European Journal of Research in Medical Sciences Vol. 5 No.

1, 2017
ISSN 2056-600X

AN INTEGRATIVE LITERATURE REVIEW FRAMEWORK FOR

POSTGRADUATE NURSING RESEARCH REVIEWS

Christmals, Christmal Dela Gross, Janet J.

University of Witwatersrand Morehead State University (USA),
SOUTH AFRICA Southern Africa Nazarene University
SWAZILAND

ABSTRACT

Difficulties in understanding review methodologies and the inability of supervisors to assist

students to conduct comprehensive reviews in fulfilment of the requirements for a master’s degree
have resulted in limited integrative literature reviews as a form of research in master of nursing
programmes. This paper synthesised the major integrative review frameworks and the research
process into a comprehensive framework to guide postgraduate students and supervisors in
conducting integrative literature reviews leading to the award of a master’s degree in nursing and
related fields of study. It is recommended that the framework for conducting a comprehensive
academic integrative literature review for use by master’s students and their supervisors in
conducting integrative literature reviews. Further research and evaluation of this framework are
needed to improve the integrative literature review methodology.

INTRODUCTION

Difficulties in understanding review methodologies and the inability of supervisors to assist

students to conduct comprehensive reviews in fulfilment of the requirements for a master’s degree
have resulted in limited systematic and integrative reviews in Sub-Saharan Africa (SSA) (Ham-
baloyi & Jordan, 2015). Mastering the field of study is an important tenet in a master’s degree
programme (Ham-baloyi & Jordan, 2015). A postgraduate research report or dissertation is not
expected to add new knowledge to the area of study (De Kock & Levey, n.d.; Rowan University,
2013; University of Sydney, 2001; University of Witwatersrand, 2015). However, it must
demonstrate an understanding of available literature and the ability to present discipline-specific
scholarly work. The research report or dissertation must demonstrate: evidence of independent
investigation, synchronise the topic to the broader field of knowledge, understanding of
investigative techniques relevant to the research question and conclude (De Kock & Levey, n.d.;
Rowan University, 2013; University of Sydney, 2001; University of Witwatersrand, 2015).

Integrative Literature Review

An integrative literature review is a non-experimental design in which the researchers objectively

critique, summarise and make conclusions about a subject matter through a systematic search,
categorization and thematic analysis of past qualitative and quantitative research studies on the
subject (LoBiondo-Wood & Haber, 2010; Sparbel & Anderson, 2000; Torraco, 2005). An
integrative review, a comprehensive and inclusive methodology, permits the inclusion of both
quantitative and qualitative research articles (Whittemore & Knafl, 2005). This review
methodology is sophisticated and therefore demands greater insight and adherence to detail
(Torraco, 2005).

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European Journal of Research in Medical Sciences Vol. 5 No. 1, 2017
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Implications of an Integrative Literature Review for a Postgraduate Research Report

Through integrative reviews, students can explore a wide variety of literature available on the area
of study aiding him or her to meet the primary goal of the study-mastering the area of study (Ham-
baloyi & Jordan, 2015; Whittemore & Knafl, 2005). It also enables the student to review previous
work done in their field of specialisation which gives them direction for their doctoral studies (De
Souza & Carvalho, 2010; Ganong, 1987; Ham-baloyi & Jordan, 2015; Russell, 2005; Sparbel &
Anderson, 2000; Whittemore & Knafl, 2005). It provides the student with the opportunity to
examine the conceptual frameworks successfully used in the area of research, the best fit data
collection tools, the optimum data analysis procedure and also the authorities within the field of
studies (Sparbel & Anderson, 2000).

Reviews are vital in the academic and clinical nursing community (Ham-baloyi & Jordan, 2015).
As nursing specialisation increases and the quantity of nursing research expand, the research
community is under Evidence-Based Practice obligation to have an accurate and up-to-date insight
into their area of practice. Reviews help the nurses to keep up with this obligation, by bringing
together and determining the quality and usability of literature (Kpodo, 2015; Russell, 2005;
Sparbel & Anderson, 2000; Torraco, 2005; Whittemore & Knafl, 2005). If the master’s student is
not expected to produce new knowledge in their research, at least he or she can synthesise the
available literature in an area of specialisation, meeting the requirement for the qualification and
also giving society an outstanding product that is useful.

PURPOSE OF THIS PAPER

This paper synthesised the major integrative review frameworks (Cooper, 1982; De Souza &
Carvalho, 2010; Ganong, 1987; Russell, 2005; Torraco, 2005; Whittemore & Knafl, 2005) and the
research process (conceptual, empirical, interpretive and communication phases) into a
comprehensive framework to guide a postgraduate students and supervisors in conducting
integrative review in partial fulfilment of the award of a master’s degree.

METHODOLOGY

This paper used the ‘best fit’ framework synthesis (Carroll, Booth, & Cooper, 2011; Carroll, Booth,
Leaviss, & Rick, 2013)to integrate the major integrative review models with the research process to
develop a comprehensive framework for integrative review as a research pathway for a master’s
degree. ‘Best fit’ framework synthesis involves creating deductive themes and codes against which
the data is analysed thematically (Carroll et al., 2011, 2013). This approach is fast, practical and
very transparent compared to other qualitative data synthesis procedures as it uses a priori codes,
themes, and patterns in analysing data. Data that cannot fit into the framework are considered
iterative and are analysed using inductive thematic analysis (Carroll et al., 2011, 2013). The
synthesis was in two phases:

Phase I

Synthesising the integrative literature review models (Cooper, 1982; De Souza & Carvalho, 2010;
Ganong, 1987; Russell, 2005; Sparbel & Anderson, 2000; Torraco, 2005; Whittemore & Knafl,
2005) under the framework (the research process-conceptual, empirical, interpretive and
communication phases) (Brink, Walt, & Rensburg, 2013).

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European Journal of Research in Medical Sciences Vol. 5 No. 1, 2017
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Phase II

Synchronising the results of 1(above) with the body (five chapters) of the research report
(Introduction, Literature review, Methodology, Results, and Discussion, conclusion and
recommendations) (Adelaide University, 2014; University of Sydney, 2001; University of
Witwatersrand, 2015).

DATA EXTRACTION AND SYNTHESIS

Data has been extracted from the included studies and synthesized into an integrative literature
review framework for master’s degree research report as in the figure below.

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 European Journal of Research in Medical Sciences Vol. 5 No. 1, 2017
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4.1 Data matrix

Study Aim Definition of Integrative Review and Search Proposed Stages Major Contributions Data Analysis
Strategy Procedure
Cooper 1982 Conceptualizes the Integrative reviews inferentially generalize main 1. Formulate problem 1. The five stages of Both statistical
integrative review as issues from a group of studies on a specific topic. 2. Collect data reviewing contain 10 and qualitative
a research process Search 3. Evaluate the data collected threats to validity. analysis
containing five stages (1) "Invisible college"; (2) ancestry approach; (3) 4. Analyse and interpret data
use of abstracting services; and (4) computerised 5. Disseminate findings
search.
Ganong To communicate the Integrative reviews are a study in which the 1. Formulate the purpose and The review must: 1. Qualitative(
1987 methods and the researcher is seeks to generalize information about review questions a. ensure valid, objective, meta-
processes used in a group of studies on a topic. 2. Establish inclusion criteria. and comprehensive analysis)
conducting integrative 3. Literature search analyses synthesis
reviews. Search 4. Develop data extraction b. Pay attention to all
1. Computer databases questionnaire aspects of the study
2. Reference lists 5. Set rules of inference for data included.
3. Associated reviews synthesis. c. Describe the studies
4. Library citation indexes. 6. Revise data extraction reviewed
questionnaire to fit purpose d. Give the audience
7. Extract data information rather than
8. systematically analyze data excessive content.
9. Synthesize data.
10. Write review report

Russell 2005 To give an overview A study in which an overall conclusion is drawn 1. Formulate problem. 1. There are seven Both statistical
of the integrative from studying what has already been done in an 2. Search literature and extract benefits of reviews to approach(meta-
research review. area 3. Evaluate the studies the reviewer analysis) and
included 2. Make the search non- statistical
Search 4. Analyse data exhaustive. approaches
1. Informal channels: 5. Interpret result and
Personal research findings, the invisible college, disseminate finings
expert contacts, conferences and workshops.
2. Primary Sources
Review of journals, and the ancestry approach
3. Secondary sources

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 European Journal of Research in Medical Sciences Vol. 5 No. 1, 2017
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Bibliographies and government archives, research
registers, and databases.
Torraco To discusses how to This study search describes critique and analyse 1. Identify an appropriate topic. Guidelines for Writing a Metatheory
2005 organize and write an literature on a topic of interest to generate new 2. Justify literature review Review: Before review,
integrative review perspectives. methodology organizing the review and
3. Search literature. reporting the review
Search 4. Analyze and critique the
Computerized database search and ancestry literature.
approach 5. Synthesize results.
Whittemore To distinguish This method seeks to give a comprehensive 1. Identification of the problem Detailed data analysis stage Thematic
& Knafl integrative reviews meaning of a phenomenon through the synthesizing 2. Literature search/ review stage into five sub categories analysis
2005 from other reviews past research o the phenomenon. 3. Evaluate data
and describe it’s Search 4. Analyse data under the
methodology 1. Computerized database following headings: “data
2. Ancestry Reduction, data display,
3. Journal hand searching data Comparison,
4. Networking conclusion drawing and
5. Research registers verification”
5. Disseminate findings
De Souza et To present integrative This method presents a way of analysing studies 1. Formulate review question 1. Stated Levels of evidence Did not state
al. 2010 review methodology and synthesizing significant results for practice. 2. Search literature and include 2. Provided a detailed and any method of
and highlight critical 3. Extract data from studies validated data extraction analysis but
activities in Search 4. Analyse studies critically instrument. evaluated the
conducting integrative 1.Electronic databases 5. Discuss results level of
reviews 2.Manual journal search 6. Disseminate the study evidence of
3.Ancestry findings articles
4.Networking involved.
5.Gray literature

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4.2 Integrative Review Research Framework for a Master’s Degree Research Report

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DISCUSSION

An integrative review is conducted to appraise the quality of scientific research, discover

gaps in what is already known, infer generalisation of a phenomenon, identify central themes
and make connections between related areas of specialisation. It helps to formulate research
questions, identify theoretical and conceptual frameworks in a research area, propose the
need for future research and explore the research methodology used (Cooper, 1982; De Souza
& Carvalho, 2010; Ganong, 1987; Russell, 2005; Torraco, 2005; Whittemore & Knafl, 2005).
All integrative review frameworks made tremendous contributions to integrative review
methodology (Cooper, 1982; De Souza & Carvalho, 2010; Ganong, 1987; Russell, 2005;
Torraco, 2005; Whittemore & Knafl, 2005). However, none of the methods is comprehensive
enough to produce a detailed review of the literature. Most frameworks were presented in
five broad stages (Cooper, 1982; Torraco, 2005; Whittemore & Knafl, 2005). Russell (2005)
only paraphrased Cooper’s stages. Torraco (2005) added justification of the integrative
review methodology to what Cooper (1982) presented and omitted the presentation phase.
Whittemore & Knafl (2005) expanded the data analysis stage of Cooper’s framework. De
Souza et al. (2010) conceptualised the integrative review into six stages by adding data
collection as a unique stage. Ganong (1987) on the other hand produced a ten (10) stage
comprehensive phases explicitly stating processes at each stage. Ganong (1987)
recommended that the reviewer provides the reader with information about the studies
reviewed but did not propose any means of evidence rating nor the quality assessment of
primary studies included. De Souza et al. (2010) used a validated data collection instrument
(Ursi & Gavão, 2006). Whittemore & Knafl (2005) expanded data analysis phase (data
reduction, data display, data comparison, drawing conclusions and verification). Cooper
(1982) proposed practical ways of protecting validity in integrative reviews. Both quantitative
(meta-analysis) and qualitative (thematic analysis) analytical procedures were proposed for
integrative reviews depending on the articles included.

The Conceptual Phase

The conceptual phase is the stage encompasses chapter one and two of the research report
which in turn comprises the phases one, two, four and five on Ganong’s (1987) integrative
review framework (Kpodo, 2015).

The Empirical Phase

The empirical phase engulfs chapter 2 of the research report which comprises phases three,
six and seven. This phases deal with data search, evaluation, inclusion, and extraction. It
covers Ganong (1987) phases 3, 6 and 7.

The Interpretive Phase

This phase comprises chapters four and five of a research report which in turn comprises of
Ganong (1987) phases 8 and 9. This phase analysis data, draws conclusions and makes
recommendations.

The Communication phases

The communication phase is the phase that disseminates the findings of a research conducted.
This deals with writing the research report and publishing journal and conference papers from

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the review. It is the last phase of the research process and the last phase (phase 10) of Ganong
(1987) integrative literature review framework.

CONCLUSION AND RECOMMENDATIONS

Integrative literature reviews are vital research methodology for a postgraduate research
report as they give the student the foundation needed to take on doctoral studies in their
chosen are of specialization. Ganong’s (1987) stages fit into the research process and the
research report formats and can be used effectively for a master’s degree research. The
integrative review framework for a master degree research report is comprehensive,
systematic and easily applicable in conducting integrative reviews leading to the partial
fulfilment of a master’s degree in nursing and related fields of study.

It is recommended that the framework for conducting a comprehensive academic integrative

literature review for use by master’s students and supervisors in conducting integrative
literature reviews leading to partial fulfilment of a master’s degree in nursing and related
fields of study. Further research and evaluation of the framework are needed to improve the
framework and the integrative review methodology.

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