Integrative review of nursing research: scientific rigor required

EDITORIAL

Integrative review of nursing research: scientific rigor required

Maria da Graça Oliveira Crossetti

Professor at the Department of Medical-Surgical Nursing, UFRGS Nursing School, coordinator of the Editorial Board for Revista Gaúcha de Enfermagem

Recent conspicuous initiatives in the development of evidence-based nursing practice have led nurses to acquire and produce specific knowledge inherent to the nature of their work in different professional contexts. The production resulting from different methodological procedures, most notably, at the present time, systematic literature reviews whose methodological and theoretical basis itself offers deep and comprehensive knowledge regarding a certain phenomenon under study, enables nurses to decide for the best conduct to follow. Among these approaches is the Integrative Research Review (IR), which has increasingly been applied to scientific production in nursing on different levels, such as development of final papers, monographs, dissertations and theses. A fact that has been demonstrated by the growing amount of papers applying this methodology that have been submitted and published in national and international journals. Less experienced researchers are often found to use the terms integrative review, literature review, systematic review and meta-analysis as synonyms ⁽¹⁾. Although there are some similarities, these methodologies differ, as they have distinct procedures that consequently lead to distinct objectives and results. A literature review is structured as critical summaries of studies on a topic of interest aiming to contextualize the study problem; it is restricted to relevant studies that point to new data related to the study goals. In such review, the update of references over time is key to scientific rigor. A systematic review is characterized by carefully summarized research evidence applied to answer questions focusing on clinical practice; it is exclusively conducted through a strict selection process and analysis of several publications on the problem under study. Meta-analysis is a methodology that quantitatively integrates and checks the association of results from multiple recent studies of a certain event in clinical practice. An integrative review summarizes results from previous studies, that is, those that have already been conducted and, most notably, shows conclusions of the body of literature on a particular phenomenon, encompassing, thus, all studies related to the question guiding the literature search. The summarized and compared data allow for the achievement of general conclusions about the research problem. A systematic and summarized analysis process follows, which, if properly conducted, qualifies the results and allows for the identification of knowledge gaps regarding the phenomenon under study, the identification of the need for future studies, the disclosure of questions that are central to the focused area, and the identification of the conceptual or theoretical framework, pointing out the state of the art of the scientific production that results from studies on a specific topic. In conducting an IR, the investigator must answer to the following questions while assessing the knowledge that already has been produced: What is known? What is the quality of what is known? What must be known? What is the next step to the investigation or practice?⁽²⁾

The integrative review of nursing research has been proposed by different authors whose methodological procedures differ as to the number of steps and the way they propose to develop and present it. The process, however, basically follows five steps: 1) problem formulation, 2) data collection or definitions for a literature search, 3) data assessment, 4) data analysis, and 5) result presentation and interpretation ^(1,3,4,5). The IR, if properly conducted, is characterized by the criticality peculiar to primary research in terms of replication, clarity and scientific rigor. Thus, one of the key aspects to be considered by the investigator is the size of the sample, that is, the literature search must be exhaustive. This means it may comprise searching for study papers from 20-30 years ago to find the origins of the practice related to the phenomenon under study. The list of articles will be complete once data have been saturated, which is identified when, once the list has been checked, each of the articles and authors turn out to be familiar to the investigators, or when data are observed to be characterized by a certain pattern, which expresses the natural completion of the integrative literature review⁽²⁾.

The final IR report for publication must not be presented as a set of summaries or abstracts, it must comprise an integration of concepts, thoughts, definitions or other relevant information peculiar to the authors whose papers were object of evaluation instead, which means the report will focus on the results and consequent conclusions from the analysis and discussion of the information derived from the articles resulting from the queries analyzed in response to the objectives or the basic question of the study.

The IR, when based on the scientific rigor required for other research approaches, represents a resource for building knowledge in nursing, and given its nature, it may contribute to the development and accuracy of clinical practice and consequent interventions that result in patient safety.

• 1 Cooper HM. The integrative research review: a systematic approach. Beverly Hills: Sage; 1984.
• 2 Russel CL. An overwiew of the integrative research review. Progress in Transplantion. Missouri: Columbia; 2005.
• 3 Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546-53.
• 4 Ganong LH. Integrative reviews of nursing research. Res Nurs Health. 1987;10(1):1-11.
• 5 Broome ME. Integrative literature reviews for the development of concepts. In: Rodgers BL, Knafl KA, organizador. Concept development in nursing: foundations, techniques and applications. Philadelphia: W.B. Saunders Company; 2000. p.231-50.

Publication Dates

• Publication in this collection
  04 Sept 2012
• Date of issue
  June 2012