importance of research findings in nursing

Nursing Research

Nursing research worldwide is committed to rigorous scientific inquiry that provides a significant body of knowledge to advance nursing practice, shape health policy, and impact the health of people in all countries. The vision for nursing research is driven by the profession's mandate to society to optimize the health and well-being of populations (American Nurses Association, 2003; International Council of Nurses, 1999). Nurse researchers bring a holistic perspective to studying individuals, families, and communities involving a biobehavioral, interdisciplinary, and translational approach to science. The priorities for nursing research reflect nursing's commitment to the promotion of health and healthy lifestyles, the advancement of quality and excellence in health care, and the critical importance of basing professional nursing practice on research.

As one of the world leaders in nursing research, it is important to delineate the position of the academic leaders in the U.S. on research advancement and facilitation, as signified by the membership of the American Association of Colleges of Nursing (AACN). In order to enhance the science of the discipline and facilitate nursing research, several factors need to be understood separately and in interaction: the vision and importance of nursing research as a scientific basis for the health of the public; the scope of nursing research; the cultural environment and workforce required for cutting edge and high-impact nursing research; the importance of a research intensive environment for faculty and students; and the challenges and opportunities impacting the research mission of the discipline and profession.

Approved by AACN Membership: October 26, 1998 Revisions Approved by the Membership: March 15, 1999 and March 13, 2006

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Research in Nursing Practice

Yates, Morgan BScN, RN

Morgan Yates works as an RN in the ED of Surrey Memorial Hospital, Surrey, British Columbia, Canada. Contact author: [email protected] . The author has disclosed no potential conflicts of interest, financial or otherwise.

Bridging the gap between clinicians and the studies they depend on.

Research provides the foundation for high-quality, evidence-based nursing care. However, there isn't a direct flow of knowledge from research into practice. When I ask nurses where the “evidence” to guide the development of “evidence-based care” comes from, I get an interesting array of answers, from “researchers” to blank stares, as if there's no connection between the worlds of researchers and bedside nurses.

If research evidence informs our nursing practice, why doesn't it come from all of us? Nurses are inquisitive, think critically about their patients’ care, and want to know the best treatments for their patients—all of which makes them perfectly suited for research. Though the majority of nurses don't have the training to conduct research projects without assistance, they know how to ask questions and they know which questions need answering.

Yet research is often perceived as something undertaken by others far removed from the front lines of nursing practice. I believe that many nurses’ notions about who does or doesn't do research are rooted in our identity as nurses, which often manifests in a belief that “good” nurses are not researchers but instead have excellent clinical skills and can manage any crisis on a unit. A 2007 study by Woodward and colleagues in the Journal of Research in Nursing found that nurse clinicians engaged in research often perceive a lack of support from nurse managers and resentment from colleagues who see the research as taking them away from clinical practice.

The distinction often drawn between nursing research and clinical practice is mirrored in the inconsistent translation of research evidence into practice. Despite widespread promotion of evidence-based practice in nursing, creation of new translational research roles for nurses in major medical centers, and Medicare reimbursement policies in the United States tied to implementation of specific evidence-supported practices, studies continue to suggest much room for improvement. In a September 2014 article in this journal, Yoder and colleagues noted that researchers have consistently found that “nurses who valued research were more likely to use research findings in practice.” Such observations suggest a need for a much stronger link between nurse clinicians and the development of research into best practices. Though this has been discussed for years, I do not yet see research as having infiltrated fundamental views of what constitutes “nursing work.”

My discussions with frontline nurses and nurses involved in research have led me to ask three key questions that need addressing before we can fully integrate research into our professional identity. These are:

• How can nurses strive for high-quality research without focusing on randomized controlled trials?
• What are the barriers to and challenges of being involved in research and how can we address these?
• How can nurses at varying education levels be involved in research?

Nurses could turn many quality improvement (QI) projects into research. Research may be viewed as a continuum, with formal projects at one end and QI projects somewhere along the continuum. Though nurses may not think that QI projects would be of interest to others, with increased understanding of the research process and greater institutional support, some QI projects could easily become research projects.

More bedside nurses are likely to engage in research if

• nursing education is strengthened.
• time away from direct care is allocated for conducting research activities.
• consultant resources such as methodologists and biostatisticians are available to staff.
• institutional and organizational support of research are strengthened.

Many nurses are intimidated by research, but change is possible if we stop seeing research as someone else's job and start making it a part of who we are and what we do. This will pave the way to evidence-based practice truly becoming the norm.

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Nursing Research -Introduction, Importance, Types, and Challenges

Nursing Research -Introduction, Importance, Types of Nursing Research Designs, Challenges in Nursing Research.Steps in Conducting Nursing Research

Table of Contents

Nursing Research -Introduction

Nursing research is an essential component of the nursing profession that promotes evidence-based practice, informs clinical decision-making, and contributes to improving patient outcomes. Nursing research is a systematic process of inquiry that seeks to answer questions related to nursing practice, education, administration, and policy. In this article, we will explore the importance of nursing research, the types of research designs, and the steps involved in conducting nursing research.

Importance of Nursing Research

Nursing research is essential to improve patient care, enhance nursing practice, and advance the nursing profession. By conducting research, nurses can identify the best practices that promote patient safety, reduce healthcare costs, and improve the quality of care. Nurses can also use research findings to guide clinical decision-making and develop evidence-based nursing interventions.

Nursing research also contributes to the development of nursing science, which helps to establish the unique role of nursing in the healthcare system. It also supports the development of nursing theories, which guide nursing practice, education, and administration. Nursing research also informs health policies that impact patient care, healthcare systems, and nursing practice.

Types of Nursing Research Designs

There are several types of nursing research designs, including quantitative, qualitative, and mixed-methods research. Each design has its unique strengths and weaknesses and is appropriate for different research questions.

1. Quantitative Research

Quantitative research involves the collection of numerical data, which is analyzed using statistical methods. This type of research design is used to test hypotheses, identify cause-and-effect relationships, and measure the frequency and prevalence of phenomena. Examples of quantitative research include randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies.

2. Qualitative Research

Qualitative research involves the collection of non-numerical data, such as words, images, and behaviors. This type of research design is used to explore complex phenomena, understand the meaning and experiences of people, and develop theories. Examples of qualitative research include phenomenology, grounded theory, ethnography, and narrative inquiry.

3. Mixed-Methods Research

Mixed-methods research involves the use of both quantitative and qualitative research designs to address research questions. This type of research design is used to provide a more comprehensive understanding of phenomena, validate findings from one method with another, and enhance the generalizability of research findings.

Steps in Conducting Nursing Research

The process of conducting nursing research involves several steps, including formulating a research question, conducting a literature review, designing the study, collecting data, analyzing data, and disseminating findings.

1. Formulating a Research Question

The first step in conducting nursing research is to formulate a research question. The research question should be relevant to nursing practice, education, or administration and should be answerable through research. The research question should be clear, concise, and specific.

2. Conducting a Literature Review

The second step in conducting nursing research is to conduct a literature review. The literature review involves a systematic search of published research studies related to the research question. The literature review helps to identify knowledge gaps, establish the significance of the research question, and inform the research design.

3. Designing the Study

The third step in conducting nursing research is to design the study. The research design should be appropriate for the research question and should include a description of the study population, data collection methods, data analysis methods, and ethical considerations.

4. Collecting Data

The fourth step in conducting nursing research is to collect data. Data collection methods may include surveys, interviews, observations, or secondary data sources. Data collection methods should be standardized to ensure data quality and should comply with ethical standards.

5. Analyzing Data

The fifth step in conducting nursing research is to analyze the data. Data analysis methods may include statistical analysis, content analysis, or thematic analysis. Data analysis should be appropriate for the research design and research question.

6. Disseminating Findings

The final step in conducting nursing research is to disseminate the findings. Dissemination involves sharing the research findings with the nursing community and other stakeholders. Dissemination methods may include publication in peer-reviewed journals, presentations at conferences, or sharing findings with policymakers and healthcare organizations. Dissemination should be tailored to the target audience and should emphasize the significance and implications of the research findings.

Challenges in Nursing Research

Nursing research faces several challenges, including funding, time constraints, access to participants, and ethical considerations. Funding is a major challenge for nursing research, as it requires resources to conduct high-quality research studies. Time constraints also pose a challenge for nursing research, as nurses often have competing demands on their time, such as patient care responsibilities.

Access to participants is also a challenge for nursing research, as nurses may have limited access to certain patient populations or healthcare settings. Ethical considerations are also an important challenge in nursing research, as research studies must comply with ethical principles, protect human subjects, and maintain confidentiality and privacy.

Conclusion – Nursing Research

Nursing research is an essential component of the nursing profession that promotes evidence-based practice, informs clinical decision-making, and contributes to improving patient outcomes. Nursing research can use different research designs, such as quantitative, qualitative, and mixed-methods research, and requires several steps, including formulating a research question, conducting a literature review, designing the study, collecting data, analyzing data, and disseminating findings. Despite the challenges that nursing research faces, it remains a critical component of the nursing profession and contributes to the development of nursing science, knowledge, and practice.

Please note that this article is for informational purposes only and should not substitute professional medical advice.

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This article has a correction. Please see:

• Correction: How to appraise quantitative research - April 01, 2019

• Xabi Cathala 1 ,
• Calvin Moorley 2
• 1 Institute of Vocational Learning , School of Health and Social Care, London South Bank University , London , UK
• 2 Nursing Research and Diversity in Care , School of Health and Social Care, London South Bank University , London , UK
• Correspondence to Mr Xabi Cathala, Institute of Vocational Learning, School of Health and Social Care, London South Bank University London UK ; cathalax{at}lsbu.ac.uk and Dr Calvin Moorley, Nursing Research and Diversity in Care, School of Health and Social Care, London South Bank University, London SE1 0AA, UK; Moorleyc{at}lsbu.ac.uk

https://doi.org/10.1136/eb-2018-102996

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Introduction

Some nurses feel that they lack the necessary skills to read a research paper and to then decide if they should implement the findings into their practice. This is particularly the case when considering the results of quantitative research, which often contains the results of statistical testing. However, nurses have a professional responsibility to critique research to improve their practice, care and patient safety. 1  This article provides a step by step guide on how to critically appraise a quantitative paper.

Title, keywords and the authors

The authors’ names may not mean much, but knowing the following will be helpful:

Their position, for example, academic, researcher or healthcare practitioner.

Their qualification, both professional, for example, a nurse or physiotherapist and academic (eg, degree, masters, doctorate).

This can indicate how the research has been conducted and the authors’ competence on the subject. Basically, do you want to read a paper on quantum physics written by a plumber?

The abstract is a resume of the article and should contain:

Introduction.

Research question/hypothesis.

Methods including sample design, tests used and the statistical analysis (of course! Remember we love numbers).

Main findings.

Conclusion.

The subheadings in the abstract will vary depending on the journal. An abstract should not usually be more than 300 words but this varies depending on specific journal requirements. If the above information is contained in the abstract, it can give you an idea about whether the study is relevant to your area of practice. However, before deciding if the results of a research paper are relevant to your practice, it is important to review the overall quality of the article. This can only be done by reading and critically appraising the entire article.

The introduction

Example: the effect of paracetamol on levels of pain.

My hypothesis is that A has an effect on B, for example, paracetamol has an effect on levels of pain.

My null hypothesis is that A has no effect on B, for example, paracetamol has no effect on pain.

My study will test the null hypothesis and if the null hypothesis is validated then the hypothesis is false (A has no effect on B). This means paracetamol has no effect on the level of pain. If the null hypothesis is rejected then the hypothesis is true (A has an effect on B). This means that paracetamol has an effect on the level of pain.

Background/literature review

The literature review should include reference to recent and relevant research in the area. It should summarise what is already known about the topic and why the research study is needed and state what the study will contribute to new knowledge. 5 The literature review should be up to date, usually 5–8 years, but it will depend on the topic and sometimes it is acceptable to include older (seminal) studies.

Methodology

In quantitative studies, the data analysis varies between studies depending on the type of design used. For example, descriptive, correlative or experimental studies all vary. A descriptive study will describe the pattern of a topic related to one or more variable. 6 A correlational study examines the link (correlation) between two variables 7  and focuses on how a variable will react to a change of another variable. In experimental studies, the researchers manipulate variables looking at outcomes 8  and the sample is commonly assigned into different groups (known as randomisation) to determine the effect (causal) of a condition (independent variable) on a certain outcome. This is a common method used in clinical trials.

There should be sufficient detail provided in the methods section for you to replicate the study (should you want to). To enable you to do this, the following sections are normally included:

Overview and rationale for the methodology.

Participants or sample.

Data collection tools.

Methods of data analysis.

Ethical issues.

Data collection should be clearly explained and the article should discuss how this process was undertaken. Data collection should be systematic, objective, precise, repeatable, valid and reliable. Any tool (eg, a questionnaire) used for data collection should have been piloted (or pretested and/or adjusted) to ensure the quality, validity and reliability of the tool. 9 The participants (the sample) and any randomisation technique used should be identified. The sample size is central in quantitative research, as the findings should be able to be generalised for the wider population. 10 The data analysis can be done manually or more complex analyses performed using computer software sometimes with advice of a statistician. From this analysis, results like mode, mean, median, p value, CI and so on are always presented in a numerical format.

The author(s) should present the results clearly. These may be presented in graphs, charts or tables alongside some text. You should perform your own critique of the data analysis process; just because a paper has been published, it does not mean it is perfect. Your findings may be different from the author’s. Through critical analysis the reader may find an error in the study process that authors have not seen or highlighted. These errors can change the study result or change a study you thought was strong to weak. To help you critique a quantitative research paper, some guidance on understanding statistical terminology is provided in  table 1 .

• View inline

Some basic guidance for understanding statistics

Quantitative studies examine the relationship between variables, and the p value illustrates this objectively.  11  If the p value is less than 0.05, the null hypothesis is rejected and the hypothesis is accepted and the study will say there is a significant difference. If the p value is more than 0.05, the null hypothesis is accepted then the hypothesis is rejected. The study will say there is no significant difference. As a general rule, a p value of less than 0.05 means, the hypothesis is accepted and if it is more than 0.05 the hypothesis is rejected.

The CI is a number between 0 and 1 or is written as a per cent, demonstrating the level of confidence the reader can have in the result. 12  The CI is calculated by subtracting the p value to 1 (1–p). If there is a p value of 0.05, the CI will be 1–0.05=0.95=95%. A CI over 95% means, we can be confident the result is statistically significant. A CI below 95% means, the result is not statistically significant. The p values and CI highlight the confidence and robustness of a result.

Discussion, recommendations and conclusion

The final section of the paper is where the authors discuss their results and link them to other literature in the area (some of which may have been included in the literature review at the start of the paper). This reminds the reader of what is already known, what the study has found and what new information it adds. The discussion should demonstrate how the authors interpreted their results and how they contribute to new knowledge in the area. Implications for practice and future research should also be highlighted in this section of the paper.

A few other areas you may find helpful are:

Limitations of the study.

Conflicts of interest.

Table 2 provides a useful tool to help you apply the learning in this paper to the critiquing of quantitative research papers.

Quantitative paper appraisal checklist

• 1. ↵ Nursing and Midwifery Council , 2015 . The code: standard of conduct, performance and ethics for nurses and midwives https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf ( accessed 21.8.18 ).
• Gerrish K ,
• Moorley C ,
• Tunariu A , et al
• Shorten A ,

Competing interests None declared.

Patient consent Not required.

Provenance and peer review Commissioned; internally peer reviewed.

Correction notice This article has been updated since its original publication to update p values from 0.5 to 0.05 throughout.

Linked Articles

• Miscellaneous Correction: How to appraise quantitative research BMJ Publishing Group Ltd and RCN Publishing Company Ltd Evidence-Based Nursing 2019; 22 62-62 Published Online First: 31 Jan 2019. doi: 10.1136/eb-2018-102996corr1

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The Importance of Nursing Research

Nursing research has a tremendous influence on current and future professional nursing practice, thus rendering it an essential component of the educational process. This article chronicles the learning experiences of two undergraduate nursing students who were provided with the opportunity to become team members in a study funded by the National Institute of Nursing Research. The application process, the various learning opportunities and responsibilities performed by the students, and the benefits and outcomes of the experience are described. The authors hope that by sharing their learning experiences, more students will be given similar opportunities using the strategies presented in this article. Nursing research is critical to the nursing profession and is necessary for continuing advancements that promote optimal nursing care.

Throughout the 21st century, the role of nurse has evolved significantly. Nurses work in a variety of settings, including the hospital, the classroom, the community health department, the business sector, home health care, and the laboratory. Although each role carries different responsibilities, the primary goal of a professional nurse remains the same: to be the client's advocate and provide optimal care on the basis of evidence obtained through research.

Baccalaureate programs in the United States prepare students for entry-level nursing positions. The focus is to care for individuals throughout the human life span. Knowledge is acquired from textbooks, classroom and Web-based instruction, simulation, and clinical experiences. The goal of all programs is for students to graduate as safe, entry-level professionals, having received a well-rounded exposure to the nursing field. Students are exposed to evidence-based nursing practice throughout their curriculum; however, the allocated time for nursing research is often limited. Many programs require only one 3-credit hour course for nursing research. This amount of time is limited, despite the broad spectrum of nursing research and its influence on current and future nursing care.

Research is typically not among the traditional responsibilities of an entry-level nurse. Many nurses are involved in either direct patient care or administrative aspects of health care. Nursing research is a growing field in which individuals within the profession can contribute a variety of skills and experiences to the science of nursing care. There are frequent misconceptions as to what nursing research is. Some individuals do not even know how to begin to define nursing research. According to Polit and Beck (2006) , nursing research is:

systematic inquiry designed to develop knowledge about issues of importance to nurses, including nursing practice, nursing education, and nursing administration. (p. 4)

Nursing research is vital to the practice of professional nursing, and the importance of its inclusion during undergraduate instruction cannot be overemphasized. Only with exposure and experience can students begin to understand the concept and importance of nursing research.

The purpose of this article is to describe undergraduate students’ experiences of becoming aware of and participating in a federally funded research study from the National Institute of Nursing Research. As a part of funding for the study, which was an AREA award ( A cademic R esearch E nhancement A ward, R15 mechanism), there were designated opportunities for student involvement. The primary aim of the research study was to investigate the effects of gene-environment interactions on risk factors of preclinical cardiovascular disease in a cohort of 585 young adults who all had a positive family history of cardiovascular disease (i.e., essential hypertension or premature myocardial infarction at age 55 or younger in one or both biological parents or in one or more grandparents), verified in the medical record. Specific genes examined included cytochrome P-450, family 1, subfamily A, polypeptide 1; cytochrome P-450 2A; glutathione S-transferase mu 1; and glutathione S-transferase theta 1. Cardiovascular-dependent measures were diastolic blood pressure, endothelium-dependent arterial vasodilation, left ventricular mass indexed for body size, systolic blood pressure, and total peripheral resistance. The effects of ethnicity and gender were also explored.

Learning Opportunity

The learning process began with the principal investigator (M.S.T.) of the study visiting the junior class (class of 2007) of baccalaureate students at the Medical College of Georgia. This particular student group was chosen due to their academic standing because they would have the chance to take full advantage of learning directly from a nurse researcher for one full year before graduation. The principal investigator briefly presented and discussed the growing field of nursing research, the advancements made by nursing research, and the critical role of nursing research to nursing practice. The principal investigator also presented an overview of the funded research study and extended an invitation to students to apply for two part-time positions on the grant that were designed specifically for nursing student involvement. Students recognized the excellent opportunity and were intrigued with the future possibilities. They understood this option was unique and appeared to be a great pathway for becoming an active participant in learning the nursing research process through involvement in an official nursing research study.

The principal investigator established objective criteria for the application process. The criteria included writing a maximum 1-page essay sharing the reasons why the students wanted to join the research project as a team member and also sharing their personal and professional goals for involvement in the study. Many students were interested; thus, it was a very competitive process. The principal investigator reviewed the essays and selected approximately 10 prospective individuals for an interview. The interview was an extension of the essay. At the interview, the principal investigator further described the positions, provided a detailed overview of the grant, and had the opportunity to gain a better understanding of the student candidates. The students were encouraged to ask questions to further understand the expectations of the prospective opportunity. The interview also provided the students with increased exposure to the study's goal and more familiarization with the expectations of the funded positions.

After the interview process was completed, two individuals were selected, per the grant specifications. The selected individuals described the interview process as a positive experience that helped solidify their desire to become involved in the research study. The principal investigator emphasized that this job opportunity was designed to be a learning experience in which the students would be guided through the entire research study process and become members of a multidisciplinary team. Time responsibilities for each student included approximately 6 hours per week. The principal investigator communicated clearly that the nursing baccalaureate program was the first priority for the students, and thus provided a flexible work schedule.

Research Study Experience

The students began working in early april 2006. The first step in the work experience included 6 weeks of funded orientation. This was their first exposure to the research process; thus, it was important for the students to be provided with a strong foundation. Orientation included attending a team meeting and being introduced to the members of the multidisciplinary team (i.e., biostatistician, cardiologist, geneticists, nurse researcher, and psychologist, all of whom served as co-investigators, and the genetic laboratory personnel); reviewing the grant application; completing the Collaborative Institutional Training Initiative (CITI) (2000) ; completing the Roche educational program on genetics; and touring the worksite facilities. Reviewing the grant gave the students a better understanding of the specific aims and objectives of the study and the intended procedures of the genetic laboratory work in which the students would be involved. The complexity of the grant required the principal investigator to further explain and clarify specific details. The CITI training, which is required by the institution's Office of Human Research Protection, was completed online and took approximately 5.5 hours. The CITI program was presented in a tutorial format, and satisfactory completion of numerous quizzes was required. The task was tedious and time consuming, but valuable and essential, as it increased the awareness of the established codes of conduct for research. At the conclusion of the CITI training, the students understood the necessary policies and procedures for maintaining security and confidentiality of human subjects, the legal and ethical issues regarding the research process, and the essential procedures for research conduct.

Although the students had a basic understanding of genetics, they completed the Roche Genetics Education Program (2004) to gain a deeper understanding. The program was direct and easy to navigate and was excellent for all learning styles, as it contained both visual and auditory explanations. The explanations covered both basic and complex genetic concepts. Through the use of the genetics program, the students were able to comprehend abstract genetic details and to further understand the importance and influence of genetics on personal health. To conclude the orientation process, students were taught basic laboratory procedures, such as polymerase chain reaction and restrictive enzyme digestion, which were used to perform genotyping for the study. After these procedures had been observed several times, the students were given the opportunity to acquire hands-on experience with these laboratory techniques. Each of these components of the orientation process provided the students with the needed foundation for becoming involved in the research study.

After approximately 2 months of orientation, the students were ready to begin working in the genetics laboratory. One of the primary responsibilities of the students would be to further learn and become confident with genotyping techniques. The laboratory was shared among research personnel of several funded studies, with various research experiments being conducted concurrently. The students, under the supervision of the principal investigator and geneticist (H.Z.), also worked with experienced research assistants to perform the genotyping. The students maintained a daily log describing the laboratory genotyping procedures and experiments, and these logs were reviewed at team meetings. Although the actual procedure for polymerase chain reaction seemed straightforward, the students quickly learned that quality control must be used. Sometimes during genotyping, the DNA samples did not produce results. The students discovered that there are numerous contributing factors to successful polymerase chain reaction, such as quality of DNA templates, primer specifications, temperature settings, gel conditions, pipette measuring accuracy, and general laboratory techniques. Even the slightest error could result in permanent DNA sample loss, major experiment failure, or DNA sample contamination.

The students met with the research team members frequently to discuss and troubleshoot potential solutions and problem solve techniques that would foster improving the success rate and productivity of the genotyping. From the laboratory experience, the students learned that every detail must be considered and addressed precisely and meticulously when conducting experiments. Sometimes the process became frustrating, but the students soon discovered that patience and persistence were the most important attributes for a laboratory researcher to possess. The laboratory experience was an excellent hands-on learning opportunity. The students no longer viewed research as strictly information gathered from a journal or textbook, but rather as a physical act that required extreme concentration, dedication, and determination.

After spending numerous months in the laboratory performing the required genotyping, the students had the opportunity to be exposed to another role of a nurse researcher. They performed literature reviews regarding the study. Although the students had written papers in their nursing school program that required literature citations, they were not familiar with all of the library resources available to them. In no time, the students learned which library and online resources had the most validity and what would be the most relevant to their study. The literature search results provided the students and principal investigator with information on new studies that had been conducted on gene-environment interactions regarding tobacco smoke exposure and cardiovascular disease. From the literature review experience, the students learned the importance of being selective and time efficient. Often when a search was first begun, thousands of articles were listed, but the students learned the importance of narrowing the searches to the specific areas of focus. After the students completed their searches, they met with the principal investigator, who provided direction on the articles identified as the most relevant to the study.

The students continued working with the principal investigator during data review, analysis, and preparation of dissemination of the results (i.e., the publishing process). They helped to prepare an abstract submission of the study presented at an international meeting ( Tingen et al., 2007 ). They also helped with the preparation of manuscripts of the study results. By the conclusion of their work experience, the students will have been exposed to and participated in the entire research process.

Benefits and Outcomes

From the students’ perspectives, this opportunity was extremely beneficial. Prior to this experience, the students were not familiar with nursing research. Their original perception of research was that it was conducted by people with chemistry, biology, biochemistry, and genetic degrees in laboratories at major universities. They now realize that nursing and research can be combined and that optimal nursing care is dependent on the latest research findings. In addition, the students believe this opportunity has been beneficial in learning that nurse researchers are valuable to nurses in other settings. For example, one of the long-term goals of this research study is to develop appropriate interventions for children who are more susceptible to and at risk for the harmful effects of tobacco smoke due to their genetic heritage. The information obtained by a nurse researcher can be disseminated to nurses who work directly with the individuals to whom the research applies. Practice that has shown to be effective through research allows nurses to better advocate for patients and provide the best possible care. Although the majority of nurses who provide patient care will be consumers of nursing research, implementing evidence-based nursing practice is crucial to provide optimal nursing care. Information from nursing research has the potential to directly impact the care provided to patients in all health care settings.

Now that the students have had the opportunity to become more familiar with nursing research through involvement as team members, they recognize that their future professional possibilities are endless. Nursing research is an emerging and growing field in which individuals can apply their nursing education to discover new advancements that promote evidence-based care. They learned the research process and the important roles that each team member plays during the study phases of conception, design, implementation, analysis, and dissemination. Each aspect of the research process is important and contributes to the overall success of the study.

The students also discovered the benefit of trying new things. Prior to this experience, they had little exposure to the research process and nursing research. Consequently, they had to be receptive to learning and recognize that acquiring new knowledge was a gradual process. At times, the students felt anxious because all aspects were new, but they realized that without trying, they would never advance and feel comfortable with the research process. As the students reflected, they thought this was an excellent growing experience professionally, scholastically, and personally. In addition, this opportunity benefited the students’ peers through discussions and their sharing of work responsibilities, the research process, and the importance of evidence-based practice. As future nurses, the students are strong proponents of nursing research, and this experience has also broadened their horizons regarding future professional growth and opportunities. In addition, they have a better understanding of the importance of scientific evidence to support their clinical practice. As a result, the students thought that a stronger emphasis should be placed on nursing research in undergraduate baccalaureate education and that more students should have the opportunity to participate as team members in nursing research studies.

The students were almost one full year into nursing school and thought they had learned about all of the possibilities for their futures when they were first presented with this learning opportunity. They knew their future options were numerous and included working in acute care and community settings. They also realized they could further their education and pursue graduate degrees to include a master's degree and become an administrator, educator, clinical nurse specialist, nurse anesthetist, or nurse practitioner, or potentially pursue a doctorate. They did not know there was an emerging and growing field in which their nursing education could be applied and furthered—the area of research and the role of becoming a nurse researcher. Prior to this experience, students perceived their possibilities for a professional career in nursing were tremendous. Now by being involved in the entire process of conducting a federally funded research study, they realized their future professional possibilities are limitless.

The authors of this paper hope that by sharing their experience, they will encourage both nursing faculty and nursing students to not only introduce the research process into the nursing curriculum, but also to consider making nursing research a tangible and more integrated process. They think that a more beneficial approach to the introduction of research may be achieved through incorporating research-related content into each nursing course throughout the educational process. This could be conducted in addition to the current curriculum plan of many schools of nursing that require a single and concentrated 3-hour research course with a goal of research becoming a positive experience for students that is enthusiastically received as a new learning opportunity. In addition, students who are involved as team members in a funded research study may be provided with scheduled classroom opportunities for making progress reports to their peers. Also, the students could field questions regarding the research project and their experiences. These activities may foster increased learning and interest about research among the students’ classmates.

As nursing students are the future members of the nursing profession, and for the profession to continue to advance, nursing research must be the foundation of comprehensive, evidence-based clinical practice. This may only occur with increased exposure to nursing research. Therefore, it is critical that the future members of the nursing profession be exposed to, develop an appreciation for, and become more involved in nursing research, and thus incorporate its outcomes into the delivery of optimal professional nursing practice.

Acknowledgments

The lead author was awarded a grant (NR008871) from the National Institutes of Health, National Institute of Nursing Research.

• Collaborative Institutional Training Initiative [April 14, 2006]; Office of Human Research Protection. The Medical College of Georgia. 2000 from http://www.mcg.edu/Research/ohrp/training/citi.html .
• Polit DF, Beck CT. Essentials of nursing research: Methods, appraisal, and utilization. 6th ed. Lippincott Williams & Wilkins; Philadelphia: 2006. [ Google Scholar ]
• Roche Genetics Education Program [May 10, 2006]; Education. 2004 from http://www.roche.com/research_and_development_r_d_overview/education.htm .
• Tingen MS, Ludwig DA, Dong Y, Zhu H, Andrews JO, Burnett AH, et al. Tobacco smoke exposure and genetics: Youth at risk for cardiovascular disease.. Proceedings of the 13th Annual Meeting of the Society for Research on Nicotine and Tobacco.2007. p. 39. [ Google Scholar ]

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Home > Online Programs > MSN > Master of Science in Nursing in Nursing Administration > Why Are Research Skills Important in the Nursing Field?

Why Are Research Skills Important in the Nursing Field?

• Published On: November 2, 2022

Nurses occupy an influential position in the field of medicine. They spend about 70% of their time at the bedside, working directly with patients and observing treatment outcomes firsthand.

They also field questions from curious patients. In many cases, patients feel more comfortable confiding in or asking nurses questions instead physicians. This relationship allows nurses to address patient concerns while providing quality care.

How can nurses feel more confident and authoritative in addressing patient needs? One answer: research.

Research in Action

Nursing research provides an opportunity for nurses to advance treatment techniques and improve patient outcomes. So, for example, one focus is on supporting the “evidence” equation of evidence-based care.

Research can also take the form of knowing how to oversee projects or interpreting cutting-edge research, which professionals can then apply directly to patient care. Ultimately, strong research skills contribute to nurses’ ability to impact the current and future state of healthcare.

Research’s Role in Improving Medicine

Developing solid research know-how impacts the types of treatment patients receive. Nurses witness which existing techniques and treatments are working (or aren’t working) for patients through direct contact, so they are perfectly positioned to report research findings that involve patients. As a result, research can provide more accurate tools and chances to advance the nursing field .

For example, Florence Nightingale, known as the “Mother of Nursing,” applied research to determine that sanitation improved the survival rates of wounded soldiers during the Crimean War. Her findings still influence how medicine is practiced today.

Nurse research strives to progress treatment protocols for a broad spectrum of patients. Research projects can harness ever-changing technology to better support the diagnosis and treatment of diseases. Discoveries made through research can be relayed to other nurses throughout the health system, allowing everyone to be better patient advocates and deliver the best care possible.

Personal and Professional Impact

Nursing research benefits patients, but it can also provide more career opportunities for those who are not content with day-to-day clinical practice – many report that a research position is less physically and mentally demanding than bedside care. Nurses who do research often like the field’s more “structured” atmosphere.

From a personal-plus-professional perspective, research is an excellent option for nurses who want to significantly impact the nursing profession. Research can support widescale policy changes that help improve patient care on a micro and macro level. Nurse administrators and educators can uncover and disseminate advancements that promote evidence-based care.

Nurse researchers also serve as leaders and mentors , especially for members of their research team. As experts, they have skills that garner respect from students, peers and other departments. Their involvement in research sets them up for careers in academia, government and publishing. Nurse researchers are welcome additions to committees and boards, having earned professional prestige through their work.

How Can You Expand Your Research Skills?

Bachelor of Science in Nursing (BSN) programs help nurses hit the ground running in entry-level positions. However, BSN programs usually have limited coursework dedicated to nursing research. Master’s programs help nurses develop the important and influential skill of conducting nursing research and gaining data insights . Nurses learn to evaluate findings and implement new practice guidelines based on study results. 

The University of Texas at Arlington offers online classes as part of the MSN Nursing Administration degree program with the goal of fostering necessary skills for nurse researchers. For example, the Principles of Research in Nursing course addresses how research generates evidence for nursing practice. Another course, Evidence-Based Practice, covers how to implement changes discovered from nursing research.

The Future Is Yours

An advanced degree is the first step to a career in nursing research, whether within academic medical centers, government agencies or other healthcare settings. As medical science continues to evolve, nurse researchers will increasingly be valuable assets to the development of the field.

Learn more about The University of Texas at Arlington’s MSN Nursing Administration online program .

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• Open access
• Published: 01 August 2024

Literature review of complementary and alternative therapies: using text mining and analysis of trends in nursing research

• Jihye Nam   ORCID: orcid.org/0000-0002-5534-2660 1 ,
• Hyejin Lee   ORCID: orcid.org/0000-0002-8501-0560 1 ,
• Seunghyeon Lee   ORCID: orcid.org/0009-0005-6411-364X 1 &
• Hyojung Park   ORCID: orcid.org/0000-0002-7804-0593 1  

BMC Nursing volume  23 , Article number:  526 ( 2024 ) Cite this article

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Metrics details

This study aimed to review the literature on complementary and alternative therapies, utilizing text mining and trend analysis in nursing research. As CAM becomes increasingly prevalent in healthcare settings, a comprehensive understanding of the current research landscape is essential to guide evidence-based practice, inform clinical decision-making, and ultimately enhance patient outcomes.

This study aimed to identify CAM-related literature published from 2018 to 2023. Using the search terms 'complementary therap*', 'complementary medicine', 'alternative therap*', and 'alternative medicine', we performed a comprehensive search in eight databases, including EMBASE, Cochrane Central, PubMed Central, Korea Education and Research Information Service (RISS), Web of Science, KMbase, KISS, and CINAHL. From the text network and topic modeling analysis of 66,490 documents, 15 topics were identified. These topics were classified into two nursing-related topics through an academic classification process involving three doctors with doctoral degrees, three nurses, and three pharmacists. Based on the classified topics, research trends were comparatively analyzed by re-searching the database for 12 nursing and 22 non-nursing literature.

This study found that in nursing literature, yoga is used to improve mental symptoms such as stress and anxiety. In non-nursing literature, most of the experimental studies on complementary and alternative therapies were conducted in a randomized manner, confirming that a variety of physiological and objective indicators were used. Additionally, it was discovered that there were differences in the diversity of research subjects and research design methods for the same intervention method. Therefore, future research should focus on broadening the scope of subjects and measurement tools in nursing studies. Additionally, such studies should be conducted with randomization and generalizability in the experimental design in mind.

This study employed text network analysis and text mining to identify domestic and international CAM research trends. Our novel approach combined big data-derived keywords with a systematic classification method, proposing a new methodological strategy for trend analysis. Future nursing research should focus on broadening the scope of subjects, diversifying measurement tools, and emphasizing randomization and generalizability in experimental designs.

Peer Review reports

The World Health Organization (WHO) defines complementary and alternative medicine (CAM) as healthcare practices outside a country's traditional or conventional medicine [ 1 ]. According to the National Center for Complementary and Integrative Health (NCCIH), CAM encompasses nutritional approaches (e.g., herbs), psychological methods (e.g., mindfulness), physical therapies (e.g., massage), integrated mind–body practices (e.g., yoga or auricular acupressure), and modalities that combine psychology and nutrition [ 2 ]. This definition suggests CAM may facilitate holistic nursing by addressing both psychological and physical aspects [ 3 ]. Consequently, substantial CAM research is conducted in nursing internationally [ 4 , 5 ], spanning areas like pain, depression, anxiety, chronic disease symptoms, sleep disturbances, and vomiting [ 4 , 5 , 6 ]. Classification systems exist, with the Korean Nursing Association (2023) delineating 12 CAM subcategories [ 6 ] and NCCIH outlining 76 therapies across major categories like nutrition, body, and psychotherapies [ 4 , 5 , 6 , 7 ]. The multitude of CAM types has prompted trend identification research, including reviews on Chinese medicine for allergic rhinitis, aromatherapy, auricular acupressure, and CAM for COVID-19 [ 6 , 8 ]. However, many previous studies have significant limitations in comprehensively identifying overall research trends in CAM. First, they tend to focus narrowly on specific diseases or treatments, lacking a broader perspective on the field as a whole [ 6 , 8 ]. Second, the use of search queries containing keywords from a specific discipline or arbitrarily selected by researchers introduces bias and hinders the identification of overarching trends [ 9 , 10 ]. These limitations highlight the need for a more systematic and data-driven approach to analyzing CAM research trends [ 11 , 12 , 13 ]. A previous study [ 14 , 15 ] suggested the use of text mining technique as an approach for literature review [ 16 ]. To date, the analysis on research trend in nursing has been conducted more than five years after publication or has only been conducted with partial analyses through literature reviews and text mining [ 17 , 18 , 19 ].

The overarching goal was to extract keywords identifying domestic and international CAM research trends using text network analysis and analyze these trends within the nursing field. Specific objectives were: 1) Identify frequency, degree centrality, closeness centrality, and betweenness centrality for keywords appearing in domestic and international CAM studies; 2) Identify key themes within these studies; 3) Discern nursing keywords among sub-topic groups; 4) Analyze and compare nursing and other disciplinary literature based on findings; and 5) Analyze the trend of CAM in nursing based on extracted nursing keywords.

Study design and methodological framework

This study employs a novel methodological framework that combines text mining techniques with expert validation to identify and analyze CAM research trends in a comprehensive and data-driven manner. The framework consists of the following key steps.

Data collection: A comprehensive search of multiple databases is conducted to collect a broad range of CAM-related literature across various disciplines.

Text preprocessing involves several techniques to prepare the data for analysis. These include natural language processing, stopword removal, and synonym standardization.

Keyword extraction and network analysis: Text mining techniques, including term frequency-inverse document frequency (TF-IDF) and centrality analysis, are applied to extract key topics and analyze their relationships within the literature.

Topic modeling: Latent Dirichlet Allocation (LDA) is used to identify latent topics within the literature and visualize their proportions and relationships.

Expert validation: An expert panel of physicians, nurses, and pharmacists is consulted to validate the relevance and credibility of the identified topics and classify them into respective academic fields.

Focused literature analysis: Based on the expert-validated nursing-related topics, a focused re-search and analysis of the literature are conducted to identify trends specific to nursing research on CAM.

This multi-step framework allows for a more comprehensive and less biased exploration of CAM research trends by leveraging text mining techniques to process large volumes of literature, identify key topics, and uncover patterns that may not be apparent through traditional review methods [ 14 , 15 , 16 ]. The integration of expert validation ensures the relevance and credibility of the findings, while the focused analysis of nursing literature provides insights specific to the nursing discipline within the broader context of CAM research. The process of selecting studies for our analysis is illustrated in Fig.  1 , which provides a clear visual representation of the key steps involved, from the initial database search to the final classification of studies into nursing and other disciplines. This multi-step approach, combined with the visual aid, enhances the clarity and transparency of our methodology, allowing readers to better understand and contextualize the subsequent data analysis steps.

Flow diagram for literature selection process

Literature selection

This study focused on complementary and alternative medicine studies conducted in the fields of medicine, public health, and nursing in Korea and abroad. After specifying the research title and abstract as the search scope to extract the literature and build a database, the literature related to nursing was classified based on the topics derived through text network analysis and then, the literature that met the selection criteria was secondarily extracted and analyzed through the abstract screening. The three researchers checked the consistency of the study selection process and if there was any discrepancy, the final decision was made through consensus among the researchers.

The selection criteria for the literature were: (1) domestic and foreign studies published within the last five years (January 2018 to September 2023) that conducted studies on complementary and alternative medicine; and

The exclusion criteria for the literature were grey literatures, dissertations, and studies for which original texts are not available.

Data collection strategies

In this study, the database was selected by referring to the COSI (Core, Standard, Ideal) [ 20 ] model presented by the National Library of Medicine for literature search. EMBASE, Cochrane Central, and PubMed Central were selected as the core databases.

On the other hand, the standard databases selected were the Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Korean database services such as the Research Information Sharing Service (RISS), KMbase, and Korean studies Information Service System (KISS). These Korean databases were included to ensure a comprehensive coverage of potentially relevant studies published in South Korea, as they index a wide range of domestic and international journals, conference proceedings, and dissertations across various disciplines, including those related to CAM. However, it is important to note that the inclusion of these Korean databases does not limit the scope of our study to Korean literature only, as the majority of our analysis focuses on studies published in English and indexed in the core and standard international databases.

In addition, the Web of Science was selected to include a wider range of literature for the ideal database, and the period of literature search focused on the last five years, from 1 January 2018 to 15 September 2023. to capture the most recent trends in CAM research following the last comprehensive analysis of CAM research trends conducted in 2018 by Sung et al. [ 19 ]. This time frame was chosen to provide an updated and comprehensive analysis of CAM research trends, building upon the findings of previous studies and identifying new patterns and areas of focus that have emerged in recent years, given the rapid evolution of CAM research and the increasing integration of CAM into mainstream healthcare.

The data collection procedure was limited for both domestic and foreign studies. In case of foreign studies, ‘English’ was limited as the search language, ‘abstract and title’ were identified as the field, ‘article’ was set as the document form, and the keywords were ‘complementary therap*,’ ‘complementary medicine,’ ‘alternative therap*,’ and ‘alternative medicine.’ For the Korean studies, ‘Korean’ was limited as the search language, ‘abstract and title’ were identified as the field, ‘article’ was set as the document form, and the search keywords used were ‘보완대체,’ ‘대체요법,’ and ‘대체의학.’ In searching for the secondary literature, studies in the field of nursing were presented to a group of nine experts including physicians, nurses, and pharmacists with a master's degree or higher, and then the relevant areas were classified to extract the keywords. These keywords were then used in the text mining search. Topic words, the majority of which were classified as nursing, were re-searched in the collected database. The literature selection and classification process were carried out independently by three researchers and promoted through discussions between the researchers.

Data analysis process

Data extraction.

A comprehensive literature search was conducted across eight databases: CINAHL, Cochrane, EMBASE, KISS, Kmbase, PubMed, RISS, and Web of Science. This extensive search yielded a total of 77,062 studies. To ensure the integrity and non-redundancy of our dataset, we employed a rigorous two-step deduplication process. First, we utilized the 'Find Duplicates' function in EndNote software for initial automatic deduplication. This function systematically identifies and groups potential duplicate records based on shared metadata such as title, authors, year, and DOI. Through this automated process, 12,107 duplicate records were identified and removed.

Following the automated process, we conducted a manual review to identify and remove any remaining duplicates that the software might have missed. This careful manual screening allowed us to catch subtle duplicates that automated systems might overlook, such as those with slight variations in titles or author names. Through this manual review, an additional 465 duplicate records were identified and removed. In total, our rigorous two-step deduplication process resulted in the removal of 12,572 duplicate records. Of these, 12,107 were removed through automated deduplication and 465 through manual review. After deduplication, 64,490 unique studies were retained for further analysis. These studies were systematically organized by title and subjected to a thorough text preprocessing phase. During this phase, unstructured words were sorted and cleaned using the social networking program Netminer 4.3.3 and text editor Notepad + + (version 8.5.8).

Also, stopwords such as pronouns, adverbs, and numbers were deleted through natural language processing, while exception list, defined words, and thesaurus were registered. The exception list and thesaurus were selected by the three researchers, and if they failed to reach a unanimous agreement, the keywords were refined through consultation and the abstracts and preambles were reviewed again to examine the context in which the words were used. In case of the exception list, literature search keywords or stopwords such as pronouns, adverbs, numbers, and special symbols were considered, while ‘complementary,’ ‘medicine,’ ‘alternative,’ ‘therapeutic,’ ‘therapy,’ ‘therap,’ ‘therapies,’ ‘the,’ ‘a,’ ‘and,’ ‘of,’ ‘for,’ ‘in,’ ‘to,’ and ‘among’ were excluded. Special symbols like ‘’,:'"()&-?# <  >  + "",‘ were excluded as well. As for defined words, ‘cells → cell,’ ‘effects → effect,’ ‘staphylococcus aureus → staphylococcus,’ ‘aureus → staphylococcus,’ ‘characteristics → characterization,’ ‘efficacy → effect,’ ‘rat → mice,’ ‘radio → radiation,’ ‘systems → system,’ ‘agents → agent,’ ‘activity → activation,’ ‘carcinoma → cancer,’ ‘cases → case,’ ‘mouse → mice,’ ‘practices → practice,’ ‘radio sensitization → radiation,’ ‘years → year,’ ‘α → alpha,’ and ‘β → beta’ were selected, and data sorting for synonyms was performed. As a result of the analysis, a database consisting of 464,625 words was constructed.

Data analysis

In this study, text mining and topic modeling analysis were employed using textom and RStudio (4.3) to identify keywords related to CAM. Word analysis, TF-IDF, and degree centrality analysis were performed through text mining, with results presented via visualization. TF-IDF determines if a keyword holds actual significance within a document, as words with high TF and TF-IDF values appear frequently and are more likely keywords or important terms [ 21 , 22 ]. Following previous studies [ 22 , 23 ], the minimum word length was set to two, with the top 20 words extracted per topic. Text network analysis created word networks expressing co-occurrence frequency as links [ 24 ]. To gauge word occurrence frequency, words were converted to word-word one-mode, and degree centrality analysis identified highly influential network words. The results of these analyses, including frequency, TF-IDF, degree centrality, closeness centrality, and betweenness centrality of core keywords, can be found in Table 1 .

This study utilized Latent Dirichlet Allocation (LDA) for topic modeling, a statistical method that estimates the probability distribution of topics within documents based on the Document Term Matrix (DTM). Following established practices in the literature, we set the Markov Chain Monte Carlo (MCMC) parameters to alpha = 1.44, beta = 0.001, and iterations = 1,000 [ 25 ]. To determine the optimal number of topics, we iteratively tested configurations ranging from 1 to 20 topics. Through a combination of silhouette clustering analysis and researcher consensus, we identified that a 15-topic model best represented the research trends in our corpus.

LDA visualization indicated that larger topic sizes represented greater proportions within the analyzed studies [ 25 ]. We confirmed that the ideal number of topics, where topics do not overlap and have distinct boundaries, is 15, as shown in Fig.  2 . To validate the relevance and credibility of the topic modeling results, we consulted an expert panel consisting of physicians, nurses, and pharmacists with master's or doctoral degrees. The panel members were asked to classify the 15 derived topics into their respective academic fields. Based on the survey results, two topics (Topics 4 and 7) were identified as nursing-related, with the majority of the expert panel categorizing them as such.

LDA topic modeling visualization

Using the words from these two nursing-related topics, a keyword search was conducted within the database to identify the final set of literature containing these terms. The selected literature was then classified as either nursing-related or non-nursing-related based on the following criteria: (1) the study was published by a nursing school or department, (2) the authors were nurses or nursing researchers, (3) the authors were hospital-affiliated nurses, or (4) the study was published in a nursing journal. The classification process was carried out independently by three authors, and the final categorization was determined through a verification process among them.

Literature review

After the three researchers re-searched the database built based on the sub-words of the extracted topics, a total of 35 articles were selected, including 13 nursing-related literatures and 22 other discipline-related literatures. The sub-words used for the re-search were derived from Topic 4 and Topic 7 in Table 2  and were classified using the PICO (Population, Intervention, Comparison, Outcome) framework. The population-related sub-words included 'patient,' 'students,' and 'nursing.' The intervention-related sub-words were 'yoga,' 'treatment,' 'radiation,' 'acupuncture,' 'education,' and 'cam.' The comparison-related sub-word was 'placebo,' and the outcome-related sub-words included 'anxiety,' 'depression,' 'symptoms,' 'knowledge,' 'attitudes,' and 'perceptions.' These PICO-classified sub-words were used to conduct the database re-search.

In order to examine the research trends in nursing and other related fields, general characteristics (author, country of publication, year of publication) and research characteristics (research design model, statistical method, research subject, intervention method, outcome variable, measurement instruments) were identified, presented, and compared. Meanwhile, the three researchers independently prepared a characteristic table to ensure the accuracy of the extracted contents and if there was any discrepancy, one data was selected through the discussion process until a consensus was reached and a characteristic table was constructed.

To assess the quality of the selected studies, we employed the Mixed Methods Appraisal Tool (MMAT), a concise tool designed to evaluate various study designs, including qualitative, randomized controlled trials, non-randomized studies, quantitative descriptive studies, and mixed methods studies [ 26 ]. This comprehensive tool allowed us to systematically evaluate the methodological rigor of our diverse selection of studies. Each study was evaluated against five MMAT criteria specific to its design, focusing on aspects such as research question appropriateness, data collection methods, and result interpretation. Our assessment revealed varying levels of methodological quality. Among nursing studies (A1-A12), 25% were high quality (5/5 criteria met), 58.3% moderate quality (4/5 criteria), and 16.7% low quality (3/5 criteria). Importantly, all included studies met at least 3 out of the 5 MMAT criteria, indicating an overall moderate to high quality across the selected literature. This suggests that the studies included in our analysis provide a reliable foundation for drawing conclusions. Studies that did not meet all criteria were carefully reviewed, and their potential limitations were considered when interpreting their findings. The MMAT provided a useful overview of study quality and was deemed suitable for assessing methodological rigor while maintaining the feasibility of our analysis. This approach ensured a balanced and nuanced interpretation of the evidence in the field of complementary and alternative medicine. The detailed results of this quality assessment can be found in Tables 3  and 4 .

Data collection and ethical considerations

Since the data used in this study did not contain information that can identify individuals, the study was conducted after obtaining an IRB approval (IRB No: ewha-202311–0008-01) from the Institutional Review Board of Ewha Womans University.

Analysis of word frequency and centrality

The frequency and percentage of the top 20 words related to complementary and alternative medicine are shown in Table 1 . The frequency and percentage of the top 20 words related to complementary and alternative medicine are shown in Table 1 . The table presents the top 20 keywords ranked by frequency, TF-IDF, degree centrality, closeness centrality, and betweenness centrality. The frequency column indicates the number of times each keyword appears in the analyzed documents, while the TF-IDF column represents the importance of each keyword within the entire document set. Degree centrality, closeness centrality, and betweenness centrality are network analysis measures that indicate the importance and influence of each keyword within the text network. The words with the highest frequency included ‘cell’ (7,653 times), ‘patient’ (6,910 times), ‘treatment’ (6,851 times), ‘cancer’ (6,722 times), ‘study’ (6,295 times), and ‘effect’ (6,203 times). The words with the highest values of TF-IDF, in order, were ‘cell,’ ‘effect,’ ‘cancer,’ ‘patient,’ ‘treatment,’ and ‘study.’ As a result of centrality analysis, the top six common words, in order, were ‘effect,’ ‘treatment,’ ‘study,’ ‘analysis,’ ‘disease,’ and ‘approach.’ Except for common words, the words with the highest values in the centrality analysis, in order, were ‘model,’ ‘patient,’ ‘activation,’ and ‘use.’ The words with the highest values for closeness centrality were ‘factor,’ ‘model,’ ‘patient,’ and ‘activation,’ while the words with the highest values for betweenness centrality were ‘factor,’ ‘model,’ ‘type,’ and ‘activation.’

Results of the topic modeling

The LDA visualization provides insights into the relative importance and distinctiveness of identified topics. In this visualization, the size of each topic circle is proportional to its prevalence within the analyzed corpus, with larger circles indicating topics that are more frequently discussed across the literature. Interestingly, we observed that some topics, despite being represented by smaller circles, were positioned at considerable distances from other topics. This spatial separation suggests that these topics, while perhaps less prevalent, possess high discriminant validity and represent distinct thematic areas within the field of complementary and alternative medicine research. This interpretation is consistent with established principles in topic modeling, where spatial relationships in visualizations can indicate semantic distinctiveness. An expert panel of 9 individuals (3 doctors, 3 nurses, and 3 pharmacists), each holding a master's or doctoral degree, conducted a survey to classify the topics based on the keywords. The topic that received the most votes from the panel was designated as the representative field for that topic. Based on the resulting values of the topic modeling, 20 sub-words for each topic were presented and provided in Table 2 , Topics 1–3, 5–6, and 9–15 were classified as Medicine, Topics 4 and 7 as Nursing, and Topics 8 and 10 as Pharmacology.

The process of selecting studies for our analysis is illustrated in Fig.  2 . To determine the optimal number of topics for our analysis, we conducted Latent Dirichlet Allocation (LDA) visualization. As Greene et al. [ 25 ] suggest, larger topic sizes in LDA visualization indicate a greater proportion of that topic within the analyzed studies. We tested topic numbers ranging from 1 to 20, seeking a configuration where topics were visually distinct and non-overlapping. This approach aligns with Liu et al. [ 24 ], who note that topics with high discriminant validity appear as small but clearly separated clusters. After careful visual analysis, we determined that 15 topics provided the most coherent and distinct groupings, as shown in Fig.  2 . This visualization demonstrates the independence and non-overlapping nature of our identified topics, supporting the robustness of our topic modeling approach. Based on the resulting values of the topic modeling, 20 sub-words for each topic were presented and provided in Table 2 . The expert panel's classification suggested that Topics 4 and 7 had relevance to nursing research. However, upon closer examination of the keywords included in these topics, it became apparent that they also encompassed literature from other medical disciplines. While the expert panel's classification indicated these topics were nursing-related, the presence of medical terminology suggested a broader interdisciplinary scope. This highlighted the limitations in identifying nursing-specific research using the current topic modeling approach. To address this issue and clarify the nursing-specific research within these topics, a further refinement of the literature search was conducted using the PICO framework. The keywords from Topics 4 and 7 were used to formulate a focused research question and search strategy. This targeted approach yielded a final selection of 12 nursing-specific articles and 22 articles from other disciplines. By employing the PICO framework and leveraging the keywords from the identified nursing-related topics, it was possible to isolate the nursing research within the broader interdisciplinary landscape.

The words included in topic 4 were the following: ‘trial,’ ‘effect,’ ‘yoga,’ ‘treatment,’ ‘radiation,’ ‘phage,’ ‘protocol,’ ‘anxiety,’ ‘dose,’ ‘zinc,’ ‘symptoms,’ ‘depression,’ ‘placebo,’ ‘acupuncture,’ ‘feasibility,’ ‘training,’ ‘insights,’ ‘toxicity,’ ‘mri,’ and ‘emergency.’ The words included in the topic 7 were: ‘role,’ ‘survey,’ ‘practice,’ ‘evidence,’ ‘failure,’ ‘utilization,’ ‘heart,’ ‘students,’ ‘cam,’ education,’ ‘healthcare,’ ‘valve,’ ‘knowledge,’ ‘communication,’ ‘narrative,’ ‘practitioners,’ ‘attitudes,’ ‘nursing,’ ‘perceptions,’ and ‘pseudomonas.’

The characteristics of the 12 studies included in the literature review analysis are shown in Table 3 .

Of the 12 final literature selections in nursing, there were four randomized controlled trials [A2] [A4] [A7] [A8], three non-randomized comparative trials [A3] [A5] [A6], four descriptive survey studies [A1] [A9] [A10] [A11], and one qualitative study [A12]. Regarding the country of the study’s publication, there were five studies from the United States, three from the United Kingdom, two from Germany and Turkey, and one from Australia. As for the statistical techniques that appeared with high frequency, 10 studies, which were [A1] [A2] [A3] [A4] [A5] [A7] [A8] [A9] [A10] [A11,] used independent t-test, and it was used in most studies. On the other hand, χ2 test was used in seven studies [A3] [A4] [A7] [A8] [A9] [A10] [A11] and one-way analysis of variance was used in four studies [A1] [A9] [A10] [A11]. Regarding the studies that were conducted targeting patients, there was one study conducted on cancer patients [A5], one study on women with post-traumatic stress disorder caused by a car accident [A8], one study on hypertension patients [A7], and one study on breast cancer patients undergoing chemoradiotherapy [A4]. There were seven studies conducted on medical staffs [A1] [A3] [A6] [A9] [A10] [A11] [A12] and one study conducted on nursing students [A2]. Among the interventional therapies used in clinical trials, the most common one was yoga, which was identified in three studies. Specifically, there was one study that used yoga therapy for chemotherapy patients [A5], laughter yoga for nursing students [A2], and yoga therapy for women with post-traumatic disorder [A8]. There were also studies conducted on virtual cancer education program [A6], education on complementary and alternative medicine [A3], auricular acupressure for hypertensive patients [A7], and music therapy for those with breast cancer [A4]. In the studies conducted among medical professionals and nursing students, knowledge [A1] [A3] [A6] [A9] [A10] [A11], attitudes [A1] [A3] [A10] [A11], and usage surveys [A1] [A11] were identified as measurement variables, whereas depression [A8], pain [A7], quality of life [A7], and anxiety [A8] [A4] were identified as the measurement variables in the studies conducted on patients.

Other disciplines

The detailed characteristics of these studies, including the study design, sample, intervention, statistical methods, and outcome measures, are presented in Table 4 .

Of the 22 final literature selections in other disciplines, there were 20 randomized controlled trials [B1] [B2] [B3] [B5] [B6] [B7] [B8] [B9] [B10] [B11] [B12] [B13] [B14] [B15] [B16] [B17] [B18] [B20] [B21] [B22], one pre- and post-hoc comparative study [B4], and one scoping review [B19]. The detailed characteristics of these studies, including the study design, sample, intervention, statistical methods, and outcome measures, are presented in Table 4 . Regarding the country of the study's publication, there were seven studies from the United States of America and the United Kingdom, three studies from China, two studies from the Netherlands, and one study each from Germany, India, and Hong Kong. As for the statistical techniques that appeared with high frequency, there were 10 studies that used independent t-test [B2] [B3] [B5] [B6] [B8] [B11] [B13] [B15] [B18] and one-way ANOVA [B3] [B6] [B7] [B9] [B11] [B14] [B18] [B21] [B20] [B22], while seven studies used repeated measures ANOVA [B2] [B4] [B10] [B11] [B15] [B20] [B22]. All studies for the literature review were conducted on patients. The most common intervention used was auricular acupressure, which was applied on patients with Parkinson’s disease [B11], poststroke depression [B6] [B14], insomnia and depression [B20] [B21], carpal tunnel syndrome [B7], soldiers with PTSD [B19], migraine [B15], pelvic organ prolapse [B8], and gallbladder stones [B22]. The second most common intervention used was yoga therapy, and the subjects were those with active arthritis [B18], generalized anxiety disorder [B17], hemodialysis [B4], and hypertension [B2]. Other subjects and interventions shown in the studies were the following: irritable bladder syndrome patients treated with cinnamon patch [B13]; depression patients treated with bouldering psychotherapy [B12]; dementia patients treated with aromatherapy [B10]; insomnia patients treated with Tai-chi and meridian pressure [B9]; Crohn’s disease patients treated with moxibustion [B3]; HIV patients treated with green tea [B5]; and peripheral arterial disease patients treated with laser acupuncture [B1]. On the other hand, the following were identified as the measurement variables for yoga intervention: level of depression, arthritis stage, anxiety level, quality of life, treatment response rate, sleep, and autonomic function [B2] [B4] [B16] [B17] [B18]. Measurement variables for auricular acupressure included level of depression, sleep quality, level of pain, physical and psychological symptoms, severity of depressive symptoms pelvic organ prolapse, and gastrointestinal symptoms [B3] [B6] [B7] [B8] [B11] [B14] [B15] [B19] [B20] [B21] [B22].

In the study conducted using cinnamon patches, the overactive bladder symptom scores and residual urine volume after urination were identified [B13]. In the study which used green tea, the level of depression was assessed while measuring the severity of depressive symptoms through bouldering [B12]. In the study that used aromatherapy, the behavior, psychology, daily living ability, and cognitive function of the patients with dementia were also assessed [B10].

The present study employed text mining techniques to analyze the literature on CAM published over the past five years and identify trends in nursing research. The text network analysis revealed keywords with high TF-IDF and degree centrality, such as 'cell', 'patient', 'treatment', 'cancer', 'study', and 'effect', suggesting a strong focus on cellular mechanisms, patient-centered approaches, and treatment effects, particularly in the context of cancer [ 22 , 23 ]. The high centrality of these keywords indicates their importance and influence within the broader network of CAM research [ 24 , 25 ]. The topic modeling approach identified 15 major topics, providing a comprehensive overview of the key areas of focus in recent CAM research. This data-driven method offers a more nuanced understanding of research trends compared to previous studies that relied on arbitrary searches or focused on narrow populations or interventions [ 27 , 28 , 29 , 30 , 31 ]. By employing this systematic approach, the present study captures the breadth and diversity of CAM research, overcoming the limitations of previous nursing studies.

An expert panel of 9 individuals (3 doctors, 3 nurses, and 3 pharmacists), each holding a master's or doctoral degree, conducted a survey to classify topics based on keywords. According to the expert classification results shown in Table 2 , Topics 1–3, 5–6, and 9–15 were classified as Medicine, Topics 4 and 7 as Nursing, and Topics 8 and 10 as Pharmacology. While Topics 4 and 7 were found to be nursing-related, closer examination revealed the presence of literature from other medical disciplines within these topics. To address this issue and clarify the nursing-specific research, a further refinement of the literature search was conducted using the PICO framework. The keywords from Topics 4 and 7 were used to formulate a focused research question and search strategy, yielding a final selection of 34 articles, with 12 nursing-specific articles and 22 articles from other disciplines. Analyzing trends in nursing and interdisciplinary studies within the context of the existing literature provides a more comprehensive understanding of CAM research trends. From a nursing perspective, the identification of topics related to patient care, such as symptom management, quality of life, and patient education, highlights the potential for CAM interventions to improve patient outcomes and experiences. The prominence of keywords such as 'patient', 'treatment', and 'effect' highlights the need for evidence-based practice and the need for rigorous studies to evaluate the efficacy and safety of CAM interventions in nursing care. Furthermore, the expert panel's validation of Topics 4 and 7 as relevant to nursing research emphasizes the relevance of these areas within the nursing discipline. Topic 4, which includes keywords such as 'trial', 'effect', 'yoga', 'anxiety', and 'depression', suggests a focus on the psychological benefits of CAM interventions, particularly in the context of clinical trials. This aligns with the growing recognition of the importance of holistic, patient-centered care in nursing practice [ 3 , 4 ]. Topic 7, which includes keywords such as 'practice', 'evidence', 'education', 'knowledge', and 'attitudes', highlights the importance of evidence-based practice and the need for nurse education and training in CAM. As CAM interventions become increasingly popular among patients, it is crucial for nurses to have the knowledge and skills needed to provide safe and effective care [ 5 , 6 ]. The insights gained from this study highlight the potential of text mining and topic modeling techniques for investigating research trends in various fields [ 11 , 12 , 13 ]. By leveraging these methods, researchers can systematically analyze large volumes of literature, identify key areas of focus, and uncover patterns and trends that may not be apparent through traditional review methods [ 14 , 15 ]. This approach can lead to a more comprehensive understanding of the current state of research and inform future directions for investigation.

In conclusion, the present study demonstrates the value of text mining and topic modeling techniques in analyzing research trends, particularly in the field of CAM [ 9 , 10 ]. The systematic approach employed in this study allowed for a more comprehensive and data-driven exploration of the research landscape, overcoming the limitations of previous studies and providing valuable insights into the trends in nursing research on CAM. The findings of this study have significant implications for nursing practice, highlighting the need for evidence-based approaches, patient-centered care, and the integration of CAM interventions into nursing education and training. Future studies should consider adopting similar methodological approaches to investigate research trends in other fields, as this can lead to a more complete understanding of the current state of research and inform future directions for investigation.

The trends analysis of nursing and interdisciplinary studies on CAM revealed notable differences in research design, subject characteristics, intervention types, and assessment methods. Nursing studies exhibited a more balanced distribution of research designs, including randomized controlled trials [A2, A4, A7, A8], non-randomized comparative trials [A3, A5, A6], descriptive survey studies [A1, A9-A11], and a qualitative study [A12]. In contrast, other disciplines predominantly utilized experimental designs, with 95.2% of the studies being randomized controlled trials [B1-B3, B5-B18, B20-B22]. This disparity suggests that nursing research on CAM should expand its focus on experimental studies to enhance the evidence base and align with the methodological approaches of other disciplines.

The subject characteristics of nursing studies differed significantly from those of other disciplines, with nursing research primarily focusing on healthcare professionals and students [A1, A3, A6, A9-A12], while other disciplines exclusively studied patient populations [B1-B22]. This highlights the need for nursing research to diversify its study subjects and investigate the effects of CAM interventions on patients and healthcare providers [ 28 , 29 ], as well as broader community and general health populations [ 3 , 6 ]. By expanding its scope, nursing research can provide valuable insights into the effectiveness and applicability of CAM interventions in promoting health and well-being across diverse settings and populations [ 4 , 5 , 7 , 8 ]. Nurses, as frontline healthcare providers, are uniquely positioned to bridge the gap between healthcare settings and the community, engaging with patients and community members to assess their health needs and provide evidence-based recommendations for CAM interventions [ 1 , 2 ]. This expanded focus, coupled with interdisciplinary collaboration and knowledge exchange [ 9 , 10 ], can lead to the development of innovative, culturally sensitive, and evidence-based CAM interventions that address the complex health needs of individuals and communities alike.

A closer examination of the intervention types in nursing studies reveals that although they focused on a relatively limited range of CAM modalities, such as yoga [A2, A5, A8] and auricular acupressure [A7], these interventions demonstrated promising potential for managing various symptoms and conditions. For instance, yoga was found to be effective in reducing psychological symptoms and cortisol levels in college students [A2], alleviating chemotherapy-related symptoms in cancer patients [A5], and improving post-traumatic stress disorder among traffic accident survivors [A8]. Similarly, auricular acupressure was shown to help decrease angina symptoms in hypertensive patients [A7]. These research findings suggest that even though the scope of CAM interventions in nursing research may be limited, they can provide significant benefits to diverse patient populations [ 2 , 4 , 22 ]. In contrast, the wide array of CAM interventions investigated in other disciplines, such as aromatherapy for dementia [B10], green tea for depression in HIV patients [B5], laser acupuncture for peripheral arterial disease [B1], cinnamon patch for irritable bladder syndrome [B13], bouldering psychotherapy for depression [B12], Tai-chi and meridian pressure for insomnia [B9], and moxibustion for Crohn's disease [B3], demonstrates the potential for nursing research to explore and apply new therapies. The safety, efficacy, and potential of these diverse CAM modalities, as evidenced in other disciplines [ 23 , 24 ], should encourage nursing researchers to investigate their applicability in patient care. By conducting rigorous studies on the safety and efficacy of various CAM interventions, nursing research can provide valuable evidence to support the integration of complementary therapies into nursing practice [ 2 , 4 , 22 ]. Moreover, this trends analysis emphasizes the importance of studying CAM interventions for chronic disease management. With the increasing prevalence of chronic conditions [ 1 , 9 , 10 ], nursing research can play a pivotal role in evaluating the effectiveness of CAM for managing these diseases. Studies on yoga for hypertension [B2] and arthritis [B18], auricular acupressure for insomnia and depression [B20, B21], and moxibustion for Crohn's disease [B3] demonstrate the potential of CAM in improving patient outcomes and quality of life. As nurses have more direct and prolonged contact with patients compared to other healthcare professionals, they are well-positioned to assess the effectiveness of CAM interventions in both clinical and community settings [ 3 , 5 ]. By conducting well-designed studies on the safety and efficacy of various CAM modalities, nursing research can provide the necessary evidence to support the integration of complementary therapies into chronic disease management plans, ultimately enhancing patient care and outcomes across diverse settings. Leveraging their unique role in patient care and conducting rigorous studies on the safety and efficacy of various CAM interventions, particularly for chronic disease management, can enable nursing research to make significant contributions to the integration of complementary therapies into nursing practice. This approach has the potential to not only improve patient outcomes and experiences but also strengthen the evidence base for CAM in healthcare, fostering interdisciplinary collaboration in CAM research and advancing the field of nursing.

The analysis of assessment methods revealed that nursing studies heavily relied on self-developed measurement instruments (58.3%) [A3, A5, A6, A9-A12], while other disciplines predominantly used previously validated tools [B1-B22]. Furthermore, nursing studies rarely incorporated physiological indicators (8.3%) [A2], in contrast to the more frequent use of such measures in other disciplines (36.3%) [B1-B22]. These findings underscore the importance of utilizing validated assessment tools and physiological indicators in nursing research to enhance the reliability and validity of study results [ 31 ]. By incorporating these objective measures, nursing research can more clearly identify significant factors and strengthen the level of evidence, ultimately improving the credibility and applicability of the results.

The trends analysis of statistical techniques revealed a higher prevalence of independent t-tests in nursing research (83.3%) [A1-A5, A7-A11], while other disciplines showed a more balanced use of various techniques, including one-way ANOVA (45.5%) [B3, B6, B7, B9, B11, B14, B18, B20-B22] and repeated measures ANOVA (31.8%) [B2, B4, B10, B11, B15, B20, B22]. This difference can be attributed to the nature of the dependent variables assessed in each field, with nursing studies primarily focusing on single assessments of knowledge, attitudes, education, beliefs, and symptoms [A1, A3-A11], whereas other disciplines frequently employed repeated measures of pain, depression, response rate, serum levels, and neurological outcomes [B2-B4, B6-B8, B10, B11, B14-B22]. These findings underscore the importance of aligning the choice of statistical techniques with the nature of the outcome measures to ensure the validity and reliability of the research findings.

In conclusion, the trends analysis of nursing and interdisciplinary studies on CAM highlights the need for nursing research to expand its focus on experimental designs, diversify study subjects, explore various CAM interventions, utilize validated assessment tools and physiological indicators, and employ robust statistical techniques. By addressing these methodological considerations, nursing research can strengthen the evidence base for CAM interventions, facilitate their integration into nursing practice, and contribute to interdisciplinary dialogue in the field of CAM research [ 11 , 12 , 13 ]. As CAM use becomes increasingly prevalent among patients, particularly those with chronic conditions [ 1 , 9 , 10 ], nursing research has a crucial role to play in investigating the safety and efficacy of various CAM modalities [ 2 , 4 , 22 ]. This approach not only has the potential to improve patient outcomes and experiences but also enables nursing research to make valuable contributions to interdisciplinary collaboration in the field of CAM [ 3 , 5 ]. By embracing the diversity of CAM interventions and fostering interdisciplinary interactions, nursing research can broaden its scope, enhance the efficiency of patient-focused care, and move closer to providing truly holistic care that addresses the multifaceted needs of patients. Also, the integration of CAM into nursing practice, supported by robust research evidence, has the power to transform healthcare delivery and improve the lives of patients, particularly those with chronic conditions who stand to benefit greatly from a more comprehensive and individualized approach to care.

The trends analysis of nursing and interdisciplinary studies on CAM highlights the potential for nursing research to draw inspiration from the diverse CAM interventions studied in other disciplines and adapt them for nursing practice. For example, the use of aromatherapy for dementia [B10], green tea for depression in HIV patients [B5], and cinnamon patch for irritable bladder syndrome [B13] could be explored in nursing research to assess their feasibility and effectiveness in nursing care settings. By learning from the experiences of other disciplines and adapting promising CAM interventions for nursing practice, researchers can expand the scope of nursing research on CAM and contribute to the development of innovative, evidence-based complementary therapies for various patient populations. Given the current trends in nursing research on CAM, it is essential for future studies to consider the research directions and methodologies employed in other disciplines to guide the advancement of nursing science in this field. In summary, this trends analysis emphasizes the need for nursing research to embrace a more diverse and rigorous approach to CAM research, drawing inspiration from the methodologies and interventions studied in other disciplines. By expanding the focus on experimental designs, diversifying study subjects, exploring novel CAM interventions, utilizing validated assessment tools and physiological indicators, nursing research can strengthen the evidence base for CAM interventions, facilitate their integration into nursing practice.

Limitations

This study aimed to identify research trends in CAM through text network analysis and to analyze nursing research trends based on the findings. The use of text mining and big data analysis allowed for a more comprehensive and less biased approach to data collection and processing compared to arbitrary search strategies. However, there were still limitations in defining each field intuitively due to the diverse and wide-ranging areas of CAM used in different disciplines. Future studies should focus on analyzing overall topics across various fields as well as keyword extraction through text mining to gain a more holistic understanding of CAM research trends. Another limitation of this study is that the search languages were restricted to Korean and English. This may have excluded relevant studies published in other languages and might limit the generalizability of the findings. As CAM is rooted in diverse cultures and traditions worldwide, it is important to include studies conducted in various languages for a comprehensive understanding. Future research should incorporate more languages to provide a global perspective on CAM research trends.

Despite these limitations, this study offers a novel methodological strategy for trend analysis by combining keywords extracted using big data rather than relying on researchers' arbitrary settings. The keyword-based classification and literature analysis provide a new approach to identifying research trends and directions. The trends analysis between nursing literature and other disciplines revealed differences in subject selection, study design, statistical techniques, and measurement of dependent variables, highlighting the need for nursing research to broaden the range of subjects and measurement tools while considering randomization and generalization in experimental designs. Furthermore, this study emphasizes the importance of using design techniques that facilitate the sharing of research results beyond the nursing community.

Conclusions

This study significantly advances CAM research in nursing by providing a comprehensive, data-driven overview of research trends. We have identified key areas for improvement, such as the need for more randomized controlled trials and broader subject diversity, and have proposed innovative methodological strategies. Our findings underscore the importance of interdisciplinary collaboration and the adoption of diverse, rigorous research approaches. By addressing these gaps, nursing research in CAM can be strengthened, ultimately enhancing the integration of evidence-based CAM practices in nursing care and improving patient outcomes.

Availability of data and materials

The data and materials of this study are available from the corresponding author upon reasonable request.

Abbreviations

Complementary and Alternative Medicine

World Health Organization

National Center for Complementary and Integrative Health

Research Information Sharing Service

Korean studies Information Service System

Cumulative Index to Nursing and Allied Health Literature

Term Frequency-Inverse Document Frequency

Latent Dirichlet Allocation

Markov Chain Monte Carlo

Document Term Matrix

Mixed Methods Appraisal Tool

Institutional Review Board

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Acknowledgements

The authors thank all participants who accepted to be part of this work.

This study was supported by the National Research Foundation of Korea (NRF-2022R1F1A1071533)

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College of Nursing, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, South Korea

Jihye Nam, Hyejin Lee, Seunghyeon Lee & Hyojung Park

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Study design: JN, HP, and HL; Data collection and Data analysis : JN and HL ;Study supervision: HP; Manuscript writing: JN, HL, and SL Critical revisions for important intellectual content: HP. All authors reviewed and approved the final manuscript.

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Correspondence to Hyojung Park .

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This study was granted an exemption from requiring ethics approval, as it utilized secondary data. The exemption was approved by the Institutional Review Board of Ewha Womans University (IRB No: ewha-202304–0016-01). Informed consent was not required due to the nature of the study, which involved the analysis of existing data that did not include any personally identifiable information. All methods were carried out in accordance with relevant guidelines and regulations.

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Nam, J., Lee, H., Lee, S. et al. Literature review of complementary and alternative therapies: using text mining and analysis of trends in nursing research. BMC Nurs 23 , 526 (2024). https://doi.org/10.1186/s12912-024-02172-9

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If you’re interested in identifying best practices and finding new and better ways to support patient care, scientific study and clinical research need nurses to serve in a variety of roles, including PhDs, DNPs, nurse researchers, and direct-care clinical nurses. In fact, all nursing roles contribute to the research cycle, speakers said during a 2024 ONS Congress ® session about the integration of and collaboration between nursing researcher roles.

“All types of scholarly work are interdependent and interconnected,” Kristen Fessele, PhD, RN, AOCN ® , a nurse scientist at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, NY, said. The process of taking research studies and analyzing data to the point of actual implementation in clinical care is complex and can take years. “It’s too much for one person to do alone, so we need different kinds of training that emphasize our skill sets so we can get all of this to our patients,” Fessele said.

Nursing Roles in Research

Research has a variety of roles for nurses for a reason: Each has a specific purpose. Nurse researchers, usually PhD prepared, focus on the generation and dissemination of knowledge, DNP-prepared nurses emphasize the application of research to clinical practice, and clinical nurses implement the new practices in direct patient care, observe side effects, identify challenges or obstacles, and provide insights and data back to nurse researchers to inform future studies.

Uniting those roles around a clinical topic is essential to solving clinical problems together, Fessele said. “It’s not until we implement the evidence in our different clinical practice, policies, procedures, workflows, clinical settings, and patient groups that we start to improve outcomes.”

That third factor is critical: Nurses are key to helping researchers understand how an innovative approach or technique works for different populations. “Especially as we start to look at scholarly work through a health equity lens, this becomes even more important,” Fessele said. “We need to ask, is it working for everyone? Is every clinician following the practice that we think is the best, and are they evolving as new evidence comes along? We need evidence and we need implementation, or we’re not going to improve the clinical problem.”

Although most research is “very regimented,” Fessele said, it will not change practice or contribute to new standards of care until the findings are implemented in direct care. And that’s where the DNP role comes into play.

The American Association of Colleges of Nursing (AACN)  approved the first DNP program in October 2004. DNP education prepares “nurse leaders at the highest level of nursing practice to improve patient outcomes and translate research into practice,” AACN said.

Cheryl Le Huquet, DNP, MSN, RN, NE-BC, project manager of hospital operations at  UCLA  Health in Los Angeles, CA, and James Simmons, DNP, AG/ACNP, acute care nurse practitioner and founder of Ask the NP and Simmons Medical, were in the first DNP cohort at UCLA. Le Huquet said that she and Simmons have been working on socializing DNPs and PhDs since 2020. 

“This is not a one-and-done situation,” she explained. “Personal relationships are required to build trust and are foundational to the working relationships.”

Why DNPs Should Consider Research

Le Huquet described herself as very process-oriented, so when she was initially finding her place in research, she knew it would be in application. “I don't need to generate more research. I need to apply what’s already out there,” she said.

Simmons’ pathway was similar: He recognized that his area of interest already had established evidence and models, but he wanted to find a new way to apply them. 

“I knew I wanted to implement the science, see with my own eyes if it worked in a community that I care about, and then give that information back to the researchers because that information was missing. So once I figured this out, the check for DNP was pretty easy,” Simmons said.

The  distinction between PhD and DNP roles in research can be vague, and collaboration can be challenging across roles and settings. However, working together can improve the research process, facilitate faster implementation and improvement, and identify additional projects to improve patient care. 

PhDs and DNPs Team Up to Conduct Better Clinical Cancer Research

As DNPs, Le Huquet and Simmons needed to collaborate with PhD researchers to accomplish their goals. In 2020, they convened a meeting of nurses interested in research at UCLA. Simmons said they had a vision that “building a collaborative scholarly PhD–DNP community will advance nursing science and improve patient outcomes.” 

Based on the concept of speed dating, the UCLA program participants come to each meeting prepared to pitch their areas of clinical interest to someone else. Simmons described the meetings as a “DNP–PhD immersive experience” and “where nurse scientists meet practice change.” 

Simmons said the original goal was to start small and use experiential learning to grow the program. However, the community was so excited about the program that it expanded organically. Word spread and the concept grew, and now participants meet virtually once a month, with in-person meetings once per quarter. The program has also evolved to allow participants to share their elevator pitch by video to distribute within or beyond the group for ideas, resources, or other support.

One topic that the group has addressed is the difference between what PhDs and DNPs do. “It was a really lovely opportunity to have some folks understand these career paths—not in a formal but in a really casual environment,” Simmons said. “The value of that has been the different perspectives that people can bring.” He said that many participant connections have led to exciting collaborations, and he is currently creating a website to expand the program and connect PhDs and DNPs around the world to talk about their interests and projects. 

Fessele implemented a similar meeting concept at MSKCC, which is called a “monthly mingle.” She said the meetings bring together the “doctorally prepared and the doctorally curious,” with about 160 people invited to the Interprofessional and Doctorally Educated Allied Scholars (IDEAS) meeting. IDEAS features speakers, networking, and ideas sharing, and Fessele said that the meetings have led nurses to create more formal collaborations around common interests.

Another benefit of research partnerships is potentially shrinking the timeline from analysis to implementation, and Fessele said that she is now prioritizing implementation science through DNP collaborations on the research team. She said that DNPs and other implementation specialists help to test interventions, plan how to launch the results, speed up timelines, and identify direct care obstacles or barriers before launch.

Initial Findings From ONS’s PhD–DNP Think Tank

ONS is leading national work to expand collaboration among nursing research roles. In April 2024, the Society convened a PhD–DNP think tank at ONS Congress that brought together 30 PhD and DNP nurses to discuss collaboration opportunities and obstacles and develop an action plan to leverage both roles. The group is currently analyzing insights from the conversations and plans to publish the findings. 

According to the participants, barriers to collaboration between PhDs and DNPs include funding, role confusion, lack of organizational support and infrastructure, time limitations, and competition for positions. The benefits, participants said, include improved patient outcomes, efficiencies, more pragmatic and clinically relevant studies, promotion of the profession, faster translation of research to practice, and more diverse skill sets. 

Do You Want to Get Involved in Nursing Research?

ONS develops research priorities designed to advance patient care, scientific inquiry, clinical applications, and the field of oncology nursing (see sidebar). They can serve as a starting point for nurses interested in developing research projects.

However, some aspects of nursing research apply to all roles. In fact, getting involved in nursing research doesn’t necessarily mean obtaining an advanced degree. “All nurses participate in evidence-based practice (EBP),” Le Huquet said. “By documenting their care in the electronic health record, each nurse is contributing to the data collection required as a baseline for EBP projects or as data for a nursing study.”

For those interested in becoming more involved in nursing research, Le Huquet provided these tips:

• Learn how to collect and present data.
• Read the literature and understand the methods and analysis, not just the results.
• Understand your organization’s goals so you can move your system forward.
• Work with a leader (often a DNP) to build the business case to support the change in your institution. 
• Build relationships with PhD- and DNP-prepared nurses. “This is an underrecognized skill in nursing but essential in the business world,” she said. “Health care is a business.”

Simmons added, “Find your passion! Nurses can leave a lasting legacy on the healthcare issues they care most about through a focus on generating new knowledge or on using the principles of implementation science to apply best practices from the literature. 

“Imagine doing what you love every single day—while changing the world? It’s entirely possible in nursing science!”

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Katherine M. Reitz, MD, MSc, has completed her general surgery residency and is a vascular surgery fellow at the University of Pittsburgh Medical Center (UPMC). During her surgical training, she completed a post-doctoral fellowship funded by The National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (NIH), through which she worked to bridge the research interests of UPMC's critical care medicine and surgery departments. In this setting, she focused on the risk of limb threat as well as amputation and, more recently, focused on the importance of timely source control for community sepsis. The collaborative research team plans to continue this important work, as such outcomes are of vital importance to patients.

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Disseminating nursing research

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• 1 Trinity College, Dublin, Ireland.
• PMID: 26219810
• DOI: 10.7748/ns.29.48.34.e8833

This article discusses the issues associated with disseminating research findings in nursing. It addresses dissemination methods in academic nursing, barriers to the use of research in practice and ways to overcome these. The researcher needs to be motivated and support from local managers and professional bodies are required to complete the dissemination cycle in nursing research. Attention should be focused on undertaking research that can be applied to, and is meaningful for, nursing practice. This should reduce the hiatus between academic nursing research and effective clinical research.

Keywords: Communication; dissemination; innovation; nursing; practice development; research; research implementation.

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