• Time period
• Discipline/field of study, etc.

Research terms will help define your question.

• A broad question might be something like: What is the homeless population like?
• A narrow and specific question may include: What social and political factors have affected the growth of the middle-aged homeless population in Toronto within the past five years?

Once you have determined an appropriate research question/topic, move on to planning your approach.

Dermody, K., Literature Reviews. (2020, January 23). Retrieved from https://learn.library.ryerson.ca/literaturereview.

Step Two: Plan Your Approach 

After you have landed a research question, ask yourself "Which specific terms will I use, and where am I going to begin?" Determine what kind of literature you want to look at, whether it be journal articles, books, electronic resources, newspapers, or even other literature reviews on similar topics.

Your keywords are the main concepts or ideas of your paper.  For example, the keywords for a paper on “youth employment in Canada” would be:

Use synonyms: Often there are multiple ways to express the same concept. Make sure to use synonyms in your research. For instance, "employment" can be researched as:

Lastly, use “ AND ” and “ OR .” By bridging your truncated keywords and synonyms with the capitalized search words “AND” and “OR” (known as Boolean operators), you can search for multiple concepts effectively. For more information, visit the "electronic resources" tab of this research guide. There is a box on Boolean operators. 

Step Four: Analyze Material

When searching for material, it is important to analyze your sources for credibility, accuracy, currency, and authenticity. Ask these questions when analyzing a source:

• What is the purpose of the work?
• How current is it?
• Who is the author? 
• What are the author's biases?
• Is this work peer reviewed? 
• How accurate is this information? What facts/empirical evidence support it?
• What time frame are you looking at for your literature review, and does the work fall within that range?

Step Five: Manage Your Results 

After analyzing your research and determining what sources you want to use, it's important to keep track of what you have looked through. Keep a list of the following:

• What searches you have completed.
• Which ones were successful and unsuccessful.
• What databases you used.
• What sources you want to use for your literature review.
• What else you may want to search for next.

You can do this using software such as Zotero , Mendeley , and EndNote .

Congratulations! You are making progress towards an exceptional literature review.

Literature Review vs. Annotated Bibliography  Both a literature review (A.K.A. literature synthesis) and an annotated bibliography summarize the existing body of knowledge on a given topic.

What is the difference between a literature review and an annotated bibliography?  Unlike literature reviews, annotated bibliographies summarize entire research articles. An annotated bibliography looks like this:

Annotated Bibliography

•    Summarizes each article separately.

o    First, students discuss article one, then two, etc.  o    Topic: Blood Donation

• Paragraph 1: Bonnie and Clyde (2019) wrote "this" on blood donation.
• Paragraph 2: Rose and Jack (1997) wrote "this" on blood donation.
• Paragraph 3: Mary-Kate and Ashley (2001) wrote "this" on blood donation.
• Result: Multiple summaries of individual research articles (Lloyd, 2017-2018).

•    Describes the existing body of knowledge by integrating and synthesizing the literature to create something new.

o     Topic: Blood Donation

• Paragraph 1: Information/research findings on red blood cells pulled from multiple sources.
• Paragraph 2: Information/research findings on platelets pulled from multiple sources.
• Paragraph 3: Information/research findings on white blood cells pulled from multiple sources.
• Paragraph 4: Information/research findings on the drawbacks of donating blood from multiple sources (Lloyd, 2017-2018).
• Result: The author points out "themes, concepts, gaps and disagreements" between articles (Hofer, Hanick & Townsend, 2019, p. 216). Students use these to describe the existing body of knowledge on their topic one concept at a time. 

References:

Hofer, A. R., Hanick S. L., & Townsend, L. (2019). Designing activities for conceptual teaching. Transforming information literacy instruction: Threshold concepts in theory and practice. (p. 209-224). Libraries Unlimited.

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Reviews of Literature in Nursing Research

Methodological considerations and defining characteristics.

Silva, Amina Regina MN; Padilha, Maria Itayra PhD; Petry, Stefany MN; Silva E Silva, Vanessa PhD; Woo, Kevin PhD; Galica, Jacqueline PhD; Wilson, Rosemary PhD; Luctkar-Flude, Marian PhD

School of Nursing, Queen's University, Kingston, Ontario, Canada (Ms Silva and Drs Woo, Galica, Wilson, and Luctkar-Flude); School of Nursing, Federal University of Santa Catarina, Santa Catarina, Brazil (Dr Padilha and Ms Petry); and Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada (Dr Silva E Silva).

Correspondence: Amina Regina Silva, MN, School of Nursing, Queen's University, 99 University Ave, Kingston, ON K7L 3N6, Canada ( [email protected] ).

The authors acknowledge the support received from the School of Nursing at Queen's University in the development of this article.

The authors have no conflict of interest to declare.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Despite the availability of guidelines about the different types of review literature, the identification of the best approach is not always clear for nursing researchers. Therefore, in this article, we provide a comprehensive guide to be used by health care and nursing scholars while choosing among 4 popular types of reviews (narrative, integrative, scoping, and systematic review), including a descriptive discussion, critical analysis, and decision map tree. Although some review methodologies are more rigorous, it would be inaccurate to say that one is preferable over the others. Instead, each methodology is adequate for a certain type of investigation, nursing methodology research, and research paradigm.

CURRENTLY, there is an information overload in the scientific literature, with millions of articles being published every year in peer-reviewed journals. 1 Although this abundance may signal advances in scientific inquiry, knowledge users in clinical practice and policy development are often overwhelmed by the volume of information available. Thus, different reviews are designed to follow structured and robust methodologies to select, collate, and synthesize existing findings to make evidence more meaningful and accessible. 2 , 3

The primary aims of conducting a review are to identify knowledge gaps, delineate an issue, and clarify concepts that are relevant to a particular question. 2 By bringing together a diversity of evidence for comparison, reviews are more reliable and powerful than single studies. 2 , 4 The various reviews are designed to respond to different research questions, and they can be distinguished by the rigor of methodological considerations. In addition, the philosophical stance that researchers embrace while conducting a review will influence the way they assemble, analyze, and interpret the data extracted from a heterogeneous body of literature to produce knowledge from that. 5 When there is an inappropriate fit between research question, review methodology, and/or philosophical stance, this can yield inconsistent results and conclusions; therefore, it is important that scholars are aware of the differences when deciding on the review methodology for their study. 6

There are several typologies of review, but the most commonly used literature reviews in nursing research are narrative, integrative, and systematic reviews. 7–9 In addition, another methodology that has been increasing in popularity and adding to the complexity of typologies of reviews is the scoping review. Currently, there is a lack of studies that assemble a comparative analysis of these 4 methodologies to provide a comprehensive guide for nursing and health care scholars to use when choosing among the different types of literature reviews. 9 , 10 Therefore, the purpose of this article is to contribute to existing knowledge by describing the defining characteristics of narrative, integrative, scoping, and systematic reviews and provide a comparative analysis and decision tree for when each methodology could be appropriate. Finally, by detailing the main characteristics of these reviews, this article is to be used as a starting point for researchers when deciding which type of review could be appropriate for their topic.

Statements of Significance

What is known or assumed to be true about this topic?

Scientific data are published at a rapid rate; thus, literature reviews are increasing in popularity to collate and synthetize the literature and make it more accessible for health care professionals. In nursing research, the most commonly used review methodologies are narrative, integrative, scoping, and systematic reviews. Despite the availability of guidelines about these reviews, the identification of the best approach is not always clear for nurse researchers, which can lead to inconsistencies in the choice of methodology and results. Also, there is a lack of studies approaching and analyzing to these 4 review methodologies together to provide guidance to researchers.

What this article adds:

In this article, we described 4 popular types of literature review in nursing research (narrative, integrative, scoping, and systematic) and provided a discussion around their definition, indication, methodological characteristics, advantages and disadvantages. Although some review methodologies are more rigorous and transparent, each methodology is adequate for a certain type of investigation and research paradigm. Thus, we also provide examples, comparative analysis, and a decision map tree to offer a comprehensive guide to be used by nursing and health care scholars while choosing among the different types of literature reviews.

REVIEWS OF LITERATURE: DEFINING CHARACTERISTICS

In this article, different frameworks used in nursing and health care research are combined to examine, organize, synthesize, and present a discussion around the topic in a comprehensive way. Some examples of the frameworks used to guide our discussion are the Joanna Briggs Institute (JBI) standards for evidence synthesis, 3 Whittemore and Knafl, 11 Ganong, 12 Mendes et al, 13 Rozas and Klein, 14 and Rother, 15 among others.

Narrative reviews

Narrative reviews, also known as traditional reviews, can be defined as the generic approach used to collate, synthesize, and present an overview of a given subject. 15 This approach is the oldest type of review, and it has been widely used to give a synopsis of the evidence related to a certain topic in academic papers, thesis, and other works. 14 Narrative reviews are usually used as a source for research ideas and knowledge of practical and theoretical issues. This review can also be used to estimate the prospect of a study and provide specific information to identify research definitions, propositions, limitations, and hypotheses. 9 , 10 , 16

Methodological and philosophical underpinnings

There are no preestablished standards related to conducting a narrative review, nor specific strategies to be used to formulate the research question ( Table 1 ); the only requirement is having a topic of interest. 9 The methodological freedom allows the researcher to conduct the review in accordance with their individual preferences related to the review purpose and inclusion of studies. 14 However, narrative reviews do not usually present a methodology that allows the data to be reproduced or verified because of the lack of clarity related to the procedures in the search strategy and study selection. 14 , 17 The philosophical underpinnings can vary widely, but as narrative reviews aim to provide a generic overview of the topic rather than summarize evidence to guide practice, the use of a subjectivist view of the phenomenon is more common. 5 The subjectivist epistemology rejects the idea that a single, objective, and measurable truth exists to be discovered; instead, it defends the notion that there is an understanding about reality that is constructed on the basis of individuals' interactions with others and their surroundings. 5 Thus, the results of a narrative review are usually based upon an interactive process among researchers, phenomenon, and context.

Narrative reviews are commonly used as they provide breadth of literature coverage and flexibility to deal with evolving knowledge and are considered valuable depending on the purpose of the review and the resources available. 14 , 17 In addition, the narrative review continues to occupy a prominent place in the synthesis of knowledge and has a fundamental role in advancing knowledge as it provides a reasonably complete overview on a topic, allowing the reader to acquire and update knowledge in a short period of time. 14 , 15 , 18

Disadvantages

Traditional reviews are criticized as a less reliable approach because the methodology is subjective and carries a high risk of bias. 2 The absence of explicit and systematic criteria for searching, extracting, analyzing, and reporting the literature can result in significant methodological issues. 9 , 19 As the methods applied for searching process and study selection are not transparent and replicable, this can lead to bias in the researcher's interpretation and conclusions about the literature extracted, as they may not question the validity of the statements made. 2 , 9 , 20 In addition, authors may selectively include literature that supports their own argument and exclude evidence that is contradictory to their hypothesis. 10

Integrative reviews

Integrative reviews, also known as semi-systematic reviews, aim to collate the results of previous scientific studies with different methodological approaches and are widely used in evidence-based practice for nursing to determine the current knowledge on a specific theme. 11 Yet, a key differentiating aspect of integrative reviews is that they aim to integrate the results to develop a new knowledge instead of summarizing and presenting previous findings. 18 In addition, the integrative review is particularly useful when the review needs to be conducted using a systematic approach but within a shorter time frame (eg, when compared with systematic/scoping reviews) since its methodological approach involves fewer steps. 11 , 14 , 18

There are 3 main foci for integrative reviews: methodological (review and analysis of designs and methodologies), theoretical (review of theories on a particular topic), and empirical (review of empirical studies with analysis of results and relationships between variables). 11 To formulate the research question for integrative reviews, the PICo (Population, phenomena of Interest, Context) strategy is usually recommended ( Table 1 ). In addition, integrative reviews commonly use a subjectivist view of the phenomenon and an interactive process to provide an overview of a certain topic instead of offering an objective measurable result to guide practice. The process of developing an integrative review is well defined in the literature; however, different authors adopt different ways of subdividing that process, with minor modifications. 11–13

Overall, 6 distinct stages are mentioned that must be followed sequentially to guarantee the quality of evidence: (1) elaboration of the guiding question (using a clear strategy, eg, PICo); (2) survey or sampling of the literature (including all of the studies found or just a selection, and clearly stating and justifying the criteria for inclusion); (3) data collection (using a preestablished data extraction instrument); (4) critical analysis of the included studies (using an organized and predefined approach, which may or may not include a quality assessment); (5) discussion of results (interpretation and synthesis of the results); and (6) presentation of the integrative review (it must be clear and complete, integrating results and without omitting any related evidence). 11–13

Integrative reviews allow the researcher to collate and synthesize scientific literature using different methodological approaches and involve preestablished steps in the process of article searching and selection. The advantage of following a predetermined and well-described process is to ensure transparency and replicability. The model of the integrative review is usually defined as a consistent method for evidence synthesis as it has detailed methods for data collection and extraction. 11

Although integrative reviews have clear methods for data collection and extraction, aspects related to analysis and synthesis can be considered a weakness of this methodology as they are not well established and usually do not include a quality appraisal. 11 In addition, the complexity inherent in the combination of several methodologies can contribute to imprecision, prejudice, and a lack of rigor as the results extracted from scientific articles that use different methodologies can result in a large tangle of varied data. 2 , 11 , 21

Scoping reviews

Scoping reviews can be considered a novelty when compared with other types of reviews. 9 Alternative names for scoping reviews are “scoping studies” or “mapping reviews,” and this methodology allows the researcher to ask broader, yet precise, questions to map the literature around a certain topic. 22 Scoping reviews are indicated to clarify key concepts or knowledge gaps in the literature, provide a map of a certain topic, guide future research, and identify implications for practice and policy. 5 , 22 Scoping reviews are particularly useful for emerging fields, where the body of literature is relatively unknown or needs to be further and/or widely explored. 9

Scoping reviews originated in social sciences and can assemble evidence from different methodological approaches (eg, qualitative, quantitative, gray, and unpublished literature). 5 This review usually uses a subjectivist epistemology and is constructed on the basis of the interaction among researchers, phenomenon, and context of study to produce a subjective knowledge of the topic instead of a single objectivist answer. 5 Nonetheless, depending on the aim of the review and the results yielded, objective answers can be part of the results of a scoping review. 22 To formulate the research question, the PCC (Population, Concept, Context) strategy is usually recommended, although the PICo strategy can also be used ( Table 1 ).

In health care research, the JBI framework proposed by Peters et al 23 identifies 9 steps to be followed in the conduct of scoping reviews: (1) define and align the objectives and research questions; (2) develop and align the inclusion criteria with the objectives and research questions; (3) describe the evidence behind the approach used for searching strategy, data selection and extraction, and demonstration of evidence; (4) search for evidence; (5) select evidence; (6) extract evidence; (7) analyze evidence; (8) present the results; and (9) summarize the evidence aligned with the purpose of the review, presenting conclusions, and reporting the implication of findings for future practice, policy, and research. 23

In addition, another important methodological consideration in the conduct of scoping reviews is the development of a protocol prior to the execution of the review. 23 An effective review protocol should give a clear introduction to the topic, key concepts, aims, research questions, inclusion criteria, types of sources, search strategy, information sources, study selection, data extraction, and data presentation, and it can/should be published (for instance, at JBI evidence synthesis or other peer-reviewed journals). 22 The protocol guides the review process and is a key aspect in the differentiation of reviews with a systematic approach, such as scoping and systematic reviews, from other less rigorous methodologies, such as narrative and integrative reviews. 24 To avoid the conduct of duplicate reviews, the title page and review should also be registered (eg, at JBI, Open Science Framework, or Figshare).

In addition, at least 2 reviewers are required to minimize bias in the data selection and extraction for scoping reviews. 3 , 25 The final report of a scoping review should include any deviation from the protocol and, although scoping reviews are not aimed at reporting implications for practice, this can be included if there are substantial findings. 22 Scoping reviews usually do not include a quality appraisal but if relevant to the topic of interest, this step can be justified and included. Finally, the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) should be used to help guide and report scoping review processes. 26 , 27

The scoping review is a rigorous and systematic methodology that promotes a broad perspective on a given topic and allows the researcher to include a wide range of literature (eg, opinion papers, articles from peer-reviewed journals, and gray literature). 5 , 9 , 22 This methodology is iterative instead of linear, as scholars need to be engaged and reflect on each step of the process and, if necessary, repeat the steps to ensure that the literature is covered in a comprehensive way. 16

Scoping reviews can be time-consuming due to the wide range of literature and the broader approach involved. This methodology does not usually include a quality appraisal of the literature, which can result in potential bias in the final report and concluding statements. 9 , 10 In addition, scoping reviews have an exploratory nature and are not aimed at producing a summary finding; consequently, they usually do not directly promote clinical practice changes or guidance, which can limit the applicability of their results. 9 , 10

Systematic reviews

Systematic reviews aim to provide a comprehensive and unbiased review on a given topic using a systematic, rigorous, and transparent methodology to find “all” literature relevant to the purpose of the review by means of a precise research question and an international perspective. 28 Systematic reviews involve a narrow and well-established topic of interest and are particularly effective in confirming or refuting the evidence behind a given practice, establishing the quality of practice or evidence, and addressing any level of uncertainty that may occur around a certain topic. 3 , 4 , 9

Systematic reviews usually use an objectivist view of the phenomena as they are constantly attempting to find an objective truth and use it to guide practice. 5 , 29 , 30 The objectivist epistemology denies knowledge as a product that interacts or is influenced by social context; instead, it defends the idea that knowledge is an objective truth to be discovered. 31 Therefore, findings of systematic reviews aim to synthesize many studies together in a linear, comprehensive, and unbiased way in order to produce a finding summary. 5 , 28

According to JBI, there are 8 different types of systematic reviews: (1) qualitative evidence; (2) effectiveness; (3) text and opinion; (4) prevalence and incidence; (5) economic evidence; (6) etiology and risk; (7) mixed methods; and (8) diagnostic test accuracy. 19 , 28 Each of these review types involves different strategies to formulate the research question ( Table 1 ). Moreover, although there are different types of systematic reviews, the systematic review process generally includes 8 steps: (1) formulate a research question; (2) define inclusion criteria; (3) locate studies through an extensive search; (4) select studies for inclusion; (5) assess the quality of studies; (6) extract the data; (7) analyze and synthesize the data; and (8) present, interpret, and report the results using an evaluation of the certainty evidence (eg, GRADE). 3 , 28

In addition, there are some terms used in the context of systematic reviews, such as “meta-analysis” and “meta-aggregation,” that can cause a certain level of confusion among scholars. 28 Meta-analysis refers to the use of a rigorous, quantitative, statistical synthesis that may or may not be included in a systematic review, depending on the review purpose and whether the data allow this type of statistical approach. 32 Meta-aggregation (or meta-synthesis) also may or may not be included in a systematic review and refers to the use of a rigorous analysis of qualitative studies to discover the essential elements and translate the primary results into a final product, resulting in (re)conceptualizations of the original conclusions. 3 , 33

Another type of systematic review approach is the umbrella review. Also known as the review of reviews, this methodology uses a systematic analysis approach to provide a comprehensive appraisal of results from other reviews. An umbrella review is particularly indicated for areas of research where there is a large body of literature and high-quality reviews, as the researcher can compare and contrast results from different systematic studies and address quality or the persistence of any uncertainty or variation of practice. 34 , 35

A recommended standard report that can be used to help guide systematic review processes is the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). 27 In addition, the conduct of systematic reviews requires a protocol (similar to that required for scoping reviews) and at least 2 reviewers to screen and select the studies, extract and analyze the data, perform an appraisal, and summarize the results. 9

Systematic reviews strive to uncover all relevant literature on the topic to provide a trustworthy overview of the specific topic of interest and are therefore ranked as the highest level of evidence. 3 , 4 , 9 This review involves a critical appraisal of the literature using predetermined tools (eg, CAPS, JBI, MMAT), which help endorse the quality of the evidence extracted. In addition, systematic reviews aim to provide a finding summary and orientation for practice, which can confirm or refute the evidence behind a given practice and give clear orientation for health care providers. 3 , 4 , 9

The narrow and objectivist approach of systematic reviews can result in limited overviews of the given topic and the loss of information about important outcomes. 36 In addition, systematic reviews usually require a substantial period of time and high costs, and, if the methodology is not rigorously followed according to the preestablished criteria of the study and protocol, the data may be collated incorrectly.

REVIEWS OF THE LITERATURE: COMPARATIVE ANALYSIS

The different approaches to conduct reviews of the literature can cause confusion among researchers. 9 But related to methodological aspects, there are some defining characteristics that can differentiate the types of reviews. To help clarify and address these main methodological differences, the Search, Appraisal, Synthesis, and Analysis (SALSA) framework has been used. 10 The SALSA framework was created in a previous study 10 to identify the characteristics of the main phases involved in each review type. These main phases are (1) the searching process, (2) quality appraisal of the evidence, (3) synthesis of the evidence, and (4) the analysis process. The use of the SALSA framework in this article will help scholars easily recognize the similarities of and differences among the steps of each review methodology; these can be found in Table 2 . 10 Furthermore, because of some similarities in methods, common confusion among health scholars is usually related to the differentiation between narrative and integrative reviews, integrative and scoping reviews, and scoping and systematic reviews; therefore, a comparative analysis that can help clarify these differentiations is presented in the following text. 7–10

Narrative versus integrative reviews

Narrative and integrative reviews usually use a subjectivist view of the phenomenon in order to provide an overview of the topic rather than summarize evidence to guide practice. However, the methodology of both types of reviews can be easily differentiated, as narrative reviews do not use an organized and transparent search method as do integrative reviews. In addition, narrative reviews collate studies within specific topics of interest to provide an overview while integrative reviews collate and analyze the results of studies on the same topic to trace an interpretation of its meaning and importance, providing an integrated new knowledge as a result.

Integrative versus scoping reviews

Both of these review types have similar research indications, which may include providing an overview of the literature and even signaling potential gaps. As well, they share similar research paradigms that include a subjectivist view of the phenomenon. Integrative and scoping reviews include a systematic and organized method of searching and extracting research results; yet, the scoping review has a more rigorous process of search strategy development and is guided by a preestablished protocol. Moreover, integrative reviews include only published scientific material while scoping reviews accept published literature and nonscientific and unpublished reports. Finally, scoping reviews group the data to present the results but do not integrate and synthesize the data to produce a new knowledge as do integrative reviews.

Scoping versus systematic reviews

Authors who conduct scoping reviews do not necessarily perform a critical appraisal of the included studies, nor do they provide a summary finding, whereas both are required for systematic reviews. 3 In addition, scoping reviews ask broader questions and are more useful for topics where the literature needs to be uncovered to provide a map, clarify concepts or knowledge gaps, or even guide future researchers. 3 , 9 , 22 In contrast, systematic reviews ask more precise and specific questions, looking to uncover “all” literature on a certain topic using an international perspective and providing a summary of findings focused on an objective truth. 9 , 22 , 28 Therefore, one could say that scoping reviews provide a macroscopic lens through a subjectivist epistemology on a given topic while systematic reviews provide a microscopic lens with an objectivist epistemology of the topic. 3 , 5

The decision tree

To help authors decide the most appropriate review type according to the purpose of the study, a fundamental decision tree has been developed. The decision tree is presented in the Figure and should be combined with other considerations (eg, paradigm of research, resources available, and desired outcomes) to facilitate the choice of the appropriate methodology of review.

Reviews of literature are essential to summarize evidence, provide a more comprehensive and synthesized literature for health care professionals, and facilitate the interpretation of research used in clinical practice. Even with the existence of guidelines for the different types of reviews, deciding the best approach is not straightforward. Although some methodologies are more rigorous and transparent, it would be inaccurate to say that one methodology is preferable over the others. Instead, each methodology of review is appropriate for a certain type of investigation and research paradigm. Therefore, in choosing the best option among narrative, integrative, scoping, and systematic reviews, researchers should consider the different types of review against the purpose of their study and the resources available.

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What are the types of reviews?

As you begin searching through the literature for evidence, you will come across different types of publications. Below are examples of the most common types and explanations of what they are. Although systematic reviews and meta-analysis are considered the highest quality of evidence, not every topic will have an Systematic Review or Metanalysis.

Use the PRISMA Online Checklist to assess research and systematic reviews

Literature Review Examples

Remember, a literature review provides an overview of a topic. There may or may not be a method for how studies are collected or interpreted. Lit reviews aren't always obviously labeled "literature review"; they may be embedded within sections such as the introduction or background. You can figure this out by reading the article . 

• Dance therapy for individuals with Parkinson's Disease Notice how the introduction and subheadings provide background on the topic and describe way it's important. Some studies are grouped together that convey a similar idea. Limitations of some studies are addressed as a way of showing the significance of the research topic.
• Ethical Issues Regarding Human Cloning: A Nursing Perspective Notice how this article is broken into several sections: background on human cloning, harms of cloning, and nursing issues in cloning. These are the themes of the different articles that were used in writing this literature review. Look at how the articles work together to form a cohesive piece of literature.

Systematic Review Examples

Systematic reviews address a clinical question.  Reviews are gathered using a specific, defined set of criteria.

• Selection criteria is defined
• The words "Systematic Review" may appear int he title or abstract
• BTW -> Cochrane Reviews aka Systematic Reviews
• Additional reviews can be found by using a systematic review limit 
• A Systematic Review of Animal-Assisted Therapy on Psychosocial Outcomes in People with Intellectual Disability
• The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews
• Cochrane Library (Wiley) This link opens in a new window Over 5000 reviews of research on medical treatments, practices, and diagnostic tests are provided in this database. Cochrane Reviews is the premier resource for Evidence Based Practice.
• PubMed (NLM) This link opens in a new window PubMed comprises more than 22 million citations for biomedical literature from MEDLINE, life science journals, and online books.

Meta-Analysis Examples

Meta-analysis is a study that combines data from OTHER studies. All the studies are combined to argue whether a clinical intervention is statistically significant by combining the results from the other studies.  For example, you want to examine a specific headache intervention without running a clinical trial.  You can look at other articles that discuss your clinical intervention, combine all the participants from those articles, and run a statistical analysis to test if your results are significant. Guess what? There's a lot of math. 

• Include the words "meta-analysis" or "meta analysis" in your keywords
• Meta-analyses will always be accompanied by a systematic review, but a systematic review may not have a meta-analysis
• See if the abstract or results section mention a meta-analysis
• Use databases like Cochrane or PubMed
• Exercise Interventions for Preventing Falls Among Older People in Care Facilities: A Meta-Analysis
• Acupuncture for the prevention of tension-type headache This is a systematic review that includes a meta-analysis. Check out the Abstract and Results for an example of what a meta-analysis looks like!
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Top Nursing Literature Review Examples for UK-Based Researchers

When it comes to conducting research in the field of nursing, a well-crafted literature review is the cornerstone of your academic journey. As a UK-based researcher, you understand the importance of aligning your work with the latest healthcare policies, guidelines, and research priorities. To help you on your path to excellence, we’ve compiled a curated selection of top nursing literature review examples that will not only inspire you but also provide practical insights into creating your own stellar literature review .

Table of Contents

The Crucial Role of a Nursing Literature Review

Before we delve into the world of nursing literature review examples, let’s take a moment to appreciate the pivotal role this section plays in your research:

• Knowledge Synthesis: A nursing literature review is your opportunity to synthesize existing research and knowledge related to your topic. It allows you to identify key themes, trends, and gaps in the literature.
• Evidence-Based Practice: Nursing is a field where evidence-based practice is paramount. Your literature review provides the foundation for making informed decisions in clinical practice, policy development, and research design.
• Critical Analysis: It demonstrates your critical thinking and analytical skills. A well-crafted literature review showcases your ability to assess the quality and relevance of research articles.
• Contextualization: Your literature review places your research within the broader context of the field, allowing readers to understand the significance of your work.

Given the significance of the nursing literature review , it’s essential to have access to high-quality examples that can guide you in creating a literature review that stands out.

Nursing Literature Review Example: A Source of Inspiration

Nursing literature review examples serve as beacons of inspiration for researchers at all levels. Here’s why they are so valuable:

• Structural Guidance: Examples provide insight into how to structure your literature review effectively. You can see how to introduce, organize, and conclude various sections.
• Writing Style: By studying examples, you can get a sense of the appropriate academic writing style, tone, and language for your literature review .
• Citation and Referencing: Examples demonstrate how to properly cite and reference sources, which is crucial for maintaining academic integrity.
• Research Focus: Examining examples specific to nursing allows you to understand the key areas of research and the current state of knowledge in the field.

Now, let’s explore where you can find these invaluable examples.

1. University Libraries and Databases

University libraries and academic databases are excellent starting points. Most universities provide access to digital dissertations, theses, and research papers through their library websites. Academic databases such as PubMed and CINAHL also host a vast collection of nursing literature reviews. You can search for literature reviews related to your specific nursing topic and access them online.

2. Online Academic Repositories

Numerous online platforms specialize in hosting academic research, including nursing literature reviews. Websites like ResearchGate and JSTOR offer a wealth of resources. These platforms often provide downloadable PDFs of research papers, dissertations, and theses.

3. Nursing Journals

Academic nursing journals frequently publish literature reviews as part of research articles. Journals like the “Journal of Advanced Nursing” and the “Journal of Nursing Scholarship” feature high-quality literature reviews. You can access these articles online and download them for reference.

4. Nursing Schools and Departments

Check the websites of nursing schools and departments at renowned universities. They often showcase exemplary student work, including literature reviews. These examples are typically curated to showcase exceptional research.

5. Online Academic Writing Services

Another valuable source of nursing literature review examples is online academic writing services like ours. These services often maintain a repository of sample papers and dissertations that students and researchers can access for reference. These examples are typically well-crafted and can serve as a guide for your own work.

Example of a Nursing Literature Review PDF: Tailored to Your Field

If you’re pursuing a nursing degree or conducting research in nursing, you may require literature review examples specific to your field. Here’s where to find an example of a nursing literature review PDF:

• University Nursing Departments: Nursing departments of universities often showcase the work of their students on their websites. These examples are tailored to nursing topics and can provide valuable insights.
• Nursing Conferences and Seminars: Nursing conferences and seminars often feature presentations and research papers with literature reviews. You may find relevant literature review examples presented at these events.

Nursing Research Organizations: Organizations like the American Nurses Association (ANA) or the Royal College of Nursing (RCN) in the UK may publish research papers and literature reviews on their websites.

Literature Review Examples Nursing: How to Make the Most of Them

Now that you know where to find nursing literature review examples, it’s crucial to understand how to make the most of these resources:

• Analyze Structure: Pay close attention to the structure of the literature review . Observe how it begins with an introduction, progresses with literature synthesis, and concludes with a summary.
• Study Citation Style: Examine how sources are cited and referenced. Ensure that you understand the citation style used (e.g., APA, MLA, Chicago) and follow it consistently in your own work.
• Identify Key Themes: Look for the identification of key themes, theories, or gaps in the literature. Understanding how these elements are woven into the narrative can guide your own literature review .

Adapt to Your Research: While examples provide valuable guidance, remember to adapt them to your specific research question and context. Your literature review should reflect your unique research focus.

Conclusion: Elevating Your Nursing Research

In your journey to contribute to the field of nursing research, access to high-quality nursing literature review examples is a powerful asset. They offer guidance, structure, and inspiration to create a literature review that makes an impact. Whether you’re a student, a seasoned researcher, or a clinician seeking to integrate evidence-based practice, these resources can help you excel.

Nursing literature review examples provide a roadmap for your research journey. They help you navigate the complexities of academic writing, ensure the credibility of your sources, and demonstrate the relevance of your research. Embrace these examples as valuable tools on your path to excellence.

Remember that while examples are invaluable, your own research and unique contribution to the nursing literature are what truly matter. Use these examples as guides, build upon them, and embark on your journey to elevate nursing research in the UK and beyond. Your dedication and commitment will shape the future of healthcare and make a lasting impact in the field of nursing.

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• Published: 01 August 2024

Literature review of complementary and alternative therapies: using text mining and analysis of trends in nursing research

• Jihye Nam   ORCID: orcid.org/0000-0002-5534-2660 1 ,
• Hyejin Lee   ORCID: orcid.org/0000-0002-8501-0560 1 ,
• Seunghyeon Lee   ORCID: orcid.org/0009-0005-6411-364X 1 &
• Hyojung Park   ORCID: orcid.org/0000-0002-7804-0593 1  

BMC Nursing volume  23 , Article number:  526 ( 2024 ) Cite this article

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Metrics details

This study aimed to review the literature on complementary and alternative therapies, utilizing text mining and trend analysis in nursing research. As CAM becomes increasingly prevalent in healthcare settings, a comprehensive understanding of the current research landscape is essential to guide evidence-based practice, inform clinical decision-making, and ultimately enhance patient outcomes.

This study aimed to identify CAM-related literature published from 2018 to 2023. Using the search terms 'complementary therap*', 'complementary medicine', 'alternative therap*', and 'alternative medicine', we performed a comprehensive search in eight databases, including EMBASE, Cochrane Central, PubMed Central, Korea Education and Research Information Service (RISS), Web of Science, KMbase, KISS, and CINAHL. From the text network and topic modeling analysis of 66,490 documents, 15 topics were identified. These topics were classified into two nursing-related topics through an academic classification process involving three doctors with doctoral degrees, three nurses, and three pharmacists. Based on the classified topics, research trends were comparatively analyzed by re-searching the database for 12 nursing and 22 non-nursing literature.

This study found that in nursing literature, yoga is used to improve mental symptoms such as stress and anxiety. In non-nursing literature, most of the experimental studies on complementary and alternative therapies were conducted in a randomized manner, confirming that a variety of physiological and objective indicators were used. Additionally, it was discovered that there were differences in the diversity of research subjects and research design methods for the same intervention method. Therefore, future research should focus on broadening the scope of subjects and measurement tools in nursing studies. Additionally, such studies should be conducted with randomization and generalizability in the experimental design in mind.

This study employed text network analysis and text mining to identify domestic and international CAM research trends. Our novel approach combined big data-derived keywords with a systematic classification method, proposing a new methodological strategy for trend analysis. Future nursing research should focus on broadening the scope of subjects, diversifying measurement tools, and emphasizing randomization and generalizability in experimental designs.

Peer Review reports

The World Health Organization (WHO) defines complementary and alternative medicine (CAM) as healthcare practices outside a country's traditional or conventional medicine [ 1 ]. According to the National Center for Complementary and Integrative Health (NCCIH), CAM encompasses nutritional approaches (e.g., herbs), psychological methods (e.g., mindfulness), physical therapies (e.g., massage), integrated mind–body practices (e.g., yoga or auricular acupressure), and modalities that combine psychology and nutrition [ 2 ]. This definition suggests CAM may facilitate holistic nursing by addressing both psychological and physical aspects [ 3 ]. Consequently, substantial CAM research is conducted in nursing internationally [ 4 , 5 ], spanning areas like pain, depression, anxiety, chronic disease symptoms, sleep disturbances, and vomiting [ 4 , 5 , 6 ]. Classification systems exist, with the Korean Nursing Association (2023) delineating 12 CAM subcategories [ 6 ] and NCCIH outlining 76 therapies across major categories like nutrition, body, and psychotherapies [ 4 , 5 , 6 , 7 ]. The multitude of CAM types has prompted trend identification research, including reviews on Chinese medicine for allergic rhinitis, aromatherapy, auricular acupressure, and CAM for COVID-19 [ 6 , 8 ]. However, many previous studies have significant limitations in comprehensively identifying overall research trends in CAM. First, they tend to focus narrowly on specific diseases or treatments, lacking a broader perspective on the field as a whole [ 6 , 8 ]. Second, the use of search queries containing keywords from a specific discipline or arbitrarily selected by researchers introduces bias and hinders the identification of overarching trends [ 9 , 10 ]. These limitations highlight the need for a more systematic and data-driven approach to analyzing CAM research trends [ 11 , 12 , 13 ]. A previous study [ 14 , 15 ] suggested the use of text mining technique as an approach for literature review [ 16 ]. To date, the analysis on research trend in nursing has been conducted more than five years after publication or has only been conducted with partial analyses through literature reviews and text mining [ 17 , 18 , 19 ].

The overarching goal was to extract keywords identifying domestic and international CAM research trends using text network analysis and analyze these trends within the nursing field. Specific objectives were: 1) Identify frequency, degree centrality, closeness centrality, and betweenness centrality for keywords appearing in domestic and international CAM studies; 2) Identify key themes within these studies; 3) Discern nursing keywords among sub-topic groups; 4) Analyze and compare nursing and other disciplinary literature based on findings; and 5) Analyze the trend of CAM in nursing based on extracted nursing keywords.

Study design and methodological framework

This study employs a novel methodological framework that combines text mining techniques with expert validation to identify and analyze CAM research trends in a comprehensive and data-driven manner. The framework consists of the following key steps.

Data collection: A comprehensive search of multiple databases is conducted to collect a broad range of CAM-related literature across various disciplines.

Text preprocessing involves several techniques to prepare the data for analysis. These include natural language processing, stopword removal, and synonym standardization.

Keyword extraction and network analysis: Text mining techniques, including term frequency-inverse document frequency (TF-IDF) and centrality analysis, are applied to extract key topics and analyze their relationships within the literature.

Topic modeling: Latent Dirichlet Allocation (LDA) is used to identify latent topics within the literature and visualize their proportions and relationships.

Expert validation: An expert panel of physicians, nurses, and pharmacists is consulted to validate the relevance and credibility of the identified topics and classify them into respective academic fields.

Focused literature analysis: Based on the expert-validated nursing-related topics, a focused re-search and analysis of the literature are conducted to identify trends specific to nursing research on CAM.

This multi-step framework allows for a more comprehensive and less biased exploration of CAM research trends by leveraging text mining techniques to process large volumes of literature, identify key topics, and uncover patterns that may not be apparent through traditional review methods [ 14 , 15 , 16 ]. The integration of expert validation ensures the relevance and credibility of the findings, while the focused analysis of nursing literature provides insights specific to the nursing discipline within the broader context of CAM research. The process of selecting studies for our analysis is illustrated in Fig.  1 , which provides a clear visual representation of the key steps involved, from the initial database search to the final classification of studies into nursing and other disciplines. This multi-step approach, combined with the visual aid, enhances the clarity and transparency of our methodology, allowing readers to better understand and contextualize the subsequent data analysis steps.

Flow diagram for literature selection process

Literature selection

This study focused on complementary and alternative medicine studies conducted in the fields of medicine, public health, and nursing in Korea and abroad. After specifying the research title and abstract as the search scope to extract the literature and build a database, the literature related to nursing was classified based on the topics derived through text network analysis and then, the literature that met the selection criteria was secondarily extracted and analyzed through the abstract screening. The three researchers checked the consistency of the study selection process and if there was any discrepancy, the final decision was made through consensus among the researchers.

The selection criteria for the literature were: (1) domestic and foreign studies published within the last five years (January 2018 to September 2023) that conducted studies on complementary and alternative medicine; and

The exclusion criteria for the literature were grey literatures, dissertations, and studies for which original texts are not available.

Data collection strategies

In this study, the database was selected by referring to the COSI (Core, Standard, Ideal) [ 20 ] model presented by the National Library of Medicine for literature search. EMBASE, Cochrane Central, and PubMed Central were selected as the core databases.

On the other hand, the standard databases selected were the Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Korean database services such as the Research Information Sharing Service (RISS), KMbase, and Korean studies Information Service System (KISS). These Korean databases were included to ensure a comprehensive coverage of potentially relevant studies published in South Korea, as they index a wide range of domestic and international journals, conference proceedings, and dissertations across various disciplines, including those related to CAM. However, it is important to note that the inclusion of these Korean databases does not limit the scope of our study to Korean literature only, as the majority of our analysis focuses on studies published in English and indexed in the core and standard international databases.

In addition, the Web of Science was selected to include a wider range of literature for the ideal database, and the period of literature search focused on the last five years, from 1 January 2018 to 15 September 2023. to capture the most recent trends in CAM research following the last comprehensive analysis of CAM research trends conducted in 2018 by Sung et al. [ 19 ]. This time frame was chosen to provide an updated and comprehensive analysis of CAM research trends, building upon the findings of previous studies and identifying new patterns and areas of focus that have emerged in recent years, given the rapid evolution of CAM research and the increasing integration of CAM into mainstream healthcare.

The data collection procedure was limited for both domestic and foreign studies. In case of foreign studies, ‘English’ was limited as the search language, ‘abstract and title’ were identified as the field, ‘article’ was set as the document form, and the keywords were ‘complementary therap*,’ ‘complementary medicine,’ ‘alternative therap*,’ and ‘alternative medicine.’ For the Korean studies, ‘Korean’ was limited as the search language, ‘abstract and title’ were identified as the field, ‘article’ was set as the document form, and the search keywords used were ‘보완대체,’ ‘대체요법,’ and ‘대체의학.’ In searching for the secondary literature, studies in the field of nursing were presented to a group of nine experts including physicians, nurses, and pharmacists with a master's degree or higher, and then the relevant areas were classified to extract the keywords. These keywords were then used in the text mining search. Topic words, the majority of which were classified as nursing, were re-searched in the collected database. The literature selection and classification process were carried out independently by three researchers and promoted through discussions between the researchers.

Data analysis process

Data extraction.

A comprehensive literature search was conducted across eight databases: CINAHL, Cochrane, EMBASE, KISS, Kmbase, PubMed, RISS, and Web of Science. This extensive search yielded a total of 77,062 studies. To ensure the integrity and non-redundancy of our dataset, we employed a rigorous two-step deduplication process. First, we utilized the 'Find Duplicates' function in EndNote software for initial automatic deduplication. This function systematically identifies and groups potential duplicate records based on shared metadata such as title, authors, year, and DOI. Through this automated process, 12,107 duplicate records were identified and removed.

Following the automated process, we conducted a manual review to identify and remove any remaining duplicates that the software might have missed. This careful manual screening allowed us to catch subtle duplicates that automated systems might overlook, such as those with slight variations in titles or author names. Through this manual review, an additional 465 duplicate records were identified and removed. In total, our rigorous two-step deduplication process resulted in the removal of 12,572 duplicate records. Of these, 12,107 were removed through automated deduplication and 465 through manual review. After deduplication, 64,490 unique studies were retained for further analysis. These studies were systematically organized by title and subjected to a thorough text preprocessing phase. During this phase, unstructured words were sorted and cleaned using the social networking program Netminer 4.3.3 and text editor Notepad + + (version 8.5.8).

Also, stopwords such as pronouns, adverbs, and numbers were deleted through natural language processing, while exception list, defined words, and thesaurus were registered. The exception list and thesaurus were selected by the three researchers, and if they failed to reach a unanimous agreement, the keywords were refined through consultation and the abstracts and preambles were reviewed again to examine the context in which the words were used. In case of the exception list, literature search keywords or stopwords such as pronouns, adverbs, numbers, and special symbols were considered, while ‘complementary,’ ‘medicine,’ ‘alternative,’ ‘therapeutic,’ ‘therapy,’ ‘therap,’ ‘therapies,’ ‘the,’ ‘a,’ ‘and,’ ‘of,’ ‘for,’ ‘in,’ ‘to,’ and ‘among’ were excluded. Special symbols like ‘’,:'"()&-?# <  >  + "",‘ were excluded as well. As for defined words, ‘cells → cell,’ ‘effects → effect,’ ‘staphylococcus aureus → staphylococcus,’ ‘aureus → staphylococcus,’ ‘characteristics → characterization,’ ‘efficacy → effect,’ ‘rat → mice,’ ‘radio → radiation,’ ‘systems → system,’ ‘agents → agent,’ ‘activity → activation,’ ‘carcinoma → cancer,’ ‘cases → case,’ ‘mouse → mice,’ ‘practices → practice,’ ‘radio sensitization → radiation,’ ‘years → year,’ ‘α → alpha,’ and ‘β → beta’ were selected, and data sorting for synonyms was performed. As a result of the analysis, a database consisting of 464,625 words was constructed.

Data analysis

In this study, text mining and topic modeling analysis were employed using textom and RStudio (4.3) to identify keywords related to CAM. Word analysis, TF-IDF, and degree centrality analysis were performed through text mining, with results presented via visualization. TF-IDF determines if a keyword holds actual significance within a document, as words with high TF and TF-IDF values appear frequently and are more likely keywords or important terms [ 21 , 22 ]. Following previous studies [ 22 , 23 ], the minimum word length was set to two, with the top 20 words extracted per topic. Text network analysis created word networks expressing co-occurrence frequency as links [ 24 ]. To gauge word occurrence frequency, words were converted to word-word one-mode, and degree centrality analysis identified highly influential network words. The results of these analyses, including frequency, TF-IDF, degree centrality, closeness centrality, and betweenness centrality of core keywords, can be found in Table 1 .

This study utilized Latent Dirichlet Allocation (LDA) for topic modeling, a statistical method that estimates the probability distribution of topics within documents based on the Document Term Matrix (DTM). Following established practices in the literature, we set the Markov Chain Monte Carlo (MCMC) parameters to alpha = 1.44, beta = 0.001, and iterations = 1,000 [ 25 ]. To determine the optimal number of topics, we iteratively tested configurations ranging from 1 to 20 topics. Through a combination of silhouette clustering analysis and researcher consensus, we identified that a 15-topic model best represented the research trends in our corpus.

LDA visualization indicated that larger topic sizes represented greater proportions within the analyzed studies [ 25 ]. We confirmed that the ideal number of topics, where topics do not overlap and have distinct boundaries, is 15, as shown in Fig.  2 . To validate the relevance and credibility of the topic modeling results, we consulted an expert panel consisting of physicians, nurses, and pharmacists with master's or doctoral degrees. The panel members were asked to classify the 15 derived topics into their respective academic fields. Based on the survey results, two topics (Topics 4 and 7) were identified as nursing-related, with the majority of the expert panel categorizing them as such.

LDA topic modeling visualization

Using the words from these two nursing-related topics, a keyword search was conducted within the database to identify the final set of literature containing these terms. The selected literature was then classified as either nursing-related or non-nursing-related based on the following criteria: (1) the study was published by a nursing school or department, (2) the authors were nurses or nursing researchers, (3) the authors were hospital-affiliated nurses, or (4) the study was published in a nursing journal. The classification process was carried out independently by three authors, and the final categorization was determined through a verification process among them.

Literature review

After the three researchers re-searched the database built based on the sub-words of the extracted topics, a total of 35 articles were selected, including 13 nursing-related literatures and 22 other discipline-related literatures. The sub-words used for the re-search were derived from Topic 4 and Topic 7 in Table 2  and were classified using the PICO (Population, Intervention, Comparison, Outcome) framework. The population-related sub-words included 'patient,' 'students,' and 'nursing.' The intervention-related sub-words were 'yoga,' 'treatment,' 'radiation,' 'acupuncture,' 'education,' and 'cam.' The comparison-related sub-word was 'placebo,' and the outcome-related sub-words included 'anxiety,' 'depression,' 'symptoms,' 'knowledge,' 'attitudes,' and 'perceptions.' These PICO-classified sub-words were used to conduct the database re-search.

In order to examine the research trends in nursing and other related fields, general characteristics (author, country of publication, year of publication) and research characteristics (research design model, statistical method, research subject, intervention method, outcome variable, measurement instruments) were identified, presented, and compared. Meanwhile, the three researchers independently prepared a characteristic table to ensure the accuracy of the extracted contents and if there was any discrepancy, one data was selected through the discussion process until a consensus was reached and a characteristic table was constructed.

To assess the quality of the selected studies, we employed the Mixed Methods Appraisal Tool (MMAT), a concise tool designed to evaluate various study designs, including qualitative, randomized controlled trials, non-randomized studies, quantitative descriptive studies, and mixed methods studies [ 26 ]. This comprehensive tool allowed us to systematically evaluate the methodological rigor of our diverse selection of studies. Each study was evaluated against five MMAT criteria specific to its design, focusing on aspects such as research question appropriateness, data collection methods, and result interpretation. Our assessment revealed varying levels of methodological quality. Among nursing studies (A1-A12), 25% were high quality (5/5 criteria met), 58.3% moderate quality (4/5 criteria), and 16.7% low quality (3/5 criteria). Importantly, all included studies met at least 3 out of the 5 MMAT criteria, indicating an overall moderate to high quality across the selected literature. This suggests that the studies included in our analysis provide a reliable foundation for drawing conclusions. Studies that did not meet all criteria were carefully reviewed, and their potential limitations were considered when interpreting their findings. The MMAT provided a useful overview of study quality and was deemed suitable for assessing methodological rigor while maintaining the feasibility of our analysis. This approach ensured a balanced and nuanced interpretation of the evidence in the field of complementary and alternative medicine. The detailed results of this quality assessment can be found in Tables 3  and 4 .

Data collection and ethical considerations

Since the data used in this study did not contain information that can identify individuals, the study was conducted after obtaining an IRB approval (IRB No: ewha-202311–0008-01) from the Institutional Review Board of Ewha Womans University.

Analysis of word frequency and centrality

The frequency and percentage of the top 20 words related to complementary and alternative medicine are shown in Table 1 . The frequency and percentage of the top 20 words related to complementary and alternative medicine are shown in Table 1 . The table presents the top 20 keywords ranked by frequency, TF-IDF, degree centrality, closeness centrality, and betweenness centrality. The frequency column indicates the number of times each keyword appears in the analyzed documents, while the TF-IDF column represents the importance of each keyword within the entire document set. Degree centrality, closeness centrality, and betweenness centrality are network analysis measures that indicate the importance and influence of each keyword within the text network. The words with the highest frequency included ‘cell’ (7,653 times), ‘patient’ (6,910 times), ‘treatment’ (6,851 times), ‘cancer’ (6,722 times), ‘study’ (6,295 times), and ‘effect’ (6,203 times). The words with the highest values of TF-IDF, in order, were ‘cell,’ ‘effect,’ ‘cancer,’ ‘patient,’ ‘treatment,’ and ‘study.’ As a result of centrality analysis, the top six common words, in order, were ‘effect,’ ‘treatment,’ ‘study,’ ‘analysis,’ ‘disease,’ and ‘approach.’ Except for common words, the words with the highest values in the centrality analysis, in order, were ‘model,’ ‘patient,’ ‘activation,’ and ‘use.’ The words with the highest values for closeness centrality were ‘factor,’ ‘model,’ ‘patient,’ and ‘activation,’ while the words with the highest values for betweenness centrality were ‘factor,’ ‘model,’ ‘type,’ and ‘activation.’

Results of the topic modeling

The LDA visualization provides insights into the relative importance and distinctiveness of identified topics. In this visualization, the size of each topic circle is proportional to its prevalence within the analyzed corpus, with larger circles indicating topics that are more frequently discussed across the literature. Interestingly, we observed that some topics, despite being represented by smaller circles, were positioned at considerable distances from other topics. This spatial separation suggests that these topics, while perhaps less prevalent, possess high discriminant validity and represent distinct thematic areas within the field of complementary and alternative medicine research. This interpretation is consistent with established principles in topic modeling, where spatial relationships in visualizations can indicate semantic distinctiveness. An expert panel of 9 individuals (3 doctors, 3 nurses, and 3 pharmacists), each holding a master's or doctoral degree, conducted a survey to classify the topics based on the keywords. The topic that received the most votes from the panel was designated as the representative field for that topic. Based on the resulting values of the topic modeling, 20 sub-words for each topic were presented and provided in Table 2 , Topics 1–3, 5–6, and 9–15 were classified as Medicine, Topics 4 and 7 as Nursing, and Topics 8 and 10 as Pharmacology.

The process of selecting studies for our analysis is illustrated in Fig.  2 . To determine the optimal number of topics for our analysis, we conducted Latent Dirichlet Allocation (LDA) visualization. As Greene et al. [ 25 ] suggest, larger topic sizes in LDA visualization indicate a greater proportion of that topic within the analyzed studies. We tested topic numbers ranging from 1 to 20, seeking a configuration where topics were visually distinct and non-overlapping. This approach aligns with Liu et al. [ 24 ], who note that topics with high discriminant validity appear as small but clearly separated clusters. After careful visual analysis, we determined that 15 topics provided the most coherent and distinct groupings, as shown in Fig.  2 . This visualization demonstrates the independence and non-overlapping nature of our identified topics, supporting the robustness of our topic modeling approach. Based on the resulting values of the topic modeling, 20 sub-words for each topic were presented and provided in Table 2 . The expert panel's classification suggested that Topics 4 and 7 had relevance to nursing research. However, upon closer examination of the keywords included in these topics, it became apparent that they also encompassed literature from other medical disciplines. While the expert panel's classification indicated these topics were nursing-related, the presence of medical terminology suggested a broader interdisciplinary scope. This highlighted the limitations in identifying nursing-specific research using the current topic modeling approach. To address this issue and clarify the nursing-specific research within these topics, a further refinement of the literature search was conducted using the PICO framework. The keywords from Topics 4 and 7 were used to formulate a focused research question and search strategy. This targeted approach yielded a final selection of 12 nursing-specific articles and 22 articles from other disciplines. By employing the PICO framework and leveraging the keywords from the identified nursing-related topics, it was possible to isolate the nursing research within the broader interdisciplinary landscape.

The words included in topic 4 were the following: ‘trial,’ ‘effect,’ ‘yoga,’ ‘treatment,’ ‘radiation,’ ‘phage,’ ‘protocol,’ ‘anxiety,’ ‘dose,’ ‘zinc,’ ‘symptoms,’ ‘depression,’ ‘placebo,’ ‘acupuncture,’ ‘feasibility,’ ‘training,’ ‘insights,’ ‘toxicity,’ ‘mri,’ and ‘emergency.’ The words included in the topic 7 were: ‘role,’ ‘survey,’ ‘practice,’ ‘evidence,’ ‘failure,’ ‘utilization,’ ‘heart,’ ‘students,’ ‘cam,’ education,’ ‘healthcare,’ ‘valve,’ ‘knowledge,’ ‘communication,’ ‘narrative,’ ‘practitioners,’ ‘attitudes,’ ‘nursing,’ ‘perceptions,’ and ‘pseudomonas.’

The characteristics of the 12 studies included in the literature review analysis are shown in Table 3 .

Of the 12 final literature selections in nursing, there were four randomized controlled trials [A2] [A4] [A7] [A8], three non-randomized comparative trials [A3] [A5] [A6], four descriptive survey studies [A1] [A9] [A10] [A11], and one qualitative study [A12]. Regarding the country of the study’s publication, there were five studies from the United States, three from the United Kingdom, two from Germany and Turkey, and one from Australia. As for the statistical techniques that appeared with high frequency, 10 studies, which were [A1] [A2] [A3] [A4] [A5] [A7] [A8] [A9] [A10] [A11,] used independent t-test, and it was used in most studies. On the other hand, χ2 test was used in seven studies [A3] [A4] [A7] [A8] [A9] [A10] [A11] and one-way analysis of variance was used in four studies [A1] [A9] [A10] [A11]. Regarding the studies that were conducted targeting patients, there was one study conducted on cancer patients [A5], one study on women with post-traumatic stress disorder caused by a car accident [A8], one study on hypertension patients [A7], and one study on breast cancer patients undergoing chemoradiotherapy [A4]. There were seven studies conducted on medical staffs [A1] [A3] [A6] [A9] [A10] [A11] [A12] and one study conducted on nursing students [A2]. Among the interventional therapies used in clinical trials, the most common one was yoga, which was identified in three studies. Specifically, there was one study that used yoga therapy for chemotherapy patients [A5], laughter yoga for nursing students [A2], and yoga therapy for women with post-traumatic disorder [A8]. There were also studies conducted on virtual cancer education program [A6], education on complementary and alternative medicine [A3], auricular acupressure for hypertensive patients [A7], and music therapy for those with breast cancer [A4]. In the studies conducted among medical professionals and nursing students, knowledge [A1] [A3] [A6] [A9] [A10] [A11], attitudes [A1] [A3] [A10] [A11], and usage surveys [A1] [A11] were identified as measurement variables, whereas depression [A8], pain [A7], quality of life [A7], and anxiety [A8] [A4] were identified as the measurement variables in the studies conducted on patients.

Other disciplines

The detailed characteristics of these studies, including the study design, sample, intervention, statistical methods, and outcome measures, are presented in Table 4 .

Of the 22 final literature selections in other disciplines, there were 20 randomized controlled trials [B1] [B2] [B3] [B5] [B6] [B7] [B8] [B9] [B10] [B11] [B12] [B13] [B14] [B15] [B16] [B17] [B18] [B20] [B21] [B22], one pre- and post-hoc comparative study [B4], and one scoping review [B19]. The detailed characteristics of these studies, including the study design, sample, intervention, statistical methods, and outcome measures, are presented in Table 4 . Regarding the country of the study's publication, there were seven studies from the United States of America and the United Kingdom, three studies from China, two studies from the Netherlands, and one study each from Germany, India, and Hong Kong. As for the statistical techniques that appeared with high frequency, there were 10 studies that used independent t-test [B2] [B3] [B5] [B6] [B8] [B11] [B13] [B15] [B18] and one-way ANOVA [B3] [B6] [B7] [B9] [B11] [B14] [B18] [B21] [B20] [B22], while seven studies used repeated measures ANOVA [B2] [B4] [B10] [B11] [B15] [B20] [B22]. All studies for the literature review were conducted on patients. The most common intervention used was auricular acupressure, which was applied on patients with Parkinson’s disease [B11], poststroke depression [B6] [B14], insomnia and depression [B20] [B21], carpal tunnel syndrome [B7], soldiers with PTSD [B19], migraine [B15], pelvic organ prolapse [B8], and gallbladder stones [B22]. The second most common intervention used was yoga therapy, and the subjects were those with active arthritis [B18], generalized anxiety disorder [B17], hemodialysis [B4], and hypertension [B2]. Other subjects and interventions shown in the studies were the following: irritable bladder syndrome patients treated with cinnamon patch [B13]; depression patients treated with bouldering psychotherapy [B12]; dementia patients treated with aromatherapy [B10]; insomnia patients treated with Tai-chi and meridian pressure [B9]; Crohn’s disease patients treated with moxibustion [B3]; HIV patients treated with green tea [B5]; and peripheral arterial disease patients treated with laser acupuncture [B1]. On the other hand, the following were identified as the measurement variables for yoga intervention: level of depression, arthritis stage, anxiety level, quality of life, treatment response rate, sleep, and autonomic function [B2] [B4] [B16] [B17] [B18]. Measurement variables for auricular acupressure included level of depression, sleep quality, level of pain, physical and psychological symptoms, severity of depressive symptoms pelvic organ prolapse, and gastrointestinal symptoms [B3] [B6] [B7] [B8] [B11] [B14] [B15] [B19] [B20] [B21] [B22].

In the study conducted using cinnamon patches, the overactive bladder symptom scores and residual urine volume after urination were identified [B13]. In the study which used green tea, the level of depression was assessed while measuring the severity of depressive symptoms through bouldering [B12]. In the study that used aromatherapy, the behavior, psychology, daily living ability, and cognitive function of the patients with dementia were also assessed [B10].

The present study employed text mining techniques to analyze the literature on CAM published over the past five years and identify trends in nursing research. The text network analysis revealed keywords with high TF-IDF and degree centrality, such as 'cell', 'patient', 'treatment', 'cancer', 'study', and 'effect', suggesting a strong focus on cellular mechanisms, patient-centered approaches, and treatment effects, particularly in the context of cancer [ 22 , 23 ]. The high centrality of these keywords indicates their importance and influence within the broader network of CAM research [ 24 , 25 ]. The topic modeling approach identified 15 major topics, providing a comprehensive overview of the key areas of focus in recent CAM research. This data-driven method offers a more nuanced understanding of research trends compared to previous studies that relied on arbitrary searches or focused on narrow populations or interventions [ 27 , 28 , 29 , 30 , 31 ]. By employing this systematic approach, the present study captures the breadth and diversity of CAM research, overcoming the limitations of previous nursing studies.

An expert panel of 9 individuals (3 doctors, 3 nurses, and 3 pharmacists), each holding a master's or doctoral degree, conducted a survey to classify topics based on keywords. According to the expert classification results shown in Table 2 , Topics 1–3, 5–6, and 9–15 were classified as Medicine, Topics 4 and 7 as Nursing, and Topics 8 and 10 as Pharmacology. While Topics 4 and 7 were found to be nursing-related, closer examination revealed the presence of literature from other medical disciplines within these topics. To address this issue and clarify the nursing-specific research, a further refinement of the literature search was conducted using the PICO framework. The keywords from Topics 4 and 7 were used to formulate a focused research question and search strategy, yielding a final selection of 34 articles, with 12 nursing-specific articles and 22 articles from other disciplines. Analyzing trends in nursing and interdisciplinary studies within the context of the existing literature provides a more comprehensive understanding of CAM research trends. From a nursing perspective, the identification of topics related to patient care, such as symptom management, quality of life, and patient education, highlights the potential for CAM interventions to improve patient outcomes and experiences. The prominence of keywords such as 'patient', 'treatment', and 'effect' highlights the need for evidence-based practice and the need for rigorous studies to evaluate the efficacy and safety of CAM interventions in nursing care. Furthermore, the expert panel's validation of Topics 4 and 7 as relevant to nursing research emphasizes the relevance of these areas within the nursing discipline. Topic 4, which includes keywords such as 'trial', 'effect', 'yoga', 'anxiety', and 'depression', suggests a focus on the psychological benefits of CAM interventions, particularly in the context of clinical trials. This aligns with the growing recognition of the importance of holistic, patient-centered care in nursing practice [ 3 , 4 ]. Topic 7, which includes keywords such as 'practice', 'evidence', 'education', 'knowledge', and 'attitudes', highlights the importance of evidence-based practice and the need for nurse education and training in CAM. As CAM interventions become increasingly popular among patients, it is crucial for nurses to have the knowledge and skills needed to provide safe and effective care [ 5 , 6 ]. The insights gained from this study highlight the potential of text mining and topic modeling techniques for investigating research trends in various fields [ 11 , 12 , 13 ]. By leveraging these methods, researchers can systematically analyze large volumes of literature, identify key areas of focus, and uncover patterns and trends that may not be apparent through traditional review methods [ 14 , 15 ]. This approach can lead to a more comprehensive understanding of the current state of research and inform future directions for investigation.

In conclusion, the present study demonstrates the value of text mining and topic modeling techniques in analyzing research trends, particularly in the field of CAM [ 9 , 10 ]. The systematic approach employed in this study allowed for a more comprehensive and data-driven exploration of the research landscape, overcoming the limitations of previous studies and providing valuable insights into the trends in nursing research on CAM. The findings of this study have significant implications for nursing practice, highlighting the need for evidence-based approaches, patient-centered care, and the integration of CAM interventions into nursing education and training. Future studies should consider adopting similar methodological approaches to investigate research trends in other fields, as this can lead to a more complete understanding of the current state of research and inform future directions for investigation.

The trends analysis of nursing and interdisciplinary studies on CAM revealed notable differences in research design, subject characteristics, intervention types, and assessment methods. Nursing studies exhibited a more balanced distribution of research designs, including randomized controlled trials [A2, A4, A7, A8], non-randomized comparative trials [A3, A5, A6], descriptive survey studies [A1, A9-A11], and a qualitative study [A12]. In contrast, other disciplines predominantly utilized experimental designs, with 95.2% of the studies being randomized controlled trials [B1-B3, B5-B18, B20-B22]. This disparity suggests that nursing research on CAM should expand its focus on experimental studies to enhance the evidence base and align with the methodological approaches of other disciplines.

The subject characteristics of nursing studies differed significantly from those of other disciplines, with nursing research primarily focusing on healthcare professionals and students [A1, A3, A6, A9-A12], while other disciplines exclusively studied patient populations [B1-B22]. This highlights the need for nursing research to diversify its study subjects and investigate the effects of CAM interventions on patients and healthcare providers [ 28 , 29 ], as well as broader community and general health populations [ 3 , 6 ]. By expanding its scope, nursing research can provide valuable insights into the effectiveness and applicability of CAM interventions in promoting health and well-being across diverse settings and populations [ 4 , 5 , 7 , 8 ]. Nurses, as frontline healthcare providers, are uniquely positioned to bridge the gap between healthcare settings and the community, engaging with patients and community members to assess their health needs and provide evidence-based recommendations for CAM interventions [ 1 , 2 ]. This expanded focus, coupled with interdisciplinary collaboration and knowledge exchange [ 9 , 10 ], can lead to the development of innovative, culturally sensitive, and evidence-based CAM interventions that address the complex health needs of individuals and communities alike.

A closer examination of the intervention types in nursing studies reveals that although they focused on a relatively limited range of CAM modalities, such as yoga [A2, A5, A8] and auricular acupressure [A7], these interventions demonstrated promising potential for managing various symptoms and conditions. For instance, yoga was found to be effective in reducing psychological symptoms and cortisol levels in college students [A2], alleviating chemotherapy-related symptoms in cancer patients [A5], and improving post-traumatic stress disorder among traffic accident survivors [A8]. Similarly, auricular acupressure was shown to help decrease angina symptoms in hypertensive patients [A7]. These research findings suggest that even though the scope of CAM interventions in nursing research may be limited, they can provide significant benefits to diverse patient populations [ 2 , 4 , 22 ]. In contrast, the wide array of CAM interventions investigated in other disciplines, such as aromatherapy for dementia [B10], green tea for depression in HIV patients [B5], laser acupuncture for peripheral arterial disease [B1], cinnamon patch for irritable bladder syndrome [B13], bouldering psychotherapy for depression [B12], Tai-chi and meridian pressure for insomnia [B9], and moxibustion for Crohn's disease [B3], demonstrates the potential for nursing research to explore and apply new therapies. The safety, efficacy, and potential of these diverse CAM modalities, as evidenced in other disciplines [ 23 , 24 ], should encourage nursing researchers to investigate their applicability in patient care. By conducting rigorous studies on the safety and efficacy of various CAM interventions, nursing research can provide valuable evidence to support the integration of complementary therapies into nursing practice [ 2 , 4 , 22 ]. Moreover, this trends analysis emphasizes the importance of studying CAM interventions for chronic disease management. With the increasing prevalence of chronic conditions [ 1 , 9 , 10 ], nursing research can play a pivotal role in evaluating the effectiveness of CAM for managing these diseases. Studies on yoga for hypertension [B2] and arthritis [B18], auricular acupressure for insomnia and depression [B20, B21], and moxibustion for Crohn's disease [B3] demonstrate the potential of CAM in improving patient outcomes and quality of life. As nurses have more direct and prolonged contact with patients compared to other healthcare professionals, they are well-positioned to assess the effectiveness of CAM interventions in both clinical and community settings [ 3 , 5 ]. By conducting well-designed studies on the safety and efficacy of various CAM modalities, nursing research can provide the necessary evidence to support the integration of complementary therapies into chronic disease management plans, ultimately enhancing patient care and outcomes across diverse settings. Leveraging their unique role in patient care and conducting rigorous studies on the safety and efficacy of various CAM interventions, particularly for chronic disease management, can enable nursing research to make significant contributions to the integration of complementary therapies into nursing practice. This approach has the potential to not only improve patient outcomes and experiences but also strengthen the evidence base for CAM in healthcare, fostering interdisciplinary collaboration in CAM research and advancing the field of nursing.

The analysis of assessment methods revealed that nursing studies heavily relied on self-developed measurement instruments (58.3%) [A3, A5, A6, A9-A12], while other disciplines predominantly used previously validated tools [B1-B22]. Furthermore, nursing studies rarely incorporated physiological indicators (8.3%) [A2], in contrast to the more frequent use of such measures in other disciplines (36.3%) [B1-B22]. These findings underscore the importance of utilizing validated assessment tools and physiological indicators in nursing research to enhance the reliability and validity of study results [ 31 ]. By incorporating these objective measures, nursing research can more clearly identify significant factors and strengthen the level of evidence, ultimately improving the credibility and applicability of the results.

The trends analysis of statistical techniques revealed a higher prevalence of independent t-tests in nursing research (83.3%) [A1-A5, A7-A11], while other disciplines showed a more balanced use of various techniques, including one-way ANOVA (45.5%) [B3, B6, B7, B9, B11, B14, B18, B20-B22] and repeated measures ANOVA (31.8%) [B2, B4, B10, B11, B15, B20, B22]. This difference can be attributed to the nature of the dependent variables assessed in each field, with nursing studies primarily focusing on single assessments of knowledge, attitudes, education, beliefs, and symptoms [A1, A3-A11], whereas other disciplines frequently employed repeated measures of pain, depression, response rate, serum levels, and neurological outcomes [B2-B4, B6-B8, B10, B11, B14-B22]. These findings underscore the importance of aligning the choice of statistical techniques with the nature of the outcome measures to ensure the validity and reliability of the research findings.

In conclusion, the trends analysis of nursing and interdisciplinary studies on CAM highlights the need for nursing research to expand its focus on experimental designs, diversify study subjects, explore various CAM interventions, utilize validated assessment tools and physiological indicators, and employ robust statistical techniques. By addressing these methodological considerations, nursing research can strengthen the evidence base for CAM interventions, facilitate their integration into nursing practice, and contribute to interdisciplinary dialogue in the field of CAM research [ 11 , 12 , 13 ]. As CAM use becomes increasingly prevalent among patients, particularly those with chronic conditions [ 1 , 9 , 10 ], nursing research has a crucial role to play in investigating the safety and efficacy of various CAM modalities [ 2 , 4 , 22 ]. This approach not only has the potential to improve patient outcomes and experiences but also enables nursing research to make valuable contributions to interdisciplinary collaboration in the field of CAM [ 3 , 5 ]. By embracing the diversity of CAM interventions and fostering interdisciplinary interactions, nursing research can broaden its scope, enhance the efficiency of patient-focused care, and move closer to providing truly holistic care that addresses the multifaceted needs of patients. Also, the integration of CAM into nursing practice, supported by robust research evidence, has the power to transform healthcare delivery and improve the lives of patients, particularly those with chronic conditions who stand to benefit greatly from a more comprehensive and individualized approach to care.

The trends analysis of nursing and interdisciplinary studies on CAM highlights the potential for nursing research to draw inspiration from the diverse CAM interventions studied in other disciplines and adapt them for nursing practice. For example, the use of aromatherapy for dementia [B10], green tea for depression in HIV patients [B5], and cinnamon patch for irritable bladder syndrome [B13] could be explored in nursing research to assess their feasibility and effectiveness in nursing care settings. By learning from the experiences of other disciplines and adapting promising CAM interventions for nursing practice, researchers can expand the scope of nursing research on CAM and contribute to the development of innovative, evidence-based complementary therapies for various patient populations. Given the current trends in nursing research on CAM, it is essential for future studies to consider the research directions and methodologies employed in other disciplines to guide the advancement of nursing science in this field. In summary, this trends analysis emphasizes the need for nursing research to embrace a more diverse and rigorous approach to CAM research, drawing inspiration from the methodologies and interventions studied in other disciplines. By expanding the focus on experimental designs, diversifying study subjects, exploring novel CAM interventions, utilizing validated assessment tools and physiological indicators, nursing research can strengthen the evidence base for CAM interventions, facilitate their integration into nursing practice.

Limitations

This study aimed to identify research trends in CAM through text network analysis and to analyze nursing research trends based on the findings. The use of text mining and big data analysis allowed for a more comprehensive and less biased approach to data collection and processing compared to arbitrary search strategies. However, there were still limitations in defining each field intuitively due to the diverse and wide-ranging areas of CAM used in different disciplines. Future studies should focus on analyzing overall topics across various fields as well as keyword extraction through text mining to gain a more holistic understanding of CAM research trends. Another limitation of this study is that the search languages were restricted to Korean and English. This may have excluded relevant studies published in other languages and might limit the generalizability of the findings. As CAM is rooted in diverse cultures and traditions worldwide, it is important to include studies conducted in various languages for a comprehensive understanding. Future research should incorporate more languages to provide a global perspective on CAM research trends.

Despite these limitations, this study offers a novel methodological strategy for trend analysis by combining keywords extracted using big data rather than relying on researchers' arbitrary settings. The keyword-based classification and literature analysis provide a new approach to identifying research trends and directions. The trends analysis between nursing literature and other disciplines revealed differences in subject selection, study design, statistical techniques, and measurement of dependent variables, highlighting the need for nursing research to broaden the range of subjects and measurement tools while considering randomization and generalization in experimental designs. Furthermore, this study emphasizes the importance of using design techniques that facilitate the sharing of research results beyond the nursing community.

Conclusions

This study significantly advances CAM research in nursing by providing a comprehensive, data-driven overview of research trends. We have identified key areas for improvement, such as the need for more randomized controlled trials and broader subject diversity, and have proposed innovative methodological strategies. Our findings underscore the importance of interdisciplinary collaboration and the adoption of diverse, rigorous research approaches. By addressing these gaps, nursing research in CAM can be strengthened, ultimately enhancing the integration of evidence-based CAM practices in nursing care and improving patient outcomes.

Availability of data and materials

The data and materials of this study are available from the corresponding author upon reasonable request.

Abbreviations

Complementary and Alternative Medicine

World Health Organization

National Center for Complementary and Integrative Health

Research Information Sharing Service

Korean studies Information Service System

Cumulative Index to Nursing and Allied Health Literature

Term Frequency-Inverse Document Frequency

Latent Dirichlet Allocation

Markov Chain Monte Carlo

Document Term Matrix

Mixed Methods Appraisal Tool

Institutional Review Board

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The authors thank all participants who accepted to be part of this work.

This study was supported by the National Research Foundation of Korea (NRF-2022R1F1A1071533)

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Study design: JN, HP, and HL; Data collection and Data analysis : JN and HL ;Study supervision: HP; Manuscript writing: JN, HL, and SL Critical revisions for important intellectual content: HP. All authors reviewed and approved the final manuscript.

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Nam, J., Lee, H., Lee, S. et al. Literature review of complementary and alternative therapies: using text mining and analysis of trends in nursing research. BMC Nurs 23 , 526 (2024). https://doi.org/10.1186/s12912-024-02172-9

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Integrity of Databases for Literature Searches in Nursing

The quality of literature used as the foundation to any research or scholarly project is critical. The purpose of this study was to analyze the extent to which predatory nursing journals were included in credible databases, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus, commonly used by nurse scholars when searching for information. Findings indicated that no predatory nursing journals were currently indexed in MEDLINE or CINAHL, and only one journal was in Scopus. Citations to articles published in predatory nursing journals are not likely found in a search using these curated databases but rather through Google or Google Scholar search engines.

Research, evidence-based practice, quality improvement studies, and other scholarly projects typically begin with a literature review. In research, the review of the literature describes existing knowledge about the topic, reveals gaps and further research questions to be answered, and provides a rationale for engaging in a new study. In evidence-based practice, the literature review provides evidence to answer clinical questions and make informed decisions. Quality improvement studies also begin with a search of the literature to gather available knowledge about a problem and explore interventions used in other settings. The appearance of journals that are published by predatory publishers has introduced the danger that reviews of the literature include inadequate, poorly designed, and low-quality information being used as “evidence”—raising the possibility of risky and harmful practice. Researchers and authors should be confident in the literature they cite; readers should have assurance that the literature review is based on sound, authoritative sources. When predatory journals are cited, that trust is eroded. No matter what type of study or project is being done, the quality of literature is critical for the development of nursing knowledge and for providing up-to-date information, concepts, theories, and approaches to care. 1

An effective literature review requires searching various reliable and credible databases such as MEDLINE (through PubMed or Ovid) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), among others that are relevant to the topic. The ease of searching using a web browser (now commonly referred to as “googling”) has increased the risk of finding sources published in predatory and low-quality journals that have not met the standards of research and scholarship that can be trusted as credible and reliable evidence.

The purpose of this article is to present an analysis of the extent to which predatory nursing journals are included in MEDLINE, CINAHL, and Scopus databases, used by nurse researchers and other nurses when searching for information, and in the Directory of Open Access Journals. This directory indexes “high-quality, open access, peer-reviewed journals” and should not include any predatory journals. 2

Statement of Significance

What is known or assumed to be true about this topic?

The quality of nursing literature used is vital for the development of research studies, application of evidence in clinical settings, and other scholarly projects. Nurse scholars need to be confident as they search the literature that they are accessing sound information sources and not articles from predatory nursing journals, which do not adhere to quality and ethical publishing standards. Citations of articles in predatory nursing journals may be found when searching Google and Google Scholar, making these citations easy to access but potentially resulting in the integration of poor quality research into the nursing literature. On the other hand, searches through credible databases—MEDLINE, CINAHL, and Scopus—are less likely to yield citations from predatory publications.

What this article adds:

This study helps validate the trustworthiness of these databases for conducting searches in nursing.

PREDATORY JOURNALS

Many studies have documented the problem of predatory journals. These journals do not adhere to quality and ethical publishing standards, often use deceptive language in emails to encourage authors to submit their manuscripts to them, are open access but may not be transparent with the article processing charge, may have quick but questionable peer review, and may publish inaccurate information on their Web sites such as impact factor and indexing. 3 – 6 Predatory publishing is an issue in many fields including nursing. In a recent study, 127 predatory journals were identified in nursing. 7

Citations acknowledge the ideas of others and give credit to the authors of the original work. When articles are cited in a subsequent publication, those citations disseminate the information beyond the original source, and the article in which it is cited might in turn be referenced again, transferring knowledge from one source to yet another. When articles in predatory journals are cited, the same process occurs. Those citations transfer knowledge from the predatory publication beyond that source. Studies have found that authors are citing articles published in predatory journals in nursing as well as other fields. 7 – 10 Nurse scholars need to be confident as they search the literature that they are accessing sound information sources and not articles from predatory journals.

NATIONAL LIBRARY OF MEDICINE INFORMATION RESOURCES

The National Library of Medicine (NLM) supports researchers and clinicians through its multiple health information resources including PubMed, MEDLINE, and PubMed Central (PMC). PubMed serves as the search engine to access the MEDLINE database, PMC, and books, chapters, and other documents that are indexed by the NLM. PubMed is free and publicly available: by using PubMed, researchers can search more than 30 million citations to the biomedical literature. 11 The majority of records in PubMed are from MEDLINE, which has citations from more than 5200 scholarly journals. For inclusion in MEDLINE, journals are assessed for their quality by the Literature Selection Technical Review Committee. 12 Five areas are included in this assessment: scope of the journal (ie, in a biomedical subject); quality of the content (validity, importance of the content, originality, and contribution of the journal to the coverage of the field); editorial standards and practices; production quality (eg, layout and graphics); and audience (content addresses health care professionals).

PMC includes journal citations and full-text articles that are selected by the NLM for digital archiving. To be included in PMC, journals are evaluated for their scope and scientific, editorial, and technical quality. 13 Journals considered for inclusion are evaluated by independent individuals both inside and outside PMC. 14 PMC serves as the repository for articles to meet the compliance requirements of the National Institutes of Health (NIH) and other funding agencies for public access to funded research. About 12% of the articles in PMC are deposited by individual authors to be in compliance with funders and 64% by publishers, scholarly societies, and other groups. 15 Beginning in June 2020, as a pilot program, preprints reporting research funded by the NIH also can be deposited in PMC. 16

CINAHL AND SCOPUS

The journal assessment and indexing processes for CINAHL and Scopus are similar to those used by the NLM. However, as private corporations, EBSCO (CINAHL) and Elsevier (Scopus) are not required to make journal selection processes publicly available or explicit. CINAHL has an advisory board for journal selection. A CINAHL representative provided the following criteria for indexing of journals in CINAHL: high impact factor; usage in reputable subject indexes (eg, the NLM catalog); peer-reviewed journals covered by other databases (eg, Web of Science and Scopus); top-ranked journals by industry studies; and article quality (avoiding low-quality journals) (personal communication, October 19, 2020).

Elsevier's Scopus provides a webpage referring to the journal selection and assessment processes. Journals being considered for indexing in Scopus are evaluated by the Content Selection and Advisory Board and must meet the following criteria: peer-reviewed with a publicly available description of the peer review process; published on a regular basis; has a registered International Standard Serial Number (ISSN); includes references in Roman (Latin) script; has English language titles and abstracts; and has publicly available publication ethics and publication malpractice statements. 17

LITERATURE REVIEW

Studies have shown that in health care fields, researchers, clinicians, faculty, and students regularly search MEDLINE for their research and other scholarly and clinical information. 18 – 21 De Groote et al 18 found that 81% of health science faculty used MEDLINE to locate articles for their research. MEDLINE was used by the majority of faculty in each individual health care field including nursing (75%) and medicine (87.5%) for searching the literature and finding articles. In another study of 15 different resources, medical faculty and residents reported that PubMed was used most frequently for searching the databases of the NLM, primarily MEDLINE. 20 Few studies have focused on the search practices of nurses. In a review of the literature, Alving et al 22 found that hospital nurses primarily searched Google for information on evidence-based nursing. They used Google more than bibliographic databases.

The quality of content that is retrieved when using PubMed as a search engine is important considering its widespread use for accessing scholarly and clinical information in nursing and other fields. Manca et al 23 reported that articles published in predatory journals were being retrieved when conducting searches using PubMed and were a concern for researchers. Based on their studies of predatory journals in neurology 24 and rehabilitation, 25 they concluded that predatory journals “leaked into PubMed” through PMC because of less stringent criteria for inclusion of journals. 23 Citations to articles from predatory journals then could be found using the PubMed search engine. However, in a letter to the editor, Topper et al 26 from the NLM clarified that individual articles published in predatory journals might be deposited in PMC to meet the requirements of research funding and be searchable in PubMed. Topper and colleagues make a clear distinction between journals indexed in MEDLINE or PMC and citations of individual articles that were deposited in PMC to meet funder requirements.

The aim of this study was to determine whether predatory nursing journals were included in databases used by nurse researchers and other nurses when searching for information. These databases included MEDLINE (searched via PubMed), CINAHL (EBSCO), and Scopus (Elsevier) and in the Directory of Open Access Journals.

In an earlier study, 127 predatory nursing journals were identified and assessed for characteristics of predatory publications. That dataset was used for the current study. For each predatory nursing journal, information was retrieved from the NLM Catalog, Ulrichsweb, and journal and publisher Web sites. Ulrichsweb 27 provides bibliographic and publisher information on academic and scholarly journals, open access journals, peer-reviewed titles, magazines, newspapers, and other publications. Journal titles of the predatory journals were often similar to nonpredatory journals and could be easily mistaken. To ensure accuracy, the information for each journal was checked for consistency between these sources using the ISSN, exact journal title, and publisher name. The purpose of an ISSN is to identify a publication and distinguish it from other publications with similar names. An ISSN is mandatory for all publications in many countries and having one assigned is considered a journal best practice. 28 For each predatory journal, the following data were collected if available: complete journal title; abbreviated journal title; acronym; ISSN (electronic and/or print); DOI prefix; publisher name and Web site URL; NLM index status; number of predatory journal articles cited in MEDLINE and PMC (when searching using PubMed), in CINAHL, and in Scopus; if the journal was indexed in the Directory of Open Access Journals; status in Ulrichsweb; and Google Scholar profile URL.

Counts of articles cited were checked individually by journal title, publisher, and/or ISSN. Once ISSNs (both electronic and print where available) were assembled, a search algorithm was created, which included all retrieved journal ISSNs. MEDLINE was searched via PubMed using a combination of NLM journal title abbreviations and ISSNs. CINAHL, Scopus, and the Directory of Open Access Journals were searched using a combination of ISSN, journal title abbreviation, full title, and publisher. Results were visually inspected for accuracy and alignment with dataset fields.

Data analysis

Data were collected between January and April 2020. Data were entered into an Excel spreadsheet and organized by predatory journal name; abbreviated journal title; acronym; ISSN (electronic, print); DOI prefix; Web site URL; entry in NLM Catalog (yes/no); index status; number of articles cited in PubMed, CINAHL, and Scopus; Directory of Open Access Journals (included/not included); Ulrichsweb status (active/ceased); publisher; and Google Scholar profile URL. Frequencies and medians are reported.

Of the 127 predatory nursing journals in the dataset, only 102 had ISSNs to use for the search. Eighteen of the journals had records in the NLM Catalog, but only 2 of those had ever been indexed in MEDLINE, and neither are currently indexed. These 2 journals had been published earlier by a reputable publisher but then were sold to one of the large predatory publishers. The NLM Catalog record for these journals indicates that citations of articles from them appeared in MEDLINE through 2014 for one of the journals and 2018 for other, but following their transition to the new publisher are no longer included. Consistent with the MEDLINE results, these same 2 journals had been indexed in Scopus as well. Citations of articles from one of these journals were added to Scopus up to 2014, with no articles cited thereafter. Articles from the second journal continue to be added through 2020. One additional journal from the predatory journal dataset is currently in Scopus, however, only through 2014. None of the predatory nursing journals were indexed in CINAHL based on full journal title, title abbreviation, ISSN, or publisher. Two journals in the dataset were found in the Directory of Open Access Journals.

When searching PubMed, we found citations of articles from 16 predatory nursing journals. The number of citations ranged from 1 to 372 citations (from one of the journals indexed earlier in MEDLINE but sold to a predatory publisher). The second highest number of citations (n = 168) was of articles from a predatory nursing journal that had been depositing articles in PMC (and thus were retrievable when searching PubMed) but is no longer adding new material to PMC. The other citations were of articles deposited in PMC to meet requirements of NIH and other research funding. The predatory journals in which these articles were published, however, are not indexed in MEDLINE or PMC.

There were no articles from predatory nursing journals cited in CINAHL. Scopus has citations from the 2 predatory nursing journals that are no longer indexed there: 616 that were published in one of the journals and 120 from the other. Articles from a third predatory nursing journal in the study dataset, which is currently indexed in Scopus, totaled 173 (see Table).

Abbreviation: CINAHL, Cumulative Index to Nursing and Allied Health Literature.

a Predatory nursing journals with 3 or more citations to articles.

b Search using PubMed.

This analysis documented that none of the predatory nursing journals in the study dataset were currently indexed in MEDLINE or CINAHL, and only one journal is still in Scopus. Most of the citations of articles from predatory journals found in a search of these databases are from earlier years before the journals were sold to one of the large predatory publishers. Other citations are to articles deposited in PMC in compliance with research funder requirements.

By using PubMed as a search engine and entry point to the databases of the NLM, researchers can search millions of records included in MEDLINE, or in process for inclusion, and articles from PMC deposited by publishers or authors for compliance with funders. Six million records, and about 5500 journals, can be searched in CINAHL Complete, 29 and Scopus, the largest of the proprietary databases, provides access to 24000 journals and 60 million records. 30 Results from this study show that very few articles published in predatory nursing journals find their way into a search done using PubMed and Scopus and none into CINAHL.

In a prior study, 814 citations of articles in predatory nursing journals were found in articles published in nonpredatory nursing journals. 7 Based on this current study, the conclusion can be made that these citations are not coming from searches in MEDLINE/PubMed, CINAHL, or Scopus and are likely from searches done using Google or Google Scholar as the search engine. The databases examined in this study are curated by organizations with a vested interest in maintaining and improving the quality of the research literature in those databases.

Searching multiple databases using different search engines can be frustrating and time consuming. There is overlap among MEDLINE, CINAHL, and Scopus. However, these are curated databases and, as this study found, are unlikely to return many, if any, predatory citations as part of the search results. Still, it falls on the searcher to eliminate duplicates and redundant citations. Further, certain types of literature, such as theses, dissertations, and fugitive (or “gray” literature), 31 are unlikely to be found in any of these databases, even though those citations may be important or relevant sources. Given this, it is easy to understand the intuitive appeal of Google Scholar, which provides “one stop shopping”: “From one place, you can search across many disciplines and sources: articles, theses, books, abstracts and court opinions, from academic publishers, professional societies, online repositories, universities and other web sites. Google Scholar helps you find relevant work across the world of scholarly research.” 32 Google and Google Scholar were founded with a mission to become the most comprehensive search engines in the world. While this allows someone to scour the World Wide Web and Internet for some of the most obscure facts available, at the same time, little is done to verify or validate the results that are returned. Thus, it falls on the searcher to be diligent and evaluate the results of a Google or Google Scholar search, which will include citations of articles in predatory journals. This is easily confirmed by the fact that many predatory journal Web sites promote the Google Scholar logo as a sign of indexing or a badge of legitimacy.

Another vexing issue that was revealed in this study is that of reputable journals that have been bought by predatory publishers. This study found 2 journals in this category. Brown 33 reported on 16 medical specialty journals that were purchased from 2 Canadian commercial publishers by a predatory publisher. In all these cases, it is the same predatory publisher, although some of the purchases were made under a different business imprint, adding further confusion to an already muddied situation. Jeffrey Beall, who coined the term “predatory publisher” and maintained the blog “Scholarly Open Access” for almost a decade, was quoted by Brown 33 : “[The company] is not only buying journals, it is buying metrics and indexing, such as the journals' impact factors and listing in Scopus and PubMed, in order to look legitimate.” One positive finding from this study was that the 2 purchased journals that were identified were quickly de-accessioned by the NLM and are no longer indexed in MEDLINE, although citations from their pre-predatory era remain intact.

Recommendations

All of this presents a confusing picture, but it is possible to make some specific recommendations to aid researchers, clinicians, faculty, and students in their literature searches. First, become familiar with the journals and publications in your field. This is a basic foundation of scholarship. As you read articles, remember where they were published, learn journal titles, and focus on sources as well as the content. As you come across predatory journals in nursing and health care, make note of them and learn their titles too. Remember that many predatory journals adopt names that are intended to be confusing and may differ from a legitimate journal by only one letter, such as “Africa” and “African.”

Second, consider carefully how to approach your search from the outset. If you choose to start with MEDLINE (searched via PubMed), CINAHL, or Scopus, then you can have some assurance that the results will not return citations from predatory journals—although you should still verify every citation that you receive. On the other hand, Google and Google Scholar can be a “quick and easy” way to get started but will require that you carefully review and evaluate the results. If you need to venture to other more specialized databases, such as PsycInfo or ERIC (Education Resources Information Center), it is important to carefully inspect the results that you receive. To reduce the risk of including a predatory journal article in research, nursing scholars should use reputable bibliographic databases, which have clear criteria for journal indexing, for their searches.

Third, when you come across a journal title that is not familiar, take time to research it, visit the journal Web site and evaluate the information at the Web site, and determine whether it is a credible source to include in your results. If something seems irregular, then it is worth your time to do more investigating—either on your own or by enlisting the help of a knowledgeable colleague or librarian. Journals change publishers all the time, and while most of these business transfers are benign and probably will not impact you as an end consumer of the literature, that is not always the case. Likewise, the major publishers in the world today are large, multinational conglomerates that regularly spin off or purchase other companies. While this probably will not impact you on a day-to-day basis, it is important to investigate any irregularities when conducting a search of the literature.

Last, because these issues are complex and multifaceted, it is always wise to consult with a librarian who can assist you in every step of the search process. Their knowledge and expertise in information literacy, data sources, and searching techniques can help to ensure that you find the information you need from sources that are reliable and credible.

Researchers, clinicians, faculty, and students need to be careful not to include citations from predatory sources in their literature searches and articles. Predatory journals publish low-quality studies and citing this work erodes the scholarly literature in nursing. The findings of this study offer some reassurance to those who search the professional nursing literature: if you begin a search in a database such as MEDLINE, CINAHL, or Scopus, then the results will probably not include citations to predatory publications. Google and Google Scholar searches, however, may very well include predatory citations, and in that case, it is the searcher's responsibility to carefully evaluate the output and discard findings from nonlegitimate sources. Enlisting the help of a librarian is always beneficial and highly recommended.

Peggy L. Chinn, PhD, RN, FAAN, Editor, Advances in Nursing Science , is a member of our research team and contributed to the study and preparation of the manuscript.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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Rhegmatogenous retinal detachment with giant retinal tear: case series and literature review.

1. Introduction

2. materials and methods, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Lee, S.; Kim, J. Rhegmatogenous Retinal Detachment with Giant Retinal Tear: Case Series and Literature Review. J. Clin. Med. 2024 , 13 , 4690. https://doi.org/10.3390/jcm13164690

Lee S, Kim J. Rhegmatogenous Retinal Detachment with Giant Retinal Tear: Case Series and Literature Review. Journal of Clinical Medicine . 2024; 13(16):4690. https://doi.org/10.3390/jcm13164690

Lee, Siyun, and Joonhyung Kim. 2024. "Rhegmatogenous Retinal Detachment with Giant Retinal Tear: Case Series and Literature Review" Journal of Clinical Medicine 13, no. 16: 4690. https://doi.org/10.3390/jcm13164690

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