Lit Review

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Literature Reviews

Laura L. Kuensting, DNP, APRN, PCNS-BC, CPNP, CPEN

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Types of Literature Reviews

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Systematic Review

Meta-Analyses

Qualitative Review

Integrative Review ✓

• Each has a distinct purpose, sampling frame, definition, and method for analysis

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Review Methods Systematic Review

• Com bine evidence from m ultiple studies about a specific clinical problem

• Clear study question, explicit m ethod, and com prehensive search for prim ary research

• Includes statistical m ethods of a m eta- analysis

• M ethod of choice for evidence-based practice (EBP) initiatives (e.g., Cochrane Collaboration)

Meta-Analysis Review • Com bines results of m ultiple prim ary studies

using statistical m ethods • Enhances objectivity and validity of

findings

• Each study is coded and entered in a quantitative database

• Effect size is calculated

• Adjustm ents for sam ple size and study quality can be included

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Review Methods (cont’d) Qualitative Review

• Meta-synthesis, meta-studies, formal grounded theory, and meta-ethnography methods synthesize findings into a new theory or framework about a phenomena

• Differing approaches in analysis and interpretation

• Potentially broaden the generalizability of the qualitative research

Integrative Review ✓ • Broadest type of review • Many purposes: define concepts, review theories, review

evidence, analyze methods • Combines theoretical and empirical literature • Results in a comprehensive portrayal of complex

concepts, theories, or health care problems • Bias and error can occur

• Examples: literature search may be incomplete or without primary sources, or data may be inaccurately interpreted

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What is an Integrative review?

• A review method summarizing past empirical or theoretical literature for a more comprehensive understanding of a particular phenomenon or healthcare problem (W hittem ore & K nafle, 2005)

• Allows for diverse methodologies (i.e., experimental and nonexperimental research)

• Allows for varied perspectives (e.g., nursing science, social science, etc.)

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Rigour

Research reviews are considered research of research

(G a n o n g , 1 9 8 7 ; C o p p e r, 1 9 9 8 a s c ite d in W h itte m o re & K n a fle , 2 0 0 5 )

G E N E R A L P R O C E S S

1. Identify a problem

2. P erform a w ell-defined literature search (prim ary studies and publications)

3. E valuate/A ppraise the literature

4. A nalyze the data (com pare/contrast the findings)

5. O rganize the findings

6. P resent the findings

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Whittemore and Knafle (2005)

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Hour-Glass Approach

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Introduction (Background & Significance): Begin broad then narrow the focus

Stem of the paper: Focused Literature Review

Sum m ary (of key findings): Begin focused but end broad

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Integrative Review Components

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INTRODUCTION (2-3 pages)

• Begin broad, with background information: set the stage for why this is a problem, then identify the problem in a problem statement as the focus narrows

Description of the problem

Describe the significance of the problem

• Purpose of the literature review • EBP framework or model identified (not explained) to guide the review • Study (Review) question(s) stated in a PICO(T) format, preferably open-ended • Brief description of content concepts to be addressed and how the review will be

organized

Last paragraph of this section should be focused and include:

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Integrative Review Components (cont’d)

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LIT E R AT U R E R E V IE W (5 -7 PA G ES ) B e g in w ith a p a ra g ra p h d e scrib in g th e lite ratu re se a rch p ro ce ss: Search engines used (at least three engines) Key search terms and phrases (including Boolean operators)

Number of initial publications generated Refined search with inclusion and exclusion criteria Number of publications generated after refined search Any other search methods (such as an ancestry method) and number of publications generated

Final number of publications selected for the literature review

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Integrative Review Components (cont’d)

LITERATURE REVIEW (cont’d) • EBP, conceptual, or theoretical framework or model

described • Provide an in-depth analysis of the current literature and

EBP related to the problem • Key concepts, themes, similarities, differences,

strengths, and weaknesses dispersed throughout the review

• Use transitions between concepts or themes • Use literature appraisals and evidence table/matrix • Identify any gaps (lack of published work on a concept

or theme)

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Elements of Data Analysis

• Note patterns and themes • Seeing plausibility • Clustering • Counting • Making findings as intervening factors • Building a logical chain of evidence

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(Whittemore & Knafle, 2005)

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Integrative Review Components (cont’d)

LITERATURE REVIEW (cont’d) • End with a paragraph (or two)

summarizing key findings (from each concept) of the literature review

• Any gaps in the literature reiterated, strengths and limitations of the review

• Recommendations for future research

• Generalization of the importance of the topic on nursing practice (broad ending)

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Summary

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Errors may occur due to inadequate literature searches, inaccurate data interpretation, and

implicit bias

Results in identification of trends, themes, etc., on a focused topic or theme

Integrative reviews are literature reviews utilizing: Va ryin g d iscip lin e stu d ie s (e .g ., so cia l

scie n ce s, m e d ica l scie n ce s, p sych o lo g ica l scie n ce s, etc.)

Va ryin g stu d y d e sig n s (e .g ., ra n d o m ize d co ntro l tria ls, o b se rvatio n a l, q u a litative ,

etc.)

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Reference

Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of Advanced Nursing, 52(5), 546-553.

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