Chapter 6

Understanding the Literature Review

in Published Studies

Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 1

 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

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 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
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 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.

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 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

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 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

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Qualitative Research Methods and the
Literature Review
 Phenomenological  Compare and combine
 Grounded theory study findings with
 Ethnographic literature
 Historical  Use literature to explain,
support, and extend
research theory
 Literature provides
background for research
 Literature develops
research questions and is
source of data

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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

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 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?

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 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?

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 Library Sources
 Academic libraries—colleges and universities
 Special libraries—hospitals, Sigma Theta Tau
Center for Nursing Scholarship
 Interlibrary loan
 Online search
 Public libraries

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 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

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 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.

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 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.

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 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.

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 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)

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 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.

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 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.

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Searching for Electronic Journals
 Because they are new, many electronic journals are
not yet in bibliographic databases.
 Ingenta (www.ingenta.com) 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.

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 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.

Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 20

 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.

Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 21

 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.

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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

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 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.

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 Synthesis of Sources
 Compile findings from all selected studies
 Analyze and interpret clustered findings
 Specify current state of research-based
knowledge

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 Sources of Integrated Reviews
 Annual Review of Nursing Research
 Journal: Evidence-Based Nursing
 Sigma Theta Tau Online Journal of Nursing
Synthesis
 The Cochrane Collaboration
(www.cochrane.org)
 The Agency for Healthcare Research and
Quality (www.ahrq.gov)

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 Meta-analyses
 Go beyond an integrated review
 Include statistical analyses
 Use summative statistical findings from
multiple published studies

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 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.

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 Writing a Review of Literature
 Purposes
 Document current knowledge of selected topic
 Indicate findings ready for use in practice
 Outline
 Introduction
 Empirical literature
 Summary

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 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

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 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

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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.

Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 32

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.

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 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

Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 34