Mapping the literature of maternal-child/gynecologic

nursing
By Susan Kaplan Jacobs MLS, MA, RN, AHIP
susan.jacobs@nyu.edu
Health Sciences Librarian
Elmer Holmes Bobst Library
New York University
70 Washington Square South
New York, New York 10012

Objectives: As part of a project to map the literature of nursing,

sponsored by the Nursing and Allied Health Resources Section of the
Medical Library Association, this study identifies core journals cited in
maternal-child/gynecologic nursing and the indexing services that
access the cited journals.
Methods: Three source journals were selected and subjected to a
citation analysis of articles from 1996 to 1998.
Results: Journals were the most frequently cited format (74.1%),
followed by books (19.7%), miscellaneous (4.2%), and government
documents (1.9%). Bradfords Law of Scattering was applied to the
results, ranking cited journal references in descending order. One-third
of the citations were found in a core of 14 journal titles; one-third were
dispersed among a middle zone of 100 titles; and the remaining third
were scattered in a larger zone of 1,194 titles. Indexing coverage for the
core titles was most comprehensive in PubMed/MEDLINE, followed by
Science Citation Index and CINAHL.
Conclusion: The core of journals cited in this nursing specialty revealed
a large number of medical titles, thus, the biomedical databases provide
the best access. The interdisciplinary nature of maternal-child/
gynecologic nursing topics dictates that social sciences databases are an
important adjunct. The study results will assist librarians in collection
development, provide end users with guidelines for selecting databases,
and influence database producers to consider extending coverage to
identified titles.

INTRODUCTION
As part of Phase I of a project to map the literature of
nursing, sponsored by the Nursing and Allied Health
Resources Section of the Medical Library Association,
the purpose of this study is to identify the core journals cited in the maternal-child/gynecologic nursing
literature and the indexing services that access these
sources. The common methodology, described in the
overview article [1], subjects selected core journals in
a discipline to citation analysis over a three-year period, 1996 to 1998, and ranks the number of cited references by journal title in descending order to identify
the most frequently cited titles according to Bradfords
Law of Scattering. From the core of most productive
titles, the bibliographic databases that provide best access to these titles will be identified to assist librarians,
to provide end users of the literature with guidance
E-56

for selecting databases to search, and to recommend

additional titles to database producers.
Maternal-child nursing is defined as, The nursing
specialty that deals with the care of women throughout their pregnancy and childbirth and the care of
their newborn children [2]. CINAHLs definitions
provide a useful framework for the boundaries of this
specialty. The subject maternal-child nursing has
three subordinate terms in the CINAHL subject headings hierarchy: obstetric nursing (care of normal, uncomplicated pregnancies only), perinatal nursing
(nursing care of childbearing families who are at risk
for increased maternal, fetal, or neonatal mortality),
and pediatric nursing [3]. The related area of gynecologic nursing is treated as a subdivision of medicalsurgical nursing in the CINAHL tree structure. Gynecology is defined as the medical-surgical specialty
concerned with the physiology and disorders primarily of the female genital tract, as well as female enJ Med Libr Assoc 94(2) Supplement 2006

Mapping the literature of maternal-child/gynecologic nursing

docrinology and reproductive physiology [4]. Maternal-child/gynecologic nurses practice in hospital settings, home health agencies, and ambulatory settings
[5].
While the combined specialization of maternalchild/gynecologic nursing emerged from the medical
model of obstetrics and gynecology, the end of the
twentieth century has seen a shift to include added
research priorities for the broader and more holistic
field of womens health, defined in MEDLINE as the
concept covering the physical and mental conditions
of women [6] and defined broadly in CINAHL as including materials concerned with physical, psychosocial, physiological, and political issues in health care
of women [3]. Raftos, Mannix, and Jackson note that
the term womens health, as used in article abstracts,
appears to be a taken-for-granted notion, that is seldom defined, and is used interchangeably and synonymously to refer to reproductive health, maternal
health, neonatal health, family health and sexual
health [7]. Yet, the area of sex-based biology has
emerged to focus on a much wider view of womens
health needs [8]. A call for research papers for JAMAs
first theme issue on womens health in almost a decade
noted that womens health involves more than navel
to knees topics [9]. The Association of Womens
Health, Obstetric, and Neonatal Nurses (AWHONN)
focuses on reproductive health and newborn health
but proposes a wider commitment to research in the
areas of womens health that past research has not adequately studied. Diseases such as heart disease and
cancer and issues of social origin such as substance
abuse, violence, and health care disparities are included in AWHONNs current research agenda [5, 10].
So, while the term womens health may be used
loosely to refer to gender-based reproductive issues, it
is deliberately not used to describe the focus of this
bibliometric study. The current study attempts to capture that literature specific to the research and practice
of nurses in maternal-child and gynecologic nursing,
within the larger scope of womens health. Nurse-midwifery, a distinct specialty of its own, is a separate
study in Phase I of this project [11].
HISTORY
The rich history of maternal-child/gynecologic caregivers encompasses the contributions of Lillian Wald
and Margaret Sanger [12] and the more invisible contributions of caregivers throughout history. Ulrichs
Midwifes Tale provides a record of Martha Ballard and
the eighteenth century community she tended, pointing out the scope of caregivers:
[T]he midwives, nurses, afternurses, servants, watchers,
housewives, sisters, and mothers . . . Female practitioners
specialized in obstetrics but also in the general care of women and children, in the treatment of minor illnesses, skin
rashes, and burns, and in nursing. Since more than twothirds of the population . . . was either female or under the
age of ten, since most illnesses were minor, at least at their
onset, and since nurses were required even when doctors

J Med Libr Assoc 94(2) Supplement 2006

were consulted, Martha and her peers were in constant motion. [13]

Modern nursings beginnings in obstetrics were tied

to public health nursing at end of the nineteenth century. Most birthsalong with antepartum, postpartum, and well child caretook place at home, frequently attended by midwives and the early public
health nurses [14]. The movement of childbirth into
hospitals at the beginning of the twentieth century was
the result of changing sociocultural patterns and an
increased demand for medical intervention, asepsis,
and efficiency. By the 1930s, physicians became the
primary caregivers, as they medicalized birth, taking over the role that midwives and public health
nurses traditionally performed. Trained as surgeons to
look at reproductive processes as potentially pathologic, physicians enlisted nurses in their campaign to
promote hospital birth, not only as a superior setting
for the use of aseptic technique, but as more economic
and efficient according to scientific management
principles [15, 16]. As nursing migrated to the hospital
setting and care became more specialized, nurses had
opportunities to develop specialized skills and to gain
postgraduate training. Advances in technology for premature infants, such as incubators and the use of oxygen demanded the involvement and specialized skills
of nurses. The earliest centers using technology to support premature infants were demonstrated in touristattraction-type settings such as the World Exposition
in Berlin and at New Yorks Coney Island. The first US
hospital center for premature infants was established
in Chicago in 1923 [14].
Nursing education moved from hospital diploma
and associate degree programs to institutions of higher education with the first masters programs to prepare nursing faculty in the 1940s; baccalaureate programs gained popularity in the 1950s [14, 17]. Postbaccalaureate advanced practice specialization for
nurses began in the 1960s with the advent of programs
for pediatric nurse practitioners, designed to prepare
nurses to perform roles previously in the scope of
medical practice. Advanced practice roles for maternalchild/gynecologic nurses began with the first certification examination in 1980 for obstetric/gynecologic
nurse practitioners [14]. Specialization for neonatal intensive care nurses, neonatal nurse practitioners, family planners, coordinators of newborn services, and reproductive endocrinology/infertility nurses followed
[18].
The issues surrounding the history of nurses caring
for women span the spectrum from the traditionalauthoritarian model, where all decision making is in
the hands of the physician, to lay-midwife-attended
home birth. In the 1970s, self-help groups and feminist
health care began to focus on self-care, wellness, and
a holistic perspective. Many patients moved from the
status of recipients to that of participants in treatment
[19]. The evolution of the role of patientsfrom
draped and restrained to participating, awake with
self-control over birth position, presence of support
E-57

Jacobs

persons during labor for both vaginal and Cesarean

deliveries, informed decision making, prevention,
breast self-exam, breast cancer support, and improved
and alternative methods of pain managementwas an
outcome of this movement. The professional role of
nurses in intrapartum care has been affected by these
changes and is inextricably bound to the social history
of women, encompassing issues of gender, authority,
autonomy, and choice. AWHONN (formerly, the Nurses Association of the American College of Obstetricians and Gynecologists) became an independent professional association in 1993 to encompass a more holistic approach to womens health as well as to provide
nurses with a more autonomous organization, separate
from the professional organization of physicians [20].
Maternal-child nurses have gained increased autonomy with the advent of education and legislation to
support advanced practice specialties and what has
been called the renaissance of nurse midwifery [21].
Womens health concerns have emerged as prominent policy issues in the national agenda: the continuing debate over the Supreme Courts 1973 Roe v. Wade
decision; late term abortions; AIDS research and prevention; issues of managed care such as hospital
length of stay for postpartum mothers and infants as
well as for post-mastectomy patients; domestic violence; rape; harassment; female genital mutilation; eating disorders; health issues for minority and immigrant women; the biological, ethical, and social issues
surrounding reproductive technologies; and postpartum depression. Increased access to information, most
notably the advent of electronic networks, launched
the trend toward evidence-based practice and affected
both professional and lay access to health information
as well as the patient-caregiver relationship. At the
same time, advances in monitoring technologies for fetal and maternal assessment, increased rates of induced labor and higher nurse-to-patient care ratios
profoundly affected the work environment [22]. Maternal-child nursing researchers have collaborated
with leaders in medicine and midwifery in areas such
as management of labor pain and practice implications
[23]. The Centers for Disease Control and Prevention
listed healthier mothers and babies and family
planning among the ten great public health achievements of the twentieth century [24].
Looking forward, the nations Healthy People 2010
initiative, with the overarching goals of eliminating
health disparities and increasing quality and years
of healthy life, lists family planning; maternal, infant,
and child health; HIV; and sexually transmitted diseases among its twenty-eight focus areas [25]. In this
complex and rapidly changing environment, specialists in maternal-child/gynecologic nursing continue to
address both the physical and emotional health of
women and their families [26].
PREVIOUS BIBLIOMETRIC STUDIES
Several bibliometric studies have been conducted related to the literature of maternal-child/gynecologic
E-58

nursing. DAurias analysis of published maternal-child

nursing research was limited to nonspecialty journals
and reported on authorship patterns [27]. Gannon, Stevens, and Steckers analysis of the content of major
English-language obstetrics and gynecology journals
was critical of the emphasis on reproduction and the
exclusion of the nonpregnant and nonfertile and
did not focus on the nursing literature [28]. ONeills
citation analysis of nursing literature explored the extent of communication between research and practice
components as evidenced by citation patterns [29].
While the core journals for the current studyJOGNN:
The Journal of Obstetric, Gynecologic, and Neonatal Nursing; Journal of Perinatal & Neonatal Nursing (JPNN); and
MCN: The American Journal of Maternal Child Nursing
were included in ONeills study, the studied variables
included author education and affiliation and the citing relationships between research and practice articles. No bibliometric studies of maternal-child/gynecologic nursing have identified core journals for the
specialty.
METHODS
The methodology of this study, described in detail in
the overview article [1], requires selecting source
journals for analysis. The interdisciplinary nature of
maternal-child/gynecologic nursing made selection
problematic. Obstetric nursing cannot be separated
from gynecologic and neonatal nursing. Maternalnewborn care is not easily teased from the literature
concerning reproductive issues or pediatrics. Clinicians caring for antepartum, laboring, and postpartum
clients also care for the neonate, and they interact with
partners and family members. The interactions between nurse and client and parent and child and the
many psychosocial aspects of health and illness cannot
be separated as a specialty. JOGNN, AWHONNs official journal, was selected as the first source journal because of its clear focus on nursing care and obstetrics,
the neonatal period, and gynecology. It has been published under several titles bimonthly since 1972. The
bimonthly MCN was selected as the second core title
for analysis. Published since 1976, it was and remains
the only professional nursing journal aimed at both
perinatal and pediatric nurses [30]. While the specialty
of pediatric nursing is distinctly separate, the journal
has a cross-disciplinary focus and emphasizes the neonatal period. The quarterly JPNN, published since
1987, was selected as the third source title for analysis.
While each issue covers a single topic in critical care,
obstetrics, neonatal intensive care, intervention outcomes, home care, professional development, or stateof-the-art technological advances, the author predicted
that a three-year analysis of citations would provide a
cross-section of topics [31].
All of the source journals contained a mix of both
practice and research articles. For the years 1998 to
2000, JOGNN contained approximately 40% research,
MCN approximately 24%, and JPNN approximately
11% [32]. These figures are increasing as the editors
J Med Libr Assoc 94(2) Supplement 2006

Mapping the literature of maternal-child/gynecologic nursing

Table 1
Cited format types by source journal and frequency of citations
No. citations in
source journals

Table 3
Distribution by zone of cited journals and references

Citations

Cited format type

JPNN

JOGNN

MCN

Total

Frequency
%

Journal articles
Books
Government documents
Miscellaneous
Total

1,803
323
12
75
2,213

4,415
1,255
128
214
6,012

1,296
422
53
140
1,911

7,514
2,000
193
429
10,136

74.1%
19.7%
1.9%
4.2%
100.0%

Cited journal references

Cited journals

JPNN 5 Journal of Perinatal and Neonatal Nursing.

JOGNN 5 Journal of Obstetric, Gynecologic and Neonatal Nursing.
MCN 5 American Journal of Maternal Child Nursing.

Zone

No.

No.

Zone 1
Zone 2
Zone 3
Total

14
100
1,194
1,308

1.1%
7.6%
91.3%
100.0%

2,494
2,513
2,507
7,514

33.2%
33.4%
33.4%
100.0%

Cumulative
total
2,494
5,007
7,514

or fewer years old. For the 3-year period analyzed,

1996 to 1998, citations from the years 1990 to 1995 (1
to 8 years old) were the most heavily cited (54.1% of
the total), regardless of the format type. Citations from
1980 to 1989 (6 to 18 years old) were consistently second in terms of percentage of citations and accounted
for another 28.8% of the cited references. Literature
more than 15 years old was rarely cited.
The total of 7,514 cited journal references in 1,308
titles were arranged in descending order by title and
divided into 3 approximately equal zones to apply
Bradfords Law of Scattering. The zones were adjusted
slightly to keep citations from journal titles being split
between zones. Table 3 displays the distribution of the
titles by zone. Zone 1, containing 2,494 citations, was
dispersed over 14 journal titles, which represented just
1.1% of the total number of titles. Zone 2, with 2,513
citations, was more widely dispersed over 100 titles
(7.6% of the total number of titles). Zone 3, with 2,507
citations was dispersed over the remaining 1,194 titles
(91.3% of the total number of titles). Table 4 displays
the cited journal titles in Zones 1 and 2 and the distribution arranged in descending order of frequency.
(Titles in Zone 3 are not displayed but are available
from the author by request.) The top-ranked 67% of
the citations were concentrated in just 8.7% of the journal titles (114 titles).
Database coverage for the core titles identified in
Zone 1 and Zone 2 was determined using the common
methodology described in the project overview article
[1], assigning a relative score to each title based on the
percentage of articles indexed in a bibliographic database for the year 1998. PubMed/MEDLINE provided

set goals to increase research content in these titles

[33]. For the years 2001 to 2003, JOGNN contained approximately 44% research, MCN approximately 29%,
and JPNN approximately 23% [34]. In 2002, all 3
source journals were listed in the Brandon/Hill list of
recommended nursing titles, with JOGNN and MCN
starred for initial purchase [35].
It is clear that a separate specialty exists for nursing
in neonatal intensive care units. Neonatal Network: The
Journal of Neonatal Nursing was not selected for this
study because of its stated focus on clinical issues relevant to level II and III neonatal intensive care units.
Birth: Issues in Perinatal Care was not selected because
its focus is more interdisciplinary, aiming beyond a
nursing audience to a wider group of health professionals, educators, and parents [36]. Citation data for
Birth is covered in ISIs Social Sciences Citation Index.
RESULTS
As shown in Table 1, 2,213 citations from articles in
JPNN, 6,012 citations from articles in JOGNN, and
1,911 citations from articles in MCN were tabulated,
for a total of 10,136 citations. Journals were the most
frequently cited format, accounting for 74.1% of the
total number of citations. Book citations constituted
19.7% of the total, leaving just 4.2% of the citations as
miscellaneous and 1.9% as government documents.
Table 2 shows the age of citations by format types.
Nearly 10% of the total citations in all formats were 3

Table 2
Cited format types by publication year periods
Publication
year
19961998*
19901995
19801989
19701979
19601969
Pre-1960
Not available

Government documents

Books

Journal articles

No.

No.

No.

200
1,004
575
137
47
31
6
2,000

10.0%
50.2%
28.8%
6.9%
2.4%
1.6%
0.3%
100.0%

17
128
38
6
1
1
2
193

8.8%
66.3%
19.7%
3.1%
0.5%
0.5%
1.0%
100.0%

686
4,127
2,218
322
97
61
3
7,514

%
9.1%
54.9%
29.5%
4.3%
1.3%
0.8%
, 0.1%
100.0%

Miscellaneous

Total citations

No.

No.

84
226
90
13
1
2
13
429

19.6%
52.7%
21.0%
3.0%
0.2%
0.5%
3.0%
100.0%

987
5,485
2,921
478
146
95
24
10,136

9.7%
54.1%
28.8%
4.7%
1.4%
0.9%
0.2%
100.0%

* Includes in press materials.

J Med Libr Assoc 94(2) Supplement 2006

E-59

Jacobs

Table 4
Distribution and database coverage of cited journals in Zones 1 and 2
Bibliographic databases

Cited journal
Zone 1
1. Am J Obstet Gynecol
2. Obstet Gynecol
3. J Obstet Gynecol Neonatal Nurs
4. Pediatrics
5. Nurs Res
6. JAMA
7. Birth
8. N Engl J Med
9. J Pediatr
10. Neonatal Netw
11. MCN Am J Matern Child Nurs
12. Am J Public Health
13. J Perinat Neonat Nurs
14. Lancet
Zone 1 average database coverage
Zone 2
15. J Midwifery Womens Health; formerly, J Nurse Midwifery
16. Res Nurs Health
17. BJOG; formerly, Br J Obstet Gynaecol
18. J Spec Pediatr Nurs 2002; continues J Soc Pediatr Nurs, formerly
Matern Child Nurs J
19. J Nurs Scholars; formerly, Image: J
Nurs Sch
20. Clin Perinatol
21. MMWR Morb Mortal Wkly Rep
22. Semin Perinatol
23. Arch Pediatri Adolesc Med; formerly, Am J Dis Child
24. Child Dev
25. Am J Nurs
26. J Adv Nurs
27. AWHONNS Clin Issues Perinat
Womens Health Nurs; absorbed in
1994 by JOGNN
28. BMJ
29. Arch Dis Child
30. Pediatr Res
31. Clin Obstet Gynecol
32. Am J Perinatol
33. ANS Adv Nurs Sci (quarterly)
34. Anesthesiology
35. Pediatr Nurs
36. Fertil Steril
37. Health Care Women Int
38. Nurse Pract
39. Acta Paediatr (includes supplements)
40. Nurs Clin North Am
41. West J Nurs Res
42. Perspect Sex Reprod Health; formerly, Family Planning Perspectives
43. Pediatr Clin North Am
44. J Hum Lact
45. J Pediatr Nurs
46. J Perinatol
47. Heart Lung
48. J Pediatr Surg
49. ACOG Educational Bull; formerly,
ACOG Tech Bull
50. Am J Orthopsychiatry
51. Contraception
52. Infant Behav Dev
53. J Reprod Med
54. Nurs Times
55. Obstet Gynecol Surv
56. Contemp Rev Ob Gyn
57. J Adolesc Health
58. J Am Acad Child Adolesc Psychiatry
59. Soc Sci Med

E-60

CINAHL

PubMed

EBSCO
NAH
Comp.

0
0
5
1
4
1
3
1
1
5
5
4
4
1
2.50

4
4
5
2
4
3
3
4
4
3
4
4
3
3
3.57

3
0
0
2
0
3
0
2
0
0
0
4
0
3
1.21

4
5
0
2
0
3
0
3
5
0
0
4
0
3
2.07

3
0
0
2
0
5
0
3
0
0
0
4
4
2
1.64

83

72
65

5
0

4
4

0
0

59

56

53
52
51
50

Total
citations

SCI

SSCI

OCLC
ArticleFirst

0
0
0
0
3
1
0
1
0
0
0
1
0
0
0.43

5
5
0
5
5
4
5
5
4
0
0
5
0
5
3.43

1
1
0
1
4
1
5
1
1
0
0
5
5
1
1.86

X
X
X
X
X
X
X
X
X
X
X
X
X
X
100%

0
4

0
0

3
0

5
5

5
1

X
X

1
3
0
1

4
3
4
4

0
5
0
0

0
0
5
4

0
3
0
4

0
0
0
0

5
0
5
5

0
0
1
1

X
X
X
X

49
47
45
44

0
5
2
NA

4
3
2
NA

0
4
3
NA

0
0
0
NA

0
3
0
NA

5
0
0
NA

0
0
0
NA

5
4
5
NA

43
42
42
40
39
37
36
36
34
34
34
32

0
0
0
0
0
5
0
5
0
5
5
0

4
3
5
4
5
4
2
4
4
4
4
5

3
0
0
0
0
0
0
0
0
5
0
0

2
4
4
4
4
0
2
0
4
0
0
5

2
0
0
0
0
4
0
4
0
0
5
0

0
0
0
0
0
3
0
0
0
3
0
0

5
5
5
5
4
0
5
0
5
0
0
5

1
1
0
1
0
5
1
0
1
0
0
1

X
X
X
X
X
X
X
X
X
X
X
X

31
29
28

5
3
2

4
3
1

0
3
5

0
0
3

0
3
1

0
3
0

0
0
0

5
5
4

X
X
X

28
25
25
25
24
24
23

1
4
5
0
5
0
0

4
5
5
5
5
4
0

0
0
0
0
0
0
0

4
0
0
0
0
4
0

0
0
0
0
0
0
0

0
0
0
0
0
0
0

5
0
0
0
5
5
0

2
0
0
0
1
1
0

X
X
X
X
X
X

23
23
23
23
23
23
22
22
22
22

0
0
0
0
5
0
0
3
0
2

4
4
0
4
4
3
0
3
3
3

0
0
0
0
0
0
0
0
0
0

3
4
0
4
0
5
5
2
3
3

1
0
0
0
3
0
0
0
1
1

4
0
5
0
0
0
0
2
3
2

5
5
0
5
0
0
0
5
5
0

5
1
5
1
0
0
0
5
5
5

X
X
X
X

379
312
306
238
186
167
157
144
114
109
105
97
94
86

Health
EMBASE Ref. Center PsycINFO

X
X
X
NA

X
X
X
X

J Med Libr Assoc 94(2) Supplement 2006

Mapping the literature of maternal-child/gynecologic nursing

Table 4
Continued
Bibliographic databases

Cited journal

Total
citations

60.
61.
62.
63.
64.
65.
66.
67.
68.

CMAJ: Can Med Assoc J

Infant Ment Health J
J Infect Dis
Nurs Outlook
Pain
Public Health Rep
Ann NY Acad Sci
J Fam Pract
Acta Obstet Gynecol Scand (includes supplements)
69. Am J Clin Nutr
70. Am J Epidemiol
71. Anesth Analg
72. Clin Nurse Spec
73. Dev Med Child Neurol
74. Med Clin North Am
75. Am Fam Physician
76. Child Abuse Negl
77. Int J Gynaecol Obstet
78. J Am Diet Assoc
79. Pediatr Infect Dis J
80. Am J Psychiatry
81. Ann Intern Med
82. Early Hum Dev
83. J Clin Endocrinol Metab
84. Science
85. Anaesthesia
86. Eur J Obstet Gynecol Reprod Biol
87. Issues Compr Pediatr Nurs
88. J Nurs Adm
89. Nurs Manage
90. Public Health Nurs
91. Zero to Three
92. Arch Intern Med
93. Clin Pediatr
94. J Holist Nurs
95. Oncol Nurs Forum
96. Transplantation
97. Am J Respir Crit Care Med
98. Cancer
99. Cancer Nurs
100. Dev Psychol
101. J Marriage Fam
102. J Prof Nurs
103. Midwifery
104. Subst Use Misuse; formerly, Int J
Addict
105. Circulation
106. Int J Obes Relat Metab Disord
107. J Consult Clin Psychol
108. J Natl Cancer Inst
109. J Psychosom Res
110. Women Health
111. Appl Nurs Res
112. Can Nurse
113. J Perinat Educ
114. Obstet Gynecol Clin North Am
Zone 2 average database coverage
Average Zones 1 and 2

CINAHL

PubMed

EBSCO
NAH
Comp.

Health
EMBASE Ref. Center PsycINFO

SCI

SSCI

OCLC
ArticleFirst

21
21
21
21
21
21
19
19
18

1
0
1
5
1
3
0
0
0

3
0
5
3
5
4
0
5
5

3
0
0
0
0
4
0
0
0

2
0
5
0
5
2
5
2
4

0
0
0
0
0
3
0
4
0

0
3
0
0
3
0
0
1
0

5
0
5
0
5
5
0
4
5

1
5
0
4
1
5
0
1
1

X
X
X
X
X
X
X
X
X

18
18
18
18
18
18
17
17
17
17
17
16
16
16
16
16
15
15
15
15
15
15
15
14
14
14
14
14
13
13
13
13
13
13
13
13

2
1
0
5
1
1
1
0
0
4
0
0
1
0
0
0
0
0
4
4
5
5
0
1
0
5
5
0
0
0
5
0
0
5
3
0

4
2
2
4
5
5
2
4
5
3
5
3
4
3
4
3
4
5
5
4
4
5
0
4
4
3
4
5
5
4
5
4
0
4
3
4

0
0
0
0
0
0
5
0
0
0
0
0
3
0
0
0
5
0
0
0
4
5
0
0
5
0
0
0
0
0
0
0
0
0
0
0

3
2
2
0
5
5
2
4
0
3
4
3
4
5
5
5
0
5
0
4
0
0
0
4
4
0
0
5
5
5
5
0
0
0
0
5

3
1
0
0
0
0
3
1
0
3
0
3
3
0
0
0
0
0
0
0
3
0
0
3
4
0
0
0
0
4
0
4
0
0
0
0

0
0
0
0
2
0
0
3
0
0
0
3
0
1
0
1
0
0
3
0
0
3
0
0
1
0
0
0
0
0
0
5
3
0
0
3

5
5
5
0
5
3
2
0
5
5
4
5
5
3
5
5
4
5
0
0
0
0
0
5
4
0
0
5
5
4
5
0
0
0
0
5

1
1
0
0
1
1
1
5
1
1
0
5
1
1
1
1
0
1
0
5
0
5
0
1
1
0
0
0
1
1
5
5
5
5
5
5

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

12
12
12
12
12
12
11
11
11
11

0
0
0
1
0
5
5
5
5
1
1.78
1.85

1
5
5
4
4
4
4
4
0
4
3.59
3.55

0
0
0
5
0
4
0
0
0
0
0.72
0.77

2
0
5
3
4
5
0
0
0
4
2.26
2.22

0
0
1
3
0
4
0
0
0
0
0.94
1.02

0
0
5
0
4
4
0
0
0
0
0.85
0.79

5
5
0
5
5
0
0
0
0
5
2.65
2.72

0
1
5
1
5
5
5
0
0
1
1.92
1.89

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
93%

Based on database coverage score: 5 (95%100%); 4 (75%94%); 3 (50%74%); 2 (25%49%); 1 (1%24%); 0 (,1%).
EBSCO NAH Comp. 5 EBSCO Nursing & Allied Health Comprehensive Edition.
SCI 5 Science Citation Index.
SSCI 5 Social Sciences Citation Index.

the best overall coverage of titles in Zone 1 for maternal-child/gynecologic nursing, followed by Science Citation Index and CINAHL, respectively (Table 4). In
Zone 2, PubMed/MEDLINE, Science Citation Index,
and EMBASE ranked higher than CINAHL and Social
J Med Libr Assoc 94(2) Supplement 2006

Sciences Citation Index. The combined average scores

for both Zones 1 and 2 ranked the biomedical databases PubMed/MEDLINE, Science Citation Index, and
EMBASE above CINAHL and Social Sciences Citation
Index.
E-61

Jacobs

DISCUSSION
The results demonstrate the expected phenomenon described by Bradford: a small core of journals is highly
productive (Table 4). As expected, journal article
was the most frequently cited format. All three of the
original source journals (JOGNN, MCN, and Journal of
Perinatal & Neonatal Nursing) are found in Zone 1,
along with two other nursing journals (Nursing Research and Neonatal Network), seven medical journals,
and two titles aimed at a more diverse audience (Birth
and American Journal of Public Health).
Seven of the fourteen titles in Zone 1 were also present in Zone 1 of the projects Phase I study of nursemidwifery (Obstetrics and Gynecology, American Journal
of Obstetrics and Gynecology, New England Journal of Medicine, JAMA, Lancet, American Journal of Public Health,
and Birth). Journal of Midwifery and Womens Health (formerly, Journal of Nurse Midwifery) narrowly missed
ranking in Zone 1. The nurse-midwifery mapping
study ranked Journal of Midwifery and Womens Health at
the top of Zone 1 [11].
In Zone 2 (Table 4), nursing and medical journals
have floated to the top of the zone, with titles in the
behavioral sciences occurring more frequently in lower
ranks. Child Development, ranked at number twentyfour, was the first behavioral science title to surface,
followed by Infant Behavior and Development, tied with
other titles at number forty-nine. Other titles such as
Social Science and Medicine and Infant Mental Health Journal ranked nearby.
Table 4 displays the relative score assigned for database coverage of journals. Given the preponderance
of medical journals identified as core for maternalchild/gynecologic nursing in Zone 1, it was not surprising that PubMed/MEDLINE and Science Citation
Index emerged as more comprehensive bibliographic
database sources than CINAHL. While 100% of the
Zone 1 titles were indexed in OCLC ArticleFirst, the
data were found to be unreliable due to the way meeting abstracts were counted. In CINAHL, all meeting
abstracts in a journal issue were indexed as a whole
(one record), rather than separately, leading to individual title index coverage scores similar to those for
PubMed/MEDLINE. Similarly, Science Citation Index
and Social Sciences Citation Index provided separate
coverage of meeting abstracts and book reviews,
which acted to increase the scores for these databases.
Therefore, scores for indexing coverageeven for a
nursing journal such as Nursing Researchwere higher
when a database was not as selective when determining
article formats to index.
The journals identified as core for this nursing specialty point out that the literature of maternal-child/
gynecologic nursing, while known to draw from many
disciplines, cites frequently from medical journals. As
a specialty that supports the medical model of obstetrics and gynecologyfocused on the pathologic aspects of pregnancy, birth, and the neonatal period
this is not surprising. It has been noted that the exE-62

perience of normalcy in womens health is not well

examined or documented [16].
Given the strong presence of medical journals in
Zone 1, it follows that, for the thesaural databases,
PubMed/MEDLINE provides more comprehensive
coverage than CINAHL. The social sciences databases
rank lower as sources for this specialty. Yet, while
PubMed/MEDLINE and Science Citation Index rank
higher in terms of articles indexed, the journal titles
and associated databases do not tell the whole story.
Topics in this nursing specialty draw from psychosocial as well as biologic research. At the article level,
perusing the table of contents of any of the source journals reveals an abundance of interdisciplinary topics,
such as Gynecologic Care for Women with Mental
Retardation or Behavioral Characteristics of Very
Low Birth Weight Infants of Varying Biologic Risk at
6, 15, and 24 Months of Age. A searcher should always use more than one database to ensure coverage
of psychosocial aspects of a nursing topic. A combined
approach to database searching using both CINAHL
and PubMed/MEDLINE is recommended, given that
Science Citation Index and OCLC ArticleFirst are not
based on controlled vocabularies. Databases with an
underlying hierarchical thesaurus of terms provide
searchers with the necessary link to relevant research.
When a topic involves the psychosocial aspects of
nursing practice, PsycINFO and Social Sciences Citation Index might prove more valuable for locating research.
CONCLUSION
This study provides a snapshot of the literature for a
three-year period (1996 to 1998) by analyzing the presence of citations, applying Bradfords Law of Scattering to identify a core of those journal titles most frequently cited, and identifying the bibliographic databases that access those titles. The quantitative picture
indicates a remarkably high concentration of the literature in biomedical journals, accessible via biomedical databases. But scholars searching the literature on
a topic in maternal-child/gynecologic nursing will
want to access the bio-psychosocial, economic, and
policy aspects tangential to an information need, mandating that a search strategy should go beyond biomedical databases. A search on a behavioral aspect of
maternal-child/gynecologic nursing could find biomedical databases of little use, with strong coverage
of the literature provided by sources such as CINAHL
and Social Sciences Citation Index. Further study is
needed to examine how authors use the literature they
cite and what other methods of scholarly communication they use in the current, increasingly electronic,
environment.
The beginning of the twenty-first century has seen
dramatic changes in the areas of medical and information technology, educational programs preparing
nurses for advanced practice, research in psychosocial
areas, qualitative research, and funding for nursing research [37]. The results of this study suggest other
J Med Libr Assoc 94(2) Supplement 2006

Mapping the literature of maternal-child/gynecologic nursing

nursing specialty areas for mapping using the same

methodology. Womens health has been only recently
viewed more holistically and should be mapped as a
separate emerging specialty for nurses. Pediatric nursing has been mapped as a specialty in Phase III of this
study [38]; neonatal intensive care nursing should be
mapped separately as well.
ACKNOWLEDGMENTS
Special thanks to the intrepid Margaret (Peg) Allen,
AHIP, for her generosity and leadership as task force
cochair and for coordinating the data collation for Table 4. Task force members Melody Allison, Kristine
Alpi, AHIP, Allen, Carol Galganski, AHIP, and Martha
(Molly) Harris, AHIP, searched databases and provided consistent data for Table 4. Reviewers Priscilla Stephenson, AHIP, Alpi, and Linda Mayberry provided
valuable criticism. Dorice Vieira and Jennifer Schwartz
at New York University provided expertise in designing and using an Access database. Ginny Chaskey and
Cinahl Information Systems supplied cited references
in electronic form for MCN: American Journal of Maternal/Child Nursing.
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Received May 2005; accepted December 2005

J Med Libr Assoc 94(2) Supplement 2006