1 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Chapter 6 Understanding the Literature Review in Published Studies

2 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. What Is a Literature Review?  Summary of current empirical and theoretical knowledge about particular practice problem that provides a basis for the study conducted  Includes:  Description of current knowledge base  Gaps in knowledge base  Contribution of present study to knowledge base

3 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Sources Included in a Literature Review  Theoretical literature: concept analyses, theories, and models that support research purpose  Empirical literature: relevant studies  Citation: a source quoted by the author  Periodical: a journal  Monograph: a book or published conference proceedings  Thesis and dissertation: research by master’s and doctoral degree students

4 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Types of Sources  Primary sources are written by the person who generated the published ideas.  In research, written by the person(s) who conducted the research  In theory, written by the theorist(s) who developed the theory  Secondary sources paraphrase the works of researchers and theorists.

5 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Purposes of Literature Review in Quantitative Studies  Direct the development and implementation of a study  Cite relevant and current sources  Document background and significance of study  Identify theoretical ideas guiding the building of a body of knowledge for the selected area of study

6 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Purpose of Literature Review in Qualitative Studies (cont’d)  Provides a basic understanding of the study problem and evidence that the study conducted was appropriate, based on current knowledge of the problem

7 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Qualitative Research Methods and the Literature Review  Phenomenological  Grounded theory  Ethnographic  Historical  Compare and combine study findings with literature  Use literature to explain, support, and extend research theory  Literature provides background for research  Literature develops research questions and is source of data

8 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Guidelines for Literature Review  Includes what is known and not known about the topic  Includes the focus of the study  Sources must be current—published within the past 5 years  Landmark studies may be included if essential to the background of the problem

9 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Questions Guiding Critique of Literature Review  Are primary sources cited in the review?  Are the references current?  Are relevant studies identified and described?  Are relevant theories identified and described?  Are relevant landmark studies described?  Are the studies critiqued?

10 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Questions Guiding Critique of Literature Review (cont’d)  Are sources paraphrased to promote the flow of content?  Is the current knowledge about the research problem described?  Does literature review identify gap(s) in knowledge base that provides basis for study?  Is the literature review clearly organized, logically developed, and concise?

11 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Library Sources  Academic libraries—colleges and universities  Special libraries—hospitals, Sigma Theta Tau Center for Nursing Scholarship  Interlibrary loan  Online search  Public libraries

12 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Selecting Databases  Bibliographic database: compilation of citations  Citation: provides information necessary to locate a reference  Full-text database: provides the entire text of articles for your use  Commonly used databases in nursing  CINAHL, Medline, OVID, EBSCOhost, GALE Cengage, and Cambridge Scientific

13 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Keywords  Major concepts or variables of a research problem or topic used to search a database  May be single terms or phrase  Most databases have a thesaurus that can be used to identify keywords.  Each keyword used should be listed in a written search plan.

14 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Recording Search Information  Name of database  Date of search  Exact search strategy used  Number of articles found  Percentage of relevant articles found  This information can be stored in a table.

15 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Performing Complex Searches  Complex searches combine two or more concepts, synonyms, or keywords in one search using “and.”  Select keywords you have used to perform simple searches.

16 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Limiting a Search  Some searches will result in thousands of hits.  To reduce number of hits while increasing the relevance of citations, limit:  To English language  The publication dates to recent years  To papers that are research  To full-text articles (this can be risky)

17 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Search Fields  Search fields are the various pieces of information provided about an article by the bibliographical database.  To select search fields in CINAHL, select the Search Fields option at top of the search page.  Of particular importance, selecting “cited reference” will give you full references of all citations included in each article. You may find “treasures” not included in the computer search.

18 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Electronic Nursing Journals  An increasing number of nursing journals publish only in electronic form.  Expensive to publish and distribute a printed journal  Electronic journals targeted to small specialty audiences  These journals have more current information because articles are published within 3 to 4 months of submission, whereas the time from submission to publication in traditional journals is 1 to 2 years.

19 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Searching for Electronic Journals  Because they are new, many electronic journals are not yet in bibliographic databases.  Ingenta ( is a commercial web site to search online journals from many disciplines.  A list of current electronic nursing journal web sites is available in your text.  You may locate the electronic journal on the Internet and then scan the titles of articles published in the journal.

20 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Searching the Internet  Search engines provide the means to search the Internet.  Some are better than others. Google Scholar is an excellent search engine.  University libraries provide a list of good search engines.  You may find information on the Internet that is useful to your topic.

21 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Assessing Web-Based Information  Advantage: information is more current than that found in books  Disadvantage: information is uneven in terms of accuracy  There is no screening process for information put on the Web.  It is important to check the source of any information obtained on the Web to judge its validity.

22 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Saving Search Results  Save the results of each search on:  Computer hard drive  Floppy disk  Zip file  CD  Record the file name of saved search results on the search record.

23 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Clarifying Evidence for Best Practice through Literature Reviews  Literature reviews can be used to define the state of the science in a given area of practice.  When results are published, these reviews are referred to as integrative reviews of literature.  The purpose is to identify, analyze, and synthesize results from independent studies to determine current knowledge in particular area.  Can use paraphrasing

24 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Development of Protocol or Critical Pathway  Integrative reviews are used to develop protocols and critical pathways.  This process is often used by nursing committees in health care facilities.  Studies are selected for inclusion based on their quality and relationship to selected practice problems.

25 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Synthesis of Sources  Compile findings from all selected studies  Analyze and interpret clustered findings  Specify current state of research-based knowledge

26 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Sources of Integrated Reviews  Annual Review of Nursing Research  Journal: Evidence-Based Nursing  Sigma Theta Tau Online Journal of Nursing Synthesis  The Cochrane Collaboration (  The Agency for Healthcare Research and Quality (

27 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Meta-analyses  Go beyond an integrated review  Include statistical analyses  Use summative statistical findings from multiple published studies

28 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Meta-analyses (cont’d)  Provide a global estimate of such things as mean number of days of hospitalization following particular procedure, or reduction in number of hours in a care unit from a particular nursing intervention  Results of meta-analyses are sometimes referred to as benchmarking.

29 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Writing a Review of Literature  Purposes  Document current knowledge of selected topic  Indicate findings ready for use in practice  Outline  Introduction  Empirical literature  Summary

30 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 1. Introduction  Indicates focus or purpose of review  Describes organization of sources  Indicates basis for ordering:  Most important to least  Earliest to most recent  Categories

31 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 2. Data-Based Literature  Includes quality studies relevant to topic  For each study, purpose, sample, sample size, design, and specific findings are presented, using paraphrasing rather than direct quotes.  Scholarly, but brief, critique of study’s strengths and weaknesses

32 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Ethical Issues in Empirical Literature  Content from studies must be presented honestly and not distorted to support selected use project.  Weaknesses of study need to be addressed, but it is not necessary to be highly critical of a researcher’s work.

33 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Ethical Issues in Empirical Literature (cont’d)  Criticism should focus on content, be related to your project, and be neutral and scholarly rather than negative and blaming.  Sources should be accurately documented.

34 Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 3. Summary  Concise presentation of research knowledge about selected topic—what is known and not known  Judgment stating whether there is adequate knowledge to direct change in clinical practice  Brief statement of proposed change in practice