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The Journal of School Nursing http://jsn.sagepub.com/ Literature Reviews as a Research Strategy
Julia Muennich Cowell The Journal of School Nursing 2012 28: 326 DOI: 10.1177/1059840512458666 The online version of this article can be found at: http://jsn.sagepub.com/content/28/5/326

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The Journal of School Nursing 28(5) 326-327 ª The Author(s) 2012 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1059840512458666 http://jsn.sagepub.com

Literature Reviews as a Research Strategy

Literature reviews have long been important strategies to assess the state of the science. As early as 1993, Broome (1993) recommended literature reviews as a strategy to assist in the development of concepts. Many graduate students in nursing and other sciences learn about synthesizing literature throughout their academic programs using a variety of guides including Cooper’s (1998) Synthesizing Research: A Guide for Literature Reviews as a common reference or Fink’s (2009) Conducting Research Literature Reviews, From the Internet to Paper. Despite years of reporting extant literature regarding a problem, many review reports still lack the rigor that is necessary to provide evidence for practice. The quality of the review may well be related to the lack of recognition that the review is a scientific method. The rigor of the scientific method needs to be applied to the literature review to make sure the approach is standardized.

Types of Literature Reviews
There are multiple types of literature reviews aside from the background reviews reported in research articles. The reviews include the integrated literature review, systematic review, meta-analysis, and qualitative reviews (Whittemore, 2005). Authors should assure the quality of reviews and use accepted guidelines to enhance the scientific process of the reviews (Evans & Kowanko, 2001). The integrated literature review remains an important strategy and differs from systematic reviews and meta-analyses because it allows the inclusion of multiple methodologies to capture the context, processes, and subjective elements of studies addressing a problem (Whittemore & Knafl, 2005). The target of the integrated literature review is broad but the methods of the integrated review require the same rigor as all qualitative studies starting with a clear statement of the problem and purpose of the review. Once the problem statement and purpose are clear, the literature search is directed by keywords in relevant databases and other sources using inclusion and exclusion criteria to maintain the focus of the search. Research questions also shape the breadth of the search. Data are evaluated using qualitative approaches that code the methods of studies, theoretical basis, and relevance of the data reported. Themes, categories, and relationships of variables, concepts, or outcomes are identified through the data analysis. Tables illustrating the resulting themes or outcomes provide for constant comparison in the data analysis phase of the review. The results and discussion go beyond reporting and allows for synthesis of multiple

comparisons and conclusions. Throughout each of the steps of the integrated literature review, steps to assure trustworthiness are adopted (Whittemore & Knafl, 2005). Integrated literature reviews have the potential to advance understanding of clinical problems and to inform health care policy. Systematic reviews and meta-analyses are based on the combination of results of multiple studies about a clinical problem for the purpose of evaluating the strength of the results and summarizing evidence for practice (Whittemore & Knafl, 2005). Systematic reviews are the approach used by The Cochrane Collaboration, an independent panel of international volunteers who systematically review and judge the strength of the evidence reported in randomized controlled trials. The methods for systematic reviews are guided by specific clinical questions and subsequent searches. If the statistical approaches cannot be combined in the parent studies, narrative analysis and quasistatistical approaches are implemented. Meta-analysis is an approach that uses statistical methods that combine results of studies that have similar designs, hypotheses, and variables. The combination of statistical findings across studies allows for the sample size to be adjusted for the calculation of effect sizes (Conn & Rath, 2003). In contrast to the integrated review, the systematic reviews and metaanalyses synthesize results from studies that use similar variables and methodologies. Methods for reviews and synthesis of qualitative studies have been advanced to develop theory and frameworks addressing particular phenomenon. Various approaches include meta-synthesis, meta-studies, formal grounded theory, and meta-ethnography. These qualitative methods can enhance the generalizability of qualitative research and differ from the integrated reviews, systematic reviews or metaanalysis, and their outcomes (Whittemore & Knafl, 2005).

Reporting Literature Reviews
The reporting of literature reviews must have the same rigor as reports for primary research. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement for reporting systematic and meta-analyses was developed to standardize systematic and meta-analyses literature review reports (Moher, Liberati, Tetzlaff, & Altman, 2009). A 27 item-checklist is available for authors preparing literature reviews and addresses standardization in reporting. The basic contents of any research report guide reporting of

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Editorial

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Table 1. Useful Resources to Guide Literature Reviews Cochrane Collaboration Joanna Briggs Institute PRISMA Group http://www.cochrane.org/ http://www.joannabriggs.edu.au http://www.prisma-statement.org/

children and the health of the school community, the focus on high-quality reporting of high-quality reviews will be maintained. Julia Muennich Cowell, PhD, RN, APHN-BC, FAAN Executive Editor The Journal of School Nursing References
Broome, M. (1993). Integrative literature reviews for the development of concepts. In B. Rodgers & K. Knafl (Eds.), Concept development in nursing (2nd ed., pp. 231–250). Philadelphia, PA: W.B. Saunders. Conn, V., & Rath, S. (2003). Managing primary study quality in meta-analyses. Research in Nursing and Health, 26, 322–333. Cooper, H. (1998). Synthesizing research: A guide for literature reviews (3rd ed.). Thousand Oaks, CA: Sage. Evans, D., & Kowanko, I. (2001). Literature reviews: Evolution of a research methodolgy. Journal of Advanced Nursing, 18, 33–38. Fink, A. (2009). Conducting research literature reviews: From the Internet to paper (3rd ed.). Thousand Oaks, CA: Sage. Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRIMSA statement. Journal of Clinical Epidemiology, 62, 1006–1012. Whittemore, R. (2005). Combining the evidence in nursing research: methods and implications. Nursing Research, 54, 56–62. Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, Dec, 52, 546–553.

literature reviews include title, abstract, introduction, methods, results, and discussion. The title of the report should include the type of literature review and the abstract should include keywords that draw readers to the review including the type of review. While the PRISMA checklist is designed for systematic reviews and meta-analyses, it is useful for all literature reviews. The PRISMA flow diagram is particularly useful because it shows a reporting system for the literature search itself. The flow diagram is comparable to the flow diagram recommended by the Consort Group (http:// www.consort-statement.org/home/) that is dedicated to the systematic reporting of population and sample in randomized clinical trials. The focus of flow diagrams is to maximize transparency in reporting population and subsequent sample selection of articles.

Implications for The Journal of School Nursing
Authors, reviewers, and readers can all contribute to the quality of literature reviews by adopting and recognizing accepted standards of quality. The PRISMA checklist that guides the review report and flow diagram showing search outcomes are most useful and can be adopted for all types of literature reviews. Useful resources are presented in Table 1. Because the mission of The Journal of School Nursing is to provide a forum for improving the health of school

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