Chapter 7 Literature Reviews: Finding and Reviewing Research Evidence

COMMENTS ON THE CRITICAL THINKING ACTIVITIES IN CHAPTER 7 Example 1:“Complementary therapy and older rural women: Who uses it and who does not?” 1. (#1) The thoroughness of the review is difficult to assess without undertaking a literature search ourselves. Shreffler-Grant and her colleagues, did however, cite numerous fairly recent studies relating to the use of complementary and alternative medicine (CAM), including several from 2004. Researchers should not be faulted for not including studies published within a couple of years of publication of their own report, because that is how long it may take for a submitted manuscript to get into print. In other words, these researchers may have written their report in 2005 or 2006 for a January 2007 publication date, and thus studies published after 2004 might not have been available for their review. Although you could not know this from the excerpted material in the textbook, the authors did cite a good mix of nursing and non-nursing sources. Several were from the fields of public health, medicine, and psychology. (#2) It does appear that all of the cited materials were primary source research reports. (#3). The literature review did offer a critique of studies that have focused on the use of CAM in rural areas, noting that discrepancies might be attributable to a number of methodological weaknesses, especially sampling limitations. The review specifically described gaps in the literature, and noted that the new study was designed to help fill that gap. (#4). The review does appear to be well-organized. It began by documenting the use of CAM in the United States, defined how the term was used, and then reviewed the literature on factors that have found to be associated with CAM use. Studies that have examined urban-rural differences were then reviewed, and gaps and problems in this literature were noted. The organization of the material helps to build a “case” for the new study. (#5). The review is written in the authors’ own words, with no quotes from original sources. The authors used appropriate language for describing the results of earlier studies (e.g., “Studies…have had conflicting results: use has been found to be…”).

it is difficult to evaluate the thoroughness of a review without actually doing a search.. It is also worth noting that the authors had 31 citations . (2007). 64. The dependent variable is use of CAM.” d. so it does appear that the researchers used up-to-date information.e. however. and factors associated with its use. The authors specifically noted that the study was designed “to address these gaps in the literature”—i. The review identified several independent variables that would be studied as possible predictors of CAM use in older rural women: education. Specific types of CAM could also be used to search in databases (e. Social Science and Medicine. c. that there are notable gaps).. however. The term rural may also have been searched. a. rurality. Note. In this study.). Examples of keywords that might have been used: complementary medicine. As for Example 1. it is unlikely that the independent variables would have been used to search the literature—for example. herbal medicine. gaps that they identified in their review. have been thorough in their search for relevant research. These variables had been studied in prior research. complementary therapy. This study was identified through PubMed by using a textword search for studies with either “complementary medicine” OR “complementary therapy” OR CAM AND old* published after 2006.) Example 2: “The experiences and challenges of pregnant women coping with thrombophilia” 1. and the review focused primarily on this variable. We must trust that these researchers. 16921703. dollars devoted to its use. as is generally true. (The Shreffler-Grant et al. we note that there were several citations to studies published within a couple of years of the publication date for this article (January 2007). spirituality. who appear wellversed in the current literature on this topic. and the results were briefly summarized in the review. b.(#6) The review appears to support the need for the new study. 2. “Getting on with life”: The experiences of older people using complementary health care. Here is but one study that might be relevant: Cartright.. CAM.e.g. T. The review covered both background information on prevalence of use. (#1) Again. alternative medicine. acupuncture. and health status. that the validity of the researchers’ conclusion about the need for a new study is dependent on the accuracy of their premise (i. etc. age. study itself was also identified through this search strategy. number of chronic illnesses. and this is impossible to ascertain without undertaking out own search. marital status. it would not have been productive to search for “marital status” or “education.

If there were important omissions. this review did not critically appraise individual studies. and information about thrombophilia itself). (#3) As is true in many reviews that serve as context for a new study.. and how the treatment itself could be stressful. psychiatry. and noted its incidence. (You would have known this only if you had looked up the original full article). (#4) The literature review does appear to be well organized. The review went on to discuss treatment for thrombophilia. the extent to which the study fills a gap in the literature is partly a function of how thorough the review was. The first paragraph described what thrombophilia is. including nursing. 2.from several fields. social work. and noted the “significant gap” in the literature pertaining specifically to the experience of of thrombophilia. The central phenomenon of this study was pregnant women’s experience with throbophilia.g. and sociology.The review seems unbiased. a. “Studies have identified…). without appraising the quality of the existing evidence. The study was undertaken not so much because of limitations in earlier research but because of the absence of earlier research on this specific topic. used appropriately objective language.g. (#5). and provided supporting citations for assertions (e. Next the review presented information from studies on other pregnancy complications. The review covered research relating to the context for this study (e. findings from studies on other difficult pregnancy situations. indicated its potential severity and consequences. medicine. As was true in the preceding example. The literature review primarily summarized what earlier researchers had found. b. However. the argument might be less convincing—although replication would be desirable in any event. This organization seems logical and well conceived. (#2) The authors included primary source research reports in their review almost exclusively.. this may in part be due to the fact that no study had previously examined what it was like to experience thrombophilia during pregnancy. the primary keywords would by thrombophilia and pregnancy. For this literature review. however. (#6) The review leads logically to the conclusion that research on the topic is needed. .

This review article was identified through PubMed by using a search for the keywords thrombophilia AND pregnan* published after 2006. and nursing. psychology. (The Martens and Emed study itself was also identified through this search strategy. and the use of subheadings made it easy for readers to follow the organizational structure. and Blood Pressure in Children” 1. but overwhelmingly the citations are for original research reports. 44. (#1) We don’t know how thorough the authors’ review was without doing our own search.) Example 3: “Anxiety. however.. (#4) The review in this article was very well-organized. Their reference list was quite long (44 citations). (#3) As is true in many reviews that serve as context for a new study. did not use subjective language. this review did not critically appraise individual studies. The section labeled “Literature review” began with a paragraph summarizing factors associated with high blood pressure in adults and adolescents. (2004)—a study that the researchers appeared to rely on heavily. as it was cited several times. The study was undertaken to address a gap in what researchers have studied—blood pressure in children in relation to anger and anxiety—and not because of study limitations of previous research on this topic.g. (2007). and documented assertions with appropriate citations from the research literature (e. 93-97. the Wyllie article). The literature review primarily summarized what earlier researchers had found. Anger.c. and then subsequent subsections summarized research on each of these factors individually. and the citations were from diverse fields. (#2) There are some secondary sources (e. The authors included citations to some recent and several older studies. Here is but one article that might be relevant: Middeldorp. The article began with an introduction that described the importance of studying hypertension in children. S. which suggests thoroughness. A summary at the end of this section might. Seminars in Hematology. especially medicine.. The most recent study they cited was by Meinginger et al.g. without appraising the quality of the existing evidence. Pregnancy failure and heritable thrombophilia. “Trait anger…and trait anxiety…are psychological . again suggesting thoroughness. (#5) The review seems unbiased. have helped to pull all of the information together and might have made a better transition to the next section on the study purpose.

Only a limited number of studies on birth trauma were found in the literature. published in 2004. psychiatric. a. height. assuming that the review was thorough. research on its association with the independent variables was succinctly summarized. as noted above. The review does rely mainly on primary source research studies. and (f) hypertension AND child*. when we used them in a PubMed search. The dependent variable was blood pressure.factors that have been associated with…). (e) hypertension AND anger. and weight. 2. (c) “blood pressure” AND child*. All these variables. and. did retrieve the Howell et al study. medical. gender. Findings were succinctly summarized. b. The references included citations from the nursing.. although one recent review article (Olde et al. trait anxiety. The independent variables in this study were trait anger. anger expression. (b) “blood pressure” AND anger. 2006) was cited. The research that had been undertaken to describe the . This is a field in which Beck is an expert. It included recent research. it offered support for a new study on factors associated with high blood pressure in children. (#6) Yes. in relation to blood pressure. but rather as a support for the need for more attention to “be focused on birth trauma and PTSD as a serous mental health problem.” (#3) The review identified an important gap in the literature. as well as other possibly relevant studies: (a) “blood pressure” AND anxiety. review. Here are several sets of keywords which. including Beck’s own studies on PTSD and birth trauma. It includes the major studies on the topic of birth trauma and PTSD after childbirth. and psychological literature. c. and represents a continuation of her program of research on psychological effects relating to pregnancy. and there was no reliance on quotes from other writings. were covered in the literature Example 4: “Anniversary of Birth Trauma” 1. (d) hypertension AND anxiety. The review article was not used as a substitute for an analysis of primary studies. These were primarily quantitative studies that examined predictors of PTSD resulting from birth trauma. (#1) The literature review does seem extremely thorough. (#2).

2. No phenomenological studies (and no studies of any kind) had been conducted specifically on the topic of the anniversary of a birth trauma. (#6). The literature review section did a good job of defining PTSD.” childbirth. Beck paraphrased throughout the review. and PTSD. (#5).meaning of the experience of a traumatic birth for women had previously been done by Beck. Beck might have used the following keywords for her computerized search: “birth trauma. and finally describing the only three qualitative studies that have focused on traumatic births. Beck discussed prior research in two sections of the report: the literature review section (part of the Introduction) and also in the discussion section. and the anniversary of those births. b. The ideas supporting the new study were well developed. . Then the argument for the new research was further developed by describing research on the potential long-term effects of such PTSD on women and their families. The article began with an introduction that described research on the prevalence of PTSD secondary to childbirth. summarizing risk factors for PTSD. a. The central phenomenon that Beck focused on in this study was the experience of traumatic births. (#4) The literature review was well organized. describing studies on triggering events for PTSD. No quotes from original sources were relied upon to describe the relevant studies. In performing her literature review. c. describing intervention research for at-risk pregnant women. There was no research relating to the experience of reliving the trauma on the anniversary of giving birth. The literature review was objective and used appropriate language. Beck’s literature review supported the need for her qualitative study. Existing literature relating to the key phenomena was adequately covered in her review.

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