Meta approaches in knowledge synthesis in nursing: A bibliometric analysis

  • Peter Kokol
    Corresponding author: Peter Kokol, Faculty of Electrical Engineering and Computer Science, University of Maribor, Žitna ulica 15, Maribor 2000, Slovenia
    Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
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      • Meta-analysis, Meta Synthesis and Meta Ethnography are most frequently used meta-approaches in nursing.
      • The percentage of funded papers and consequently studies employing meta-approaches is larger than in the overall nursing research.
      • Global collaboration dynamics should be intensified to optimize resources in tackling general health care crises and prevent regional concentration of the literature production.



      To analyze the bibliometric patterns of meta-approaches use in nursing research literature.


      Descriptive, exploratory and historical bibliometrics analyses were used. The papers were harvested from the Web of Science Core Collection.


      The search resulted in 2065 publications. The trends in using most individual meta approaches show that the use of meta-analysis is increasing exponentially, the use of meta-synthesis is increasing linearly, while the use of meta-ethnography is constant in last 6 years. Most productive countries were United States of America, United Kingdom and Peoples Republic of China. Most publications were published in the Journal of Advanced Nursing, International Journal of Nursing Studies, and Journal of Clinical Nursing. Twenty-seven percent of all publications were funded. Thirty-four meta approaches were identified.


      The study revealed that the trend in the literature production is positive. Research community use of meta-approaches in nursing exhibit considerable growth. Regional concentration of literature production was observed.


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        • Adams J.
        • Gurney K.A.
        Bilateral and multilateral coauthorship and citation impact: Patterns in UK and US International Collaboration.
        Frontiers in Research Metrics and Analytics. 2018; 3
        • Ball R.
        Chapter 3—bibliometric methods: Basic principles and indicators.
        in: Ball R. An Introduction to Bibliometrics. Chandos Publishing, 2018: 15-56
        • Barton C.J.
        • Merolli M.A.
        It is time to replace publish or perish with get visible or vanish: Opportunities where digital and social media can reshape knowledge translation.
        British Journal of Sports Medicine. 2019; 53: 594-598
        • Begum M.
        • Lewison G.
        • Lewison G.
        • Lewison G.
        Web of science research funding information: Methodology for its use in analysis and evaluation.
        Journal of Scientometric Research. 2017; 6: 65-73
      1. Blažun Vošner, H., Carter-Templeton, H., Završnik, J., & Kokol, P. (2020). Nursing informatics: A historical bibliometric analysis. CIN: Computers, Informatics, Nursing, Publish ahead of print.

        • Bovbjerg M.L.
        Current resources for evidence-based practice.
        Journal of Obstetric Gynecologic and Neonatal Nursing. 2020; 49: 116-124
        • Brook J.
        • Aitken L.
        • Webb R.
        • MacLaren J.
        • Salmon D.
        Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: A systematic review.
        International Journal of Nursing Studies. 2019; 91: 47-59
        • Carney K.B.
        • Guite J.W.
        • Young E.E.
        • Starkweather A.R.
        Forced enlightenment: A metasynthesis of experiences during childhood cancer survivorship.
        Cancer Nursing. 2020; 43: E159-E171
        • Chalmers I.
        • Hedges L.V.
        • Cooper H.
        A brief history of research synthesis.
        Evaluation & the Health Professions. 2002; 25: 12-37
        • Chang W.P.
        • Peng Y.X.
        Does the oral administration of ginger reduce chemotherapy-induced nausea and vomiting? A meta-analysis of 10 randomized controlled trials.
        Cancer Nursing. 2019; 42: E14-E23
        • Chen H.-M.
        • Tu Y.-H.
        • Chen C.-M.
        Effect of continuity of care on quality of life in older adults with chronic diseases: A meta-analysis.
        Clinical Nursing Research. 2017; 26: 266-284
        • Cheng L.
        • Feng S.
        • Hu Y.
        Evidence-based nursing implementation in mainland China: A scoping review.
        Nursing Outlook. 2017; 65: 27-35
        • Cheng L.J.
        • Wang W.
        • Lim S.T.
        • Wu V.X.
        Factors associated with glycaemic control in patients with diabetes mellitus: A systematic literature review.
        Journal of Clinical Nursing. 2019; 28: 1433-1450
        • Corcoran P.M.
        • Catling C.
        • Homer C.S.E
        Models of midwifery care for Indigenous women and babies: A meta-synthesis.
        Women and Birth. 2017; 30: 77-86
        • de Camargo O.P.
        The Growth in scientific production.
        Acta Ortopedica Brasileira. 2020; 28: 211
        • DerSimonian R.
        • Laird N.
        Meta-analysis in clinical trials.
        Controlled Clinical Trials. 1986; 7: 177-188
        • Drevdahl D.
        • Taylor J.Y.
        • Phillips D.A.
        Race and ethnicity as variables in nursing research, 1952-2000.
        Nursing Research. 2001; 50 (Scopus): 305-313
        • Du M.-C.
        • Ouyang Y.-Q.
        • Nie X.-F.
        • Huang Y.
        • Redding S.R.
        Effects of physical exercise during pregnancy on maternal and infant outcomes in overweight and obese pregnant women: A meta-analysis.
        Birth-Issues in Perinatal Care. 2019; 46: 211-221
        • Durkin J.
        • Usher K.
        • Jackson D.
        Embodying compassion: A systematic review of the views of nurses and patients.
        Journal of Clinical Nursing. 2019; 28: 1380-1392
        • Elmore J.
        • Wright D.K.
        • Paradis M.
        Nurses’ moral experiences of assisted death: A meta-synthesis of qualitative research.
        Nursing Ethics. 2018; 25: 955-972
        • Facchinetti G.
        • D'Angelo D.
        • Piredda M.
        • Petitti T.
        • Matarese M.
        • Oliveti A.
        • De Marinis M.G
        Continuity of care interventions for preventing hospital readmission of older people with chronic diseases: A meta-analysis.
        International Journal of Nursing Studies. 2020; 101 (UNSP 103396)
        • Fan G.
        • Zhou Z.
        • Zhang H.
        • Gu X.
        • Gu G.
        • Guan X.
        • Fan Y.
        • He S.
        Global scientific production of robotic surgery in medicine: A 20-year survey of research activities.
        International Journal of Surgery. 2016; 30 (Scopus): 126-131
        • Fang M.L.
        • Sixsmith J.
        • Sinclair S.
        • Horst G.
        A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: Findings from a scoping review.
        BMC Geriatrics. 2016; 16: 107
        • Fang S.-C.
        • Wu Y.-L.
        • Tsai P.-S.
        Heart rate variability and risk of all-cause death and cardiovascular events in patients with cardiovascular disease: A meta-analysis of cohort studies.
        Biological Research for Nursing. 2020; 22: 45-56
        • Fowdar K.
        • Chen H.
        • He Z.
        • Zhang J.
        • Zhong X.
        • Zhang J.
        • Li M.
        • Bai J.
        The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: A meta-analysis and systematic review.
        Heart & Lung. 2017; 46: 120-128
        • Hebert C.
        Evidence-based practice in perianesthesia nursing: Application of the American Geriatrics Society Clinical Practice Guideline for postoperative delirium in older adults.
        Journal of Perianesthesia Nursing. 2018; 33: 253-264
        • Hermosilla-Avila A.
        • Sanhueza-Alvarado O.
        The experience of cancer patients and nursing care.
        Revista Cuidarte. 2020; 11: e782
        • Herubel J.
        Historical bibliometrics: Its purpose and significance to the history of disciplines.
        Libraries & Culture. 1999; 34: 380-388
        • Higgins J.P.T.
        • Altman D.G.
        • Gøtzsche P.C.
        • Jüni P.
        • Moher D.
        • Oxman A.D.
        • Cochrane Bias Methods Group, & Cochrane Statistical Methods Group
        The Cochrane Collaboration's tool for assessing risk of bias in randomised trials.
        BMJ (Clinical Research Ed.). 2011; 343: d5928
        • Houghton C.
        • Murphy K.
        • Brooker D.
        • Casey D.
        Healthcare staffs’ experiences and perceptions of caring for people with dementia in the acute setting: Qualitative evidence synthesis.
        International Journal of Nursing Studies. 2016; 61: 104-116
        • Jin K.
        • Khonsari S.
        • Gallagher R.
        • Gallagher P.
        • Clark A.M.
        • Freedman B.
        • Neubeck L.
        Telehealth interventions for the secondary prevention of coronary heart disease: A systematic review and meta-analysis.
        European Journal of Cardiovascular Nursing. 2019; 18: 260-271
        • Kokol P.
        • Blažun Vošner H.
        Discrepancies among Scopus, Web of Science, and PubMed coverage of funding information in medical journal articles.
        Journal of the Medical Library Association: JMLA. 2018; 106: 81-86
        • Kokol P.
        • Blažun Vošner H.
        Historical, descriptive and exploratory analysis of application of bibliometrics in nursing research.
        Nursing Outlook. 2019; 67: 680-695
        • Kokol P.
        • Blažun Vošner H.
        • Završnik J.
        Application of bibliometrics in medicine: A historical bibliometrics analysis.
        Health Information and Libraries Journal. 2020;
        • Kokol P.
        • Završnik J.
        • Blažun Vošner H.
        Bibliographic-based identification of hot future research topics: An opportunity for hospital librarianship.
        Journal of Hospital Librarianship. 2018; 0: 1-8
        • Kokol P.
        • Železnik D.
        • Završnik J.
        • Blažun Vošner H.
        Nursing research literature production in terms of the scope of country and health determinants: A bibliometric study.
        Journal of Nursing Scholarship. 2019; 51: 590-598
      2. Kuhn, T. S. (1962). The structure of scientific revolutions. Retrieved from:

        • Kyngäs H.
        Qualitative research and content analysis.
        in: Kyngäs H. Mikkonen K. Kääriäinen M. The application of content analysis in nursing science research. Springer International Publishing, 2020: 3-11
        • Lee S.E.
        • Quinn B.L.
        Safety culture and patient safety outcomes in East Asia: A literature review.
        Western Journal of Nursing Research. 2020; 42: 220-230
        • Leeman J.
        • Crandell J.L.
        • Lee A.
        • Bai J.
        • Sandelowski M.
        • Knafl K.
        Family functioning and the well-being of children with chronic conditions: A meta-analysis.
        Research in Nursing & Health. 2016; 39: 229-243
        • Leung L.
        Validity, reliability, and generalizability in qualitative research.
        Journal of Family Medicine and Primary Care. 2015; 4: 324
        • Levett-Jones T.
        • Cant R.
        • Lapkin S.
        A systematic review of the effectiveness of empathy education for undergraduate nursing students.
        Nurse Education Today. 2019; 75: 80-94
        • Liao G.
        • Zheng K.
        • Lalu M.M.
        • Fergusson D.A.
        • Allan D.S.
        A scoping review of registered clinical trials of cellular therapy for COVID-19 and a Framework for Accelerated Synthesis of Trial Evidence—FAST evidence.
        Transfusion Medicine Reviews. 2020; 34: 165-171
        • Lin K.J.
        • Lengacher C.A.
        Anthracycline chemotherapy-induced cardiotoxicity in breast cancer survivors: A systematic review.
        Oncology Nursing Forum. 2019; 46: E145-E158
        • Lin M.-Y.
        • Liu M.F.
        • Hsu L.-F.
        • Tsai P.-S.
        Effects of self-management on chronic kidney disease: A meta-analysis.
        International Journal of Nursing Studies. 2017; 74: 128-137
        • MacEntee M.I.
        A typology of systematic reviews for synthesising evidence on health care.
        Gerodontology. 2019; 36: 303-312
        • Magistretti C.M.
        • Downe S.
        • Lindstrom B.
        • Berg M.
        • Schwarz K.T.
        Setting the stage for health: Salutogenesis in midwifery professional knowledge in three European countries.
        International Journal of Qualitative Studies on Health and Well-Being. 2016; 11: 33155
        • Mansell R.
        • Purssell E.
        Treatment abandonment in children with cancer in Sub-Saharan Africa: Systematic literature review and meta-analysis.
        Journal of Advanced Nursing. 2018; 74: 800-808
        • Marx W.
        • Bornmann L.
        • Barth A.
        • Leydesdorff L.
        Detecting the historical roots of research fields by reference publication year spectroscopy (RPYS).
        Journal of the Association for Information Science and Technology. 2014; 65: 751-764
        • Mbuzi V.
        • Fulbrook P.
        • Jessup M.
        Indigenous peoples’ experiences and perceptions of hospitalisation for acute care: A metasynthesis of qualitative studies.
        International Journal of Nursing Studies. 2017; 71: 39-49
        • Michelson M.
        • Chow T.
        • Martin N.A.
        • Ross M.
        • Tee Qiao Ying A.
        • Minton S.
        Artificial intelligence for rapid meta-analysis: Case study on ocular toxicity of hydroxychloroquine.
        Journal of Medical Internet Research. 2020; 22
        • Mishra S.I.
        • Scherer R.W.
        • Snyder C.
        • Geigle P.
        • Gotay C.
        Are exercise programs effective for improving health-related quality of life among cancer survivors? A systematic review and meta-analysis.
        Oncology Nursing Forum. 2014; 41: E326-E342
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        • Group T.P.
        Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.
        PLOS Medicine. 2009; 6e1000097
        • Moretti F.
        Distant reading.
        Verso, 2013
        • Munn Z.
        • Stern C.
        • Aromataris E.
        • Lockwood C.
        • Jordan Z.
        What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences.
        BMC Medical Research Methodology. 2018; 18: 5
        • Nightingale F.
        Notes on nursing: What it is, and what it is not. 1859. Harrison, 1859
        • Noblit G.W.
        • Hare R.D.
        Meta-ethnography: Synthesizing qualitative studies.
        SAGE, 1988
        • Perrier L.
        • Lightfoot D.
        • Kealey M.R.
        • Straus S.E.
        • Tricco A.C.
        Knowledge synthesis research: A bibliometric analysis.
        Journal of Clinical Epidemiology. 2016; 73 (Scopus): 50-57
        • Perriman N.
        • Davis D.L.
        • Ferguson S.
        What women value in the midwifery continuity of care model: A systematic review with meta-synthesis.
        Midwifery. 2018; 62: 220-229
        • Phillips C.S.
        • Becker H.
        Systematic review: Expressive arts interventions to address psychosocial stress in healthcare workers.
        Journal of Advanced Nursing. 2019; 75: 2285-2298
        • Pilkington P.
        • Rominov H.
        • Brown H.K.
        • Dennis C.-L.
        Systematic review of the impact of coparenting interventions on paternal coparenting behaviour.
        Journal of Advanced Nursing. 2019; 75: 17-29
        • Robinson-Garcia N.
        • Woolley R.
        • Costas R.
        Making sense of global collaboration dynamics: Developing a methodological framework to study (dis)similarities between country disciplinary profiles and choice of collaboration partners.
        ArXiv:1909.04450 [Cs]. 2019;
        • Rogers Van Katwyk S.
        • Hoffman S.J.
        • Mendelson M.
        • Taljaard M.
        • Grimshaw J.M.
        Strengthening the science of addressing antimicrobial resistance: A framework for planning, conducting and disseminating antimicrobial resistance intervention research.
        Health Research Policy and Systems. 2020; 18: 60
        • Savoy S.M.
        • Penckofer S.
        Depressive symptoms impact health-promoting lifestyle behaviors and quality of life in healthy women.
        Journal of Cardiovascular Nursing. 2015; 30: 360-372
        • Sedlar N.
        • Lainscak M.
        • Martensson J.
        • Stromberg A.
        • Jaarsma T.
        • Farkas J.
        Factors related to self-care behaviours in heart failure: A systematic review of European Heart Failure Self-Care Behaviour Scale studies.
        European Journal of Cardiovascular Nursing. 2017; 16: 272-282
        • Sinclair P.M.
        • Kable A.
        • Levett-Jones T.
        • Booth D.
        The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review.
        International Journal of Nursing Studies. 2016; 57: 70-81
        • Song D.
        • Yu D.S.F.
        • Li P.W.C.
        • Lei Y
        The effectiveness of physical exercise on cognitive and psychological outcomes in individuals with mild cognitive impairment: A systematic review and meta-analysis.
        International Journal of Nursing Studies. 2018; 79: 155-164
        • Stolley J.M.
        • Buckwalter K.C.
        • Garand L.
        The evolution of nursing research.
        Journal of the Neuromusculoskeletal System. 2000; 8: 10-15
        • Suleiman-Martos N.
        • Gomez-Urquiza J.L.
        • Aguayo-Estremera R.
        • Canadas-De La Fuente G.A.
        • De La Fuente-Solana E.I.
        • Albendin-Garcia L
        The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis.
        Journal of Advanced Nursing. 2020; 76: 1124-1140
        • Sutton A.
        • Clowes M.
        • Preston L.
        • Booth A.
        Meeting the review family: Exploring review types and associated information retrieval requirements.
        Health Information & Libraries Journal. 2019; 36: 202-222
        • Taylor-Piliae R.E.
        • Finley B.A.
        Tai Chi exercise for psychological well-being among adults with cardiovascular disease: A systematic review and meta-analysis.
        European Journal of Cardiovascular Nursing. 2020; 1474515120926068
        • Tricco A.C.
        • Tetzlaff J.
        • Moher D.
        The art and science of knowledge synthesis.
        Journal of Clinical Epidemiology. 2011; 64: 11-20
        • Tung Y.-J.
        • Lo K.K.H.
        • Ho R.C.M.
        • Tam W.S.W
        Prevalence of depression among nursing students: A systematic review and meta-analysis.
        Nurse Education Today. 2018; 63: 119-129
        • Van Aernam B.
        • Lindeman C.A.
        Nursing intervention with the presurgical patients—The effects of structured and unstructured preoperative teaching.
        Nursing Research. 1971; 20: 319-332
        • van Eck N.J.
        • Waltman L.
        Software survey: VOSviewer, a computer program for bibliometric mapping.
        Scientometrics. 2010; 84: 523-538
        • van Eck N.J.
        • Waltman L.
        • Noyons E.C.M.
        • Buter R.K
        Automatic term identification for bibliometric mapping.
        Scientometrics. 2010; 82: 581-596
        • Vongmany J.
        • Hickman L.D.
        • Lewis J.
        • Newton P.J.
        • Phillips J.L.
        Anxiety in chronic heart failure and the risk of increased hospitalisations and mortality: A systematic review.
        European Journal of Cardiovascular Nursing. 2016; 15: 478-485
        • Wang B.
        • Zhao P.
        Worldwide research productivity in the field of back pain.
        Medicine. 2018; 97
        • Whall A.L.
        • Hicks F.D.
        The unrecognized paradigm shift in nursing: Implications, problems, and possibilities.
        Nursing Outlook. 2002; 50: 72-76
        • Whittemore R.
        • Chao A.
        • Jang M.
        • Minges K.E.
        • Park C.
        Methods for knowledge synthesis: An overview.
        Heart & Lung. 2014; 43: 453-461
        • Wilken M.
        The impact of child tube feeding on maternal emotional state and identity: A qualitative meta-analysis.
        Journal of Pediatric Nursing. 2012; 27: 248-255
        • Yamaji N.
        • Suto M.
        • Takemoto Y.
        • Suzuki D.
        • Lopesda K.S.
        • Ota E.
        Supporting the decision making of children with cancer: A meta-synthesis.
        Journal of Pediatric Oncology Nursing, UNSP. 2020; 1043454220919711
        • Yanbing S.
        • Hua L.
        • Chao L.
        • Fenglan W.
        • Zhiguang D.
        The state of nursing research from 2000 to 2019: A global analysis.
        Journal of Advanced Nursing. 2021; 77: 162-175
        • Younas A.
        • Parsons K.
        Implications for paradigm shift in nursing: A critical analysis of Thomas Kuhn's revolutionary science and its relevance to nursing.
        Advances in Nursing Science. 2019; 42: 243-254
        • Zabaleta-del-Olmo E.
        • Vlacho B.
        • Jodar-Fernandez L.
        • Urpi-Fernandez A.-M.
        • Lumillo-Gutierrez I.
        • Agudo-Ugena J.
        • Violan C.
        Safety of the reuse of needles for subcutaneous insulin injection: A systematic review and meta-analysis.
        International Journal of Nursing Studies. 2016; 60: 121-132
        • Zhao F.-F.
        • Suhonen R.
        • Koskinen S.
        • Leino-Kilpi H.
        Theory-based self-management educational interventions on patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials.
        Journal of Advanced Nursing. 2017; 73: 812-833
        • Zhu R.
        • Liu M.
        • Su Y.
        • Meng X.
        • Han S.
        • Duan Z.
        A bibliometric analysis of publication of funded studies in nursing research from Web of Science, 2008–2018.
        Journal of Advanced Nursing. 2021; 77: 176-188