Integrative reviews of nursing research

Integrative reviews of research are a valuable part of the process of creating and organizing a body of literature. It has been argued that integrative reviews should be held to the same standards of clarity, rigor, and replication as primary research. In this paper methods for conducting an integrative review are discussed. Seventeen reviews from nursing journals were examined and compared with a proposed set of criteria for reviews. The results indicated that the majority of integrative reviews in nursing fell short of primary research standards. Guidelines for conducting more rigorous reviews are presented.     

Title analysis of (systematic) scoping review studies: Chaos or consistency?

The scoping review is one of the alternatives of producing a literature review. However, this approach still lacks a clearly accepted definition, and the scoping terminology is also somewhat fuzzy. Although the methodology of scoping review processing is relatively uniform, terminological chaos appears in the titles of studies with scoping review methodology. This paper presents an analysis of selected published studies with a focus on the content of their titles. A total of 13 thematic dimensions were identified covering the content of titles that show a degree of inconsistency and frequent terminological and methodological “chaos.” This study includes a broad scope of themes and areas for which scoping reviews were produced. We would like to recommend to authors (especially scoping review beginners) to – if not necessary or desirable – avoid introducing new concepts and specifications of titles of produced and published scoping review studies. In the case of literature reviews and knowledge synthesis it is necessary to search according to specific keywords and search phrases – more fragmented scoping review terminology makes literature search more difficult or even impossible.     

Strategies to engage people with dementia and their informal caregivers in dyadic intervention: A scoping review

Dyadic interventions simultaneously engage both people with dementia (PWD) and their informal caregivers (ICGs). This scoping review study identified the strategies for engaging dyads, described the perceptions of the dyads on these strategies, and reported the attrition rates of the dyadic interventions reported in the literature. Articles published up to July 2020, reporting a PWD-ICG-dyads intervention were searched in PubMed (Medline), PsycInfo, CINAHL, and the SSCI. Backwards citation chasing was conducted. A total of 37 studies were included. Seven engagement strategies were identified, which involved: ensuring a good-quality interventionist; offering take-home supporting materials; establishing peer support among the participants; tailoring the intervention content; conducting the intervention in a convenient location; conducting the intervention in a comfortable physical environment, and using a short and succinct programme. The dyads’ subjective experiences of these strategies were reported. The attrition rates of the included studies were ranged 0% - 59.1%.     

Elements of a systematic review

This paper examines the subject of systematic reviews from a nursing viewpoint. The history of the evidence-based healthcare movement and the major differences between systematic reviews and traditional literature reviews are discussed. The steps of the process used by those conducting reviews are examined in detail. These include structuring a research question, searching and appraising the literature, data extraction, analysis and synthesis, and reporting the results. It is this process that ensures reviews can be considered as a legitimate form of nursing research.     

Systematic Review Methodology for the Fatigue in Emergency Medical Services Project

Abstract

Background: Guidance for managing fatigue in the Emergency Medical Services (EMS) setting is limited. The Fatigue in EMS Project sought to complete multiple systematic reviews guided by seven explicit research questions, assemble the best available evidence, and rate the quality of that evidence for purposes of producing an Evidence Based Guideline (EBG) for fatigue risk management in EMS operations. Methods: We completed seven systematic reviews that involved searches of six databases for literature relevant to seven research questions. These questions were developed a priori by an expert panel and framed in the Population, Intervention, Comparison, and Outcome (PICO) format and pre-registered with PROSPERO. Our target population was defined as persons 18 years of age and older classified as EMS personnel or similar shift worker groups. A panel of experts selected outcomes for each PICO question as prescribed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We pooled findings, stratified by study design (experimental vs. observational) and presented results of each systematic review in narrative and quantitative form. We used meta-analyses of select outcomes to generate pooled effects. We used the GRADE methodology and the GRADEpro software to designate a quality of evidence rating for each outcome. Results: We present the results for each systematic review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). More than 38,000 records were screened across seven systematic reviews. The median, minimum, and maximum inter-rater agreements (Kappa) between screeners for our seven systematic reviews were 0.66, 0.49, and 0.88, respectively. The median, minimum, and maximum number of records retained for the seven systematic reviews was 13, 1, and 100, respectively. We present key findings in GRADE Evidence Profile Tables in separate publications for each systematic review. Conclusions: We describe a protocol for conducting multiple, simultaneous systematic reviews connected to fatigue with the goal of creating an EBG for fatigue risk management in the EMS setting. Our approach may be informative to others challenged with the creation of EBGs that address multiple, inter-related systematic reviews with overlapping outcomes.     

Virtual visitation in the NICU: A scoping literature review

ObjectiveThis scoping literature review aims to identify how virtual visitation (VV) is currently being used in the Neonatal Intensive Care Unit (NICU), with a specific focus on the experiences and perceptions of parents and neonatal nurses, as well as research gaps.MethodGuided by the Joanna Briggs Institute method for conducting a scoping literature review, the PubMed, CINAHL, and Web of Science databases were utilized to identify articles answering the research questions. Gray literature was also identified through ProQuest, and the home websites of the two largest commercial virtual visitation vendors were explored for additional relevant information.ResultsFollowing a comprehensive search, 12 articles were identified for inclusion in this scoping literature review. Overall, parents report positive experiences with VV, welcoming this technology in connecting to their infant. The experiences and perceptions of NICU nurses regarding the addition of VV to their practice environment are generally negative. With a paucity of research exploring the questions guiding this scoping review, research gaps are evident.ConclusionVirtual visitation in the NICU aids in connecting parents to their hospitalized infants. However, published literature reveals significant differences in the experiences and perceptions of parents and neonatal nurses for the use of VV in the NICU. Further research is warranted to understand the impact of VV in this specialized environment fully.     

Quantitative reviewing: the literature review as scientific inquiry

The literature review process is conceptualized as a form of scientific inquiry that involves methodological requirements and inferences similar to those employed in primary research. Five stages of quantitative reviewing that parallel stages in primary investigation are identified and briefly described. They include problem formation, data collection, data evaluation, analysis and interpretation, and reporting the results. The first two stages provide information and guidelines relevant to reviewers' employing traditional narrative procedures or conducting reviews of qualitative research literature. The final three stages relate specifically to the methodology of quantitative reviewing. The argument is made that quantitative reviewing procedures represent a paradigm shift that can assist researchers and clinicians in occupational therapy to establish a scientific data base that will serve to guide theory development and validate clinical practice.     

Methodology for the systematic reviews on occupation- and activity-based intervention related to productive aging

Systematic reviews of the literature relevant to community-dwelling older adults are important to the practice of occupational therapy. We describe the four questions that served as the focus for the systematic reviews of the effectiveness of occupational therapy interventions for older adults living in the community. This article includes the background for the reviews; the process followed for each question, including search terms and search strategy; the databases searched; and the methods used to summarize and critically appraise the literature. The final number of articles included in each systematic review; a summary of the results; the strengths and limitations of the findings; and implications for practice, education, and research are presented.     

Systematic reviews in laboratory medicine: principles, processes and practical considerations

BACKGROUND: Systematic reviews and meta-analyses are generally accepted to represent the highest level of evidence, and are a cornerstone in practising evidence-based medicine. So far, these efforts have been largely confined to the evaluation of the efficacy and effectiveness of therapeutic and preventive interventions. Systematic reviews in laboratory medicine are scarce and many of them do not meet essential quality criteria [Clin. Chem. Lab. Med. 38 (2000) 577]. Most of these problems are related to the poor design and heterogeneity of primary research, and that there are no agreed methods or quality standards for making systematic reviews in laboratory medicine. AIMS AND OBJECTIVES: For better evidence in laboratory medicine, not only higher quality primary studies but also standardized methodologies for designing, conducting and reporting systematic reviews in diagnostics are needed. The aim of this review is to present the general principles and provide a step-by-step process of systematic reviewing in laboratory medicine. METHODS: This narrative review is based on the overview of the medical literature on the methodology of systematic reviewing and that of the "state of the art" of evidence-based diagnosis. RESULTS: Systematic reviews of diagnostic interventions differ from that of therapeutic interventions in the methods of question formulation, the choice of study design, the assessment of study quality and the statistical methods used to combine results. Therefore, the general principles of systematic reviewing are adapted to the specialist field of laboratory medicine. The process of systematic reviewing consists of six key steps: (1) preparation for the review, (2) systematic search of the primary literature, (3) selection of papers for review, (4) critical appraisal of the selected literature, (5) analysis and synthesis of data, and (6) interpretation of data. The most important technical and methodological aspects of each step and the essential elements of a good systematic review in laboratory medicine are presented. CONCLUSIONS: Systematic reviews of diagnostic interventions support clinical and policy decisions, the development of practice guidelines, clinical audit, technology assessment, economic evaluations, education and training, and identify gaps in our knowledge for future research. Systematic reviewing of laboratory data is expected to result in better, bigger and more reliable primary studies, which hopefully will support the diffusion of new diagnostic technologies with scientifically proven efficacy and effectiveness in the future.     

Methodology for the systematic reviews on occupational therapy for adults with Alzheimer's disease and related dementias

Systematic reviews of literature relevant to adults with Alzheimer's disease and their families are important to the practice of occupational therapy. We describe the seven questions that served as the focus for systematic reviews of the effectiveness of occupational therapy interventions for adults with Alzheimer's disease and their families. We include the background for the reviews; the process followed for each question, including search terms and search strategy; the databases searched; and the methods used to summarize and critically appraise the literature. The final number of articles included in each systematic review; a summary of the results; the strengths and limitations of the findings; and implications for practice, education, and research are presented for the six questions addressing interventions in the areas of occupation, perception, environment, activity demands, fall prevention, and caregiver strategies.     

Academic-practice partnerships in evidence-based nursing education: Protocol of a theory-guided scoping review

AimThis theory-guided scoping review aims to provide an overview of existing literature about academic-practice partnerships in evidence-based nursing education.BackgroundAcademic-practice partnership is an approach to improve evidence-based nursing education, to promote evidence-based nursing practice which could reduce the nursing care discrepancy, improve the nursing care quality and patient safety, reduce healthcare costs and promote nursing professional development. However, the related research is limited and there is a lack of systematic review of related literature.DesignA scoping review guided by the theories of the Practice-Academic Partnership Logic Model and the JBI Model of Evidence-Based Healthcare.MethodsThe researchers will use JBI guidelines for scoping reviews and related theories to guide this theory-guided scoping review. The researchers will systematically search Cochrane Library, PubMed, Web of Science, CINAHL, EMBASE, SCOPUS and Educational Resource Information Centre (ERIC) using major search concepts including academic-practice partnership, evidence-based nursing practice and education. Two reviewers will be responsible for independent literature screening and data extraction. Discrepancies would be solved by a third reviewer.Expected resultsThis scoping review will identify related research gaps to provide implications for researchers and identify specific information to provide implications for developing interventions of academic-practice partnerships in evidence-based nursing education.Registration numberThis scoping review had been registered on Open Science Framework (https://osf.io/83rfj).     

Scoping Meta‐Review: Introducing a New Methodology

For researchers, policymakers, and practitioners facing a new field, undertaking a systematic review can typically present a challenge due to the enormous number of relevant papers. A scoping review is a method suggested for addressing this dilemma; however, scoping reviews present their own challenges. This paper introduces the “scoping meta‐review” (SMR) for expanding current methodologies and is based on our experiences in mapping the field of consumer engagement in healthcare. During this process, we developed the novel SMR method. An SMR combines aspects of a scoping review and a meta‐review to establish an evidence‐based map of a field. Similar to a scoping review, an SMR offers a practical and flexible methodology. However, unlike in a traditional scoping review, only systematic reviews are included. Stages of the SMR include: undertaking a preliminary nonsystematic review; building a search strategy; interrogating academic literature databases; classifying and excluding studies based on titles and abstracts; saving the refined database of references; revising the search strategy; selecting and reviewing the full text papers; and thematically analyzing the selected texts and writing the report. The main benefit of an SMR is to map a new field based on high‐level evidence provided by systematic reviews.     

Professional identity in interprofessional teams: findings from a scoping review

Integrated care has been identified as being fundamental to health and social care reforms. How this interprofessional working impacts on professional identity is unclear. There is a lack of reviews synthesising this growing body of literature. It is therefore timely to conduct a scoping study of the literature which explores the intersection between interprofessional care and professional identity. The aim of this study is to identify the factors that impact on professional identity when working in interprofessional teams. A scoping review was conducted; Business Source Complete (EBSCO); CINAHL; Proquest; Medline; Scopus; and Cochrane Reviews (January 1980 to July 2018) were systematically searched for studies focusing on professional identity and interprofessional teams. Inclusion and exclusion criteria were identified and applied, data were charted, and a synthesis of the narrative was conducted. Sixteen papers are identified as central to this scoping review. Analysis of the papers highlights three key areas of interest: the creation of professional identity; challenges and barriers to professional identity; and implications for leadership and management. The significance of this review is considered along with an agenda for future research. Expanding the research to include more empirical studies to consider areas such as the value of interprofessional education programmes and to include the voice of those professionals no longer working or choosing not to work in an interprofessional care setting should also feature within future research.     

Nursing faculty shortage in Canada: A scoping review of contributing factors

BackgroundStrong nursing faculty is paramount to promote disciplinary leadership and to prepare future nurses for practice. Our understanding of the factors associated with or predictive of nurse faculty retention and/or turnover is lacking.PurposeThe aim of this review is to identify and synthesize the existing literature on factors contributing to nurse faculty shortage in Canada and implications on nursing practice.MethodsA scoping review based on the Arskey and O'Malley's five stage framework for scoping reviews was undertaken. Utilizing the PRISMA protocol, a comprehensive and structured literature search was conducted in five databases of studies published in English.FindingsLimited through search inclusion and relevance of research, nine studies out of 220 papers met the criteria for this review and were thematically analyzed. Identified themes were supply versus demand; employment conditions; organizational support; and personal factors.DiscussionImpending retirement of faculty, unsupportive leadership, and stressful work environments were frequently reported as significant contributing factors to the faculty shortage.ConclusionThis scoping review provides insights into how Canada's schools of nursing could engage in grounded efforts to lessen nursing faculty shortage, both nationally and globally. We identified a gap in the literature that indicates that foundational work is needed to create context-specific solutions. The limited studies published in Canada suggest that this is a critical area for future research and funding.     

Adapting and Implementing Open Dialogue in the Scandinavian Countries: A Scoping Review

Open Dialogue is a resource-oriented mental health approach, which mobilises a crisis-struck person's psychosocial network resources. This scoping review 1) identifies the range and nature of literature on the adoption of Open Dialogue in Scandinavia in places other than the original sites in Finland, and 2) summarises this literature. We included 33 publications. Most studies in this scoping review were published as “grey” literature and most grappled with how to implement Open Dialogue faithfully. In the Scandinavian research context, Open Dialogue was mainly described as a promising and favourable approach to mental health care.     

Writing an Effective Literature Review

A literature review can be an informative, critical, and useful synthesis of a particular topic. It can identify what is known (and unknown) in the subject area, identify areas of controversy or debate, and help formulate questions that need further research. There are several commonly used formats for literature reviews, including systematic reviews conducted as primary research projects; reviews written as an introduction and foundation for a research study, such as a thesis or dissertation; and reviews as secondary data analysis research projects. Regardless of the type, a good review is characterized by the author's efforts to evaluate and critically analyze the relevant work in the field. Published reviews can be invaluable, because they collect and disseminate evidence from diverse sources and disciplines to inform professional practice on a particular topic. This directed reading will introduce the learner to the process of conducting and writing their own literature review.     

Evidence-Based Guidelines for Fatigue Risk Management in EMS: Formulating Research Questions and Selecting Outcomes

Background: Greater than half of Emergency Medical Services (EMS) personnel report work-related fatigue, yet there are no guidelines for the management of fatigue in EMS. A novel process has been established for evidence-based guideline (EBG) development germane to clinical EMS questions. This process has not yet been applied to operational EMS questions like fatigue risk management. The objective of this study was to develop content valid research questions in the Population, Intervention, Comparison, and Outcome (PICO) framework, and select outcomes to guide systematic reviews and development of EBGs for EMS fatigue risk management. Methods: We adopted the National Prehospital EBG Model Process and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for developing, implementing, and evaluating EBGs in the prehospital care setting. In accordance with steps one and two of the Model Process, we searched for existing EBGs, developed a multi-disciplinary expert panel and received external input. Panelists completed an iterative process to formulate research questions. We used the Content Validity Index (CVI) to score relevance and clarity of candidate PICO questions. The panel completed multiple rounds of question editing and used a CVI benchmark of ≥0.78 to indicate acceptable levels of clarity and relevance. Outcomes for each PICO question were rated from 1 = less important to 9 = critical. Results: Panelists formulated 13 candidate PICO questions, of which 6 were eliminated or merged with other questions. Panelists reached consensus on seven PICO questions (n = 1 diagnosis and n = 6 intervention). Final CVI scores of relevance ranged from 0.81 to 1.00. Final CVI scores of clarity ranged from 0.88 to 1.00. The mean number of outcomes rated as critical, important, and less important by PICO question was 0.7 (SD 0.7), 5.4 (SD 1.4), and 3.6 (SD 1.9), respectively. Patient and personnel safety were rated as critical for most PICO questions. PICO questions and outcomes were registered with PROSPERO, an international database of prospectively registered systematic reviews. Conclusions: We describe formulating and refining research questions and selection of outcomes to guide systematic reviews germane to EMS fatigue risk management. We outline a protocol for applying the Model Process and GRADE framework to create evidence-based guidelines     

Teaching strategies of clinical reasoning in advanced nursing clinical practice: A scoping review

Aim/objectiveTo report and synthesize the main strategies for teaching clinical reasoning described in the literature in the context of advanced clinical practice and promote new areas of research to improve the pedagogical approach to clinical reasoning in Advanced Practice Nursing.BackgroundClinical reasoning and clinical thinking are essential elements in the advanced nursing clinical practice decision-making process. The quality improvement of care is related to the development of those skills. Therefore, it is crucial to optimize teaching strategies that can enhance the role of clinical reasoning in advanced clinical practice.DesignA scoping review was conducted using the framework developed by Arksey and O’Malley as a research strategy. Consistent with the nature of scoping reviews, a study protocol has been established.MethodsThe studies included and analyzed in this scoping review cover from January 2016 to June 2022. Primary studies and secondary revision studies, published in biomedical databases, were selected, including qualitative ones. Electronic databases used were: CINAHL, PubMed, Cochrane Library, Scopus, and OVID. Three authors independently evaluated the articles for titles, abstracts, and full text.Results1433 articles were examined, applying the eligibility and exclusion criteria 73 studies were assessed for eligibility, and 27 were included in the scoping review. The results that emerged from the review were interpreted and grouped into three macro strategies (simulations-based education, art and visual thinking, and other learning approaches) and nineteen educational interventions.ConclusionsAmong the different strategies, the simulations are the most used. Despite this, our scoping review reveals that is necessary to use different teaching strategies to stimulate critical thinking, improve diagnostic reasoning, refine clinical judgment, and strengthen decision-making. However, it is not possible to demonstrate which methodology is more effective in obtaining the learning outcomes necessary to acquire an adequate level of judgment and critical thinking. Therefore, it will be necessary to relate teaching methodologies with the skills developed.     

The complexity of searching the literature

Sindhu F, Dickson R. International Journal of Nursing Practice 1997; 3: 211–217
The complexity of searching the literature
The science of systematically reviewing literature has become a research process in its own right. The key word of course, is systematic. In the context of a systematic review this indicates that all possible sources have been comprehensively searched using a pre-defined search strategy designed to identify all relevant published and unpublished work. This paper illustrates the components of a comprehensive search, examines the yield of this approach and discusses the time and resource requirements for conducting the search. It uses as an example a recently completed systematic review. The paper goes on to discuss ways in which nurses can become more involved in conducting and using the results of good quality reviews.