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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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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
• PICO - Worksheet
• What Is a PICOT Question?

Seminal Works: Search Key Indexing/Citation Databases

• Google Scholar
• Web of Science

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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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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Literature Review Research

What is a literature review, how to complete a literature review, how to write a literature review.

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Researching Instruction will cover: 

Discussion about what is a literature review and how to complete a literature review. 

Use of Smart Search and Google Scholar

A literature review is an account of what has been published on a topic by accredited scholars and researchers. Occasionally you will be asked to write one as a separate assignment (sometimes in the form of an annotated bibliography —see the bottom of the next page), but more often it is part of the introduction to an essay, research report, or thesis. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are.

From  Taylor, D. (n/a). The Literature Review: A Few Tips On Conducting It. University of Toronto, Health Sciences Writing Centre. 

• The Literature Review: A Few Tips On Conducting It Writing Advice from the University of Toronto, Canada.
• Record Title: Writing & Research. Writing a Literature Review. Neill, C. (2017). Writing & Research. Writing a Literature Review. Radiation Therapist, 26(1), 89–91.

There are several steps in developing a literature review.  These include:

• Define your paper’s goal
• Literature review will match paper’s goal
• Review articles related to your paper’s topic
• Articles are written by scholars
• Identify top scholars in the field about your topic
• Include most pertinent publications by those scholars
• Summarize articles you identified
• Provide the importance of the article as it relates to your thesis/project statement
• Establish its relevance to the discussion
• What where the earliest ideas on the?
• How did grow and evolve in the academic conversation?
• As you write you will include author and date
• Create comprehensive citation for each article
• Follow APA format
• Literature Reviews From Purdue OWL
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Nursing Literature Reviews

• Literature and Other Types of Reviews
• Starting Your Search
• Developing a Research Question and the Literature Search Process
• Conducting a Literature Search
• Levels of Evidence
• Creating a PRISMA Table
• Literature Table and Synthesis
• Other Resources

Introduction

There are many types of literature reviews, but all should follow a similar search process.  Below are a few types of literature reviews, as well as definitions and examples. Much of this information can be found in the article A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies.

Additional information about types of reviews, including an updated list of 48 types of reviews can be found in the article Meeting the Review Family: Exploring Review Types and Associated Information Retrieval Techniques

Literature Review : This is a generic term that can cover a wide range of subjects, and varies in completeness and comprehensiveness. They are typically narrative, and analysis may be chronological, conceptual, thematic, or however the author decides to organize the material. Anesthesia Personnel's Experiences With Digital Anesthesia Information Management Systems: A Literature Review.

Scoping Review : A preliminary assessment of the size and scope of available published literature. A scoping review is intended to identify current research and the extent of such research, and determine if a more comprehensive review is viable. Can include research in progress, and the completeness of searching is determined by time/scope. Traumatic Subarachnoid Hemorrhage: A Scoping Review

Mapping Review: Looks at existing literature and maps out future directions and current gaps in the research literature. Search may be determined by time/scope. Classification of Mild Stroke: A Mapping Review

Rapid Review : Assessment of what is already known about a policy or practice issue. Uses systematic review methods to search and critically evaluate existing research, but search is limited by time constraints. The Current State Of Telehealth Evidence: A Rapid Review

State-of-the-art/state-of-the-literature review: Addresses current matters as opposed to other types of reviews that address retrospective and current approaches. Comprehensive searching of the literature, and looks for current state of knowledge and sets priorities for future investigation and research. Artificial Intelligence for the Otolaryngologist: A State of the Art Review

Integrative Review: Combines empirical and theoretical research to examine research on a given area. Includes non-experimental research, and can include case studies, observational studies, theories, guidelines, etc., and is generally used to inform healthcare policy and practice. An Integrative Review of Yoga and Mindfulness-Based Approaches for Children and Adolescents with Asthma

Systematic Review: Seeks to systematically search, appraise, and synthesize research evidence. Requires exhaustive, comprehensive searching, including searching of grey literature. The efficacy of rehabilitation in people with Guillain-Barrè syndrome: a systematic review of randomized controlled trials

Systematic Review and Meta-Analysis: Includes all of systematic review, but requires quantitative analysis for the meta-analysis piece. The Efficacy and Safety of Disease-Modifying Osteoarthritis Drugs for Knee and Hip Osteoarthritis—a Systematic Review and Network Meta-Analysis

Umbrella Review: Specifically refers to searching for reviews only-usually systematic reviews only. Should discuss what is known, unknown, and recommendations for future research. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes

Which Type of Review Should I Do?

• Which Review Is Right For You? A great diagram and flow chart for picking the type of review that is right for you, based on scope, time, and research team.
• Which Review Is Right For You? A survey tool designed to help determine the most appropriate method for your review. It's not a prescriptive tool, but is intended to help identify options for your 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
• RESEARCH HELP

Research Librarian

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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Library Guides

Nursing and Midwifery

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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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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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What is a Literature Review?

Traditional narrative/literature review, scoping review, integrative review, systematic review, meta-analysis, realist reviews and evaluation reviews.

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 A literature review provides an overview of what's been written about a specific topic. There are many different types of literature reviews. They vary in terms of comprehensiveness, types of study included, and purpose. 

• Grant, M.J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26, 91–108.
• Higgins JPT, Green S (editors).Box 2.3.b: Timeline for a Cochrane review. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Available from http://handbook-5-1.cochrane.org . Accessed February 16, 2018.

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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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"What is a literature review used for?" .cls-1{fill:#fff;stroke:#79a13f;stroke-miterlimit:10;stroke-width:5px;}.cls-2{fill:#79a13f;} Literature reviews can communicate what the current state of a problem or question is. You might find a literature review in a journal article. An original experiment, in theory, would be based on where previous research had led in order to progress past stopping points.

• Literature Reviews
• Review Articles
• Search Strategy For Your Lit Review

What is a Literature Review?

“A review of the literature consists of reading, analyzing, and writing a synthesis of scholarly materials about a specific topic. When the review is of scientific literature, the focus is on the hypotheses, the scientific methods, the strengths and weaknesses of the study, the results, and the authors’ interpretations and conclusions. A review of the scientific literature is fundamental to understanding the accumulated knowledge about the topic being reviewed" (Gerard, 2017).

• Literature Reviews from the Writing Center at UNC Chapel Hill This handout will explain what literature reviews are and offer insights into the form and construction of literature reviews in the humanities, social sciences, and sciences.
• Health sciences literature review made easy: The matrix method by Judith Garrard The Matrix Method is an organizational system that guides you through the literature review process from start to finish, outlined in the book Health Sciences Literature Review Made Easy by Judith Garrard. It is “intended to teach you how to read a paper, organize the review using the Matrix Method, analyze it, and create a narrative synthesis” (2017, p. 31).
• Demystifying literature reviews by Brian T. Conner This brief, easy-to-read article describes different types of literature reviews.
• Matrix Method Handout This handout provides a general introduction to the Matrix Method. Please refer to Garrard’s book for further instructions on using the Matrix Method.

Structure of a Literature Review

When you're writing a literature review, you won't just summarize all of the articles that you've found on your topic. Instead, you'll synthesize the evidence. This means that you'll look at the state of the evidence as a whole, telling your reader what it means when you put it all together. Rather than reviewing your sources one at a time, you'll organize your lit review by concept, chronology, methodology, etc. -- whatever makes the most sense for your topic.

Watch Video

This video from the North Carolina State Libraries offers a thorough 10-minute introduction to literature reviews. It's a great resource if you still aren't sure how to approach your lit review.

Garrard, J. (2017). Health sciences literature review made easy: The matrix method . Burlington, MA: Jones and Bartlett Learning.

Libncsu [Username]. (July 30, 2009). Literature reviews: An overview for graduate students [Video]. Youtube. Retrieved April 29, 2020 from https://www.youtube.com/watch?v=t2d7y_r65HU&feature=youtu.be

University of North Carolina Writing Center. (n.d.). Literature reviews . Retrieved April 29, 2020 from https://writingcenter.unc.edu/tips-and-tools/literature-reviews

Comparing Different Types of Reviews

Here you will find descriptions of narrative, integrative, and systematic reviews. You will also find additional information about finding and understanding systematic reviews. Once you understand what a systematic review is and where to search for them, see the Search Tips page in this guide for help with finding the articles you need.

From the Oak Ridge Institute for Science and Education

Literature Review (Narrative Review)

"Literature reviews in the introduction to a report provide readers with an overview of existing evidence, and contribute to the argument for the new study. These reviews are usually only 2 to 4 double spaced pages, and so, only key studies can be cited. The emphasis is on summarizing and evaluating an overall body of evidence" (Polit & Beck, 2012).

Integrative Reviews

"An integrative review is a specific review method that summarizes past empirical or theoretical literature to provide a more comprehensive understanding of a particular phenomenon or healthcare problem...Well-done integrative reviews present the state of the science, contribute to theory development, and have direct applicability to practice and policy" (Whittemore & Knafl, 2005).

If you're conducing an integrative review, read Whittemore and Knafl because they clearly explain what an integrative review is and how to design and implement one.

Systematic Reviews

A systematic review attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a specific research question. Researchers conducting systematic reviews use explicit, systematic methods that are selected with a view aimed at minimizing bias, to produce more reliable findings to inform decision making. See the Cochrane Library

"A systematic review involves the identification, selection, appraisal, and synthesis of the best available evidence for clinical decision making. A properly conducted systematic review uses reproducible, preplanned strategies to reduce bias and instill rigor and pools information from both published and unpublished sources... Systematic reviews are conducted to answer specific, often narrow, clinical questions. These questions are formulated according to the mnemonic PICO addressing: a specific population (P) (such as people traveling long distance), the intervention of interest (I) (e.g., preventive measures for deep vein thrombosis), an optional comparison (C) (such as the standard of care, which may be no intervention), and one or more specific outcomes (such as prevention of deep vein thrombosis)" (Kazer & Fitzpatrick, 2012).

Meta-Analyses

Meta-analysis is a quantitative approach that permits the synthesis and integration of results from multiple individual studies focused on a specific research question. A meta-analysis is a rigorous alternative to the traditional narrative review of the literature. It involves the application of the research process to a collection of studies in a specific area. The individual studies are considered the sample.

A systematic review may include meta-analysis if it is able to combine the results of comparable randomized controlled trials. See Systematic Review in the Encyclopedia of Nursing Research .

Kazer, M. W., & Fitzpatrick, J. J. (2012). Systematic Reviews. In The Encyclopedia of Nursing Research , Third Edition. New York, NY: Springer Publishing Company. https://ezproxy.simmons.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=387241&site=ehost-live&scope=site&ebv=EB&ppid=pp_500

Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice . Lippincott Williams & Williams.

Whittemore R, & Knafl K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing . 52 (5), 546–553. https://doi-org.ezproxy.simmons.edu/10.1111/j.1365-2648.2005.03621.x

Search Strategy For Your Lit Review (See also NURS 507/508 Search Basics )

For a narrative review as part of a research report, you want to conduct a comprehensive search to identify as many sources as possible on your topic. You'll then choose the key studies to include in your report.

Database Searching

Search health sciences databases (i.e. Cinahl, Medline) for keywords related to your topic. (See the Search Basics page of this guide for tips and resources). Having trouble? Meet with a librarian with a librarian to discuss databases, keywords, and search strategies.

Citation Searching

When you find a relevant article, use it to identify other potentially relevant articles: Look at its references to identify other relevant articles that you haven't found. Use Google Scholar or Scopus to identify more recent articles that have cited that one. Reviews that are part of a research report don't usually share their search strategy, but it's still a good idea to take notes to make the process as organized and efficient as possible.

Document Your Sources

• List the databases you search and the keywords you used
• Explain how you used citation searching to identify additional articles
• Discuss the exclusion criteria you used

Inclusion & Exclusion Criteria

• Relevance to your topic (i.e. different meaning of a term, different aspect of your topic, etc.)
• Publication type (journals, grey literature, etc.)
• Language of publication
• Time period
• Geographic considerations

The Matrix Method

A synthesis matrix helps you compare research articles side-by-side so you can identify common themes and visualize the bigger picture.

• Using a Synthesis Matrix to Plan a Literature Review by Kevin Clark and Mary Buckley This very brief article explains what a synthesis matrix is and how to use one for your literature review.
• Health sciences literature review made easy: The matrix method by Judith Garrard This book goes into detail about the matrix method, which is a system of organizing the literature review process. Chapters 5 and 6 explain how to set up a synthesis matrix, with an example on pages 157-158.

Garrard, J. (2017). Health sciences literature review made easy: The matrix method . Fifth edition. Jones & Bartlett Learning. https://ezproxy.simmons.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=1229455&site=ehost-live&scope=site

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Reviews of Literature in Nursing Research: Methodological Considerations and Defining Characteristics

Affiliation.

• 1 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).
• PMID: 35213877
• DOI: 10.1097/ANS.0000000000000418

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.

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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Conflict of interest statement

The authors have no conflict of interest to declare.

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Chapter 1: Introduction

Learning objectives.

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

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

1.1 What is a Literature Review?

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

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

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

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

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

Literature reviews:

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

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

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

Literature Review Tutorial

1.2 Literature Review Basics

An effective literature review must:

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

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

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

1.3 Types of Literature Reviews

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

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

1.3.1 Types of Review

1.3.1.1 conceptual.

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

Examples of a Conceptual Review:

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

1.3.1.2 Empirical

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

Examples of an Empirical Review:

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

1.3.1.3 Exploratory

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

Examples of an Exploratory Review:

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

1.3.1.4 Focused

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

Examples of a Focused Review:

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

1.3.1.5 Integrative

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

Examples of an Integrative Review:

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

1.3.1.6 Meta-analysis

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

Examples of a Meta-Analysis:

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

1.3.1.7 Narrative/Traditional

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

Examples of a Narrative/Traditional Review:

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

1.3.1.8 Realist

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

Examples of a Realist Review:

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

1.3.1.9 Scoping

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

Examples of a Scoping Review:

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

1.3.1.10 Synoptic

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

Examples of a Synoptic Review:

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

1.3.1.11 Systematic Review

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

Examples of a Systematic Review:

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

1.3.1.12 Umbrella/Overview of Reviews

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

Examples of an Umbrella/Overview Review:

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

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

1.4 Why do a Literature Review?

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

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

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

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

1.4.2 Second – It’s good for you!

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

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

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

1.4.4 Why do a literature review?

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

1.5 Common Literature Review Errors

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Test Yourself

See Answer Key for the correct responses.

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

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

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

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

• Meta-analysis
• Exploratory

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

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Introduction to critical appraisal

Evidence-based nursing (EBN) means using the best available evidence from research, along with patient preferences and clinical experience, when making nursing decisions. 1 Nurses are increasingly concerned about ensuring that care is research based, and EBN offers a strategy to help nurses achieve this goal by using 5 steps:

Step 2: translating these areas of uncertainty into focused, searchable questions 2

Step 3: searching the literature for studies that use appropriate designs to help answer the question 3 – 6

Step 4: critically appraising the research

Step 5: changing practice if the research suggests this is necessary.

Previous Notebooks in Evidence-Based Nursing that have described the process of EBN 2 – 6 were written with busy clinical nurses in mind. The next series of Notebooks will explore step 4 in detail—how to assess whether research findings are valid and appropriate for clinical application.

The volume of healthcare literature has been described in graphic terms. Did you know, for example, that Medline has indexed more than 9 million citations in more than 4,000 journals since 1966? 7 Clearly, no individual practitioner can read this volume of research; nor should they try, as only a small proportion of it is of good quality. The trick to keeping abreast of the latest research is to quickly filter the good from the bad. For example, staff of the evidence-based journals office recently calculated that of 136 journals read for 4 evidence-based journals ( Evidence-Based Nursing , Evidence-Based Mental Health , Evidence-Based Medicine , and ACP Journal Club ), an estimated 8% of 21 100 articles passed evidence-based methodologic filters (personal communication, A McKibbon, 20 Mar 2000).

Anyone who has designed or implemented a research study knows that it can be difficult to do well. Researchers, like …

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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.

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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)

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Nursing ethical values and definitions: A literature review

Mohsen shahriari.

Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Eesa Mohammadi

1 Department of Nursing, Medical Sciences Faculty, Tarbiat Modares University, Bridge Nasr (Gisha), Tehran, Iran

Abbas Abbaszadeh

2 Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Masoud Bahrami

3 Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Background:

Ethical values offer a framework for behavior assessment, and nursing values influence nurses’ goals, strategies, and actions. A literature review was adopted in order to determine and define ethical values for nurses.

Materials and Methods:

This literature review was conducted based on the Centre for Reviews and Dissemination guidelines. The key words used to search relevant sources were nursing, ethics, ethical values, and nursing values. The search of articles in English was carried out in Medline, CINAHL, PubMed, Scopus, Ovid, and Proquest databases. The search of articles in Persian was conducted in databases of Magiran, SID, and Irandoc publications. After assessing and analyzing the obtained data, 17 articles which had a distinct definition of ethical values were chosen and subjected to a thorough study.

The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency.

Conclusions:

This study showed that common ethical values are generally shared within the global community. However, in several areas, influences of social, cultural, and economical status and religious beliefs on values result in a different definition of these values. This study revealed that based on humanistic nature of nursing, common values in nursing protect human dignity and respect to the patients. Recognizing and definition of ethical values can help to improve nursing practice and develop codes of ethics.

I NTRODUCTION

Nurses as one of the health service providers and members in health system who are responsible for giving care to the clients and patients based on ethical issues.[ 1 ] They need ethical knowledge to conduct their appropriate function to manage situations and to give safe and proper legal and ethical care in today's changing world.[ 2 ] With regard to practical care, they always try to answer the question of “What can I do?,” whereas they should try to answer what is essential to be done for the patients in the context of ethical principles.[ 3 ] Ethics seek the best way of taking care of the patients as well as the best nursing function.[ 4 ]

Nurses are responsible for their clinical function, and their main responsibility is to take care of the clients and patients who deserve appropriate and safe care.[ 5 ] They act based on the values they have selected. These values form a framework to evaluate their activities influencing their goals, strategies, and function.[ 6 ] These values can also be counted as a resource for nurses’ conduct toward clinical ethical competency and their confrontation with contemporary ethical concerns. Values conduct human life priorities and form the world we live in. They act as one of the most basic parts of human life. Ethical values are inseparable components of the society and, as a result, nursing profession.[ 7 , 8 ]

Discovery of basic values and reaching an agreement on clinical ethical values are essential with regard to constant changes in nurses’ social class and role.[ 9 ] Nurses’ awareness of their values and the effect of these values on their behavior is a core part of humanistic nursing care.[ 10 ] They need to tailor their function to the value system and cultural beliefs of their service recipients.[ 11 ] Values originate from cultural environment, social groups, religion, lived experiences, and the past. Social, cultural, religious, political, and economic considerations influence individuals and their value system,[ 6 ] and ultimately, health, education, social strategies, and patients’ care. Numerous documents have been prepared in nursing texts and literature concerning these values and clarification of their traits.[ 7 , 9 , 12 , 13 , 14 , 15 , 16 ]

Recognition and definition of nursing ethical values in various communities can help nurses have mutual understanding in international level. It can also bring nurses closer to reach a common meaning of care in patients with different cultures. However, there is a paucity of research particularly in the Iranian context to deeply explore nursing ethical values. Therefore, in the first step, the main aim of the study was to identify and explore nursing ethical values reflected in nursing texts. This search was then used to prepare code of ethics and clinical guidelines for Iranian nurses, along with other documents and evidences. Results of other aspects of the study have been reported in other articles from the researchers.

M ATERIALS AND M ETHODS

This study is a part of a bigger study conducted in the Isfahan University of Medical Sciences. A literature review was carried out in 2010 to determine ethical values and related definitions in nursing systems of various countries.

In this literature review, the York University four-step approach was applied. These steps are as follows: Forming questions and determining search strategies, extracting synthesis, providing quality assessments and applying study evaluation tools, and suggesting methods to analyze and data synthesis.[ 17 ]

Search strategy

The study tried to answer the following questions:

• What nursing ethical values are determined and offered in this study?
• What is the definition of each value?

In this literature review, all published articles in English language from 1995 to 2010, as well as articles in Persian from 1996 to 2010 were searched by separated keywords and then keywords in combination, respectively. AND/OR was used combination and collection of various key words together. A manual search was also adopted and the references of the articles were studied as well. The search yielded about 82 articles whose titles and abstracts were studied. The articles not meeting the inclusion criteria were left out. Inclusion criteria were: Articles published in English or Persian and those articles on nursing ethical values in patients’ care. At this stage, 37 articles were excluded and 45 were selected and comprehensively reviewed. In the next stage, the articles were completely studied with regard to inclusion criteria and their answers to the questions of the present study.

Finally, 17 related articles were selected and considered for the study. Data were extracted through firstly writing down the detected values and their definitions in the related articles. Then, the research team compared the findings and recorded them in a table, and selected the best definition of each value among the suggested definitions. Finally, after comparison of the names and words, a unique definition for each value was achieved based on the trait of definition.

Research team checked all selected articles concerning assessment of quality based on criteria of study quality evaluation tool. This tool was designed by the research team with regard to the study goal. Two questions were considered with respect to the various research methods employed in the selected articles. The questions were as follows:

• Does the article express nursing ethical values?
• Does the article contain a clear and specific definition for the expressed ethical values?

In order to increase study credibility, the abstracts were studied by researchers individually and the obscure points were discussed by the research team. In case of a disagreement to include an article in the study, a third member of the research team conducted further investigations, the obscure points were discussed in the group, and a final decision was made.

In the stage of data combination, all textual obtained data from the selected articles were classified and completely described. After textual data had been extracted and studied critically, the traits were separated and finalized based on the obtained definition for each value or ethical concept and finally a unique definition was obtained. Each obtained defined value has been explained in the section “Discussion.” These defined values suggested appropriate answers to literature review questions.

Articles methodological traits

The articles were from 12 countries: Four from US, two from Canada, five from European countries (Belgium, England, Finland), and six from Asian countries (Iran, Japan, China, Thailand, and Taiwan).

Reviewed articles included two quantitative studies, eight qualitative studies, three literature reviews, two philosophical inquiries, and two action research philosophical methods. Various sampling methods had been precisely employed in these studies. 1360 subjects comprised the recruited subjects in these 17 articles. In two quantitative descriptive studies, 922 clinical nurses and nursing students had been randomly selected through census sampling. In qualitative researches, the participants comprised 438, randomly selected through purposive sampling. The number of participants ranged between 20 and 300 individuals. In most of these qualitative studies, the participants included clinical nurses accompanied by nurse educators.[ 9 , 18 , 19 , 20 ] In one study, the participants were just clinical nurses, and in another,[ 21 ] they were just nursing students.[ 22 ]

The data were mostly collected through individual interviews which were, in some cases, the only source of data and in some other cases accompanied by other methods. The data had been collected by different methods: One by individual interviews and group discussion,[ 20 ] one by individual interview and observation,[ 18 ] one by narration and individual interview,[ 19 ] one by group discussion and narration,[ 22 ] and finally, in only one by group discussion.[ 9 ] In two studies, data had been collected through literature content analysis;[ 10 , 13 ] in two, by applying intervention;[ 16 , 23 ] in two other, through literature review;[ 7 , 24 ] and finally, in two studies, the data had been collected through philosophical inquiries.[ 6 , 25 ]

In two quantitative studies adopted to collect data, standard tools had been employed. In the study of Weis (2000), Nurses’ Professional Values Scale (NPVS) with confirmed reliability and validity had been utilized.[ 26 ] Rassin (2008) used nursing code of ethics related to International Nursing Association to evaluate nurses’ professional values as well as the Rokeach Values Survey with confirmed reliability and content validity to assess nurses’ personal values.[ 15 ]

Quality appraisal

The selected articles were reviewed concerning their quality. Application of a systematic literature scientific method in the present literature review study let the research review the articles based on research questions, research project, data collection method, data analysis method, data credibility, ethical considerations, and the results.

In quantitative studies reviewed, standard questionnaires had been adopted for data collection, data analysis method had been clearly defined, and the necessary permissions had been obtained from university and other needed institutes to respect ethical considerations. The results were also in the direction of research questions.

In qualitative studies, research methodology and data analysis had been clearly stated, and participants’ consents had been obtained to respect ethical considerations. Various methods had been employed for credibility: Data collection from various methods,[ 19 , 20 , 22 ] precise transcription, and data recheck and conformability with participants and colleagues.[ 18 , 19 , 20 ]

Data analysis methods of the studies, conducted based on philosophical research methodology and action research, had not been clearly mentioned, but their results were related.

General traits of reviewed studies

General traits of reviewed studies in the context of nursing ethical values have been presented in Table 1 . The reviewed articles had investigated nurses’ ethical values from different aspects.

Outline of studies included in the review

In various studies, the values had been differently introduced and defined. Most of the reviewed articles had focused on common nursing ethical values.[ 22 ] In some, several values and in some other, only one value had been introduced and defined. Konishi (2009) had only studied the value of harmony in nursing and had suggested that as one of the most fundamental values in Japan.[ 13 ] Verpeet (2003) had defined values as nurses’ responsibility against their patients, profession, other health team members, and society.[ 10 ] Naden (2004) in his study to define components of human dignity indicated braveness, responsibility, respect, commitment, and ethical desires.[ 18 ] Wros (2004) reported a significant difference in ethical value of decision making among the nurses in two countries.[ 19 ] Trailer (2004) claims that respect to the patients has the highest priority among codes of ethics and acts as a basic value to design the nursing ethical codes which include three main elements of respect, reliability, and mutuality.[ 25 ]

Shih (2009) reported that 75% of the participants had indicated taking care of the patients and their related individuals and altruism as the most common nursing values. Other values in his study were provision of holistic professional and appropriate care, promotion of personal and professional competency, disease prevention, health promotion, promotion of interpersonal communication skills, and receiving fair reward.[ 9 ]

Weis (2000), through factor analysis, introduced eight factors for professional values of which the most important one was nurses’ role in care and dimension of commitment.[ 26 ] Pang (2009) stated nursing professional values in seven themes of altruism, care, respecting the dignity, trust, accountability, independency, and justice.[ 20 ] Mahmoodi (2008) indicated responsibility, having mental and emotional communication, value, and ethics criteria such as honesty in work, mutual respect, religious margins and confidentiality, justice and fairness.[ 21 ] Shaw (2008) and Fahrenwald (2005) in our studies, in a different way, investigated application of five nursing professional values in nursing education, including altruism, independency, respect to dignity, nursing interventions’ integrity, and social justice.[ 16 , 23 ] Horton (2007) stated that personal and organizational values have effects on nursing and introduced values such as responsibility, honesty, patients’ participation, integrity and humanity protection, patients’ independency, deep humanistic relationship, dignity, hope, passion, teamwork, differentiation, versatility, altruism, nurturing, integrity and support, reciprocal trust, sound knowledge, clinical competence, communications, unity, homogeneity, coordination, self-sacrifice and devotion, self-protection, privacy preservation, creativity, aesthetics, management, economizing, braveness, commitment, ethical attitude, personal orientation, judgment, freedom, individualism, acknowledgment, and personal success.[ 7 ] Two studies had stated detection of ethical values as the basis for collection of codes of ethics.[ 24 , 27 ]

D ISCUSSION

In all of the articles studied in the present literature review, patients’ dignity and respect had been stated as the most frequent value indicated in 12 articles, equality and justice in 8 articles, and altruism and precise care and making appropriate relationships were indicated in 6 articles, respectively.

Comparison and finalization of the obtained data concerning nursing ethical values in patients’ care yielded 10 values mostly indicated in the articles: Human dignity, altruism, social justice, autonomy in decision making, precision and accuracy in caring, responsibility, human relationship, individual and professional competency, sympathy, and trust. The 10 obtained values in this literature review and their definitional traits are presented subsequently.

Human dignity

Respecting human dignity was the most common value indicated in the reviewed articles. Respect to individuals including the persons, their families, and the society has been mentioned as an important nursing ethical value. Dignity respect has been defined with definitional traits as consideration of human innate values, respecting patient's beliefs and preservation of their dignity and privacy during clinical procedures, and communication with the patients, and contains understanding the patients and devoting to fulfill clients’ needs.[ 15 , 16 , 18 , 20 , 22 , 23 , 24 , 27 ] Pang (2009) argues that nurses should accept that people deserve respect and dignity in action. They should practically cover patients’ body parts if exposed and keep patients’ secrets confidential.[ 20 ]

This value has been suggested in most of the articles possibly as a result of humanistic nature of nursing profession in helping others. This value had been emphasized in all articles of Asian countries, reflecting cultural similarities in these countries. This value has also been indicated in most of the codes of ethics in various countries all over the world.

Social justice

Justice is an ethical value suggested in nursing literatures. Social justice has been defined by the traits which, in addition to consideration of individuals’ dignity and respect, focus on equal access to health services and the right of being fairly treated and cared free of economic, social, and cultural status.[ 9 , 10 , 15 , 16 , 20 , 21 , 23 ] Social justice had been the indication in most of the countries and had been defined as fair distribution of resources and provision of individuals’ equal treatment and care.

Verpeet (2003) stated that equality means access of all individuals to health services. She claims every individual in Belgium is supposed to have equal right of receiving equal nursing care.[ 10 ]

Altruism is a common nursing value in various countries. It has been defined with traits of consideration of human as the axis of attention and focus in nursing, helping others and provision of the utmost health and welfare for the clients, their families, and the society, selflessness, and self-devotion.[ 6 , 9 , 13 , 15 , 16 , 18 , 22 , 23 , 27 ] Therefore, altruism is defined as focusing on clients as a human and struggling to preserve their health and well-being. Pang (2009) debated that based on the principle of altruism, nurses should have spirit of selflessness and helpfulness toward others.[ 20 ]

Autonomy in decision making

Independency in decision making is a value suggested in some studies as a nursing ethical value. Nurses have defined its traits as having right of independency in decision making, right to accept or reject suggested treatments, interventions, or care. In addition, autonomy in decision making necessitates giving appropriate and adequate information to the clients and, if necessary, to their families.[ 13 , 15 , 23 ] So, autonomy in decision making occurs when nurses let patients be informed, free, and independent to decide on the diagnosis, treatment, and prevention through giving them appropriate information.

Konishi (2009) debates that conscious adult patients should themselves decide. With regard to nursing profession, nurses should provide the patients with information, explain suggested interventions, and let them free to either accept or reject oncoming procedures so that they and their families can make a decision about their condition.[ 13 ]

Precision and accuracy in caring

Precise and accurate care has been indicated as a nursing ethical value. Based on this definition, this sort of care is a precise, safe, appropriate, multidimensional, and kind care given to the patients by nurses. This is also thoughtful, based on adequate clinical skills and nursing knowledge to fulfill clients’ needs, promote their health, and relieve their pain and suffering. It is also based on standards and results in patients’ safety and satisfaction.[ 6 , 9 , 15 , 23 , 24 , 27 ] In this regard, Shih (2009) states that holistic and appropriate professional care is to prevent diseases, promote health, and make the feeling of comfort and safety for the patients.[ 9 ]

Responsibility

Responsibility has been defined as a nursing ethical value. It is defined with traits of commitment, feeling responsible for the duties toward patients, and respecting the patients’ rights for decision making.[ 15 , 18 , 19 , 21 , 24 , 26 , 28 ] Based on this definition, nurses are responsible for giving evidence-based care, best clinical function, and applicable and valid research, and are accountable for their actions and duties. Verpeet (2005) argues that nurses are responsible for promotion of patients’ well-being, having a holistic approach toward them and completing their duties.[ 28 ]

Human relationship

Human relationship has been indicated as a nursing ethical value with traits of mutual respect, trust, and reliance which are accompanied by patients’ confidentiality and privacy. It can be verbal or non-verbal and defined through having honesty in words and practice, sympathy and mutual understanding, courtesy, and friendliness.[ 9 , 15 , 19 , 21 , 25 ]

In this regard, giving care is possible only through making humanistic, efficient, and effective relationship, a relationship based on mutual respect and understanding.

Individual and professional competency

Individual and professional competency as a nursing ethical value has been defined with traits of struggling to make nursing as a profession, feeling the need to acquire personal and professional competency so that nurses can grow and develop in the direction of advances and new technology. Personal competency and development of the nurses result in acquiring up-to-date knowledge and promotion of clinical skills and practical abilities, and the ability to give more holistic and comprehensive care. Promotion of personal and professional competency comes true when nurses make a background for the best patients’ care by trying to give evidence-based care, and their empowerment for participation in activities in relation with other health team members and interpersonal and inter-professional skills development.[ 7 , 9 , 15 , 20 , 24 ] Pang (2009) debates that participation in continuing professional development suggests that individuals should preserve their competency in their activities and participate in professional continuing education programs throughout their occupational life.[ 20 ]

Sympathy has been indicated as a nursing ethical value with traits of understanding patients’ and their families’ needs and giving care based on making a fair communication.[ 6 , 19 ] In some cultures, such as Japanese, nurses share patients’ physical and mental pains and sufferings.[ 19 ]

Trust has been indicated as a nursing ethical value and is defined by traits of honesty in words and practice. Nurses should gain patients’, their families,’ and society's trust through understanding patients’ situation and status and appropriate conformation with them.[ 15 , 20 , 23 , 24 ] Based on this definition, gaining clients’ trust and reliance comes true when nurses are honest in their words and practice, and gain individuals’ trust and reliance by doing their duties appropriately.

C ONCLUSION

This study showed that nursing ethical values in patients’ and clients’ care are similar in many cases due to a common core in humanistic and spiritual approach of nursing profession, which is taking care of a human. Values such as human dignity, kindness and sympathy, altruism, responsibility and commitment, justice and honesty, and personal and professional competency were similar in most of the cultures.

Despite the similarities in ethical and professional values among various countries, it is essential to detect and highlight these values in each country, for example, in Iran, with regard to the prevalent social, cultural, economic, and religious conditions. Detection and declaration of nursing ethical values in each country can be a valuable, scientific, valid, and essential document to design nursing codes of ethics. This search was used to prepare proposed code of ethics and clinical guidelines for Iranian nurses. Findings of this study search must be considered within its limitation. An attempt was made to conduct a search as vast as possible. However, it might be possible that we could not access to all articles available in the period of the search.

A CKNOWLEDGMENT

The authors would also like to acknowledge the Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, for supporting this work.

Source of Support: Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences

Conflict of Interest: None

R EFERENCES