Printer Friendly

Evidence-Based Reviews: Trends in Nephrology Nursing.

Evidence-based practice (EBP) is a key foundation of the nursing profession. Given the value of EBP in nursing, there is an increasing emergence of review papers to form the basis for practice, theory, and policy. Not all published research is of high quality and reliable (Aromataris & Pearson, 2014), and as such, it can be a difficult and time-consuming process to appraise this information. Published literature reviews or systematic reviews of evidence can be particularly helpful due to the synthesizing of results of many studies into one source. Discrepancies and questions exist with these reviews as the knowledge base continues to evolve.

In 2009, Grant and Booth reported 14 different evidence-based review types and methods found in the health literature. In a traditional literature review, authors present a summary of published research on a topic without any formal method of sorting, quality assessment, or rigor (Ham-Baloyi & Jordan, 2016). Literature reviews were and continue to be the common method used to investigate and communicate a practice issue or problem. Yet some researchers have suggested that literature reviews in nursing are now obsolete, and systematic reviews are now being recommended (Lockwood & Oh, 2017). The essence of a systematic review, as described by Grant and Booth in 2009, is "gathering research, getting rid of rubbish, and summarizing the best of what remains" (p. 92). Diverse research methods (qualitative, quantitative, mixed method) are commonly conducted in nursing, and as a result, different types of evidence reviews are required. This article offers nephrology nurses the opportunity to learn more about systematic reviews and examine recent trends in evidence reviews published previously in the Nephrology Nursing Journal (NNJ).

What Is a Systematic Review?

Systematic reviews are the 'cornerstone' of EBP, serving as a means to synthesize the evidence in a transparent and rigorous method to recommend best approaches and interventions (Dixon-Woods et al., 2006). Research synthesis provides well-founded knowledge, which can increase understanding of the collective patient experience, and ultimately, improve the capacity to provide effective nursing care (Schick-Makaroff, 2012). Systematic reviews have an advantage over literature reviews because while literature reviews are at risk for bias or systematic error (Aromataris & Pearson, 2014), systematic reviews tend to be rigorous and provide a summary of sound studies, which is generally more powerful than results of a single study (DiCenso Cullum, & Ciliska, 1998). Systematic reviews should be conducted with the same rigor expected of all research--comprehensive, unbiased, and reproducible. The process for a systematic review includes multiple logical steps, including the development of a research question and an overall method developed and agreed upon by research team members, stated inclusion/exclusion criteria, selection of studies, critical appraisal, planned data extraction performed independently then discussed collaboratively, an outlined method for resolving discrepancies, and a detailed data analysis that is potentially reproducible (see Table 1). The research question should guide the method (Aromataris & Pearson, 2014). The data analysis or synthesis can be performed with statistics (metaanalysis), qualitative synthesis, or a narrative descriptive synthesis (Holly, Salmond, & Saimbert, 2011).

There are some disadvantages to systematic reviews. Systematic reviews are time-consuming to complete, trained nurse researchers in this area may be lacking, data may be too little or too great to synthesize, and it may be difficult for authors to get this type of research published (Ham-Baloyi & Jordan, 2016). It remains a topic of debate whether nurses in graduate school should acquire the skill to complete a systematic review during their studies, recognizing it may lengthen the time to degree completion (Ham-Baloyi & Jordan, 2016). The authors of this review acknowledge the tremendous benefit of systematic reviews, but often find inconsistent labeling as to the type of review, unclear methods used, and gaps in how data were synthesized. For the purposes of this paper, the term 'evidence review' was used as an overall classification (see Figure 1).

Research Aim

The use and current understanding of evidence reviews in nephrology nursing is unknown. This systematic review was conducted with the goal of providing some guidance and recommendations for further research. The research question that guided this systematic review was as follows: What are the trends in the publication of evidence reviews (literature reviews and systematic reviews) in NNJ? The research team was assembled by the primary authors who defined the aim of the systematic review, the methodology to be used, and duties of team members.


Search and Selection of Studies

Titles of all publications in the NNJ from January 2003 to April/May 2018 were hand-searched. The research team's decision to examine publications in NNJ for this 16-year time period was an arbitrary one because there were no formal guidelines in the literature as to the appropriate length of time for such a review. The search included all publications that stated they were review articles, such as systematic reviews, literature reviews, and concept analyses. Key words included in the search of titles were literature review, systematic review, meta-synthesis, meta-analysis, scoping review, narrative review, meta-ethnography, integrative review, concept review, concept analysis, and review. If there was any question regarding inclusion/ exclusion criteria for our systematic review, the abstract was reviewed and consideration given for inclusion with a conservative approach to exclusion. The decision to do a hand search versus an electronic search was made due to the ease of availability of print copies of NNJ and that the review was focused on only one journal. Titles and abstracts from the search were then reviewed by a second author for preliminary inclusion in the systematic review. Full articles were reviewed by both authors independently and then discussed. Discrepancies regarding inclusion in the review were discussed by the authors.

Data Collection and Summarizing the Data

Two data extraction forms were developed and used to retrieve the data. One included data on characteristics of each paper, such as author(s), country, type of review, results of the study or project, and conclusion. This was conducted by one author and reviewed by a second. The second extraction focused on the method of the review, such as sample size, type of review, aim/research question, search strategy, appraisal/consensus, and analysis (see Table 2). The second data extraction was completed independently by one author and reviewed by a second. Discrepancies were discussed after this extraction regarding inclusion/exclusion criteria. A supplemental search was conducted for publications in NNJ from June 2018 to September/October 2018 prior to submission of this paper. Results of that review did not reveal any further publications that met inclusion criteria for this review.

No formally established critical appraisal tool was used to assess for quality. Instead, each systematic review of the literature was appraised by the details of the components of a systematic review and narratively synthesized (Popay et al., 2006).


After review of the titles in NNJ, a total of 23 articles were found. The total number of publications in NNJ from the years 2003-2018 was not recorded. After reviewing all 23 papers in full, two publications were discussed regarding their inclusion in the review. The decision to include the two papers (Carter & Ratnam, 2013; Zornzanello, Fleming & Prowant, 2001) in the review was based on the authors titling their articles literature reviews and then applying that literature to a clinical problem/case study.

Synthesis Results

Characteristics of the included studies. A descriptive narrative analysis was conducted to examine the data for similarities, differences, and gaps, as well as standard criteria for a systematic review. Table 2 contains details of the 23 papers included in this systematic review. Of the 23 reviews, the majority (66%) of authors were from the United States (n=15), then Canada 14% (n=3), Brazil 4% (n=1), China 4% (n=1), Korea 4% (n=1), New Zealand 4% (n=1), and Thailand 4% (n=1). This finding is most likely a reflection of the journal being published in the United States. Of the published reviews, 52% (n=12) were literature reviews, 22% (n=5) were systematic reviews, 9% (n=2) were scoping reviews, and 4% (n=3) were described as a meta-synthesis (n=1), meta-analytic review (n=1), and a psychometric review (n=1) as defined by the authors. The scoping reviews (Harwood, Wilson, & Goodman, 2017; Sauve, Vandyk, & Bourbonnais, 2016), meta-syntheses (Bayhakki & Hatthakity, 2012; Schick Makaroff, 2012), meta-analytic reviews (Landreneau, Lee, & Landreneau, 2010) and psychometric reviews (Danquah, Wasserman, Meininger, & Bergstrom, 2010) were further categorized under the broad category of a systematic review, based upon components of systematic reviews described in the literature. The integrative literature review (Pilger, Molzahn, Pilotto de Oliveira, & Kumato, 2016) was categorized as a systematic review because the method was clearly described and transparent, which met criteria for a systematic review. This resulted in 52% (n=12) of the articles reviewed being categorized as systematic reviews and 48% (n=11) as literature reviews.

Publications from 2015-2018 included more systematic reviews (n=7) as compared to only four literature reviews, for a total of 11 publications during that time period. This is an increase in total reviews published, with only 12 reviews having been published between the years of 2003-2014; five of these were categorized as systematic reviews and seven as literature reviews. The number of research articles included in the systematic reviews ranged from six (Cervantes, Zoucha, Jones, & Fischer, 2016) to 36 (Harwood et al., 2017). Some literature reviews (n=4) reported the number of research papers in their review, while others did not (n=7).

In the 12 systematic reviews, the most common type of research studies or data reviewed were quantitative at 42% (n=5), followed by 33% (n=4) qualitative studies with mixed methods, or with combined qualitative and quantitative, with studies least common at 25% (n=3). All systematic reviews reported a search strategy and a study aim or research question that guided the review. The most frequently used framework to guide the search strategy was Problem/Patient/Population Intervention/Indicator Comparison Outcome (PICO) (Schardt, Adams, Owen, Keitz, & Fontelo, 2007), which was used in 25% (n=3) of the studies. Eleven (n=11) systematic reviews described a method of quality appraisal for their studies, while one did not (Lockwood, Bidwell, Werner, & Lee, 2016). Further, each of the 11 systematic reviews used varied appraisal tools and methods. Different methods were used for the data synthesis, with meta-analysis (n=2) (Kim, Evangelista, & Park, 2015; Landreneau et al., 2010) being the most commonly used. Two studies did not describe their data synthesis method (n=2) (Lockwood et al., 2016; Zins, Gross, & Hooke, 2018). Various forms of qualitative synthesis were also used, including meta-synthesis-reciprocal transl ation (Schick-Makarrof, 2012), thematic synthesis (Cervantes et al., 2016), thematic analysis (Pilger et al., 2016), and metaethnography (Bayhakki & Hatthakity, 2012).

Concept Mapping of Topics

Upon further examination of the titles and topics included in the evidence review, a post hoc decision was made to use concept mapping as the best method to conceptualize this information (see Figure 2). Concept mapping is a strategy that can be utilized to visually explore relationships among articles included in a systematic review (Popay et al., 2006). In this case, it offers a graphical synopsis of publication trends in NNJ from January 2003 to September/October 2018. Development of the concept map was guided by the aforementioned research question, and the method described by Popay and colleagues (2006). Concept mapping was done individually by three of the authors, then preliminary drafts were compared and discussed. It was developed by reviewing the titles and content of the 23 evidence-based reviews. Specifically, for each article, the purpose statement and results sections were reviewed to examine the focus of the content. The title of each evidence-based review was then paraphrased into a heading that represents the key concept of the title. Each evidence-based review is depicted by a heading and rectangular box in the concept map. All 23 headings were further examined and sorted based on topic. Each concept was depicted by a heading and shaded circle. Three concepts were identified that pertained to quality of life, access to health services, and interventions. These three concepts were interconnected to a central concept related patient experience. Four titles aligned most appropriately to the patient experience concept.


This review is the first to examine the types, quality, and trends of evidence-based reviews found in NNJ from January 2003-September/0ctober 2018. Results of this review have revealed significant variations in the types of reviews conducted, with quantitative being the most common. The extraction demonstrated that the purpose/ research aims of the systematic reviews were stated 100% of the time, and seemingly appropriate research methods followed to address/guide the question(s) in each review. It is important to note that chronologically, earlier publications were more consistent with literature reviews, while systematic reviews have become more predominant since 2015. This is a positive trend that supports the growth of EBP in nephrology nursing.

One challenge identified throughout this review was the differences and inconsistencies in the literature regarding of the use of the term 'systematic review.' This provided an area of debate for the authors. In the end, evidence reviews were categorized under the broad category of a systematic review if they contained elements of a systematic review (see Figure 1). For example, systematic review was used as the broad category, and the scoping reviews, integrative review, meta-analytic review, and meta-syntheses were all classified as types of systematic reviews. Dixon-Woods and colleagues (2006) have questioned whether systematic reviews are meant to describe specific and well-defined methodology (e.g., meta-analysis) and characteristics or if they are a broad framework for synthesis of many forms of evidence. There is currently no definitive method for this categorization. Clarity and agreement in using consistent terminology in this area would be beneficial.

Results of this review demonstrated the authors of these systematic reviews include the important details regarding purpose, search strategy, inclusion criteria, quality appraisal, and synthesis of the data. In contrast, these details are not consistently reported in literature reviews, leading to gaps in available information for the individual(s) searching the literature. This highlights the advantage of a systematic review in terms of both transparency and rigor. Unfortunately, there were several publications in which the authors labeled the paper as a systematic review; however, some aspects of the methods that are essential to systematic reviews were omitted. The most common omission was a description of how data were synthesized, which is a key component in reducing bias. The onus is on authors to include detailed information in the publication and on peer reviewers to question the authors regarding these important details.

In addition, there was also great variability in how data were synthesized and appraised, with no consistent instrument used, highlighting the diversity in nursing research methods. The qualitative reviews and meta-analysis reviews were clear on the analysis method. However, for studies deemed neither purely qualitative or purely quantitative in design, the data synthesis method was not always explicitly stated. The readers must then assume data were analyzed as a narrative synthesis, the synthesis of multiple studies using words and text (Popay et al., 2006). More clarity in how study methods for the data synthesis are described in the literature would reduce ambiguity in the future.

In 1999, the ANNA Research Committee conducted a Delphi study to identify and prioritize research topics that were important to nephrology nurses (Lewis The Delphi technique is a research method that aims to seek out information from experts with the goal to building a consensus of opinion among a group. It involves the completion of a series of questionnaires by a group of participants distributed at regular intervals as a means to achieving this consensus (Keeney, Hasson, & McKenna, 2011). Results included five areas of research priorities: 1) nursing interventions for infections related to vascular access, 2) nursing interventions to maintain vascular access patency, 3) educational needs of patients and families, 4) nursing competence and patient outcomes, and 5) nursing interventions to achieve improved patient outcomes (Lewis et al., 1999). From our analysis, a number of evidence reviews were conducted in these identified priority areas. One review was conducted on vascular access (Harwood et al., 2017); one on access patency, although in peritoneal dialysis catheters and not vascular access (Zorzanello et al., 2004); and one regarding education and modality choices (Key, 2008). However, no reviews were published on vascular access infections or nursing competence. Some reviews were conducted on nursing interventions to achieve patient outcomes on topics such as fatigue interventions (Astroth, Russell, & Welch, 2013); calciphylaxis (Carter & Ratnam, 2013), cannulation outcomes (Harwood et al., 2017), music and anxiety (Kim et al., 2015), and complementary pain therapies (Zins et al., 2018). It is important to note that systematic reviews may have been conducted on these topics but published in other journals. In addition, it is important to acknowledge that individual research studies on a particular topic would not have been captured in this review.

Research priorities for individuals with chronic kidney disease (CKD) who are not on dialysis have recently been reported following surveys administered to caregivers, people with CKD, health care providers, researchers, and policy makers (Hemmelgarn et al., 2017). The top research priorities the authors identified were treatments and lifestyle adjustments to prevent the progression of CKD, symptom management, provider-patient collaborative strategies for managing CKD, harmful effects of medications, optimal treatments for cardiovascular disease in patients with CKD, early identification of kidney disease, and access to care (Hemmelgarn review, the majority of studies focused on hemodialysis or transplantation, not on the earlier stages of CKD. There would appear to be a gap in the literature with respect to the aforementioned CKD topics. Once again, these reviews may have been conducted but published in journals other than NNJ or as individual studies not captured in this review. Access to care/health services was the focus of several published evidence reviews (see Figure 2). There was also an appreciable quantity of reviews published in the areas of quality of life and understanding the patient experience. This is a positive finding and may reflect efforts to address symptom management/burden, which is identified above as a priority area.

The most prominent concept studied/investigated was quality of life, encompassing reviews exploring lifestyle dimensions for patients with end stage renal disease. Seven papers were included in that category. Concepts of access to health services and interventions were each included in six reviews. For this review, the access to health services category refers to barriers and facilitators to renal disease treatment. Similarly, the interventions category refers to interventions implemented by health care staff as part of renal disease treatment. The model in Figure 2 depicts how the patient experience is central and influenced through bilateral relationships to the other three concepts (quality of life, access to health services, and interventions).


There are several limitations with this systematic review. First, the authors acknowledge a publication bias because the review included publications from only one journal and may not reflect trends in other parts of the world with respect to nephrology nursing. This review does not address the question of evidence reviews in nephrology nursing published in journals other than NNJ and may not be generalizable beyond that context. The total number of publications and titles searched was not recorded, which is commonly reported in systematic reviews. This review also has a language bias because only articles written in English are published in NNJ.

Finally, it is important to acknowledge that this examination of publications in NNJ was merely to examine the types of reviews and information reported in publications during the designated time period. The intent was not to compare literature reviews to systematic reviews nor to compare or critique the quality of the literature reviews to those of systematic reviews. The outcome of this analysis reinforces there are no standard criteria by which to appraise the literature reviews.

Implications for Future Research

This systematic review of publication trends of evidence reviews in NNJ highlights some implications for future research. On a positive note, this review highlights a trend toward more transparency and rigor in the recent reviews. Some reviews were conducted in priority areas of research; however, this can be improved because presumably, these priority areas are also important for evidence-based nursing practice. Currently, nursing research methodology tends to be pluralistic, including qualitative, quantitative, and mixed, and is an area for further generation of evidence. This article also serves as a resource to other investigators conducting systematic reviews because it identifies several resources available to perform evidence reviews, such as appraisal tools and synthesis methods (see Table 2).


Literature reviews continue to be published in NNJ; however, the trend in recent years is a greater emphasis on systematic reviews of quantitative and/or qualitative data. Published evidence-based reviews have most commonly focused on quality of life. There is a need for systematic, rigorous reviews as related to EBP, as well as a need for future reviews on identified priority areas of research.


Aromataris, E., & Pearson, A. (2014). The systematic review: An overview. American Journal of Nursing, 114(3), 53-58.

Astroth, K.S., Russell, C.L., & Welch, J.L. (2013). Non-pharmaceutical fatigue interventions in adults receiving hemodialysis: A systematic review. Nephrology Nursing Journal, 40(5), 407-427.

Bayhakki, & Hatthakit, U. (2012). Lived experiences of patients on hemodialysis: A meta-synthesis. Nephrology Nursing Journal, 39(4), 295-304.

Bridge, A.B., & Holt, K.E. (2015). Effect of nocturnal dialysis on prognosis in adult patients: A review of the literature. Nephrology Nursing Journal, 42(4), 375-379.

Carter, T., & Ratnam, S. (2013). Calciphylaxis: A devastating complication of derangements of calcium-phosphorus metabolism--A case report and review of the literature. Nephrology Nursing Journal, 40(5), 431-435.

Cesario, S., Morin, K., & Santa-Donato, A. (2002). Evaluating the level of evidence of qualitative research. Journal of Obstetric, Gynecologic & Neonatal Nursing, 31(6), 708-714.

Cervantes, L., Zoucha, J., Jones, J., & Fischer, S. (2016). Experience and values of Latinos with end stage renal disease: A systematic review of qualitative studies. Nephrology Nursing Journal, 43(6), 479-493.

Danquah, F.V., Wasserman, J., Meininger, J., & Bergstrom, N. (2010). Quality of life measures for patients on hemodialysis: A review of psychometric properties. Nephrology Nursing Journal, 37(3), 255-269.

DiCenso, A., Cullum, N., & Ciliska, D. (1998). Implementing evidence-based nursing: Some misconceptions. Evidence-Based Nursing, 1(2), 38-40.

Dixon-Woods, M. Bonas, S., Booth, A., Jones, D.R., Miller, T., Sutton, AJ., ... Young, B. (2006). How can systematic reviews incorporate qualitative research? A critical perspective. Qualitative Research, 6(1), 27-44.

Elliott, R.W. (2012). Demographics of the older adult and chronic kidney disease: A literature review. Nephrology Nursing Journal, 39(6), 491-496.

Ford, D., & Steele-Moses, S. (2011). Predictors for African Americans' willingness to donate organs: A literature review. Nephrology Nursing Journal, 38(5), 405-409, 415.

Grant, MJ., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information and Libraries Journal, 26(2), 91-108.

Guo, YJ., Tang, Q., & Gu, Y. (2017). Measurements of self-efficacy in patients with chronic kidney disease: A literature review. Nephrology Nursing Journal, 44(2), 159-176.

Ham-Baloyi, W.T., & Jordan, P. (2016). Systematic review as a research method in post-graduate nursing education. Health SA Gebsondheid, 21, 120-128.

Haras, M.S., Astroth, K.S., Woith, W.L., & Kossman, S.P. (2015). Exploring advance care planning from the nephrology nurse perspective: A literature review. Nephrology Nursing Journal, 42(1), 23-35.

Harwood, L., Wilson, B., & Goodman, M. (2017). Cannulation outcomes of the arteriovenous fistula for hemodialysis: A scoping review. Nephrology Nursing Journal, 44(5), 411-425.

Hemmelgarn, B.R., Pannu, N., Ahmed, S.B., Elliott, MJ., Tam-Tham, H., Lillie, E., ... Laupacis, A. (2017). Determining the research priorities for patients with chronic kidney disease not on dialysis. Nephrology Dialysis Transplantation, 32(5), 847-854, doi:10.1093/ndt/gfw065

Holly, C., Salmond, S., & Saimbert, M.K. (Eds.). (2011). Comprehensive systematic review for advanced practice nursing. New York, NY: Springer Publishing Company.

The Joanna Briggs Institute, (2015). The Joanna Briggs' Institute reviewers' manual 2015: Methodology for JBI scoping reviews. Retrieved from Reviewers-Manual_Methodology-for-JBI-ScopingReviews_2015_v1.pdf

Keeney, S., Hasson, F., & McKenna, H. (2011). The Delphi technique in nursing and health research. West Sussex UK: A John Wiley & Sons, Ltd.

Key, S.M. (2008). Optimizing dialysis modality choices around the world: A review of literature concerning the role of enhanced early pre-ESRD education in choice of renal replacement therapy modality. Nephrology Nursing Journal, 35(4), 387-394.

Kim, Y., Evangelista, L.S., & Park, Y.G. (2015). Anxiolytic effects of music interventions in patients receiving in center hemodialysis: A systematic review and meta-analysis. Nephrology Nursing Journal, 42(4), 339-347.

Landreneau, K., Lee, K., & Landreneau, M.D. (2010). Quality of life in patients undergoing hemodialysis and renal transplantation --A meta-analytic review. Nephrology Nursing Journal, 37(1), 37-44.

Lewis, S.L., Cooper, C.L., Cooper, K.G., Bonner, P.N., Parker, K., & Frauman, A. (1999). Research priorities for nephrology nursing: American Nephrology Nurses' Association's delphi study. ANNA Journal, 26(2), 215-225.

Lockwood, C., & Oh, E.G. (2017). Systematic reviews: Guidelines, tools, and checklists for authors. Nursing and Health Sciences, 19(3), 273-277.

Lockwood, M.B., Bidwell, J.T., Werner, D.A., & Lee, C.S. (2016). Non-biological barriers to referral and the pre-kidney transplant evaluation among African Americans in the United States: A systematic review. Nephrology Nursing Journal, 43(3), 225-238.

Melnyk, B.M., & Fineout-Overholt, E. (2015). Rating system for the hierarchy of evidence for intervention/treatment questions in Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed., p. 11). Philadelphia, PA: Wolters Kluwer Health.

National Collaborating Centre for Methods and Tools. (2008). Quality assessment tool for qualitative studies. Hamilton, ON, Canada: McMaster University. Retrieved from http://,html

Pilger, C., Molzahn, A.E., Pilotto de Oliveira, M., & Kusumota, L. (2016). The relationship of the spiritual and religious dimensions with quality of life and health of patients with chronic kidney disease: An integrative literature review. Nephrology Nursing Journal, 43(5), 411-426.

Polaschek, N. (2003). The experience of living on dialysis: A literature review. Nephrology Nursing Journal, 30(3), 303-313.

Popay, J., Roberts, H., Sowden, A., Petticrew, M., Arai, L., Rodgers, M., ... Duffy, S. (2006). Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC Methods Programme. doi:10.13140/2.1.1018.4643

Roy, C., & Andrews, H. (1991). The Roy Adaptation Model: The definitive statement. Norwalk, CT: Appleton & Lange

Sandelowski, M., & Barroso, J. (2003). Classifying the findings in qualitative studies. (Qualitative Health Research, 13(7), 905-923. doi:10.1177/1049732303253488

Sandelowski, M., Barroso, J., & Voils, C.I. (2007). Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings. Research in Nursing and Health, 30(1), 99-111. doi:10.1002/nur.20176

Sauve, C., Vandyk, A.D., & Bourbonnais, F.F. (2016). Exploring the facilitators and barriers to home dialysis: A scoping review. Nephrology Nursing Journal, 43(4), 295-308.

Schardt, C., Adams, M.B., Owens, T., Keitz, S., & Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics and Decision Making, 7, 16. doi:10.1186/1472-69477-1

Schick-Makaroff, K. (2012). Experiences of kidney failure: A qualitative meta-synthesis. Nephrology Nursing Journal, 39(1), 21-29.

Stewart, M. (2006). Narrative literature review: Sexual dysfunction in the patient on hemodialysis. Nephrology Nursing Journal, 33(6), 631-641.

Tong, A., Flemming, K., McInnes, E., Oliver, S., & Craig, J. (2012). Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology, 12(181), 1-8. doi:10.1186/1471-2288-12-181

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. doi: 10.1093/ intqhc/mzm042

Ursi, E.S. (2005). Provencao de lesoes de pele no perioperatorioL Revisaeintegrativa da literature [Prevention of skin lesions perioperatively: Integrative literature review] [Doctoral thesis]. Ribeirao Preto: University of Sao Paulo at Riberao Preto College of Nursing.

Williams, L.A., Wicks, M.N., Graff, J.C., Cowan, P.A., White-Means, S., Caldwell, L.D., & Tolley, E.A. (2016). Male caregivers of persons with end stage renal disease: A literature review. Nephrology Nursing Journal, 43(6), 495-519.

Zins, S., Gross, R., & Hooke, M.C. (2018). Complementary therapies for pain among individuals receiving hemodialysis: A systematic review. Nephrology Nursing Journal, 45(1), 13-23.

Zorzanello, M.M., Fleming, W.J., & Prowant, B.E. (2004). Use of tissue plasminogen activator in peritoneal dialysis catheters: A literature review and one center's experience. Nephrology Nursing Journal, 31(5), 534-537.

Copyright 2019 American Nephrology Nurses Association

Lori Harwood, PhD, RN(EC), CNeph(C), is a Nurse Practitioner, Hemodialysis, London Health Sciences Centre, London, Ontario, Canada; a member of the ANNA Research Committee; and a member of ANNA's MichigANNA Chapter.

Barbara Wilson, MScN, RN(EC) CNeph(C), is a Nurse Practitioner, Hemodialysis, London Health Sciences Centre, London, Ontario, Canada; and a member of ANNA's MichigANNA Chapter.

Darrin Pye, BScN, RN, is a Research Assistant, London Health Sciences Centre, London, Ontario, Canada.

Nicole Stroud, BAS, is a Research Assistant, London Health Sciences Centre, London, Ontario, Canada.

Statement of Disclosure: The authors reported no actual or potential conflict of interest in relation to this continuing nursing education activity.

Note: Additional statements of disclosure and instructions for CNE evaluation can be found on page 260.

Exploring the Evidence is a department in the Nephrology Nursing Journal designed to provide a summary of evidence-based research reports related to contemporary nephrology nursing practice issues. Content for this department is provided by members of the ANNA Research Committee. Committee members review the current literature related to a clinical practice topic and provide a summary of the evidence and implications for best practice. Readers are invited to submit questions or topic areas that pertain to evidence-based nephrology practice issues. Address correspondence to: Tamara Kear, Exploring the Evidence Department Editor, ANNA National Office, East Holly Avenue/Box 56, Pitman, NJ 08071-0056; (856) 256-2320; or via e-mail at The opinions and assertions contained herein are the private views of the contributors and do not necessarily reflect the views of the American Nephrology Nurses' Association.

Caption: Figure 1

Evidence-Based Reviews Classification

Caption: Figure 2

Concept Map
Table 1

Characteristics of a Systematic Review

* Research team +/- health librarian

* Clearly stated plan and methods which are peer
  reviewed by the research team

* Articulated research question

* Objectives/Aim

* Stated inclusion and exclusion criteria

* Comprehensive search

* Method for determining eligible studies

* Appraisal of quality of research

* Data extraction method

* Synthesis/data analysis method

* Transparent reporting of findings

* Recommendations/conclusions

Table 2
Details of Evidence Reviews

Author               Size *    Country    Review Type

Astroth, Russell,      25      United     Systematic
& Welch (2013)                 States     review

Bayhakki &             10      Thailand   Meta-
Hatthakity (2012)                         synthesis

Bridge & Holt        Unclear   United     Literature
(2015)                         States     review

Carter & Ratnam                United     Literature
(2013)                         States     review and
                                          case report

Cervantes, Jones,       6      United     Systematic
Zoucha, & Fischer              States     review

Danquah,               34      United     A review of
Wasserman,                     States     psychometric
Meininger, &                              properties
Bergstrom (2010)                          [systematic

Elliott (2012)                 United     Literature
                               States     review

Ford & Steele-         12      United     Literature
Moses (2011)                   States     review

Guo, Tang, & Gu                China      Literature
(2017)                                    review

Haras, Astroth,        20      United     Literature
Woith, & Kossman               States     review

Harwood, Wilson,       36      Canada     Scoping
& Goodman                                 review

Key (2008)                     United     Literature
                               States     review

Kim, Evangelista,       7      Korea      Systematic
& Park (2015)                             review

Landreneau, Lee,       16      United     Meta-Analytic
& Landreneau                   States     review

Lockwood,              24      United     Systematic
Bidwell, Werner, &             States     review
Lee (2016)

Pilger, Molzahn,       11      Brazil     Integrative
Pilotto de                                literature
Oliveira, &                               review
Kumuota (2016)                            [systematic

Polaschek (2003)        8      New        Literature
                               Zealand    review

Sauve, Vandyk, &       12      Canada     A scoping
Bourbonnais                               review

Schick-Makaroff,       13      Canada     Meta-
(2012)                                    synthesis

Stewart (2006)         31      United     Literature
                               States     review

Williams et al.                United     Literature
(2016)                         States     review

Zins, Gross, &          8      United     Systematic
Hooke (2018)                   States     review

Zorzanello,                    United     Literature
Fleming, &                     States     review and
Prowant (2004)                            one center's

                                                 Search Strategy/
Author                 Aim/Research Question       Type of Data

Astroth, Russell,    Examine the effectiveness   Electronic
& Welch (2013)       of non-pharmacologic        Reference lists
                     interventions used to       hand
                     minimize fatigue.           searched


Bayhakki &           Overview of qualitative     Electronic
Hatthakity (2012)    research on lived
                     experience of patients
                     on HD.

Bridge & Holt        Comparing the prognosis     Electronic
(2015)               for patients undergoing
                     nocturnal HD compared to    Quantitative
                     conventional HD.

Carter & Ratnam      Overview of calciphylaxis
(2013)               and its treatment.

Cervantes, Jones,    Examine qualitative         Electronic
Zoucha, & Fischer    studies to gain a deeper    Reference lists
(2016)               understanding of the        hand searched
                     cultural values and
                     traditions that influence   Health librarian
                     the experience,
                     perceptions and behaviors   ENTREQ reporting
                     of Latino patients with     guidelines
                     ESRD and caregiver.         (Tong, Flemming,
                                                 McInnes, Oliver,
                                                 & Craig, 2012)

Danquah,             Overview of QOL             Electronic
Wasserman,           instruments and their       Reference lists
Meininger, &         reliability and validity    hand searched
Bergstrom (2010)     when used in patients
                     with ESRD.                  Quantitative

Elliott (2012)       Overview of demographics
                     of older adults with CKD.

Ford & Steele-       Overview of the             Electronic
Moses (2011)         predictive factors for      Quantitative
                     African Americans
                     willingness to donate

Guo, Tang, & Gu      Review the measurement
(2017)               tools of self-efficacy
                     for patients with CKD.

Haras, Astroth,      Explore the literature      Electronic
Woith, & Kossman     about ACP from the          Reference lists
(2015)               nephrology nurse            hand searched

Harwood, Wilson,     To examine the nature and   Electronic
& Goodman            distribution of relevant    Health librarian
(2017)               studies regarding patient   Grey literature
                     and provider perspectives   included
                     on successful/unsuccessful  Reference lists
                     cannulation of the AVF.     hand searched

                                                 search prior to


Key (2008)           What is the nature of
                     current evidence on the
                     effects of early pre-ESRD
                     education and RRT
                     modality availability of
                     self-care selection.

Kim, Evangelista,    Identify the                Electronic
& Park (2015)        methodological quality      Grey literature
                     and examine the             included
                     effectiveness of music      Reference lists
                     interventions on anxiety    hand
                     in people on HD.            searched


Landreneau, Lee,     Provide a synthesis of the  Quantitative
& Landreneau         effectiveness of renal      studies
(2010)               transplantation in
                     improving QOL and           Electronic
                     physical functioning.

Lockwood,            To synthesize the current   Electronic
Bidwell, Werner, &   literature related to non-  Reference lists
Lee (2016)           biological barriers to      hand searched
                     early stages of the pre-    Quantitative and
                     kidney transplant           Quantitative
                     continuum for African

Pilger, Molzahn,     What is the relationship    Electronic
Pilotto de           between religious and       Quantitative
Oliveira, &          spiritual dimensions of     studies
Kumuota (2016)       QOL with health for         Qualitative
                     people with CKD?            studies

Polaschek (2003)     To understand the           Qualitative
                     experience of people
                     living on dialysis.

Sauve, Vandyk, &     Identify facilitators and   Electronic
Bourbonnais          barriers related to         Reference
(2016)               patients' uptake and use    lists hand
                     of home dialysis.           searched


Schick-Makaroff,     Examine the research on     Electronic
(2012)               individuals' experiences    Reference lists
                     of kidney failure and       hand searched
                     document interpretation
                     of this phenomenon.         Qualitative

Stewart (2006)       Review the literature for   Electronic
                     descriptions of health      Qualitative and
                     care providers' assessment  Quantitative
                     of sexual dysfunction and
                     the effect on adults on

Williams et al.      Examined burden,            Electronic
(2016)               depressive symptoms and     Reference lists
                     perceived health of male    hand
                     caregivers for people       searched
                     with end stage renal

Zins, Gross, &       Identify non-               Electronic
Hooke (2018)         pharmacological             Quantitative
                     complementary therapies
                     and evaluate their
                     effectiveness for
                     reducing pain for people
                     with HD.

Zorzanello,          Review of the literature
Fleming, &           for tPA administration in
Prowant (2004)       peritoneal dialysis

Author                  Appraisal/Consensus           Analysis

Astroth, Russell,    Strength and                 Reviewed for
& Welch (2013)       limitations of               purpose, design,
                     each study                   sample,
                                                  measures and

Bayhakki &           Quality assessed by          Meta-
Hatthakity (2012)    Cesario, Morin, and          ethnography
                     Santa-Donato (2002)
                     process and assigned a
                     scoring system.

Bridge & Holt        Highest level of evidence
(2015)               Melnyk (Melnyk &
                     Fineout-Overholt, 2015)
                     rating system for the
                     hierarchy of evidence

Carter & Ratnam

Cervantes, Jones,    Discussed and agreement      Thematic
Zoucha, & Fischer    reached                      synthesis
(2016)               COREQ framework (Tong,
                     Sainsbury, & Craig, 2012)

Danquah,                                          The review
Wasserman,                                        focused on
Meininger, &                                      reports of
Bergstrom (2010)                                  evidence of
                                                  stability, and
                                                  between ratings

Elliott (2012)

Ford & Steele-       Appraisal done               Comparisons
Moses (2011)                                      of sample,
                                                  and findings

Guo, Tang, & Gu

Haras, Astroth,      Title and abstract           Conceptual
Woith, & Kossman     reviewed                     framework to
(2015)                                            guide analysis.
                                                  Review of

Harwood, Wilson,     PICO (Schardt et al.,        Narrative
& Goodman            2007) to identify            analysis
(2017)               potential studies            Research
                                                  examined on the
                     Discussion and               topic, nature,
                     consensus                    results and
                     Quality assessment-          studies in
                     Critical Appraisal           the context
                     skills                       of the
                     Program checklist            collective body

Key (2008)

Kim, Evangelista,    PICO (Schardtet al.,         Meta-analysis
& Park (2015)        2007) to identify study
                     Quality Assessment tool
                     for Quantitative Studies
                     (QATOS) (National
                     Collaborating Centre for
                     Methods and Tools, 2008)
                     Discussion and

Landreneau, Lee,     Discussion and               Meta-analysis
& Landreneau         consensus

Bidwell, Werner, &
Lee (2016)

Pilger, Molzahn,     Data extraction form         Results
Pilotto de           developed by Ursi (2005)     organized
Oliveira, &          which includes evaluation    by themes
Kumuota (2016)       of rigor.

Polaschek (2003)

Sauve, Vandyk, &     Joanna Briggs                Meta-synthesis
Bourbonnais          Methodology for              Content analysis
(2016)               systematic reviews (The      with Constant
                     Joanna Briggs Institute,     Comparison
                     2015)                        approach and
                     PICO (Schardt et al.,        narratively
                     2007) used to identify the   reported the
                     inclusion criteria           synthesized
                     Discussion and consensus     interpretations

Schick-Makaroff,     Audit trail of decisions     Meta-synthesis-
(2012)               made (Sandelowski &          reciprocal
                     Barroso, 2003;               translation
                     Sandelowski, Barroso, &
                     Voils, 2007) typology
                     qualitative findings.

Stewart (2006)       Roy's Adaptation Model       Descriptive
                     (Roy & Andrews, 1991)        narrative

Williams et al.      Quality assessment
(2016)               based upon design,
                     interventions, pain
                     measures, limitations
                     and strengths.

Zins, Gross, &
Hooke (2018)

Fleming, &
Prowant (2004)

Notes: Blank = not described.

* Refers to the numbers of research papers included in the review.

HD = hemodialysis; QOL = quality of life; ESRD = end stage renal
disease; CKD = chronic kidney disease; AVF = arteriovenous fistual;
ACP = advance care planning; PICO = Problem/Patient/Population,
Intervention/Indicator, Comparison, Outcome; RRT = renal replacement
COPYRIGHT 2019 Jannetti Publications, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2019 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Exploring the Evidence
Author:Harwood, Lori; Wilson, Barbara; Pye, Darrin; Stroud, Nicole
Publication:Nephrology Nursing Journal
Article Type:Report
Date:Mar 1, 2019
Previous Article:Standing on the Shoulders of Giants: Innovations in Dialysis.
Next Article:Changing the World--Nurses as Inventors.

Terms of use | Privacy policy | Copyright © 2022 Farlex, Inc. | Feedback | For webmasters |