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Composing an Authentic, Academic Narrative Literature Review: How to Evaluate Scholarly Articles and Write a Thorough Narrative Literature Review

Don't get caught plagiarizing

Over the course of many years of teaching, I’ve found that both my students and I struggle with our course unit on research writing. It’s boring, it’s difficult, and we all undoubtedly become aggravated with each other throughout the process.

If you’ve ever experienced a lesson burnout, like I have so many times, you know how frustrating it can be for both teacher and students. Unless you’ve written tons of research papers in your lifetime, they can seem like a daunting task. This is especially true for middle school and high school students who are likely just learning how to do so.

If your students are embarking on a research project, one of their first steps in the research process will be completing a comprehensive narrative literature review.

Ironically, I’ve had to do my own narrative literature review of sorts to bring you the resources you’ll find herein. Of note, after you’ve made it to the end of this post, you’ll be able to effectively guide your students in composing a narrative literature review by focusing on these basic tenets:

What is a narrative literature review?

Defining, Differentiating, and Composing a Narrative Literature Review

Essentially, it is a step in the research process that follows selecting a topic and asking a research question. Before developing an engaging thesis, a researcher has to ascertain that scholarly literature exists in support of their proposed thesis.

There Are Many Important Steps in the Research Process

For students who have grown up with the ability to simply Google a wealth of information and receive desired results in a moment’s time, vetting sources may seem like a foreign concept. Teaching your students how to write this type of work will teach them how to scrutinize sources.

But what is a narrative literature review? According to top researchers, “A literature review is a type of research article published in a professional peer-reviewed journal.” These articles are published in vetted, scholarly journals that you and your students can trust as fact.

In essence, your students select a research topic then hit the databases in search of reputable, trustworthy journal articles that answer their research query and support their anticipated position on that topic. By reviewing the existing literature on the selected topic, students can be sure there is proven data and a body of existing knowledge that supports their thesis.

According to J.D. Baker, a professor at Charles Sturt University, acquiring current and relevant literature on a given topic is, “…an essential part of the research process [that] help[s] to establish a theoretical framework and focus or context for your research.” For this reason, the narrative literature review may very well be one of the most important steps in the research process.

Narrative Literature Review Is One of the Most Important Parts of the Research Process

As one of the first few steps in the research process, a step that is likely a foreign task to your students, it’s imperative that the process is broken down into simplified, manageable tasks.

Rebecca Alber, blogger for Edutopia, discusses the importance of scaffolding projects for students. She expounds upon the pedagogy of breaking projects into manageable chunks and “providing concrete structure for each.”

By reading through and analyzing the body of knowledge on a given topic, researchers, like your students, can focus and justify their research. As discussed here , the thesis is the most important part of a research paper, but you can’t arrive at your thesis without a thorough narrative literature review.

In this video, research specialist, Sarah Bronson, explains what a narrative literature review does, how to plan it, and how to write a cohesive and proper review.

Systematic vs. Narrative Literature Reviews: Knowing the Difference

In short, the difference between a narrative literature review and a systematic literature review has to do with the search terms used and the methodology employed when searching databases.

According to those in the know, “A narrative literature review is fairly broad, as it involves gathering, critiquing and summarizing journal articles and textbooks about a particular topic.” In other words, you enter general search terms into a search engine and sift through the yielded articles.

These Are the Key Steps in Writing Narrative Literature Review

Essentially, a narrative literature review summarizes and synthesizes the body of work on a topic. The review may be generally focused on a broad topic or a specific research question.

A systematic literature review, on the other hand, “tend[s] to use specific search terms and inclusion/exclusion criteria, whereas the criteria for narrative reviews may not be as strict.” This type of work is best employed by writers who have already focused their query and/or thesis. By including or excluding particular terms, a more pointed search return is gleaned.

In essence, the goal of a systematic literature review is to answer a focused objective question. To be clear, in this type of work, the researcher is working with a clearly defined question.

Check out this helpful video that further explicates the point and process of a systematic literature review. Cochrane provides insight into why, in some instances, a systematic review is more useful than its narrative counterpart.

Though both systematic and narrative literature reviews can be useful in producing desired and relevant research documents, knowing which method to use depends on your experience and how far into the research process you’ve gone.

If you are beginning preliminary research, you’ll likely only be able to perform a narrative literature review. You may have a general topic that you’d like to investigate before committing to a topic and a thesis.

However, if you’ve already focused your study and have a better grip on the direction you wish to go, then you may find the systematic review to be useful.

Again, the literature review is just one step in a series of interrelated steps that help students write a focused and cohesive research paper. In this article, you can take a look at later steps in the writing process.

Narrative Literature Reviews: Four Unique Approaches

According to Onwuegbuzie and Frels, there are four common types of narrative literature reviews. Essentially, literature reviews can be broken down into these four categories: general, methodological, theoretical, and historical. Let’s take a look at how they differ from one another.

There Are 4 Main Types of the Narrative Literature Review

A general literature review takes a close look at the most important and most current knowledge on a given topic. This type of work will form the basis for your thesis or dissertation; it’s what you’ll do before focusing your query.

Sources cited in a general literature review may include scholarly articles, governmental data, books, interviews, and websites. The general literature includes a summary and assessment of the literature.

A methodological literature review defines the methodology used to apprehend the literature. In other words, this type of paper outlines and explains research methods and parameters.

A Methodological Literature Review Can Help You to Highlight and Understand All the Research Methods

The methodological literature review analyzes how information was arrived at not necessarily what the literature asserts.

A theoretical literature review analyzes how theories inform research practices. Basically, this type of paper identifies pre-existing theories, the connection between and among them, how well scrutinized the theories are, and the development of new possible theories.

Finally, a historical literature review focuses on the emergence, development, and historical context of a research topic as it presents in a body of knowledge. To be clear, this type of literature review traces the history of a particular issue or theory and how it has evolved since its onset.

In this excellent resource featuring Leigh Hall of teachingacademia.com, Hall further explains the different types of narrative literature reviews. Hall explains the four types of reviews in further detail to help writers determine which is best suited for their research purposes.

Teachers should be clear about their expectations of students concerning which type of narrative literature review is expected of them. A closer look at which type of review is best suited to your students’ projects can help you, the teacher, in guiding your students.

As one of the most important steps in the research process, it’s imperative students can successfully complete a literature review before moving on in the research process.

Lisa L. Munro, Phd., a blogger who examines the importance of creating writing communities among our students, asserts the importance of, “writing a concise literature review just comprehensive enough for the purpose of an academic journal article.”

Narrative Literature Review: A Writer’s Checklist

The writing process is a step-by-step undertaking and some steps are more of a process than others. That’s especially true of composing a narrative literature review.

This Step-by-Step Process Takes Time but It's Worth It

Essentially, a narrative literature review is a project in and of itself. A proper review adheres to the following steps.

Entitle your review as a “review of…” Titling your work this way lets your reader know exactly what you’re setting out to do in the subsequent paragraphs. However, as a researcher, doing so helps you keep your sources organized and makes it easy to refer back to that source.

Write a brief summary of the article and how it applies to your course of study. This step is where you synthesize the information gleaned from a particular source. It will provide you, the researcher, with an opportunity to decide if it’s useful information that will support your research query.

Your abstract should include a sentence about how the source applies to your own research, your purported thesis, a summary of the literature, and conclusions you’ve made based on your findings.


The writer provides his/her rationale and objectives for the literature review. Your introduction should establish your topic of study and an explanation of why your research is important.

Describe the methods used in performing the research. Essentially this is a few sentences explaining the steps and mediums used to acquire your sources. This indicates whether or not your research comes from reputable sources.

Nowadays You Can Easily Find Billions of Sources

Here is where you explain if you used computer databases along with the search terms you employed, scoured physical files at a given office building, read physical texts on a given topic, etc.


The writer discusses his/her discoveries as well as an overall summary of the information. Without repeating what you’ve written in the other parts of your review, in the discussion, you summarize your main findings, interpret those findings, identify the strengths and weaknesses of the given source, compare your findings with other literature on the topic, explain how and if your findings answer your research query, and assert if your thesis is supported by the literature.

In this helpful tutorial, David Taylor, an online writing professor, walks you through the formatting of a literature review. He walks writers through the five-step process of completing a paper in less than 30 minutes.

As in writing any type of composition, students should be reminded to carefully proofread for clarity and correctness. I always suggest that students read their compositions aloud as readers will often hear mistakes before they see them.

A final consideration that students inevitably need to be reminded of is avoiding plagiarism. I find it’s helpful to define plagiarism for students so there’s no question about why copying another’s ideas is problematic.

There are many online plagiarism checkers for teachers and students to use to ensure work is entirely authentic. Check out this article for some tips and tricks for avoiding and identifying plagiarism.

Useful Resources

One of the most arduous tasks in a research project is gathering the right sources for your purpose. Help students understand how to search in the right places for articles and how to evaluate sources.

One of the questions my students rightfully ask is why they can’t use news media websites. News networks like CNN deliver the facts, don’t they? This article may help you and them to better recognize and evaluate credible source material.

A thorough narrative literature review will get your students off on the right foot. Everything after the literature review falls into place more readily when you have the right sources for your purpose.

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Internet Literature Reviews Samples For Students

355 samples of this type

If you're looking for a workable method to streamline writing a Literature Review about Internet, WowEssays.com paper writing service just might be able to help you out.

For starters, you should skim our large database of free samples that cover most diverse Internet Literature Review topics and showcase the best academic writing practices. Once you feel that you've analyzed the basic principles of content structuring and drawn actionable insights from these expertly written Literature Review samples, composing your own academic work should go much easier.

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Free Industry Innovators Literature Review Example

The article begins by explaining how all organizations operating different networks have the daunting task of protecting the data on their network. The technological advancement affords companies to operate at a global level. There is a lot of data sharing and information communication through the internet. The infrastructure supporting the network is at risk of being attacked as well as the data it carries. The writer explains that attacks on data are direct, and the target is highest for critical and sensitive data. Almost all organizations handle some data including trade secrets, credit card data, medical records, personally identifiable information.

Ebusiness Literature Review Examples

Using the service encounter model to enhance our understanding of business-to-consumer transactions in an eenvironment, a critical review of literature review example.

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This paper provides a description of the problem that the researcher intends to address, particularly about how risks can be managed in e-businesses. It also provides an annotated bibliography of three sources that will enable the researcher to provide answers to this problem. In particular, these sources discuss the importance of consumer trust in ensuring the success of online businesses; what the consumers’ concerns are; and how these risks can be managed. As well, a comparison and contrast of these three sources is made in order to show their relevance in relation to the research problem.

Statement of the Research Problem

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This research paper have been written by (insert your name). I am therefore requesting you kindly and humbly not to copy any part, distribute, transmit or store any part or all parts without the permission of the author as this shall lead to serious consequences.


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Literature Review:

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Young adults of today spend more time “accessing digital-media information than information from traditional printed texts” (Hsu & Wang, 2011, p. 68), which contributes to their negative reading achievement. As such, it is important to determine how online literacies and new media affect the reading skills of students in higher education.

Example Of Stevie Smith Literature Review

Florence Smith was born in 1902 in Hull, England. However, she and her family moved to London in 1906 after her father left. Unusually, she stayed in the same house until she died in 1971. She went by the nick-name 'Stevie' for much of her life and, despite some romantic relationships, she never married. For 30 years, Smith earned a living working as a secretary, though she retired while still in her early fifties after attempting suicide while at work (BBC).

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Related Papers

Mark D Griffiths

It has been alleged by some academics that excessive Internet use can be pathological and addictive. This paper reviews what is known from the empirical literature on Internet addiction and its derivatives (e.g., Internet Addiction Disorder, Pathological Internet Use, etc.) and assesses to what extent it exists. Empirical research into Internet addiction can roughly be divided into five areas: (1) survey studies that compare excessive Internet users with non-excessive users, (2) survey studies that have examined vulnerable groups of excessive In- ternet use, most notably students, (3) studies that examine the psychometric properties of excessive Internet use, (4) case studies of excessive Internet users and treatment case studies, and (5) correlational studies examining the relationship of excessive Internet use with other behaviours (e.g., psychiatric problems, depression, self-esteem, etc.). Each of these areas is reviewed. It is concluded that if FInternet addiction_ does indeed exist, it affects a relatively small percentage of the online population. However, exactly what it is on the Internet that they are addicted to still remains unclear.

narrative literature review example from the internet

Research suggests that excessive online gaming may lead to symptoms commonly experienced by substance addicts. Since games are particularly appealing to children and adolescents, these individuals may be more at risk than other groups of developing gaming addiction. Given these potential concerns, a literature review was undertaken in order (i) to present the classification basis of online gaming addiction using official mental disorder frameworks, (ii) to identify empirical studies that assess online gaming addiction in children and adolescents, and (iii) to present and evaluate the findings against the background of related and established mental disorder criteria. Empirical evidence comprising 30 studies indicates that for some adolescents, gaming addiction exists and that as the addiction develops, online gaming addicts spend increasing amounts of time preparing for, organizing, and actually gaming. Further evidence suggests that problematic online gaming can be conceptualized as a behavioral addiction rather than a disorder of impulse control.

Computers & Education

keziah jayona

This study explores Internet addiction among some of the Taiwan’s college students. Also covered are a discussion of the Internet as a form of addiction, and related literature on this issue. This study used the Uses and Gratifications theory and the Play theory in mass communication. Nine hundred and ten valid surveys were collected from 12 universities and colleges around Taiwan. The results indicated that Internet addiction does exist among some of Taiwan’s college students. In particular, 54 students were identified as Internet addicts. It was found that Internet addicts spent almost triple the number of hours connected to the Internet as compare to non-addicts, and spent significantly more time on BBSs, the WWW, e-mail and games than non-addicts. The addict group found the Internet entertaining, interesting, interactive, and satisfactory. The addict group rated Internet impacts on their studies and daily life routines significantly more negatively than the non-addict group. The study also found that the most powerful predictor of Internet addiction is the communication pleasure score, followed by BBS use hours, sex, satisfaction score, and e-mail-use hours.

Mustafa Koc

This study focused on exploring Internet abuse among teenagers and its relations to some Internet usage patterns and demographic characteristics in a digitalizing country, Turkey. It was designed as a cross–sectional research on three types of school that differ in their academic performances. The data were collected from 1380 high school students through a paper–based questionnaire. The results identified a small portion of students as Internet abusers experiencing severe problems and one fourth as possible abusers experiencing occasional problems in their lives. Excessive use, tolerance, preoccupation with the Internet, and using the Internet to escape from negative feelings were the most frequently reported symptoms of disturbed patterns of online behaviors. One–way between–groups ANOVA tests revealed that Internet abuse differed significantly based on gender and perceived academic achievement with small effect sizes, and frequency of Internet use, dominant place of Internet use and dominant purpose for Internet use with medium and large effect sizes. On the contrary, no significant differences were found based on perceived socio–economic status and the type of school attended.

In the last decade, Internet usage has grown tremendously on a global scale. The increasing popularity and frequency of Internet use has led to an increasing number of reports highlighting the potential negative consequences of overuse. Over the last decade, research into Internet addiction has proliferated. This paper reviews the existing 68 epidemiological studies of Internet addiction that (i) contain quantitative empirical data, (ii) have been published after 2000, (iii) include an analysis relating to Internet addiction, (iv) include a minimum of 1000 participants, and (v) provide a full-text article published in English using the database Web of Science. Assessment tools and conceptualisations, prevalence, and associated factors in adolescents and adults are scrutinised. The results reveal the following. First, no gold standard of Internet addiction classification exists as 21 different assessment instruments have been identified. They adopt official criteria for substance use disorders or pathological gambling, no or few criteria relevant for an addiction diagnosis, time spent online, or resulting problems. Second, reported prevalence rates differ as a consequence of different assessment tools and cut-offs, ranging from 0.8% in Italy to 26.7% in Hong Kong. Third, Internet addiction is associated with a number of sociodemographic, Internet use, and psychosocial factors, as well as comorbid symptoms and disorder in adolescents and adults. The results indicate that a number of core symptoms (i.e., compulsive use, negative outcomes and salience) appear relevant for diagnosis, which assimilates Internet addiction and other addictive disorders and also differentiates them, implying a conceptualisation as syndrome with similar etiology and components, but different expressions of addictions. Limitations include the exclusion of studies with smaller sample sizes and studies focusing on specific online behaviours. Conclusively, there is a need for nosological precision so that ultimately those in need can be helped by translating the scientific evidence established in the context of Internet addiction into actual clinical practice.

American Journal of Drug and Alcohol Abuse

Aviv Weinstein

Emily Abad , Adler James W

ABSTRACT Title: CORRELATES OF INTERNET ADDICTION AMONG ADOLESCENTS Author: Alfred D. Waldo, RN, RGC Keywords: Adolescents; Internet Addiction; Spiritual Intelligence; Psychological Wellbeing; Social desirability Background: Internet addiction is a broad concept. Despite inconclusive or inconsistent definition for this disorder, usage of the internet is growing rapidly each year especially among adolescents, making it imperative to look into factors that can be correlated to it. Objectives: This study was conducted with the aim of describing internet addiction, spiritual intelligence, psychological wellbeing, and social desirability among adolescents. The study examined the differences between Adolescent Internet Addiction and factors such as age, gender, type of institution enrolled at, online behaviors. Moreover, the study was carried out to examine relationships and the risks of internet addiction to spiritual intelligence, psychological wellbeing, and social desirability of adolescents. Methods: The study used quantitative descriptive correlational design. Multistage sampling was conducted in the sampling procedure where school participants and student participants from Baguio City were selected. Questionnaire was used in data collection. The Internet Addiction Test, Spiritual Intelligence SelfReport Inventory, Ryff’s Scales of Psychological Wellbeing, and Social Desirability Scale were adapted. A total of 1059 valid questionnaires were analyzed. Data was managed using frequency counts, percentages, ANOVA, ttest of independence, Pearson’s Correlation and Logistic Regression. Findings: Adolescents are frequent online users, have average spiritual intelligence; good/maintained psychological wellbeing, and have average social desirability. There is no significant difference between internet addiction and age. However, adolescent internet addiction is significantly different in terms of gender, school type, and online behaviors. Social desirability has strong positive relationship with adolescent internet addiction. Spiritual intelligence and Autonomy are greatly affected by internet addiction. Conclusions: 24. 7% Adolescents have internet addiction. Although the level of spiritual intelligence is average and the degree psychological wellbeing is good adolescents encounter problems with their internet use. This problem can be seen at any age group. Male adolescents, adolescents from private institutions, adolescents using the internet for mainly for surfing and consumes 7+ hours online are more addicted to the internet. Adolescents deny the encountered problems and conform to the benefits of internet use instead. The levels of Spiritual intelligence and degree of Autonomy are significant predictors in determining adolescent internet addiction. Recommendations: Awareness to the extent of this problem should be pursued to a wide range of audiences especially to schools and concerned agencies involved in adolescent welfare. Effective management may also be necessary as preventive actions. Mental health providers may utilize/design appropriate techniques and treatment approaches are may be practical, inexpensive and flexible to Filipino culture. Future research may employ different methods of inquiry particularly on a causal perspective. Likewise, it is highly recommended that the study be pursued to a wider scale of population and different target groups.

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What is a Narrative Review?

A narrative literature review is an integrated analysis of the existing literature used to summarize a body of literature, draw conclusions about a topic, and identify research gaps.  By understanding the current state of the literature, you can show how new research fits into the larger research landscape.  

A Literature Review is NOT:

Purposes of a Literature Review

Literature Review Process

1. choose a topic & create a research question.

2. Select the sources for searching & develop a search strategy

3. Conduct the search

4. Review the references

5. Summarize Findings

Narrative Review Guidance

Cover Art

Example Narrative Reviews

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Narrative Review

Narrative reviews fail to content-code the studies either for theoretically important aspects or for aspects that gauge methodological quality, with the result that the accuracy of the review’s claims about the characteristics of the studies and the quality of their methods is difficult to judge.

From: Handbook of Child and Adolescent Sexuality , 2013

Related terms:

Defining and Analyzing the Problem

George Demiris , ... Karla T. Washington , in Behavioral Intervention Research in Hospice and Palliative Care , 2019

3.2.1 Narrative Review

A narrative review is the type first-year college students often learn as a general approach. Its purpose is to identify a few studies that describe a problem of interest. Narrative reviews have no predetermined research question or specified search strategy, only a topic of interest. They are not systematic and follow no specified protocol. No standards or protocols guide the review. Although the reviewers will learn about the problem, they will not arrive at a comprehensive understanding of the state of the science related to the problem. Fins and colleagues provide an example of a narrative review in hospice and palliative care. 6 Box 3.3 outlines steps for conducting a narrative review.

Steps for Conducting a Narrative Literature Review

The published scientific literature is indexed in a variety of databases. Search these databases for studies. It is important to search numerous databases to ensure that the majority of relevant studies have been identified. Neglecting a database in the search strategy will result in studies going unidentified. Common databases for hospice and palliative care studies include PubMed, PsycINFO, and CINAHL.

Authors call out several keywords when publishing their research so others can identify the work during database searches. Once you find a relevant article, use its keywords and similar ones in your search. To find individual studies on similar topics, you must use the keywords that were used when they were indexed. You may try numerous keywords before finding a paper that is pertinent to your review question.

After the search is complete and all duplicates are thrown out, it is time to review the abstracts of the remaining articles to ensure that they address your review question. With narrative reviews, it is not necessary to include every article on a topic.

Summarize and synthesize the findings from the articles you have found, and integrate them into your writing as appropriate. You do not need to document your literature search. Reference the articles as you use information from the studies.

Volunteering and health in later life*

Jeffrey A. Burr , ... Sae Hwang Han , in Handbook of Aging and the Social Sciences (Ninth Edition) , 2021

Mortality risk

Narrative reviews and meta-analyses conclude that the association between volunteering and risk of mortality is substantial, with the earliest evidence found in the seminal work of Berkman and Syme (1979) . A meta-analysis study by Okun et al. (2013) reports that volunteering is associated with an average adjusted effect of 24% decreased risk of death (95% CI=16%–31%). Similarly, the Jenkinson et al. (2013) meta-analysis finds an average adjusted effect of 22% (95% CI=10%–34%). Based on their evaluation, Okun et al. (2013 , 576) conclude that

…it is no longer a question of whether volunteering is predictive of reduced mortality risk; rather, our results suggest that the volunteering-mortality association is reliable, and that the magnitude of the relationship is sizable.

Further, prospective research design studies demonstrating an association between volunteering and mortality include Ayalon (2008) , using Israeli data, Luoh and Herzog (2002) , using the Assets and Health Dynamics (AHEAD) data, and Musick, Herzog, and House (1999) , using data from the American’s Changing Lives study, adding to substantial empirical literature that evaluates the benefits of helping others and being socially engaged.

Some research indicates that the benefit of volunteering for human longevity may be strongest for certain kinds of people and under certain conditions. For example, Konrath, Fuhrel-Forbis, Lou, and Brown (2012) , examining 4-year follow-up data from the Wisconsin Longitudinal Study, discovered that the survival benefits accrue only to those who volunteer for “other-oriented” reasons (i.e., in alignment with social connections or altruistic values). Lee, Steinman, and Tan (2011) demonstrated with Health and Retirement Study data that volunteering is only beneficial in reducing mortality risk among those who are nondrivers, and they propose that volunteering may benefit those who are otherwise at risk of social isolation.

Okun et al. (2010) , using 6-year follow-up data from the Later Life Study of Social Exchanges, argue that volunteering serves as a buffer between functional limitations and mortality, with one result being that people with functional limitations may benefit from volunteering in terms of expanded longevity. In comparison, Rogers et al. (2016) , using the English Longitudinal Study on Aging in an 11-year follow-up research design, reveal that the benefit of volunteering for reducing risk of mortality occurs only among those who report no disabilities.

Case Conceptualization and Treatment: Adults

Alan Carr , in Comprehensive Clinical Psychology (Second Edition) , 2022 Adults

Narrative reviews and meta-analyses support the effectiveness of FBPIs as an adjunct to medical care for adults with chronic pain, heart disease, cancer, diabetes, HIV, and caring for aging relatives with dementia ( Campbell, 2003 ; Han et al., 2019 ; Hartmann et al., 2010 ; Nguyen et al., 2019 ; Vintilă et al., 2019 ). For example, in a meta-analysis of 52 randomized controlled trials involving a range of conditions in adults including cardiovascular disease, stroke, cancer, and chronic pain conditions such as arthritis, Hartmann et al. (2010) found that FBPIs led to significantly better physical health in patients and better physical and mental health in both patients and other family members compared with routine care. Effect sizes were small, ranging from 0.28 to 0.35 indicating that the average case treated with systemic therapy fared better than 61%–64% of cases who received routine care. Effects were stable over long follow-up periods. FBPIs included psychoeducational and cognitive behavioral couple and family therapy as well as multifamily support groups, and carer support groups. These interventions had some or all of the following elements ( McDaniel et al., 2013 ; Rolland, 1994 ). They provided psychoeducation about the affected family member's medical condition and its management. They promoted adherence to medical regimes, an increase in adaptive “well behavior”, and a reduction of “illness behavior”. They offered a context within which to enhance support for the person with the chronic illness, and other family members. They provided a forum for exploring ways of coping with the condition, and its impact on family relationships.

Other Sources of Evidence

Susan M. Wilczynski , in A Practical Guide to Finding Treatments That Work for People with Autism , 2017

Narrative Reviews

Narrative reviews include consensus and critical reviews. When a group of scholars create a consensus review (also known as a best practice panel), they draw from their expertise and evaluation of the scientific literature. These experts have been asked to lend their expertise to the review because they are very familiar with the evidence and have been regular contributors to the literature. The greatest weakness of a consensus review results from the potential for bias entering into the final conclusions. Bias may result from the selection process that initiates a review. That is, there is little transparency about how editors or funding agencies select the experts to complete reviews. Editors (of a book, journal, or other document) or funders may include experts who confirm their biases and exclude experts who offer disconfirmatory perspectives ( Slocum et al., 2012 ). The expert may also introduce bias by placing inordinate weight on a single research article or completely ignore another. This form of bias is typically unintentional; however, human beings inadvertently allow bias to influence their conclusions. Group-based bias can also influence the reported outcomes of consensus reviews. For example, when a highly prestigious member of an expert panel states his or her opinion, others may agree without applying due diligence. This source of bias is less likely to occur when experts hold diverse views about the literature. Unfortunately, it is also more difficult to achieve consensus when a larger, more diverse group of experts write a review ( Wilczynski, 2012 ).

A critical review is similar to a consensus review, but it is completed by a single researcher or a group of researchers who have not been invited to discuss their views based on their expertise. These reviews are prone to the same sources of bias as consensus reviews. Despite these limitations, consensus and critical reviews were the primary source of evidence that could guide practitioners until recently. They may still prove very useful, particularly when a systematic review closely matching the characteristics of a given case is not available. Evidence-based practitioners should recognize that a consensus or critical review of the literature may reflect a better fit with the specifics of a given case. For example, a critical review could match the setting, diagnosis for participant, target behavior, etc., in every way—and better than the parameters used to conduct the only available systematic review.

Sensorimotor Rehabilitation

Hamza Farooq , ... David W. Cadotte , in Progress in Brain Research , 2015

This narrative review captures a subset of recent advances in imaging of the central nervous system. First, we focus on improvements in the spatial and temporal profile afforded by optical coherence tomography, fluorescence-guided surgery, and Coherent Anti-Stokes Raman Scattering Microscopy. Next, we highlight advances in the generation and uses of imaging-based atlases and discuss how this will be applied to specific clinical situations. To conclude, we discuss how these and other imaging tools will be combined with neuronavigation techniques to guide surgeons in the operating room. Collectively, this work aims to highlight emerging biomedical imaging strategies that hold potential to be a valuable tool for both clinicians and researchers in the years to come.

Behavioral Couples Therapy in the Treatment of Alcohol Problems

Adrian B. Kelly , in Evidence-Based Addiction Treatment , 2009

How Well does ABCT Work?

Recent narrative reviews (e.g., O’Farrell & Fals-Stewart, 2003 ) and meta-analytic reviews (e.g., Powers, Vedel, & Emmelkamp, 2008 ) conclude that ABCT has better outcomes than individual-based treatment for alcoholism, and indeed other drug use problems. Based on 12 randomized controlled trials of BCT (8 relating to alcohol and 4 relating to other substance abuse), Powers et al. (2008) found that ABCT outperformed controlled conditions when all follow-up time points were combined. When results were assessed for specific post-therapy time points, results were somewhat different. Specifically, ABCT produced improvements in relationship satisfaction at post-treatment, but did not result in improvements in the frequency or consequences of alcohol/substance use relative to control conditions. At follow-up, ABCT retained its superiority in terms of elevated relationship satisfaction, but also showed better outcomes on alcohol/substance use measures at later follow-ups. As noted earlier, ABCT programs contain some variability in therapeutic factors that may differentially account for positive findings. For example, three studies reviewed by Powers et al. (2008) included naltrexone or disulfiram in the couple conditions and not others. However, Powers and colleagues found that the effect sizes for BCT with and without these medication regimes were comparable. These authors conclude that the improvements in relationship satisfaction evident at the end of therapy may provide a context for improved substance-related gains in the longer term.

In general, ABCT has been used with couples in which only one partner (typically the male) is the identified drinker and the alcohol problems are moderate to severe. It is less clear how well ABCT works for couples where both partners have substance abuse problems and how well ABCT works for problem drinkers (as opposed to alcohol-dependent people). O’Farrell and Fals-Stewart (2006) recommend that a couples approach is contraindicated when both partners have substance abuse problems. Preliminary research suggests that ABCT may not be any more efficacious than alcohol-focused spouse involvement for people with mild to moderate alcohol problems. Walitzer and Dermen (2004) compared BCT (group format) to alcohol-focused spouse involvement and treatment for problem drinkers only. For those whose partners participated, identified drinkers reported fewer heavy drinking days and more abstinence/light drinking days in the year following treatment relative to treatment for problem drinkers only. However, the combination of alcohol-focused spouse involvement and BCT yielded no better outcomes than alcohol-focused spouse involvement alone. More research is needed on the utility of ABCT for problem drinkers. It is possible that couples with less severe alcohol problems may also have less severe couple relationship problems, so ABCT-related improvements may not be as marked. It is also possible that these couples may have more circumscribed problems than those with severe alcohol problems and that a tailored ABCT program to meet circumscribed relationship issues might yet prove effective. It would be surprising if such couples approaches were not helpful to couples with less severe alcohol problems, but this remains an empirical question yet to be tested.

Personality and Type 2 Diabetes

Mika Kivimäki , ... Markus Jokela , in Personality and Disease , 2018

Conclusions and Practical Implications

In this narrative review , we have described evidence for an association between personality and diabetes. Individuals with high conscientiousness seem to experience a reduced risk of developing, and dying from, diabetes, indicating that this personality trait may affect both the etiology and prognosis of type 2 diabetes. One of the mechanisms underlying the protective effect of high conscientiousness was the ability to maintain a healthy body weight. Other evidence suggests bidirectionality whereby having multiple chronic conditions, including diabetes, was related to reductions in conscientiousness over time.

In general, the contribution of personality to diabetes risk and prognosis seemed relatively modest compared with conventional diabetes risk factors, such as obesity and physical inactivity. In light of this small effect size and the overall difficulty to modify psychological characteristics, personality is unlikely to be considered as an important risk factor in diabetes prevention strategies. In relation to targeted strategies, however, personality might have a role. Better understanding of the role of personality in diabetes etiology and progression could help in developing more personalized prevention and treatment strategies for people with high risk of diabetes and those who already have type 2 diabetes.

Environmental protection through societal change

Sebastian Bamberg , ... Maxie Schulte , in Psychology and Climate Change , 2018

8.4.1 Positive and negative outcomes of being an activist

In an extensive narrative review , Vestergren, Drury, and Chiriac (2016) summarized the outcomes for participants after they had taken part in protest and activism. The authors categorized the changes they found in published research articles into two domains, the behavioral or objective and the psychological or subjective changes. As already suggested, these effects point to both negative and positive personal outcomes for individuals engaging in protest and activism. On the one hand, activists reported negative objective changes, such as a higher rate of divorces, fewer children, and tension affecting personal relationships, which were not part of their activism. These effects might be related, for example, to participants’ changes in attitudes toward life or a lack of time caused by the engagement in collective actions. However, on the other hand, activists also described the formation of new and strong social relationships during the collective action. They emphasized positive subjective changes of, e.g., feeling empowered by the participation, increased self-esteem and self-confidence, taking up a new job in the educational, social or creative area, gaining new organizational skills and knowledge.

Participating in collective action in general and in the context of environmental activism more specifically can be a frustrating enterprise. Especially when actions do not succeed as planned, such failures can evoke feelings of frustration and helplessness. Activists need strategies for dealing with frustration to ensure their continued participation, given that fundamental societal change usually needs a long time to unfold and that the process of change is often characterized by setbacks. One obvious psychosocial resource for coping with these negative experiences is the group itself: As part of groups, individuals experience that collective action helps them deal with what might seem like an unsolvable, overwhelming problem at first. To elaborate on this idea of the group as a psychological resource, we briefly review evidence from the London road protests including the mass occupation of a green area ( Drury & Reicher, 2005 ). This campaign in northeast London was part of an active UK-wide antiroads movement. People living in the area were involved and hundreds of people motivated by ecological principles joined the protests. The activists mobilized for a rally at a green area, which should be removed within the construction of the road. On the day of the rally, contractors had erected a fence around the green and it was guarded by security. The rally first took place in front of the fence. After the rally had finished, participants started to climb over the fence, started to push it down, and the crowd entered the site.

The Human Hypothalamus: Neuropsychiatric Disorders

Michael Nair-Collins , Ari R. Joffe , in Handbook of Clinical Neurology , 2021

Management of the patient diagnosed as “brain dead”

There are many narrative reviews on the management of patients diagnosed as brain dead ( Gupta and Dhanani, 2016 ; Maciel and Greer, 2016 ; Chamorro-Jambrina et al., 2017 ; Meyfroidt et al., 2019 ; Opdam, 2019 ). There are also systematic reviews ( D’Aragon et al., 2017 ; Buchanan and Mehta, 2018 ) and guidelines on this management ( Kotloff et al., 2015 ; Canadian Blood Services, 2019 ). These publications give guidance on all acute clinical management of patients with brain death, with an emphasis on maintaining organ functions to optimize organ donation rates. It is beyond the scope of this chapter to discuss all of this management, and here we focus on what has been called Hormonal Replacement Therapy (HRT) aimed to replace hypothalamic–pituitary axis hormonal deficiencies.

When hypothalamic–posterior pituitary function is lost, indicated by central diabetes insipidus (see previously for manifestations of this), treatment with antidiuretic hormone replacement is indicated to prevent dehydration, hypovolemia, hemodynamic instability, and hypernatremia from the hypoosmotic polyuria. This can be done using desmopressin (1-deamino-8- d -arginine vasopressin or DDAVP), a vasopressin analogue with a much greater affinity for V2 renal receptors than for V1 vascular smooth muscle receptors. Usually, a dose of 1–4   mcg IV is used initially, typically followed by 1–2   mcg IV q6h titrated to maintain urine output <   34   mL/kg/h ( Kotloff et al., 2015 ). In pediatrics, the dose for DDAVP is 0.25–1   mcg IV q6h for the same target urine output ( Gupta and Dhanani, 2016 ). If the dosing is adequate, intravenous fluids can be administered as insensible losses (20% maintenance fluids as dextrose 5% in 0.9% sodium chloride) plus urine output (as normal saline (NS)); if the serum sodium is dropping at a rate more than 10   mmol/L/day, and urine sodium is measured to be much lower than that of NS (i.e., ≪   154   mmol/L), urine replacement fluid may need to be changed to 0.45% sodium chloride with a close following of serum sodium measured every 4–6   h initially.

Another option to replace antidiuretic hormone is to use vasopressin, which has affinity for all three receptors, and thus can treat diabetes insipidus and also improve vasodilatory shock from vasopressin deficiency at the vascular smooth muscle V1 receptor ( Gupta and Dhanani, 2016 ; Maciel and Greer, 2016 ; Chamorro-Jambrina et al., 2017 ; Meyfroidt et al., 2019 ; Opdam, 2019 ). In the presence of hypotension from vasodilatory shock, vasopressin is considered as a first-line vasoactive agent and given by intravenous infusion ( Kotloff et al., 2015 ; Canadian Blood Services, 2019 ). The dosing of vasopressin suggested in the literature can be confusing, given variously in units/min, units/h, milliunits/h, milliunits/kg/min (mU/kg/min), etc., and clinicians need to pay close attention to these details when prescribing vasopressin to avoid dosing errors. We suggest that the dose used is best given as 0.3–0.7   mU/kg/min, with the maximum being an absolute dose of 40   mU/min (which is 2.4   U/h) IV, titrated to effect on blood pressure and urine output of ~   100   mL/h in adults and 2–3   mL/kg/h in children. Oral DDAVP is used in the setting of chronic vasopressin deficiency from loss of hypothalamic–posterior pituitary function; however, this is not a reliable treatment in the acute setting and will not be discussed more here.

More controversial is whether to treat for hypothalamic–anterior pituitary loss of function. As reviewed previously, central thyroid deficiency may occur in 16%–22% of patients with brain death and central adrenal deficiency in at least 27%–29% of patients with brain death. Studies and reviews focus on whether replacing thyroid and adrenal hormones improves the outcomes of the number of organs donated and post-organ-transplant organ function, and not on efficacy for long-term maintenance. Most narrative reviews suggest replacement of thyroid and corticosteroid hormones based on retrospective observational studies and expert opinion; however, the evidence from randomized controlled trials is not supportive of this practice ( Meyfroidt et al., 2019 ; Opdam, 2019 ). There are no studies of the efficacy of HRT in pediatric patients.

Thyroid hormone replacement has had no effect on the number of organs donated (based on findings from five of six observational studies), on heart donation rates (based on four of six observational studies and four of four randomized controlled trials), or on heart function (based on three of three randomized controlled trials; Buchanan and Mehta, 2018 ; Canadian Blood Services, 2019 ). Nevertheless, the Society of Critical Care Medicine guideline still suggests that thyroid replacement be “considered” for hemodynamically unstable donors or for potential heart donors with “left ventricular ejection fraction less than 45%” ( Kotloff et al., 2015 ). If used, T4 can be given as 20   mcg IV bolus followed by 10   mcg/h IV, or, if available, T3 can be given as 4   mcg IV bolus followed by 3   mcg/h IV infusion ( Kotloff et al., 2015 ). In pediatrics, the dosing of T4 is an initial bolus of 1–5   mcg/kg IV followed by 0.8–1.4   mcg/kg/h IV infusion. These ranges are based on age: for age ranges of 0–6   months, 6–12   months, 1–5   years, 6–12   years, 13–16   years, and   greater than 16   years, the loading dose is 5, 4, 3, 2.5, 1.5, and 0.8   mcg/kg IV, respectively, followed by the infusion dose of 1.4, 1.3, 1.2, 1.0, 0.8, and 0.8   mcg/kg/h IV, respectively. T3 dosing in pediatrics is 0.05–0.2   mcg/kg/h IV infusion, with the higher dose used in younger patients ( Kotloff et al., 2015 ; Gupta and Dhanani, 2016 ). Again, for chronic thyroid deficiency, oral dosing is used, and this is beyond the scope of this review.

Replacement of corticosteroids has had a possible benefit on treating hypotension (based on two of four observational studies reporting increased donor blood pressure; however, this was not confirmed in meta-analysis of three randomized controlled trials), no clear benefit on the number of organs donated (based on five observational studies and two randomized controlled trials), and no effect on post-organ-transplant organ function in recipients (based on nine randomized controlled trials) ( D’Aragon et al., 2017 ; Canadian Blood Services, 2019 ). In spite of these findings, for unclear reasons, the guideline from the Society of Critical Care Medicine states that administration of corticosteroids “reduces the potential deleterious effects of the inflammatory cascade on donor organ function” and therefore recommends using methylprednisolone 15   mg/kg (up to 1   g) IV daily or 250   mg IV bolus followed by 100   mg/h infusion ( Kotloff et al., 2015 ). In pediatrics, the dose is 20–30   mg/kg IV daily (up to a maximum of 1   g IV daily) ( Kotloff et al., 2015 ; Gupta and Dhanani, 2016 ). Some reviews suggest an alternative is to use hydrocortisone 1   mg/kg/dose q6h, up to 50   mg IV q6h ( Canadian Blood Services, 2019 ; Opdam, 2019 ). In the setting of chronic adrenal insufficiency oral corticosteroids are used, and the dosing is beyond the scope of this review.

It is important to emphasize that these reviews and guidelines only address the acute short-term (i.e., at most days) management of the hypothalamic–pituitary axis in brain-dead patients. No study we are aware of addresses whether treatment of thyroid and/or adrenal failure can change the results of apnea testing. No study we are aware of addresses cases of “chronic-brain-death” where testing for, and treatment of central thyroid and/or adrenal failure may be used to support homeostasis. The testing and treatment of these deficiencies in the chronic setting are beyond the scope of this chapter.

Health Psychology

Chris J. Main , Michael K. Nicholas , in Comprehensive Clinical Psychology (Second Edition) , 2022 The Yellow Flags Framework

In 1997, following a narrative review , a system for the identification and management of (primarily) psychological risk factors (or yellow flags) for the development of chronic low back disability were developed. The clinical yellow flags were further differentiated from psychiatric factors ( orange flags) and socio-occupational factors. The latter comprised blue flags potentially modifiable worker and workplace centered risk factors (such as perceptions of work as harmful or the possibility or work accommodations); and black flags or system factors such as conditions of employment, and benefit entitlement that are outside the immediate control of the employee and/or the team trying to facilitate the return to work. They are more fully described elsewhere ( Main et al., 2008 ; Nicholas et al., 2011 ; Shaw et al., 2009 ).

There is specific evidence for both yellow flags and blue flags as risk factors for long-term work disability. There also is evidence for the influence of pain severity and level of depressive symptoms on the transition to chronicity. The influence of these factors is variable across studies, and there is dispute among authors as to their relative importance, but the weight of current evidence supports the yellow flag hypothesis, with maladaptive pain coping behaviors, anxiety, and depressive features being especially salient factors. ( Chou and Shekelle, 2010 ). However, the Flags classification is offered however as a framework rather than a model and has been developed as a way of thinking about interventions in the context of obstacles to recovery. In that sense it aligns both with the sociological framework distinguishing macro-, meso- and micro-levels of focus, but draws attention to fact that the prevention of chronic pain or disability may involve different sorts of solution. The framework has three important features. It offers a “systems perspective” and assumes that an adequate understanding of the problem requires consideration of both the injured worker and the individual's social and occupational context. It contains both clinical and occupational elements. Finally, it makes an important distinction between the individual's perception of the situation and the objective features. However, it is important to understand yellow flags in context and to appreciate that they do not operate in isolation from other factors.

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How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes .

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, frequently asked questions, introduction.

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

Literature review guide

Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

You can also check out our templates with literature review examples and sample outlines at the links below.

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Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).


The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.


If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:


A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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Organizing Your Social Sciences Research Paper

A literature review surveys books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have explored while researching a particular topic and to demonstrate to your readers how your research fits within a larger field of study.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

Given this, the purpose of a literature review is to:

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE : Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

The critical evaluation of each work should consider :

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] Thematic reviews of literature are organized around a topic or issue, rather than the progression of time. However, progression of time may still be an important factor in a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it will still be organized chronologically reflecting technological developments in media. The only difference here between a "chronological" and a "thematic" approach is what is emphasized the most: the role of the Internet in presidential politics. Note however that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point made. Note that this is the most common approach in the social and behavioral sciences. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information but that are not key to understanding the research problem can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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Holistic Nursing Practice

A Narrative Literature Review of the Experiences of Patients Living With Heart Failure

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September/October 2015, Volume :29 Number 5 , page 280 - 302 [Free]

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This article reviews the literature on the experiences of patients with heart failure and their coping strategies and learning needs. Previous studies have consistently demonstrated that heart failure had negative impacts on the individuals who experienced it. Studies have also focused on the learning needs and the various coping strategies that patients with heart failure have adopted. However, there are limited studies that have investigated the experience of heart failure from the Asian patient's perspective. By incorporating the perspectives of patients with heart failure from the Asian context into clinical practices, research will promote patient-centered holistic care and improve patients' quality of life and satisfaction.

Article Content

Global urbanization and sedentary lifestyles have contributed to the rise in cardiovascular diseases (CVDs). 1 In 2008, 30% of the global deaths (17.3 million) were attributed to CVD. 2 Among the various CVDs, heart failure (HF) is regarded as the most prevalent and life-altering disease in most parts of the world. 3 It is predicted that the prevalence of HF will rise significantly while the proportion of older people continues to increase rapidly worldwide, as they have the highest incidence of CVD and hypertension. 3

Heart failure is defined as a clinical syndrome in which the heart's pumping ability is inadequate to meet the body's needs. 4 The severity of HF can be measured using several methods, with the New York Heart Association (NYHA) functional classification being the most common. 5 The NYHA measures the limitations on physical activities for patients with HF. 6 Because of its chronic progressive nature, HF impacts on the physical, psychological, and social aspects of one's life, thus influencing overall health-related quality of life (HRQOL). 5 The general consensus is that HRQOL is a multifaceted construct made up of physical, mental, and social components; it is also acknowledged to be a highly subjective phenomenon based on how an individual evaluates his or her life satisfaction and life experiences. 5 Coping strategies help the individuals to adapt to their condition. This literature review aims to provide an understanding of the patient's experiences of living with HF, their learning needs, and copying strategies. The findings will help health care professionals to develop and provide a patient-centered holistic care to improve their HRQOL and satisfaction. Hence, this review will discuss 3 issues: the impact of living with HF, coping strategies, and learning needs.

Search strategy

A literature search was conducted with the following 5 electronic databases: CINAHL, ScienceDirect, PubMed, Scopus, and Google Scholar. Search terms included "coping strategies," "life experiences," "heart failure," "learning needs," "perspectives," "quality of life," and "health-related quality of life," and these were used in different combinations. Articles were read and assessed for relevance. The inclusion criteria were (i) peer-reviewed academic journals published in English and between the years 2003 and 2013; (ii) research that focused on the adult's experiences with HF; and (iii) articles with accessible abstracts and full text. Exclusion criteria were (i) editorials, commentaries, discussion papers, conference abstracts, reviews, and duplicates; (ii) journals focusing solely on health care professionals and caregivers; and (iii) studies on congenital heart disease and palliative care.

After screening through the articles, 37 relevant studies were included in the review (Figure). Seventeen were qualitative studies and 20 were quantitative studies. Three major themes were identified: impacts of HF, coping strategies, and learning needs. The characteristics of the reviewed articles are summarized in the Table .

Impacts of HF

As a chronic, debilitating condition, HF has a major impact on various aspects of an individual's life, influencing the individual's quality of life (QOL). Health care providers often use HRQOL, a multidimensional concept, to understand the impact of chronic disease on patients' well-being, in particular, on physical, psychological, and social well-being. 5 Because of the various effects of HF on patients' day-to-day living, it is essential to develop individualized coping strategies to facilitate long-term adaptation and to improve QOL.

Physical well-being

Physical well-being is the state of being physically healthy, not just the absence of disease. 7 Physical symptoms of HF have an impact on the patient's perception of physical well-being. 4 , 8-11 The most frequently reported HF-related symptoms were fatigue and breathlessness, followed by dizziness, edema, chest pain, and sleeping difficulties. These findings were consistent with quantitative studies stating that physical symptoms were a major influence on HRQOL. 12-14

In addition, studies have found that the severity of these symptoms, if not well managed, could further compromise the individual's functional capacity, thus leading to limitations in the choices of activities. 10 , 14-16 Individuals were also reported to feel a sense of inadequacy as they were restricted by their condition and had lost their freedom. 4 , 9 , 10 , 17

Different health beliefs among cultures may result in different experiences of illness. A cross-sectional study conducted by Huang et al 14 found that patients in the United States perceived themselves to be more physically impaired than Taiwanese patients. They suggested that this disparity could be attributed to the difference between the individual's lifestyles before and after being affected by HF. However, these authors used different instruments to measure the severity of physical symptoms, and the findings may not be comparable.

Social well-being

Social well-being is a sense of involvement with other people and communities. 18 Because of the limitations on physical ability, studies have consistently reported poorer social well-being among patients with HF. Patients felt less confident about their ability to cope with the demands of their previous social lives and, consequently, the loss of their roles in life. 4 , 8 , 19-21 These roles included gender-specific roles, such as motherhood, socially defined roles within the family context, and work roles.

Side effects from the treatment are associated with social well-being. Several studies identified that the medications for controlling HF-related symptoms brought about certain side effects that impeded the individual's ability to participate in social activities. 4 , 11 , 17 Side effects such as frequent urination and drug-related impotence affected their social lives and placed a strain on relationships, especially for couples due to sexual disability. 9 , 22 Individuals experienced restrictions on normal socializing, and this was associated with increased social isolation and loss of employment and income. 10 , 17

The relationship between HF and social well-being may vary between patients. Two qualitative studies by Rodriguez et al 17 and Thornhill et al 21 identified that the loss of a work role had a greater impact on younger patients as they felt that they had lost their purpose in life. On the contrary, older retired individuals were better at accepting the change. This suggests that age may be an important factor in influencing their illness experience due to the differences in life experience and the perception of career limitations. However, both studies used convenience samples, resulting in a majority of male participants. The relationship of HF on the social aspect of QOL for females has not been adequately explored.

Psychological well-being

Psychological well-being is a sense of how happy or contented the individual feels with life. 23 As a result of the limitations on physical and social capabilities, patients with HF were subjected to multiple psychological stressors. Studies have examined the various ways these patients react to their diagnoses. They concluded that most patients with HF often expressed intense negative emotions, such as depression, anxiety, and frustrations. 8 , 9 , 11 , 19 , 21 In addition, due to the unpredictable nature of the illness, patients also expressed fear of the unknown, as they were uncertain about the future and even fear of death. 8 , 17 , 23

Depression in patients with HF

Several qualitative studies have identified depression as one of the most common negative emotions among patients with HF. 4 , 8 , 9 , 19 This finding is consistent with many quantitative studies, which examined the variables associated with psychological issues using regression analysis. 16 , 24-29 Through using instruments, such as the Beck Depression Inventory and the Hospital Anxiety and Depression Scale, the researchers found that prevalence of depression ranged from 28.9% to 78% in patients with HF.

The differences in findings may be related to the differences in symptom severity among the study population. Bean et al 24 and Son et al 28 conducted studies with more than 50% of the patients classified under NYHA class I and II, while both Gottlieb et al 26 and Vollman et al 29 conducted studies with more than 50% of the patients classified under NYHA class III and class IV. In addition, 2 of the studies did not specify the differences between depressive symptoms and clinical depression. 27 , 29 The differences in the study populations and the instruments used to measure depression could have resulted in the discrepancies in findings, supporting the idea that depression may depend on the study population and the definition being employed. 4

Fear and anxiety

Several qualitative studies have also reported other common psychological issues, such as fear and anxiety, among patients with HF. The participants consistently reported that the causes of these psychological issues were due to the unpredictable nature of HF, uncertainty about the future, and the likelihood of death. 4 , 8 , 19 , 22 , 23 , 30 , 31 Through the utilization of the Hospital Anxiety and Depression Scale instrument, some quantitative studies registered anxiety prevalence at between 30% and 77%. 16 , 24 , 25

From the literature, studies suggested that individuals undergo a transition process, and fear and anxiety were associated with the earlier stages of the illness. 4 , 20 However, these negative emotions would subside gradually with adequate support. 8 , 19 Other studies found that fear of death becomes more apparent as the disease progresses, especially during severe episodes of HF-related symptoms. 20 , 21 , 23 Despite being afraid of dying, death may not always be seen by the individual as a negative issue. A study conducted by Burstrom et al 23 suggested that some individuals may perceive the prospect of death as a way to avoid suffering.

In spite of the advancements in HF treatment in improving the individual's physical abilities, the relationship between HF and emotional well-being may vary among patients. A longitudinal study by Goodman et al 25 found that anxiety and depression remained high, although physical symptoms improved over 6 months. They attributed this finding to the lack of confidence in the individual's self-care, or their fear, which may have impeded their ability to cope. 25 Despite the strengths of a longitudinal study design, the authors did not explain whether they compensated for the difference in study samples between 2 time points: where participants had died (n = 21) or failed to complete the follow-up (n = 17). This may have influenced the results of the findings, as the increase in negative emotions may have been due to the difference in study samples.

Coping strategies

Coping is the cognitive and behavioral attempt made by an individual to manage the impacts of a stressful event. 32 In response to the various impacts of HF, individuals have developed diverse coping strategies to overcome the effects of their condition. Without sufficient coping, the individual may suffer from poor physical and psychological well-being.

Types of coping strategies

From the literature, several studies examined the relationship between coping strategies and HRQOL on patients with HF. The 2 common types of strategies were problem-focused and emotion-focused coping. 6 , 16 , 27 , 29 , 33 , 34 The researchers identified that emotion-focused coping strategies, such as denial, behavioral avoidance, and venting of emotions, were often less adaptive, whereas problem-focused coping strategies, such as acceptance of the condition, sharing the illness experience, receiving support from others, and adjustment to the illness, were considered to be more adaptive.

Relationship between coping strategies and HRQOL emotion-focused coping strategies

Previous studies suggested a relationship between emotion-focused coping strategies and poor physical and psychological HRQOL. 6 , 16 , 24 , 29 , 33 , 35 They identified that coping strategies, such as denial or behavioral avoidance, would result in an increase in HF-related symptoms due to the delay or nonadherence to treatment, thus resulting in greater depressive symptoms. However, a qualitative study by Hopp et al 30 highlighted that certain emotion-focused coping strategies, such as religion or spiritual support, have a positive influence on HRQOL. The study was conducted using both individual and focus-group interviews. The researchers concluded that individuals who followed religious beliefs and coped with spiritual support found greater meaning in life. However, the informants comprised African American participants. Thus, their findings may not be demonstrative of patients with HF from another context, as cultural values may be different.

Problem-focused coping strategies

Problem-focused coping strategies were reported to be significantly associated with physical and psychological HRQOL. 29 , 33 , 34 , 36 The use of problem-focused coping strategies had led to fewer depressive symptoms, increased adherence to treatment regimens and fewer HF-related symptoms.

However, problem-focused coping strategies are not always associated with a positive effect on the individual. Several qualitative studies reported that individuals who receive support from others perceived themselves as a burden to others and felt they had lost their independence. 8 , 9 , 21 , 37 Support is appreciated only if independence is maintained, and the individual has control over their situation. 10 , 37 A cross-sectional study suggested that problem-focused coping was associated with a lowered QOL. 24 The findings were attributed to the increase in anxiety, as possible problem-focused coping strategies had already been applied and worn out, leading to a heightened awareness of the severity of the individual's illness. 24 , 27 A longitudinal study also demonstrated that there was no relationship between problem-focused coping strategies and patients' HRQOL. 27

Among the literature discussing coping strategies and HRQOL, a common limitation of these studies is that the samples comprised mostly males or white participants. Thus, these findings may not be representative of patients with HF from other countries.

Culture and belief

Of the reviewed literature, few studies have placed emphasis on the importance of the cultural differences of the individual and their influence on health belief. Some authors have reported that the differences in culture were not related to the illness experience and coping strategies, 14 , 25 while others suggested otherwise. 1 , 30 , 38 , 39

A qualitative study conducted in Malaysia highlighted that problem-focused coping strategies, such as diet and adherence to treatment, might be influenced by cultural belief. 1 Although lifestyle modification is important for patients with HF, the researchers noted that the participants shared the belief that the sick should consume more water "to reduce heat and cleanse the body" and remove excess medicine from the body. 1 However, the sample of the study (n = 20) comprised mostly male participants (n = 15). Thus, studies that examine cultural and gender differences are needed.

Learning needs

Both quantitative and qualitative literature consistently reported the need for informational knowledge as the main concern among patients with HF. Patients with HF need to follow a strict treatment regime, such as adhering to medications, a low-sodium diet, and fluid restriction. Thus, knowledge about treatment and rehabilitation is important when promoting adherence to the regime and effective self-management of the condition. 22 , 40

Relationship between learning needs and coping

No study has demonstrated a causal relationship between patients recognizing their need to learn and the ability to cope with HF. However, a recent study suggested that individuals with sufficient knowledge about their illness acknowledge that information may improve illness management and outcomes. 38 This is supported by another study indicating that the individual's knowledge about illness was associated with HRQOL and the use of coping strategies. 40 However, both studies were cross-sectional in design, thus causal relationships cannot be evaluated. In addition, the former study excluded patients with hypertension and valvular heart disease, while the latter involved only female participants (n = 35). Thus, it is necessary to explore a diagnostically diverse sample from both genders in the future.

Informational support

Qualitative studies revealed that patients with HF expressed an interest in knowing more about their medications, treatment options, and ways to manage their current state of health. 17 , 22 , 37 This finding is echoed in 3 quantitative studies that identified HF-related symptoms and medications as the top learning needs, which patients with HF perceived to be most important. 38 , 39 , 41 All of these studies used the Heart Failure Patients' Learning Needs Inventory, and the mean scores varied among the 3 studies, with the United States being the highest (mean = 3.955) and China being the lowest (mean = 3.291). 38 , 39 , 41 This suggests that factors such as cultural differences may influence the patient's perception of the importance of learning needs. Both Kim et al 38 and Yu et al 39 suggested that Asian patients tend to depend on the recommendations of health care professionals as a sign of respect for authority. The former attributed this to the paternalistic influence from the family, while the latter ascribed this to the Chinese belief that maintaining harmony is cardinal. Thus, the differences in cultures are associated with the perceived importance of the learning needs. However, both Kim et al 38 and Yu et al 39 examined samples comprising mostly of NYHA class I and II patients, while Clark and Lan 41 did not indicate the severity of HF of their participants. As these individuals may have different severities of HF, they may have different expectations of learning needs. In addition, these studies adopted a questionnaire approach and could identify only the content of learning needs. Hence, more in-depth research is necessary to explore patients' knowledge and their learning needs.

Several studies suggested that although information was provided through written or verbal means, patients with HF still had difficulty in managing and understanding their condition. 11 , 20 , 22 , 23 , 42 , 43 The researchers attribute this to the language of the self-management information delivered. Some authors also identified that individuals were left to develop their own strategies to manage their condition, thus exposing them to danger. 20 , 22 , 42 One qualitative study conducted by Boyde et al 43 in Australia identified that conflicting information from different health care providers also contributed to the difficulty in managing and understanding the individual's condition. Through interviewing a purposive sample of 12 participants, the authors found that individuals were confused by conflicting information and eventually lost faith in the health care professionals. Notably, the need for appropriate informational support was apparent.

This review examined the recent literature on the experience of patients with HF, the coping strategies they adopted, and their learning needs.

The overall QOL of patients with HF is greatly affected by the presence and severity of HF-related symptoms. The impact extends beyond physical health and into the social and psychological aspects of the individual's life. The review also illustrated that individuals adopted diverse coping strategies to overcome the effects of their condition. Patients with HF need to follow a strict treatment regime. If their learning needs on the management of HF could be identified and fulfilled, their ability to adopt appropriate coping strategies and make decisions about self-care may be enhanced and their QOL improved.

A significant gap is that the majority of the studies were carried out in the Western countries, namely, the United States, the United Kingdom, and European countries. Of the 37 studies reviewed, only 4 quantitative studies were conducted in Asian countries such as China, Korea, and Taiwan. 14 , 28 , 38 , 39 The review reveals that no qualitative study that explores the patient's experience of living with HF has been conducted in the Asian context. This narrative review showed that differences in the individual's lifestyle and cultural beliefs are associated with their perspective of HF and their ability to manage and cope with HF and its consequences. 1 , 14 , 30 , 38 , 39 Hence, existing findings may not be applicable to other countries with dissimilar cultures.

Many studies that were included in this review focused on the negative aspects of patients' experiences with HF, and most of the qualitative studies had mainly explored male participants' perspectives. 17 , 21 , 43 This does not allow comparison of the differences in experiences between genders. In addition, while studies had been conducted with patients at various stages of HF, there is a lack of information regarding the experiences and learning needs of patients with a more severe class of HF, specifically NYHA class IV. Thus, more studies with a diagnostically diverse sample from both genders would provide a more in-depth understanding of their experiences, perceptions, and needs while living with HF. 21 , 38

Limitations and conclusion

While this review may not have included all the relevant published literature due to the limited databases examined and the language criterion, this narrative review meets the specific aim of summarizing empirical evidence concerning experiences of patients with HF and identifying their coping strategies and learning needs. Current evidence highlights the need to conduct studies to address the research gaps and to better understand the experiences, coping strategies, and learning needs of patients with HF in an Asian society. This literature review serves as a basis for future efforts to promote patient-centric holistic care and improve patients' HRQOL through meeting their needs.

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3. Richards AM, Lam C, Wong RC, Ping C. Heart failure: a problem of our age. Ann Acad Med. 2011;40(9):392-393. [Context Link]

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12. Bekelman DB, Havranek EP, Becker DM, et al. Symptoms, depression, and quality of life in patients with heart failure. J Card Fail. 2007;13(8):643-648. [Context Link]

13. Heo S, Doering LV, Widener J, Moser DK. Predictors and effect of physical symptom status on health-related quality of life in patients with heart failure. Am J Crit Care. 2008;17(2):124-132. [Context Link]

14. Huang T, Moser DK, Hwang S, Lennie TA, Chung M, Heo S. Comparison of health-related quality of life between American and Taiwanese heart failure patients. J Transcult Nurs. 2010;21(3):212-219. [Context Link]

15. Fotos NV, Giakoumidakis K, Kollia Z, et al. Health-related quality of life of patients with severe heart failure. A cross-sectional multicentre study. Scand J Caring Sci. 2013;27(3):686-694.

16. Hallas CN, Wray J, Andreou P, Banner NR. Depression and perceptions about heart failure predict quality of life in patients with advanced heart failure. Heart Lung. 2011;40(2):111-121. [Context Link]

17. Rodriguez KL, Appelt CJ, Switzer GE, Sonel AF, Arnold RM. "They diagnosed bad heart": a qualitative exploration of patients' knowledge about and experiences with heart failure. Heart Lung. 2008;37(4):257-265. [Context Link]

18. Cicognani E, Pirini C, Keyes C, Joshanloo M, Rostami R, Nosratabadi M. Social participation, sense of community and social well being: a study on American, Italian and Iranian university students. Soc Indic Res. 2008;89(1):97-112.

19. Allen JW, Arslanian-Engoren C, Lynch-Sauer J. The lived experience of middle-aged women with New York Heart Association class III heart failure: a pilot study. Prog Cardiovasc Nurs. 2009;24(3):96-101. [Context Link]

20. Pihl E, Fridlund B, Martensson J. Patients' experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis. Scand J Caring Sci. 2011;25(1):3-11. [Context Link]

21. Thornhill K, Lyons AC, Nouwen A, Lip GY. Experiences of living with congestive heart failure: a qualitative study. Br J Health Psychol. 2008;13(pt 1):155-175. [Context Link]

22. Nordgren L, Asp M, Fagerberg I. Support as experienced by men living with heart failure in middle age: a phenomenological study. Int J Nurs Stud. 2008;45(9):1344-1354. [Context Link]

23. Burstrom M, Brannstrom M, Boman K, Strandberg G. Life experiences of security and insecurity among women with chronic heart failure. J Adv Nurs. 2012;68(4):816-825. [Context Link]

24. Bean MK, Gibson D, Flattery M, Duncan A, Hess M. Psychosocial factors, quality of life, and psychological distress: ethnic differences in patients with heart failure. Prog Cardiovasc Nurs. 2009;24(4):131-140. [Context Link]

25. Goodman H, Firouzi A, Banya W, Lau-Walker M, Cowie MR. Illness perception, self-care behaviour and quality of life of heart failure patients: a longitudinal questionnaire survey. Int J Nurs Stud. 2013;50(7):945-953. [Context Link]

26. Gottlieb SS, Khatta M, Friedmann E, et al. The influence of age, gender, and race on the prevalence of depression in heart failure patients. J Am Coll Cardiol (JACC). 2004;43(9):1542-1549. [Context Link]

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28. Son YJ, Song Y, Nam S, Shin WY, Lee SJ, Jin DK. Factors associated with health-related quality of life in elderly Korean patients with heart failure. J Cardiovasc Nurs. 2012;27(6):528-538. [Context Link]

29. Vollman MW, LaMontagne LL, Hepworth JT. Coping and depressive symptoms in adults living with heart failure. J Cardiovasc Nurs. 2007;22(2):125-130. [Context Link]

30. Hopp FP, Thornton N, Martin L, Zalenski R. Life disruption, life continuation: contrasting themes in the lives of African-American elders with advanced heart failure. Soc Work Health Care. 2012;51(2):149-172. [Context Link]

31. Nordgren L, Asp M, Fagerberg I. Living with moderate-severe chronic heart failure as a middle-aged person. Qual Health Res. 2007;17(1):4-13. [Context Link]

32. Aldwin CM. Stress, Coping, and Development. 2nd ed. New York, NY: Guilford; 2007. [Context Link]

33. Doering LV, Dracup K, Caldwell MA, et al. Is coping style linked to emotional states in heart failure patients? J Card Fail. 2004;10(4):344-349. [Context Link]

34. Park CL, Fenster JR, Suresh DP, Bliss DE. Social support, appraisals, and coping as predictors of depression in congestive heart failure patients. Psychol Health. 2006;21(6):773-789. [Context Link]

35. Kristofferzon M-L, Lindqvist R, Nilsson A. Relationships between coping, coping resources and quality of life in patients with chronic illness: a pilot study. Scand J Caring Sci. 2011;25(3):476-483. [Context Link]

36. Dekker RL, Peden AR, Lennie TA, Schooler MP, Moser DK. Living with depressive symptoms: patients with heart failure. Am J Crit Care. 2009;18(4):310-318. [Context Link]

37. Sundin K, Bruce E, Barremo AS. Elderly women's experiences of support when living with congestive heart failure. Int J Qual Stud Health Well-Being. 2010;5(2):1-10. [Context Link]

38. Kim S-S, Ahn J-A, Kang S-M, Kim G, Lee S. Learning needs of patients with heart failure: a descriptive, exploratory study. J Clin Nurs. 2013;22(5/6):661-668. [Context Link]

39. Yu M, Chair SY, Chan CWH, Li X, Choi KC. Perceived learning needs of patients with heart failure in China: a cross-sectional questionnaire survey. Contemp Nurse. 2012;41(1):70-77. [Context Link]

40. Jackson JL, Emery CF. Illness knowledge moderates the influence of coping style on quality of life among women with congestive heart failure. Heart Lung. 2011;40(2):122-129. [Context Link]

41. Clark JC, Lan VM. Heart failure patient learning needs after hospital discharge. Appl Nurs Res. 2004;17(3):150-157. [Context Link]

42. Andersson L, Eriksson I, Nordgren L. Living with heart failure without realising: a qualitative patient study. Br J Community Nurs. 2012;17(12):630-637. [Context Link]

43. Boyde M, Tuckett A, Peters R, Thompson D, Turner C, Stewart S. Learning for heart failure patients (the L-HF patient study). J Clin Nurs. 2009;18(14):2030-2039. [Context Link]

coping strategies; experiences; heart failure; learning needs; review

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Literature review introduction sample.

Literature Review Introduction Sample

How to Write Literature Review Introduction Sample

Table of contents, literature review (lr) introduction: revelation of concept, sample text 1, conceptual framework, declaration on lr type, sample text 2, follow referencing style, in-text referencing for lr introduction, sample text 3.

Notes- Footnotes & Endnotes

Sample Text 4

Sample Text 5

The Literature Review (LR) is an integral part of an in-depth research process, which involves critically scrutinized content attained from former research works and empirical reports. In a research paper , the LR is meant to address the identified issue and gain adequate knowledge to resolve it. However, since every research is unique in its way, soon the researcher discovers that the former research works are inadequate or limited in meeting the current research objectives. In this way, the LR brings forth the research gaps, which leads to further research process at the researcher’s end. 

It is important to note here that the Literature Review format may differ from one University to another. However, the process of analysis and declarations remain universal. For the formatting and the inclusion list always check the University module.

In this article, we will focus on understanding the relevance and content to be established in the Introduction part of the Literature Review.

On a standard basis, the structure of the Literature Review is meant to offer three sections – Introduction, Body, and the Conclusion. In the case of Introduction, the researcher must offer detailed information about the context and the intellectual narration about the topic. Historical contexts and the developmental process of the concern need to be summed up in this section. The researcher should declare the theories and the relevance of the theories to the research in a very comprehensive manner. While elaborating the relevance of the selected theories the key writers and philosophers should be introduced in the Introduction section of the LR. 

Sample Text 1 - Literature Review Introduction Sample

It is highly recommended that the researcher considers the inclusion of the Conceptual Framework in the LR Introduction. The objective behind the inclusion of the Conceptual Framework is to develop an in-depth thinking process and thereby understand the complexity of the identified issue of the research. This framework acts as a roadmap while constructing the Body and Conclusion or the Research Gaps. The conceptual framework as prescribed in Figure 1 should be considered while answering the specified questions one-by-one:

Figure 1: Map to Construct the Conceptual Framework

Map to Construct the Conceptual Framework - Literature Review Introduction Sample - Words Doctorate

The Literature Review Introduction can vary as per the type of review process considered by the researcher. Following the selected topic and the availability of secondary sources the LR can be:

For all these types, it is necessary that the Literature Review Introduction makes clear declarations about the selection process and justify the selection of the type in the most intellectually logical manner.

If you select the narrative approach to review the collected literature, then mention it in the first few lines. You need to state that you will summarise the content of the selected literature and will derive the research gaps.

Alternatively, your literature review can be argumentative in approach. In this case, the Literature Review Introduction must declare the process of examining the biases and ways to identify the shortcomings of the selected literature.

In case, you select a systematic review of very narrowly selected literature; make sure that you identify the right process. Since systematic literature review can be shaped as meta-analysis or as meta-synthesis, the LR Introduction must clarify the approach. Mention how you follow statistical procedures to meet the meta-analysis approach and undergo a deductive process under quantitative methodology. For the meta-synthesis approach, give a clear idea about the non-statistical techniques under qualitative methodology.

For the theoretical approach of the literature review, introduce and establish the relevance of the selected theories in the LR Introduction. On the other hand, for the integrative review approach, generate the necessary framework about the process of leading the critiques.

Sample Text 2 - Literature Review Introduction Sample

The literature Review Introduction will not mention anything about the selected referencing style. The in-text citations will make it all clear. You must follow the right kind of in-text referencing style as per your selected subject and approach of your research.

In this article, we are offering three samples for a clear understanding. These exemplified referencing styles are:

It is the presence of the references in the form of ‘parenthetical in-text citations, which determines the selected referencing style for the entire research work. Note that for subjects from Humanities, the common selection is of MLA style. Even in Humanities, if you are from dealing with History, Business Fine Arts, then you can consider the Chicago style of referencing. As for the APA referencing style the subjects from Social Sciences, Engineering, Education, etc. remains as the basic selection.  Still, we would recommend that always have a consultation with your Guide or Supervisor about the right selection of the referencing style.

APA Style (7 th edition)

APA style  of referencing under 7 th edition is a parenthetical way of declaring the references. The bracketed mode of references that you need to add to the Literature Review Introduction must comprise of –

Sample Text 3 - Literature Review Introduction Sample

For instance, in Sample Text 1 for a fictitious book, ‘Evaluation of Education System’ by Simon Hillary , published in 2019; the APA style in-text referencing should appear like- (Hillary, 2019, p. 84) or (Hillary, 2019, pp. 84-88). Note that ‘p.’ stands for a single page, whereas ‘pp.’ for consecutive multiple pages. The page or page numbers are used when you quote from a text directly. In case there is no direct quote, you can avoid using the page or page numbers. In some cases like old texts, it is recommended to use paragraph or couplet numbers.

This format is a general application that varies slightly in the case of multiple authors. Let’s add Walter as co-author for two authored books. The in-text citations under the APA system follow the following provisions of using the commas ‘,’: There is no difference while referring to in-text reference to any book, journal or web article, or internet sources.

For APA in-text citations always remember:

Chicago Style (17 th edition)

Chicago referencing style (17 th edition) is used for documentations of –

Though this style is very similar to the APA style of adding-

Yet the placement of the comma makes all the difference in the in-text citation process. Instead of putting the comma ‘,’ after the Surname of the Author, Chicago places it after the publication date and there is no space for ‘p.’ or ‘pp.’.

If we consider the same text ‘Evaluation of Education System’ by Simon Hillary, published in 2019 by Oxford Open Press in Oxford; the Chicago style in-text referencing should appear like- (Hillary 2019, 84) or (Hillary 2019, 84-88). Let’s add Walter as co-author for two authored books.

Author-date (in-text)

There is no difference while referring to in-text reference to any book, journal or web article, or internet sources.

The usage of Chicago is more particular when it comes to the inclusion of footnote or endnote in a text. Here, if you need to add any footnote or endnote to the Literature Review Introduction, then follow the following rules:

Sample Text 4 - Literature Review Introduction Sample

MLA Style (8 th edition)

MLA referencing style under 8 th edition is also a parenthetical way of declaring the references. The brackets in the in-text referencing process for the Introduction of your Literature Review must comprise of –

Considering the same book, ‘Evaluation of Education System’ by Simon Hillary, published in 2019; the MLA style in-text referencing should appear like- (Hillary 84) or (Hillary 84-88). It is important that in the case of MLA the non-consecutive pages are just added by commas, as in- (Hillary 84, 26, 104). Let’s add Walter as co-author for two authored books. There is no difference while referring to in-text reference to any book, journal or web article, or internet sources. Note that there is no use of ‘p.’ or ‘pp.’ for page number/s and there is no space for commas ‘,’.

The MLA style is popular for its facilities to accommodate various kinds of exceptional in-text citations. In your Literature Review Introduction, these exceptions can occur in the following manner, yet MLA holds solutions for the-

No Author Citation: The in-text citation needs to be added by matching the very foremost element in the entry of the Cited Work, which can be the organisation’s name or source title.

Example: For the source- United Nations International Children's Emergency Fund. International Annual Report for FY 2020-21, the in-text citation would be UNICEF (or United Nations International Children's Emergency Fund) 162.

No Page Number/s Citation: In an in-text citation, when there is no page number, then you can consider the number of the chapter, scene, section, or anything that can locate the page.

Example: For the source- ‘Evaluation of Education System’ by Simon Hillary, the in-text citation would be (Hillary ch 2).

Same Author Different Sources:   The in-text citation of different works by the same author, MLA follows the regulation of shortening the title of the sources.

Example: For the source- ‘Evaluation of Education System’ by Simon Hillary, and ‘Education in Global Platform’ by Simon Hillary, the in-text citation would be (Hillary, Evaluation 84; and Hilary, Global 65).

Same Last Names: The in-text citation of different authors with the same surnames, MLA follows the trend of adding the First name initial.

Example: For the authors- Thomas Hilary and Simon Hilary with different sources, the in-text citation would be (T. Hillary 65 & S. Hillary 84).

Indirect Citation: The in-text citation for the information attained from indirect sources, MLA prescribes the provision of adding the source with parentheses and by the end of the sentence.

Example: If a piece of information about Hillary has been gathered from James Walter’s text published in 2020, then the in-text citation would be Hillary declared that the style of referencing … (Walter ch.2)

MLA style is very peculiar for its art of paraphrasing or delivering the context with the sources. For instance, in your Introduction, you can have sentences like-

Sample Text 5 - Literature Review Introduction Sample - Words Doctorate

In the conclusion, it is suggested that the Literature Review Introduction is very important for the success of your research However, to get your research approved by the University you need to take care of all the aspects and points mentioned above. 

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Literature Review – Examples, PDF

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literature review sample

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14+ Literature Review Examples

A literature review reveals the in-depth knowledge of your subject. But hold on! Don’t quickly jump to the conclusion of a Book review. The title of the article discusses umpteen things. It (Literature Review), in fact, sample survey and survives on scholarly articles and other sources such as dissertations and conference proceedings. In other words, it is the process of searching and evaluating the available literature on your chosen topic. There are many literature review sample outline examples available online, and many of them have to do with whatever subject you’re handling. You can find both long and short APA simple report content on health, science, history, and so much more. You can even incorporate complementary materials like an itinerary printable chart or data table for your literature review.

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Planning For Your Literature Review in the Health Professions

Narrative literature reviews.

Further Reading

Narrative or traditional literature reviews can take many shapes and forms. They do not need to follow any specific guideline or standard. A narrative literature view may be assigned as part of your coursework or capstone.

A narrative literature review can be a first step to building on other research in the field. After all, if it's a topic that you're interested in, you need to know what's already been done, right?

Your Narrative Literature Review Should Have...

A common structure for narrative literature reviews is IMRaD, or:

While the structure above may be sufficient for your topic, you may also consider using the similar but more robust structure IAMRDC, or:

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About Systematic Reviews

The Difference Between Narrative Review and Systematic Review

Reviews in scientific research are tools that help synthesize literature on a topic of interest and describe its current state. Different types of reviews are conducted depending on the research question and the scope of the review. A systematic review is one such review that is robust, reproducible, and transparent. It involves collating evidence by using all of the eligible and critically appraised literature available on a certain topic. To know more about how to do a systematic review , you can check out our article at the link. The primary aim of a systematic review is to recommend best practices and inform policy development. Hence, there is a need for high-quality, focused, and precise methods and reporting. For more exploratory research questions, methods such as a scoping review are employed. Be sure you understand the difference between a systematic review and a scoping review , if you don’t, check out the link to learn more.

When the word “review” alone is used to describe a research paper, the first thing that should come to mind is that it is a literature review. Almost every researcher starts off their career with literature reviews. To know the difference between a systematic review and a literature review , read on here.  Traditional literature reviews are also sometimes referred to as narrative reviews since they use narrative analysis to synthesize data. In this article, we will explore the differences between a systematic review and a narrative review, in further detail.

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narrative literature review example from the internet

Narrative Review vs Systematic Review

Both systematic and narrative reviews are classified as secondary research studies since they both use existing primary research studies e.g. case studies. Despite this similarity, there are key differences in their methodology and scope. The major differences between them lie in their objectives, methodology, and application areas.

Differences In Objective

The main objective of a systematic review is to formulate a well-defined research question and use qualitative and quantitative methods to analyze all the available evidence attempting to answer the question. In contrast, narrative reviews can address one or more questions with a much broader scope. The efficacy of narrative reviews is irreplaceable in tracking the development of a scientific principle, or a clinical concept. This ability to conduct a wider exploration could be lost in the restrictive framework of a systematic review.

Differences in Methodology

For systematic reviews, there are guidelines provided by the Cochrane Handbook, ROSES, and the PRISMA statement that can help determine the protocol, and methodology to be used. However, for narrative reviews, such standard guidelines do not exist. Although, there are recommendations available.

Systematic reviews comprise an explicit, transparent, and pre-specified methodology. The methodology followed in a systematic review is as follows,

A narrative review on the other hand does not have a strict protocol to be followed. The design of the review depends on its author and the objectives of the review. As yet, there is no consensus on the standard structure of a narrative review. The preferred approach is the IMRAD (Introduction, Methods, Results, and Discussion) [2]. Apart from the author’s preferences, a narrative review structure must respect the journal style and conventions followed in the respective field.

Differences in Application areas

Narrative reviews are aimed at identifying and summarizing what has previously been published. Their general applications include exploring existing debates, the appraisal of previous studies conducted on a certain topic, identifying knowledge gaps, and speculating on the latest interventions available. They are also used to track and report on changes that have occurred in an existing field of research. The main purpose is to deepen the understanding in a certain research area. The results of a systematic review provide the most valid evidence to guide clinical decision-making and inform policy development [1]. They have now become the gold standard in evidence-based medicine [1].

Although both types of reviews come with their own benefits and limitations, researchers should carefully consider the differences between them before making a decision on which review type to use.

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Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.

Cover of Handbook of eHealth Evaluation: An Evidence-based Approach

Handbook of eHealth Evaluation: An Evidence-based Approach [Internet].

Chapter 9 methods for literature reviews.

Guy Paré and Spyros Kitsiou .

9.1. Introduction

Literature reviews play a critical role in scholarship because science remains, first and foremost, a cumulative endeavour ( vom Brocke et al., 2009 ). As in any academic discipline, rigorous knowledge syntheses are becoming indispensable in keeping up with an exponentially growing eHealth literature, assisting practitioners, academics, and graduate students in finding, evaluating, and synthesizing the contents of many empirical and conceptual papers. Among other methods, literature reviews are essential for: (a) identifying what has been written on a subject or topic; (b) determining the extent to which a specific research area reveals any interpretable trends or patterns; (c) aggregating empirical findings related to a narrow research question to support evidence-based practice; (d) generating new frameworks and theories; and (e) identifying topics or questions requiring more investigation ( Paré, Trudel, Jaana, & Kitsiou, 2015 ).

Literature reviews can take two major forms. The most prevalent one is the “literature review” or “background” section within a journal paper or a chapter in a graduate thesis. This section synthesizes the extant literature and usually identifies the gaps in knowledge that the empirical study addresses ( Sylvester, Tate, & Johnstone, 2013 ). It may also provide a theoretical foundation for the proposed study, substantiate the presence of the research problem, justify the research as one that contributes something new to the cumulated knowledge, or validate the methods and approaches for the proposed study ( Hart, 1998 ; Levy & Ellis, 2006 ).

The second form of literature review, which is the focus of this chapter, constitutes an original and valuable work of research in and of itself ( Paré et al., 2015 ). Rather than providing a base for a researcher’s own work, it creates a solid starting point for all members of the community interested in a particular area or topic ( Mulrow, 1987 ). The so-called “review article” is a journal-length paper which has an overarching purpose to synthesize the literature in a field, without collecting or analyzing any primary data ( Green, Johnson, & Adams, 2006 ).

When appropriately conducted, review articles represent powerful information sources for practitioners looking for state-of-the art evidence to guide their decision-making and work practices ( Paré et al., 2015 ). Further, high-quality reviews become frequently cited pieces of work which researchers seek out as a first clear outline of the literature when undertaking empirical studies ( Cooper, 1988 ; Rowe, 2014 ). Scholars who track and gauge the impact of articles have found that review papers are cited and downloaded more often than any other type of published article ( Cronin, Ryan, & Coughlan, 2008 ; Montori, Wilczynski, Morgan, Haynes, & Hedges, 2003 ; Patsopoulos, Analatos, & Ioannidis, 2005 ). The reason for their popularity may be the fact that reading the review enables one to have an overview, if not a detailed knowledge of the area in question, as well as references to the most useful primary sources ( Cronin et al., 2008 ). Although they are not easy to conduct, the commitment to complete a review article provides a tremendous service to one’s academic community ( Paré et al., 2015 ; Petticrew & Roberts, 2006 ). Most, if not all, peer-reviewed journals in the fields of medical informatics publish review articles of some type.

The main objectives of this chapter are fourfold: (a) to provide an overview of the major steps and activities involved in conducting a stand-alone literature review; (b) to describe and contrast the different types of review articles that can contribute to the eHealth knowledge base; (c) to illustrate each review type with one or two examples from the eHealth literature; and (d) to provide a series of recommendations for prospective authors of review articles in this domain.

9.2. Overview of the Literature Review Process and Steps

As explained in Templier and Paré (2015) , there are six generic steps involved in conducting a review article:

Although these steps are presented here in sequential order, one must keep in mind that the review process can be iterative and that many activities can be initiated during the planning stage and later refined during subsequent phases ( Finfgeld-Connett & Johnson, 2013 ; Kitchenham & Charters, 2007 ).

Formulating the research question(s) and objective(s): As a first step, members of the review team must appropriately justify the need for the review itself ( Petticrew & Roberts, 2006 ), identify the review’s main objective(s) ( Okoli & Schabram, 2010 ), and define the concepts or variables at the heart of their synthesis ( Cooper & Hedges, 2009 ; Webster & Watson, 2002 ). Importantly, they also need to articulate the research question(s) they propose to investigate ( Kitchenham & Charters, 2007 ). In this regard, we concur with Jesson, Matheson, and Lacey (2011) that clearly articulated research questions are key ingredients that guide the entire review methodology; they underscore the type of information that is needed, inform the search for and selection of relevant literature, and guide or orient the subsequent analysis. Searching the extant literature: The next step consists of searching the literature and making decisions about the suitability of material to be considered in the review ( Cooper, 1988 ). There exist three main coverage strategies. First, exhaustive coverage means an effort is made to be as comprehensive as possible in order to ensure that all relevant studies, published and unpublished, are included in the review and, thus, conclusions are based on this all-inclusive knowledge base. The second type of coverage consists of presenting materials that are representative of most other works in a given field or area. Often authors who adopt this strategy will search for relevant articles in a small number of top-tier journals in a field ( Paré et al., 2015 ). In the third strategy, the review team concentrates on prior works that have been central or pivotal to a particular topic. This may include empirical studies or conceptual papers that initiated a line of investigation, changed how problems or questions were framed, introduced new methods or concepts, or engendered important debate ( Cooper, 1988 ). Screening for inclusion: The following step consists of evaluating the applicability of the material identified in the preceding step ( Levy & Ellis, 2006 ; vom Brocke et al., 2009 ). Once a group of potential studies has been identified, members of the review team must screen them to determine their relevance ( Petticrew & Roberts, 2006 ). A set of predetermined rules provides a basis for including or excluding certain studies. This exercise requires a significant investment on the part of researchers, who must ensure enhanced objectivity and avoid biases or mistakes. As discussed later in this chapter, for certain types of reviews there must be at least two independent reviewers involved in the screening process and a procedure to resolve disagreements must also be in place ( Liberati et al., 2009 ; Shea et al., 2009 ). Assessing the quality of primary studies: In addition to screening material for inclusion, members of the review team may need to assess the scientific quality of the selected studies, that is, appraise the rigour of the research design and methods. Such formal assessment, which is usually conducted independently by at least two coders, helps members of the review team refine which studies to include in the final sample, determine whether or not the differences in quality may affect their conclusions, or guide how they analyze the data and interpret the findings ( Petticrew & Roberts, 2006 ). Ascribing quality scores to each primary study or considering through domain-based evaluations which study components have or have not been designed and executed appropriately makes it possible to reflect on the extent to which the selected study addresses possible biases and maximizes validity ( Shea et al., 2009 ). Extracting data: The following step involves gathering or extracting applicable information from each primary study included in the sample and deciding what is relevant to the problem of interest ( Cooper & Hedges, 2009 ). Indeed, the type of data that should be recorded mainly depends on the initial research questions ( Okoli & Schabram, 2010 ). However, important information may also be gathered about how, when, where and by whom the primary study was conducted, the research design and methods, or qualitative/quantitative results ( Cooper & Hedges, 2009 ). Analyzing and synthesizing data : As a final step, members of the review team must collate, summarize, aggregate, organize, and compare the evidence extracted from the included studies. The extracted data must be presented in a meaningful way that suggests a new contribution to the extant literature ( Jesson et al., 2011 ). Webster and Watson (2002) warn researchers that literature reviews should be much more than lists of papers and should provide a coherent lens to make sense of extant knowledge on a given topic. There exist several methods and techniques for synthesizing quantitative (e.g., frequency analysis, meta-analysis) and qualitative (e.g., grounded theory, narrative analysis, meta-ethnography) evidence ( Dixon-Woods, Agarwal, Jones, Young, & Sutton, 2005 ; Thomas & Harden, 2008 ).

9.3. Types of Review Articles and Brief Illustrations

EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic. Our classification scheme is largely inspired from Paré and colleagues’ (2015) typology. Below we present and illustrate those review types that we feel are central to the growth and development of the eHealth domain.

9.3.1. Narrative Reviews

The narrative review is the “traditional” way of reviewing the extant literature and is skewed towards a qualitative interpretation of prior knowledge ( Sylvester et al., 2013 ). Put simply, a narrative review attempts to summarize or synthesize what has been written on a particular topic but does not seek generalization or cumulative knowledge from what is reviewed ( Davies, 2000 ; Green et al., 2006 ). Instead, the review team often undertakes the task of accumulating and synthesizing the literature to demonstrate the value of a particular point of view ( Baumeister & Leary, 1997 ). As such, reviewers may selectively ignore or limit the attention paid to certain studies in order to make a point. In this rather unsystematic approach, the selection of information from primary articles is subjective, lacks explicit criteria for inclusion and can lead to biased interpretations or inferences ( Green et al., 2006 ). There are several narrative reviews in the particular eHealth domain, as in all fields, which follow such an unstructured approach ( Silva et al., 2015 ; Paul et al., 2015 ).

Despite these criticisms, this type of review can be very useful in gathering together a volume of literature in a specific subject area and synthesizing it. As mentioned above, its primary purpose is to provide the reader with a comprehensive background for understanding current knowledge and highlighting the significance of new research ( Cronin et al., 2008 ). Faculty like to use narrative reviews in the classroom because they are often more up to date than textbooks, provide a single source for students to reference, and expose students to peer-reviewed literature ( Green et al., 2006 ). For researchers, narrative reviews can inspire research ideas by identifying gaps or inconsistencies in a body of knowledge, thus helping researchers to determine research questions or formulate hypotheses. Importantly, narrative reviews can also be used as educational articles to bring practitioners up to date with certain topics of issues ( Green et al., 2006 ).

Recently, there have been several efforts to introduce more rigour in narrative reviews that will elucidate common pitfalls and bring changes into their publication standards. Information systems researchers, among others, have contributed to advancing knowledge on how to structure a “traditional” review. For instance, Levy and Ellis (2006) proposed a generic framework for conducting such reviews. Their model follows the systematic data processing approach comprised of three steps, namely: (a) literature search and screening; (b) data extraction and analysis; and (c) writing the literature review. They provide detailed and very helpful instructions on how to conduct each step of the review process. As another methodological contribution, vom Brocke et al. (2009) offered a series of guidelines for conducting literature reviews, with a particular focus on how to search and extract the relevant body of knowledge. Last, Bandara, Miskon, and Fielt (2011) proposed a structured, predefined and tool-supported method to identify primary studies within a feasible scope, extract relevant content from identified articles, synthesize and analyze the findings, and effectively write and present the results of the literature review. We highly recommend that prospective authors of narrative reviews consult these useful sources before embarking on their work.

Darlow and Wen (2015) provide a good example of a highly structured narrative review in the eHealth field. These authors synthesized published articles that describe the development process of mobile health ( m-health ) interventions for patients’ cancer care self-management. As in most narrative reviews, the scope of the research questions being investigated is broad: (a) how development of these systems are carried out; (b) which methods are used to investigate these systems; and (c) what conclusions can be drawn as a result of the development of these systems. To provide clear answers to these questions, a literature search was conducted on six electronic databases and Google Scholar . The search was performed using several terms and free text words, combining them in an appropriate manner. Four inclusion and three exclusion criteria were utilized during the screening process. Both authors independently reviewed each of the identified articles to determine eligibility and extract study information. A flow diagram shows the number of studies identified, screened, and included or excluded at each stage of study selection. In terms of contributions, this review provides a series of practical recommendations for m-health intervention development.

9.3.2. Descriptive or Mapping Reviews

The primary goal of a descriptive review is to determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre-existing propositions, theories, methodologies or findings ( King & He, 2005 ; Paré et al., 2015 ). In contrast with narrative reviews, descriptive reviews follow a systematic and transparent procedure, including searching, screening and classifying studies ( Petersen, Vakkalanka, & Kuzniarz, 2015 ). Indeed, structured search methods are used to form a representative sample of a larger group of published works ( Paré et al., 2015 ). Further, authors of descriptive reviews extract from each study certain characteristics of interest, such as publication year, research methods, data collection techniques, and direction or strength of research outcomes (e.g., positive, negative, or non-significant) in the form of frequency analysis to produce quantitative results ( Sylvester et al., 2013 ). In essence, each study included in a descriptive review is treated as the unit of analysis and the published literature as a whole provides a database from which the authors attempt to identify any interpretable trends or draw overall conclusions about the merits of existing conceptualizations, propositions, methods or findings ( Paré et al., 2015 ). In doing so, a descriptive review may claim that its findings represent the state of the art in a particular domain ( King & He, 2005 ).

In the fields of health sciences and medical informatics, reviews that focus on examining the range, nature and evolution of a topic area are described by Anderson, Allen, Peckham, and Goodwin (2008) as mapping reviews . Like descriptive reviews, the research questions are generic and usually relate to publication patterns and trends. There is no preconceived plan to systematically review all of the literature although this can be done. Instead, researchers often present studies that are representative of most works published in a particular area and they consider a specific time frame to be mapped.

An example of this approach in the eHealth domain is offered by DeShazo, Lavallie, and Wolf (2009). The purpose of this descriptive or mapping review was to characterize publication trends in the medical informatics literature over a 20-year period (1987 to 2006). To achieve this ambitious objective, the authors performed a bibliometric analysis of medical informatics citations indexed in medline using publication trends, journal frequencies, impact factors, Medical Subject Headings (MeSH) term frequencies, and characteristics of citations. Findings revealed that there were over 77,000 medical informatics articles published during the covered period in numerous journals and that the average annual growth rate was 12%. The MeSH term analysis also suggested a strong interdisciplinary trend. Finally, average impact scores increased over time with two notable growth periods. Overall, patterns in research outputs that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline (DeShazo et al., 2009).

9.3.3. Scoping Reviews

Scoping reviews attempt to provide an initial indication of the potential size and nature of the extant literature on an emergent topic (Arksey & O’Malley, 2005; Daudt, van Mossel, & Scott, 2013 ; Levac, Colquhoun, & O’Brien, 2010). A scoping review may be conducted to examine the extent, range and nature of research activities in a particular area, determine the value of undertaking a full systematic review (discussed next), or identify research gaps in the extant literature ( Paré et al., 2015 ). In line with their main objective, scoping reviews usually conclude with the presentation of a detailed research agenda for future works along with potential implications for both practice and research.

Unlike narrative and descriptive reviews, the whole point of scoping the field is to be as comprehensive as possible, including grey literature (Arksey & O’Malley, 2005). Inclusion and exclusion criteria must be established to help researchers eliminate studies that are not aligned with the research questions. It is also recommended that at least two independent coders review abstracts yielded from the search strategy and then the full articles for study selection ( Daudt et al., 2013 ). The synthesized evidence from content or thematic analysis is relatively easy to present in tabular form (Arksey & O’Malley, 2005; Thomas & Harden, 2008 ).

One of the most highly cited scoping reviews in the eHealth domain was published by Archer, Fevrier-Thomas, Lokker, McKibbon, and Straus (2011) . These authors reviewed the existing literature on personal health record ( phr ) systems including design, functionality, implementation, applications, outcomes, and benefits. Seven databases were searched from 1985 to March 2010. Several search terms relating to phr s were used during this process. Two authors independently screened titles and abstracts to determine inclusion status. A second screen of full-text articles, again by two independent members of the research team, ensured that the studies described phr s. All in all, 130 articles met the criteria and their data were extracted manually into a database. The authors concluded that although there is a large amount of survey, observational, cohort/panel, and anecdotal evidence of phr benefits and satisfaction for patients, more research is needed to evaluate the results of phr implementations. Their in-depth analysis of the literature signalled that there is little solid evidence from randomized controlled trials or other studies through the use of phr s. Hence, they suggested that more research is needed that addresses the current lack of understanding of optimal functionality and usability of these systems, and how they can play a beneficial role in supporting patient self-management ( Archer et al., 2011 ).

9.3.4. Forms of Aggregative Reviews

Healthcare providers, practitioners, and policy-makers are nowadays overwhelmed with large volumes of information, including research-based evidence from numerous clinical trials and evaluation studies, assessing the effectiveness of health information technologies and interventions ( Ammenwerth & de Keizer, 2004 ; Deshazo et al., 2009 ). It is unrealistic to expect that all these disparate actors will have the time, skills, and necessary resources to identify the available evidence in the area of their expertise and consider it when making decisions. Systematic reviews that involve the rigorous application of scientific strategies aimed at limiting subjectivity and bias (i.e., systematic and random errors) can respond to this challenge.

Systematic reviews attempt to aggregate, appraise, and synthesize in a single source all empirical evidence that meet a set of previously specified eligibility criteria in order to answer a clearly formulated and often narrow research question on a particular topic of interest to support evidence-based practice ( Liberati et al., 2009 ). They adhere closely to explicit scientific principles ( Liberati et al., 2009 ) and rigorous methodological guidelines (Higgins & Green, 2008) aimed at reducing random and systematic errors that can lead to deviations from the truth in results or inferences. The use of explicit methods allows systematic reviews to aggregate a large body of research evidence, assess whether effects or relationships are in the same direction and of the same general magnitude, explain possible inconsistencies between study results, and determine the strength of the overall evidence for every outcome of interest based on the quality of included studies and the general consistency among them ( Cook, Mulrow, & Haynes, 1997 ). The main procedures of a systematic review involve:

Many systematic reviews, but not all, use statistical methods to combine the results of independent studies into a single quantitative estimate or summary effect size. Known as meta-analyses , these reviews use specific data extraction and statistical techniques (e.g., network, frequentist, or Bayesian meta-analyses) to calculate from each study by outcome of interest an effect size along with a confidence interval that reflects the degree of uncertainty behind the point estimate of effect ( Borenstein, Hedges, Higgins, & Rothstein, 2009 ; Deeks, Higgins, & Altman, 2008 ). Subsequently, they use fixed or random-effects analysis models to combine the results of the included studies, assess statistical heterogeneity, and calculate a weighted average of the effect estimates from the different studies, taking into account their sample sizes. The summary effect size is a value that reflects the average magnitude of the intervention effect for a particular outcome of interest or, more generally, the strength of a relationship between two variables across all studies included in the systematic review. By statistically combining data from multiple studies, meta-analyses can create more precise and reliable estimates of intervention effects than those derived from individual studies alone, when these are examined independently as discrete sources of information.

The review by Gurol-Urganci, de Jongh, Vodopivec-Jamsek, Atun, and Car (2013) on the effects of mobile phone messaging reminders for attendance at healthcare appointments is an illustrative example of a high-quality systematic review with meta-analysis. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs to health systems. These authors sought to assess whether mobile phone-based appointment reminders delivered through Short Message Service ( sms ) or Multimedia Messaging Service ( mms ) are effective in improving rates of patient attendance and reducing overall costs. To this end, they conducted a comprehensive search on multiple databases using highly sensitive search strategies without language or publication-type restrictions to identify all rct s that are eligible for inclusion. In order to minimize the risk of omitting eligible studies not captured by the original search, they supplemented all electronic searches with manual screening of trial registers and references contained in the included studies. Study selection, data extraction, and risk of bias assessments were performed inde­­pen­dently by two coders using standardized methods to ensure consistency and to eliminate potential errors. Findings from eight rct s involving 6,615 participants were pooled into meta-analyses to calculate the magnitude of effects that mobile text message reminders have on the rate of attendance at healthcare appointments compared to no reminders and phone call reminders.

Meta-analyses are regarded as powerful tools for deriving meaningful conclusions. However, there are situations in which it is neither reasonable nor appropriate to pool studies together using meta-analytic methods simply because there is extensive clinical heterogeneity between the included studies or variation in measurement tools, comparisons, or outcomes of interest. In these cases, systematic reviews can use qualitative synthesis methods such as vote counting, content analysis, classification schemes and tabulations, as an alternative approach to narratively synthesize the results of the independent studies included in the review. This form of review is known as qualitative systematic review.

A rigorous example of one such review in the eHealth domain is presented by Mickan, Atherton, Roberts, Heneghan, and Tilson (2014) on the use of handheld computers by healthcare professionals and their impact on access to information and clinical decision-making. In line with the methodological guide­lines for systematic reviews, these authors: (a) developed and registered with prospero ( www.crd.york.ac.uk/ prospero / ) an a priori review protocol; (b) conducted comprehensive searches for eligible studies using multiple databases and other supplementary strategies (e.g., forward searches); and (c) subsequently carried out study selection, data extraction, and risk of bias assessments in a duplicate manner to eliminate potential errors in the review process. Heterogeneity between the included studies in terms of reported outcomes and measures precluded the use of meta-analytic methods. To this end, the authors resorted to using narrative analysis and synthesis to describe the effectiveness of handheld computers on accessing information for clinical knowledge, adherence to safety and clinical quality guidelines, and diagnostic decision-making.

In recent years, the number of systematic reviews in the field of health informatics has increased considerably. Systematic reviews with discordant findings can cause great confusion and make it difficult for decision-makers to interpret the review-level evidence ( Moher, 2013 ). Therefore, there is a growing need for appraisal and synthesis of prior systematic reviews to ensure that decision-making is constantly informed by the best available accumulated evidence. Umbrella reviews , also known as overviews of systematic reviews, are tertiary types of evidence synthesis that aim to accomplish this; that is, they aim to compare and contrast findings from multiple systematic reviews and meta-analyses ( Becker & Oxman, 2008 ). Umbrella reviews generally adhere to the same principles and rigorous methodological guidelines used in systematic reviews. However, the unit of analysis in umbrella reviews is the systematic review rather than the primary study ( Becker & Oxman, 2008 ). Unlike systematic reviews that have a narrow focus of inquiry, umbrella reviews focus on broader research topics for which there are several potential interventions ( Smith, Devane, Begley, & Clarke, 2011 ). A recent umbrella review on the effects of home telemonitoring interventions for patients with heart failure critically appraised, compared, and synthesized evidence from 15 systematic reviews to investigate which types of home telemonitoring technologies and forms of interventions are more effective in reducing mortality and hospital admissions ( Kitsiou, Paré, & Jaana, 2015 ).

9.3.5. Realist Reviews

Realist reviews are theory-driven interpretative reviews developed to inform, enhance, or supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision-making ( Greenhalgh, Wong, Westhorp, & Pawson, 2011 ). They originated from criticisms of positivist systematic reviews which centre on their “simplistic” underlying assumptions ( Oates, 2011 ). As explained above, systematic reviews seek to identify causation. Such logic is appropriate for fields like medicine and education where findings of randomized controlled trials can be aggregated to see whether a new treatment or intervention does improve outcomes. However, many argue that it is not possible to establish such direct causal links between interventions and outcomes in fields such as social policy, management, and information systems where for any intervention there is unlikely to be a regular or consistent outcome ( Oates, 2011 ; Pawson, 2006 ; Rousseau, Manning, & Denyer, 2008 ).

To circumvent these limitations, Pawson, Greenhalgh, Harvey, and Walshe (2005) have proposed a new approach for synthesizing knowledge that seeks to unpack the mechanism of how “complex interventions” work in particular contexts. The basic research question — what works? — which is usually associated with systematic reviews changes to: what is it about this intervention that works, for whom, in what circumstances, in what respects and why? Realist reviews have no particular preference for either quantitative or qualitative evidence. As a theory-building approach, a realist review usually starts by articulating likely underlying mechanisms and then scrutinizes available evidence to find out whether and where these mechanisms are applicable ( Shepperd et al., 2009 ). Primary studies found in the extant literature are viewed as case studies which can test and modify the initial theories ( Rousseau et al., 2008 ).

The main objective pursued in the realist review conducted by Otte-Trojel, de Bont, Rundall, and van de Klundert (2014) was to examine how patient portals contribute to health service delivery and patient outcomes. The specific goals were to investigate how outcomes are produced and, most importantly, how variations in outcomes can be explained. The research team started with an exploratory review of background documents and research studies to identify ways in which patient portals may contribute to health service delivery and patient outcomes. The authors identified six main ways which represent “educated guesses” to be tested against the data in the evaluation studies. These studies were identified through a formal and systematic search in four databases between 2003 and 2013. Two members of the research team selected the articles using a pre-established list of inclusion and exclusion criteria and following a two-step procedure. The authors then extracted data from the selected articles and created several tables, one for each outcome category. They organized information to bring forward those mechanisms where patient portals contribute to outcomes and the variation in outcomes across different contexts.

9.3.6. Critical Reviews

Lastly, critical reviews aim to provide a critical evaluation and interpretive analysis of existing literature on a particular topic of interest to reveal strengths, weaknesses, contradictions, controversies, inconsistencies, and/or other important issues with respect to theories, hypotheses, research methods or results ( Baumeister & Leary, 1997 ; Kirkevold, 1997 ). Unlike other review types, critical reviews attempt to take a reflective account of the research that has been done in a particular area of interest, and assess its credibility by using appraisal instruments or critical interpretive methods. In this way, critical reviews attempt to constructively inform other scholars about the weaknesses of prior research and strengthen knowledge development by giving focus and direction to studies for further improvement ( Kirkevold, 1997 ).

Kitsiou, Paré, and Jaana (2013) provide an example of a critical review that assessed the methodological quality of prior systematic reviews of home telemonitoring studies for chronic patients. The authors conducted a comprehensive search on multiple databases to identify eligible reviews and subsequently used a validated instrument to conduct an in-depth quality appraisal. Results indicate that the majority of systematic reviews in this particular area suffer from important methodological flaws and biases that impair their internal validity and limit their usefulness for clinical and decision-making purposes. To this end, they provide a number of recommendations to strengthen knowledge development towards improving the design and execution of future reviews on home telemonitoring.

9.4. Summary

Table 9.1 outlines the main types of literature reviews that were described in the previous sub-sections and summarizes the main characteristics that distinguish one review type from another. It also includes key references to methodological guidelines and useful sources that can be used by eHealth scholars and researchers for planning and developing reviews.

Table 9.1. Typology of Literature Reviews (adapted from Paré et al., 2015).

Typology of Literature Reviews (adapted from Paré et al., 2015).

As shown in Table 9.1 , each review type addresses different kinds of research questions or objectives, which subsequently define and dictate the methods and approaches that need to be used to achieve the overarching goal(s) of the review. For example, in the case of narrative reviews, there is greater flexibility in searching and synthesizing articles ( Green et al., 2006 ). Researchers are often relatively free to use a diversity of approaches to search, identify, and select relevant scientific articles, describe their operational characteristics, present how the individual studies fit together, and formulate conclusions. On the other hand, systematic reviews are characterized by their high level of systematicity, rigour, and use of explicit methods, based on an “a priori” review plan that aims to minimize bias in the analysis and synthesis process (Higgins & Green, 2008). Some reviews are exploratory in nature (e.g., scoping/mapping reviews), whereas others may be conducted to discover patterns (e.g., descriptive reviews) or involve a synthesis approach that may include the critical analysis of prior research ( Paré et al., 2015 ). Hence, in order to select the most appropriate type of review, it is critical to know before embarking on a review project, why the research synthesis is conducted and what type of methods are best aligned with the pursued goals.

9.5. Concluding Remarks

In light of the increased use of evidence-based practice and research generating stronger evidence ( Grady et al., 2011 ; Lyden et al., 2013 ), review articles have become essential tools for summarizing, synthesizing, integrating or critically appraising prior knowledge in the eHealth field. As mentioned earlier, when rigorously conducted review articles represent powerful information sources for eHealth scholars and practitioners looking for state-of-the-art evidence. The typology of literature reviews we used herein will allow eHealth researchers, graduate students and practitioners to gain a better understanding of the similarities and differences between review types.

We must stress that this classification scheme does not privilege any specific type of review as being of higher quality than another ( Paré et al., 2015 ). As explained above, each type of review has its own strengths and limitations. Having said that, we realize that the methodological rigour of any review — be it qualitative, quantitative or mixed — is a critical aspect that should be considered seriously by prospective authors. In the present context, the notion of rigour refers to the reliability and validity of the review process described in section 9.2. For one thing, reliability is related to the reproducibility of the review process and steps, which is facilitated by a comprehensive documentation of the literature search process, extraction, coding and analysis performed in the review. Whether the search is comprehensive or not, whether it involves a methodical approach for data extraction and synthesis or not, it is important that the review documents in an explicit and transparent manner the steps and approach that were used in the process of its development. Next, validity characterizes the degree to which the review process was conducted appropriately. It goes beyond documentation and reflects decisions related to the selection of the sources, the search terms used, the period of time covered, the articles selected in the search, and the application of backward and forward searches ( vom Brocke et al., 2009 ). In short, the rigour of any review article is reflected by the explicitness of its methods (i.e., transparency) and the soundness of the approach used. We refer those interested in the concepts of rigour and quality to the work of Templier and Paré (2015) which offers a detailed set of methodological guidelines for conducting and evaluating various types of review articles.

To conclude, our main objective in this chapter was to demystify the various types of literature reviews that are central to the continuous development of the eHealth field. It is our hope that our descriptive account will serve as a valuable source for those conducting, evaluating or using reviews in this important and growing domain.

This publication is licensed under a Creative Commons License, Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0): see https://creativecommons.org/licenses/by-nc/4.0/

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