original research articles in nursing

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Nursing students’ stressors and coping strategies during their first clinical training: a qualitative study in the United Arab Emirates

Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and probl...

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Nurses’ and patients’ perceptions of physical health screening for patients with schizophrenia spectrum disorders: a qualitative study

Despite worldwide concern about the poor physical health of patients with schizophrenia spectrum disorders (SSD), physical health screening rates are low. This study reports nurses’ and patients’ experiences o...

Pre-treatment assessment of chemotherapy for cancer patients: a multi-site evidence implementation project of 74 hospitals in China

Chemotherapy, whilst treating tumours, can also lead to numerous adverse reactions such as nausea and vomiting, fatigue and kidney toxicity, threatening the physical and mental health of patients. Simultaneous...

Effectiveness of simulation-based interventions on empathy enhancement among nursing students: a systematic literature review and meta-analysis

This study aimed to secure and analyze evidence regarding the enhancement of nursing students’ empathy through simulation-based interventions. It comprehensively analyzed self-reported emotions and reactions a...

The role of nurses for patients with Parkinson’s disease at home: a scoping review

Parkinson’s disease is a neurodegenerative disease, and many patients are cared for at home by nurses. Parkinson’s disease nurse specialists have been certified in several countries. This study aimed to provid...

Predictive factors of occupational stress among nurses during the COVID-19 pandemic: a cross-sectional study in Kashan, Iran

Considering the severe and sudden changes in the job conditions of nurses during the covid-19 pandemic, the increase in job tensions during this critical period and its consequences on the quantity and quality...

Improve the satisfaction of medical staff on the use of home nursing mobile APP by using a hybrid multi-standard decision model

To identify critical satisfaction gaps in a home nursing mobile application (APP) using a systematic decision-making model.

Nurses′ knowledge and practice about neonatal pain management in public hospitals in West Oromia, Ethiopia, 2022: multi-centered cross-sectional study

In low-and middle-income countries inadequate neonatal pain management persists as a significant public health issue despite the availability of guidelines. Newborns often experience pain from routine medical ...

Working with a robot in hospital and long-term care homes: staff experience

Although there is a growing literature on the use of telepresence robots in institutional dementia care settings, limited research focused on the perspectives of frontline staff members who deliver dementia ca...

Translation and psychometric testing of the Persian Version of nurses’ ethical decision-making in End-of-Life Care Scale

Ethical decision-making in end-of-life care is one of the most challenging aspects of healthcare: providing ethical care to the society is one of the most important responsibilities of healthcare professionals...

Unraveling the synergy: how organizational intelligence fuel soft skills and nurses’ thriving: a cross-sectional study

Investigate the influence of organizational intelligence on the development of soft skills and the overall thriving of nurses at Alexandria Main University Hospital in Egypt.

Experience of undergraduate nursing students participating in artificial intelligence + project task driven learning at different stages: a qualitative study

Artificial intelligence is a growing phenomenon that will soon facilitate wide-scale changes in many professions, and is expected to play an important role in the field of medical education. This study explore...

Job performance and associated factors among nurses working in adult emergency departments at selected public hospitals in Ethiopia: a facility-based cross-sectional study

Optimizing the performance level of nursing staff is crucial for the efficient functioning of hospitals and better patient health outcomes. However, published data on the job performance levels and associated ...

The impact of nurse’s sense of calling, organizational commitment, job stress, and nursing work environment on patient safety management activities in comprehensive nursing care service units during the covid-19 pandemic

As the number of COVID-19 patients rises, there has been a notable increase in the workload for nurses. However, medium-sized hospitals lacked standardized protocols or consistent approaches to address the spe...

Spiritual nursing education programme for nursing students in Korea: a systematic review and meta-analysis

This study conducts a systematic review and meta-analysis to understand the characteristics and contents of studies on spiritual nursing education programmes and their effects.

Usability of Standards for Scaffolding in a Health Sciences Programme: A feasibility Study

Standards contribute to comprehensive and programmatic implementation of educational strategies, such as scaffolding. Although the development of educational standards follows a rigorous consensus approach, th...

A qualitative study of the value of simulation-based training for nursing students in primary care

Clinical placement is an essential component of nursing education, providing students with the opportunity to apply theoretical knowledge to practice. However, challenges such as lack of supervision and passiv...

Effectiveness of a family empowerment program on caregiving capacity and adverse mood in caregivers of children with acute leukemia: a quasi-experimental study

Family-centered empowerment programs have been widely used in the pediatric field. Therefore, the current study investigated the effectiveness of family empowerment programs on caregiving ability and adverse m...

Clinical nursing competency during epidemics: a qualitative content analysis

Nurses are on the frontline for managing epidemic diseases. Different aspects of clinical nursing competencies during epidemics are important issues that need investigation.

Discriminating factors of body composition characteristics for academic performance in nursing college students: a cross-sectional study

Poor body composition may affect health status, and better body composition is often associated with better academic performance. Nursing students face heavy academic and practical pressures, and the relations...

The impact of perceived work dirtiness on nursing students’ professional commitment: the mediating role of career adaptability and the moderating role of social support - a cross sectional study

Social consensus in the nursing industry is that the job is accompanied by dirtiness. It is generally accepted that negative cognition about a career is an important determinant in reducing nursing students’ p...

Home care practice behavior and its influencing factors of primary care providers: a multicenter cross-sectional study in Sichuan Province, China

Primary care providers play an important role in home health care, and their practice behavior is significant for care quality and patient outcomes. This study aimed to assess the home care practice behavior o...

Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study

The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice ...

Assessing satisfaction in simulation among nursing students: psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale

The Satisfaction with Simulation Experience scale is a 5-point Likert scale that measures students’ satisfaction in medium and high-fidelity simulation scenarios. This study aims at investigating the psychomet...

Association between self-efficacy, spiritual well-being and the willingness to provide spiritual care among nursing staff in Taiwan: a cross-sectional study

Spiritual care plays a significant role in holistic patient care, addressing not only physical ailments but also attending to patients’ emotional and spiritual well-being. While the importance of spiritual car...

Sociocultural and perceived public image of nurses among nursing students: the mediating role of self-concept

Studying the public perception of nurses among nursing students is vital in establishing strategic solutions to recruit and retain more students in nursing programs and to contain nurses in the health care sys...

Development and psychometric evaluation of "Caring Ability of Mother with Preterm Infant Scale" (CAMPIS): a sequential exploratory mixed-method study

Caring ability is one of the most important indicators regarding care outcomes. A valid and reliable scale for the evaluation of caring ability in mothers with preterm infants is lacking.

Reliability and validity assessment of the Chinese version of the Intrahospital Transport Safety Scale (IHTSS) in intensive care units

Intrahospital transport of critically ill patients is a common practice in intensive care units (ICUs), where patients’ safety is constantly challenged in high-intensity and dynamic environments. While Intraho...

Nurse rostering: understanding the current shift work scheduling processes, benefits, limitations, and potential fatigue risks

Implementing appropriate shift work schedules can help mitigate the risk of sleep impairment and reduce fatigue of healthcare workers, reducing occupational health and safety risks. In Australia, the organisat...

Exploring the relationship between nursing students’ knowledge and attitudes towards climate change and their psychological distress: a cross-national investigation

Climate change poses a worldwide challenge with anticipated exacerbation in the future, resulting in irreversible consequences. Nursing students may be vulnerable to experiencing psychological effects associat...

Adaptation and validation of a Korean version of the speaking up about patient safety questionnaire (KSUPS-Q)

Speaking up by healthcare providers is an essential assertive communication strategy for ensuring patient safety and preventing incidents. However, more is needed to know about speaking up and instruments to a...

Perceived professional preparedness and identity among senior nursing students: a latent profile Analysis

Senior nursing students’ perceptions of their professional preparedness help them for expectations of their future nursing role with more confidence, and professional identity may contribute to cultivating nur...

Exploring the relationships between resilience, burnout, work engagement, and intention to leave among nurses in the context of the COVID-19 pandemic: a cross-sectional study

Nurses have faced significant personal and professional stressors during the COVID-19 pandemic that have contributed to increased rates of burnout, intention to leave, and poorer work engagement. Resilience ha...

Attitudes, knowledge and practices concerning delirium among paediatric intensive care unit nurses: a multisite cross-sectional study in Sichuan, China

Delirium is an acute mental state associated with poor outcomes. The incidence of delirium is high, especially in the paediatric intensive care unit (PICU). It is important for staff, particularly nurses, to u...

The effect of perceived organizational justice on workplace deviant behavior of new nurses: the role of emotional labor and psychological capital

New nurses are prone to workplace deviant behavior in the constrained hospital environment, which will not only directly affect the safety of patients, but also reduce the work efficiency of nurses and bring n...

Factors promoting and impeding efforts to deprescribe antidepressants among nursing home residents with dementia– a process evaluation guided by normalization process theory

Despite recommendations against psychotropic medication in older nursing homes residents with behavioral and psychological symptoms of dementia (BPSD), antidepressants and other psychotropic drugs are still pr...

Towards a national policy on nursing education and training: an imperative framework for integrating nursing education within South Africa’s post-school education system

The aim of this study article is to present an analysis of the first national policy framework, which provides a coherent approach to integrating nursing education into a newly defined band for higher educatio...

Increasing nurses’ occupational well-being: the role of career shocks, job crafting and supervisor autonomy support

This study aims to explore the influence of career shocks on nurses’ occupational well-being through job crafting and the moderating role of supervisor autonomy support.

The caregiver contribution to self-care of stroke inventory (CC-SCSI): evaluation of psychometric characteristics

The caregiver contribution to self-care plays an important role in improving the health outcomes of chronic patients, which needs urgent attention. However, it has been hindered by the lack of a tailored instr...

Factors influencing the development of nursing professionalism: a descriptive qualitative study

The shortage of nurses threatens the entire healthcare system, and nursing professionalism can improve nurse retention and enhance the quality of care. However, nursing professionalism is dynamic, and the fact...

Missing nurses cause missed care: is that it? Non-trivial configurations of reasons associated with missed care in Austrian hospitals – a qualitative comparative analysis

Errors of omissions affect the quality of nursing care in hospitals. The Missed Nursing Care Model explains that the reasons for missed care are linked with 1) demand for patient care, 2) labor resource alloca...

Knowledge, attitude, practice, needs, and implementation status of intensive care unit staff toward continuous renal replacement therapy: a survey of 66 hospitals in central and South China

Continuous renal replacement therapy (CRRT) is a commonly utilized form of renal replacement therapy (RRT) in the intensive care unit (ICU). A specialized CRRT team (SCT, composed of physicians and nurses) eng...

Psychosocial characteristics pattern correlated with suicidal ideation and non-suicidal self-injury among nurse staff: a latent profile analysis

Nurses frequently endure elevated levels of psychosocial stress, which often correlates with an increased suicide risk. This study aimed to investigate the impact of latent psychosocial characteristic patterns...

The mediating role of flow in the relationship between simulation design and simulation educational satisfaction in korean nursing students: a cross-sectional study

In Korea, there has been recent interest in nursing simulation education. In nursing, simulation education has many advantages, such as improving nursing students’ problem-solving and judgment skills. Simulati...

Health literacy as mediator between perception of illness and self-medication behaviour among outpatients in the Kingdom of Saudi Arabia: implication to primary healthcare nursing

Perception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and S...

Knowledge levels of doctors and nurses working in surgical clinics about nutrients and food supplements, a multicentre descriptive study

The use of nutrients and food supplements is increasing worldwide. Nutrients and food supplements frequently used in the surgical period may cause complications and side effects. This study was conducted to de...

Development of nursing handoff competency scale: a methodological study

Nursing handoff competency is the ability of the nurse performing the handoff to select and interpret the necessary information for patient care and to convey it efficiently to the nurse accepting the handoff....

Factors influencing non-conveyance care encounters in the ambulance service, registered nurses experiences - a qualitative study

There is a notable variation in the percentage of non-conveyed patients within the ambulance service. Discharging patients at the scene includes a risk of adverse events, and both patients and ambulance clinic...

Prevalence of needle-stick injury in Iranian nurses: an updated systematic review and meta-analysis of observational studies

The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses.

Disaster literacy in disaster emergency response: a national qualitative study among nurses

As the largest group of healthcare professionals, nurses play an indispensable and crucial role in disaster response. The enhancement of nurses’ disaster literacy is imperative for effective disaster emergency...

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Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review

Affiliation.

• 1 M Carmen Rodríguez-García is a senior doctoral student and Verónica V. Márquez-Hernández and Genoveva Granados-Gámez are associate professors in the Department of Nursing, Physiotherapy and Medicine, Research Group for Health Sciences CTS-451, Faculty of Health Sciences, at the University of Almería in Almería, Spain. Teresa Belmonte-García and Lorena Gutiérrez-Puertas are associate professors in the Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, at the University of Almería. Contact author: Verónica V. Márquez-Hernández, [email protected]. The authors have disclosed no potential conflicts of interest, financial or otherwise.
• PMID: 32541337
• DOI: 10.1097/01.NAJ.0000681648.48249.16

Objective: As the number of Magnet hospitals continues to rise in the United States and abroad, the body of literature regarding various outcomes at Magnet hospitals is increasing also. A systematic review examining and compiling the most recent evidence would be invaluable to those seeking to pursue Magnet recognition for their facility. We conducted this systematic review to investigate how Magnet hospital status affects outcomes for nursing professionals, patients, and health care organizations.

Methods: In January 2018, the databases CINAHL, ProQuest, PubMed, and La Biblioteca Cochrane Plus were searched for relevant studies. The reference lists of selected articles were also examined to identify additional studies. The PRISMA statement was followed, and established methods for systematic review were used to produce a narrative summary. The quality of the reviewed studies was assessed according to the 22-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies.

Results: Of the 163 studies identified, 21 met the eligibility criteria and are included in this review. On the whole, lower rates of nursing shortages, burnout, job dissatisfaction, and turnover were observed at Magnet hospitals compared with non-Magnet hospitals. The rates of patient mortality, falls, hospital-acquired infections, and pressure ulcers were also lower. Nursing work environments were found to be safer and were associated with a higher quality of care in Magnet hospitals than in non-Magnet hospitals, and Magnet hospitals were found to provide more cost-effective care.

Conclusion: This review provides nursing managers and administrators with the most recent evidence demonstrating that Magnet hospitals have better nursing work environments and are associated with better outcomes for nurses, patients, and organizations than non-Magnet hospitals. This evidence should inform future decision-making with regard to pursuing Magnet designation.

Publication types

• Systematic Review
• Evidence-Based Nursing
• Hospital Administration*
• Inpatients*
• Nursing Staff, Hospital*
• Outcome Assessment, Health Care
• Quality Indicators, Health Care*

Research articles

Ultra-processed food consumption and all cause and cause specific mortality, comparative effectiveness of second line oral antidiabetic treatments among people with type 2 diabetes mellitus, efficacy of psilocybin for treating symptoms of depression, reverse total shoulder replacement versus anatomical total shoulder replacement for osteoarthritis, effect of combination treatment with glp-1 receptor agonists and sglt-2 inhibitors on incidence of cardiovascular and serious renal events, prenatal opioid exposure and risk of neuropsychiatric disorders in children, temporal trends in lifetime risks of atrial fibrillation and its complications, antipsychotic use in people with dementia, predicting the risks of kidney failure and death in adults with moderate to severe chronic kidney disease, impact of large scale, multicomponent intervention to reduce proton pump inhibitor overuse, esketamine after childbirth for mothers with prenatal depression, glucagon-like peptide 1 receptor agonist use and risk of thyroid cancer, use of progestogens and the risk of intracranial meningioma, delirium and incident dementia in hospital patients, derivation and external validation of a simple risk score for predicting severe acute kidney injury after intravenous cisplatin, quality and safety of artificial intelligence generated health information, large language models and the generation of health disinformation, 25 year trends in cancer incidence and mortality among adults in the uk, cervical pessary versus vaginal progesterone in women with a singleton pregnancy, comparison of prior authorization across insurers, diagnostic accuracy of magnetically guided capsule endoscopy with a detachable string for detecting oesophagogastric varices in adults with cirrhosis, ultra-processed food exposure and adverse health outcomes, added benefit and revenues of oncology drugs approved by the ema, exposure to air pollution and hospital admission for cardiovascular diseases, short term exposure to low level ambient fine particulate matter and natural cause, cardiovascular, and respiratory morbidity, optimal timing of influenza vaccination in young children, effect of exercise for depression, association of non-alcoholic fatty liver disease with cardiovascular disease and all cause death in patients with type 2 diabetes, duration of cpr and outcomes for adults with in-hospital cardiac arrest, clinical effectiveness of an online physical and mental health rehabilitation programme for post-covid-19 condition, atypia detected during breast screening and subsequent development of cancer, publishers’ and journals’ instructions to authors on use of generative ai in academic and scientific publishing, effectiveness of glp-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes, neurological development in children born moderately or late preterm, invasive breast cancer and breast cancer death after non-screen detected ductal carcinoma in situ, all cause and cause specific mortality in obsessive-compulsive disorder, acute rehabilitation following traumatic anterior shoulder dislocation, perinatal depression and risk of mortality, undisclosed financial conflicts of interest in dsm-5-tr, effect of risk mitigation guidance opioid and stimulant dispensations on mortality and acute care visits, update to living systematic review on sars-cov-2 positivity in offspring and timing of mother-to-child transmission, perinatal depression and its health impact, christmas 2023: common healthcare related instruments subjected to magnetic attraction study, using autoregressive integrated moving average models for time series analysis of observational data, demand for morning after pill following new year holiday, christmas 2023: christmas recipes from the great british bake off, effect of a doctor working during the festive period on population health: experiment using doctor who episodes, christmas 2023: analysis of barbie medical and science career dolls, christmas 2023: effect of chair placement on physicians’ behavior and patients’ satisfaction, management of chronic pain secondary to temporomandibular disorders, christmas 2023: projecting complete redaction of clinical trial protocols, christmas 2023: a drug target for erectile dysfunction to help improve fertility, sexual activity, and wellbeing, christmas 2023: efficacy of cola ingestion for oesophageal food bolus impaction, conservative management versus laparoscopic cholecystectomy in adults with gallstone disease, social media use and health risk behaviours in young people, untreated cervical intraepithelial neoplasia grade 2 and cervical cancer, air pollution deaths attributable to fossil fuels, implementation of a high sensitivity cardiac troponin i assay and risk of myocardial infarction or death at five years, covid-19 vaccine effectiveness against post-covid-19 condition, association between patient-surgeon gender concordance and mortality after surgery, intravascular imaging guided versus coronary angiography guided percutaneous coronary intervention, treatment of lower urinary tract symptoms in men in primary care using a conservative intervention, autism intervention meta-analysis of early childhood studies, effectiveness of the live zoster vaccine during the 10 years following vaccination, effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women, pyrotinib versus placebo in combination with trastuzumab and docetaxel in patients with her2 positive metastatic breast cancer, association of dcis size and margin status with risk of developing breast cancer post-treatment, racial differences in low value care among older patients in the us, pharmaceutical industry payments and delivery of low value cancer drugs, rosuvastatin versus atorvastatin in adults with coronary artery disease, clinical effectiveness of septoplasty versus medical management for nasal airways obstruction, ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder, early versus delayed antihypertensive treatment in patients with acute ischaemic stroke, mortality risks associated with floods in 761 communities worldwide, interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities, association between changes in carbohydrate intake and long term weight changes, future-case control crossover analysis for adjusting bias in case crossover studies, association between recently raised anticholinergic burden and risk of acute cardiovascular events, suboptimal gestational weight gain and neonatal outcomes in low and middle income countries: individual participant data meta-analysis, efficacy and safety of an inactivated virus-particle vaccine for sars-cov-2, effect of invitation letter in language of origin on screening attendance: randomised controlled trial in breastscreen norway, visits by nurse practitioners and physician assistants in the usa, non-erosive gastro-oesophageal reflux disease and oesophageal adenocarcinoma, venous thromboembolism with use of hormonal contraception and nsaids, food additive emulsifiers and risk of cardiovascular disease, balancing risks and benefits of cannabis use, promoting activity, independence, and stability in early dementia and mild cognitive impairment, effect of home cook interventions for salt reduction in china, cancer mortality after low dose exposure to ionising radiation, effect of a smartphone intervention among university students with unhealthy alcohol use, long term risk of death and readmission after hospital admission with covid-19 among older adults, mortality rates among patients successfully treated for hepatitis c, association between antenatal corticosteroids and risk of serious infection in children, the proportions of term or late preterm births after exposure to early antenatal corticosteroids, and outcomes, safety of ba.4-5 or ba.1 bivalent mrna booster vaccines, comparative effectiveness of booster vaccines among adults aged ≥50 years, third dose vaccine schedules against severe covid-19 during omicron predominance in nordic countries, private equity ownership and impacts on health outcomes, costs, and quality, healthcare disruption due to covid-19 and avoidable hospital admission, follow us on, content links.

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Nursing: Recognizing Original/Primary Research

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Original Research

What is original research.

Original research is considered a primary source.

An article is considered original research if...

• it is the report of a study written by the researchers who actually did the study.
• the researchers describe their hypothesis or research question and the purpose of the study.
• the researchers detail their research methods.
• the results of the research are reported.
• the researchers interpret their results and discuss possible implications.

Diagram of a Research Article

How can i tell if an article is original research.

There is no one way to easily tell if an article is a research article like there is for peer-reviewed articles in the Libraries' databases.  The only way to be sure is to read the article to verify that it is written by the researchers and that they have explained all of their findings, in addition to listing their methodologies, results, and any conclusions based on the evidence collected. 

All that being said, there are a few key indicators that will help you to quickly decide whether or not your article is based on original research. 

• Literature Review or Background
• Conclusions
• Read through the abstract (summary) before you attempt to find the full-text PDF. The abstract of the article usually contains those subdivision headings where each of the key sections are summarized individually. 
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Finding Quantitative or Qualitative Nursing Research Articles

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RESEARCH ARTICLES

Qualitative vs. quantitative, mixed methods research, review articles, systematic review, integrative review, meta-analysis.

A research article describes an original study that the author(s) conducted themselves.

It will include a brief literature review, but the main focus of the article is to describe the theoretical approach, methods, and results of the authors' own study.

Look at the abstract or full text of the journal article and look for the following:

• Was data collected?
• Were there surveys, questionnaires, interviews, interventions (as in a clinical trial)?
• Is there a population?
• Is there an outline of the methodology used?
• Are there findings or results?
• Are there conclusions and a discussion of the significance?

Research articles use a standard format to clearly communicate information about an experiment. A research article usually has 7 major sections:

• Introduction/Objective
• Discussion/Conclusion

A research article has a hypothesis, a method for testing the hypothesis, a population on which the hypothesis was tested, results or findings, and a discussion or conclusion.

From A Dictionary of Nursing

Mixed methods research combines quantitative and qualitative research methods in a single study. The use of mixed methods research is increasingly popular in nursing and health sciences research. This growth in popularity has been driven by the increasing complexity of research problems relating to human health and wellbeing.

• Mixed Methods Research in the Health Sciences

Review articles summarize the current state of research on a subject by organizing, synthesizing, and critically evaluating the relevant literature. They tell what is currently known about an area under study and place what is known in context. This allows the researcher to see how their particular study fits into a larger picture. Review articles are NOT original research articles. Instead, they are a summary of many other original research articles. When your teacher tells you to obtain an "original research article"or to use a primary source, do not use an article that says review. Review articles may include a bibliography that will lead you back to the primary research reported in the article.

Systematic Review  - A systematic review is conducted to answer specific, often narrow clinical questions. These questions are formulated according to the mnemonic PICO (Population, Intervention, Comparison, Outcomes). A systematic review involves the identification, selection, appraisal and synthesis of the best available evidence for clinical decision making. A properly conducted systematic review uses reproducible, preplanned strategies to reduce bias and instill rigor and pools of information from both published and unpublished sources. A quantitative systematic review uses staistical methods to combine results of multiple systems, and may or may not be a meta-analysis.

It is not unusual now to find more that one systematic review addressing the same or similar questions paving the way for meta-summary or meta-study, a systematic review of systematic review.

Encyclopedia of Nursing Research

Integrative Review  - a specific review method that summarizes past empirical or theoretical literature to provide a more comprehensive understanding of a particular phenomenon or healthcare problem. The integrative review method is an approach that allows for the inclusion of diverse methodologies and has the potential to play a greater role in evidence-based practice for nursing.  

Whittemore & Knafl, 2005

Meta-Analysis  - a quantitative approach that permits the synthesis and integration of results from multiple individual studies focused on a specific research question. The outcome of this quantitative approach for reviewing literature has tremendous potential for a practice-based discipline such as nursing.

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Identifying a Primary or Secondary Research Article

Differences between qualitative and quantitative research.

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Here are some criteria for evaluating if a research article is primary or secondary:

• Consists of original studies conducted by the authors
• Includes: controlled trials, cohort studies, case studies
• Includes: methods, results, tables, figures
• Consists of assimilated evidence from a number of high-quality primary studies
• Includes: systematic review, meta-analyses, evidence summaries
• May include: methods as a literature review, cited tables, and results from other studies
• Example 1 - Primary or Secondary?
• Example 2 - Primary or Secondary?

" Quantitative research ," also called " empirical research ," refers to any research based on something that can be accurately and precisely measured.  For example, it is possible to discover exactly how many times per second a hummingbird's wings beat and measure the corresponding effects on its physiology (heart rate, temperature, etc.).

" Qualitative research " refers to any research based on something that is impossible to accurately and precisely measure.  For example, although you certainly can conduct a survey on job satisfaction and afterwards say that such-and-such percent of your respondents were very satisfied with their jobs, it is not possible to come up with an accurate, standard numerical scale to measure the level of job satisfaction precisely.

It is so easy to confuse the words "quantitative" and "qualitative," it's best to use "empirical" and "qualitative" instead.

Hint: An excellent clue that a scholarly journal article contains empirical research is the presence of some sort of statistical analysis .

Examples of Qualitative vs Quantitative

Courtesy of Ebling Library, University of Wisconsin - Madison Health Sciences  

More information on the definitions of the different kinds of studies in medical research is available in this easy-to-understand article on the subject:

Röhrig, B., Prel, J.-B. du, Wachtlin, D., & Blettner, M. (2009). Types of Study in Medical Research . Deutsches Ärzteblatt International. https://doi.org/10.3238/arztebl.2009.0262

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Nursing: How to Read a Research Article

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Evaluating the Evidence

Guidelines for reading and critiquing a research article  from my american nurse.

1. Critiquing the research article

a. Title describes the article b. Abstract summarizes the article c. Introduction makes the purpose clear d. Problem is properly introduced e. Purpose of the study is explained f. Research question(s) are clearly presented g. Theoretical framework informs the research h. Literature review is relevant, comprehensive, and includes recent research i. Methods section details how the research questions were addressed or hypotheses were tested j. Analysis is consistent with the study questions and research design k. Results are clearly presented and statistics clearly explained l. Discussion explains the results in relation to the theoretical framework, research questions, and significance to nursing m. Limitations are presented and their implications discussed n. Conclusion includes recommendations for nursing practice, future research, and policymakers

2. Is it an appropriate level of evidence?  (See the visual examples below)

3. Decide if the study is applicable to your practice.

How to Critically Evaluate a Research Article

Reading and Critiquing a Research Article--from the American Nurse Website

Is it a Research Article?

Primary research examples.

Primary sources are original materials.  It is authored by researchers, contains original research data, and is usually published in a peer-reviewed journal. Different methodologies can be used but the distinguishing characteristic is that the authors of the study designed and conducted the study first hand.  Examples include case studies and randomized control trials. 

Secondary Research Examples

Literature reviews are summaries of the literature on a particular topic. Reviews are generally considered "research", especially systematic and integrative reviews, but are not experimental in nature. There are several kinds of reviews: plain  literature reviews ,  systematic reviews , and  integrative reviews  are the most common.  Chapter 5 of  Introduction to Nursing Research: Incorporating Evidence-based Practice  (Cannon & Boswell, 2011, 2nd ed. Sudbury, Mass: Jones & Bartlett Learning) covers the purpose and process of a literature review in the context of writing a research article, thesis, or dissertation.  How to undertake a literature search: a step-by-step guide  (Watson, 2020, BJN, 29(7): 431-435) is a good overall guide.

Types of literature reviews:

• summaries of relevant literature
• generally descriptive
• not necessarily any analysis of the literature
• methodology of the literature search is not always given
• good for gaining background knowledge of a subject without having to do all the searches and reading yourself.
• good source for starting reading lists and literature searches.
• not generally considered a good source for clinical decision making
• Note: In the past, reviews were not differentiated by type, so older reviews may use systematic or integrative methodology but not be specified as such.
• Reading:  Ten simple rules for writing a literature review  (Pautasso, M. (2013).  PLoS Comput Biol ,  9 (7), e1003149.)
• Reading:  Conducting Your Literature Review  (Hempel, S. (2020). Washington, DC : American Psychological Association.)
• specifically includes experimental research studies
• search and selection methodology is very precise and should be explicitly described well enough for another researcher to duplicate the searches and the study selection. See  Table 1 of this article  (Hoojimans et al. (2012).  PLoS One,  7 (11): e48811) for a good example of describing the search methods.
• the purpose of a systematic review is to reach some conclusion regarding the topic: for example, the selection of high quality studies to be used in a meta-analysis*, the gaps in current research, or the best clinical evidence for determining evidence based practice.
• the first stage of meta-analysis studies--all meta-analyses should include a systematic review, but all systematic reviews do not lead to a meta-analysis
• usually done in a group to reduce researcher bias in the selection and evaluation of individual studies
• Reading:  A practical guide to conducting a systematic review  (Forward & Hobby, 2002,  Nursing Times,  98 (2), 36) provides some basic advice for conducting a systematic review. Reading:   PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews . (Rethlefsen, M.L., et al. (2021).  Syst Rev   10 ,  39. https://doi.org/10.1186/s13643-020-01542-z)
• commonly include non-experimental research, such as case studies, observational studies, and meta-analyses, but may also include practice applications, theory, and guidelines
• should have clear and precise search and selection criteria
• search and selection methodology should be described well enough for another researcher to duplicate the process
• selected literature should be analyzed, not just summarized--articles and groups of articles compared, themes identified, gaps noted, etc.
• Reading:  The integrative review: updated methodology  (Whittemore & Knaf, 2005, Journal of Advanced Nursing, 52(5), 546–553) provides an overview of the purpose and practice of integrative reviews.  
• aims at determining the scope or extent of the research on a topic.

*A meta-analysis study is one where carefully selected data from previous studies is combined to bring more rigor to a statistical or other analysis. No additional experimental work is done (usually). A systematic review is necessary to be sure that the data from the selected studies is comparable and combinable

Levels of Evidence

In some journals, you will see a 'level of evidence' assigned to a research article. Levels of evidence are assigned to studies based on the methodological quality of their design, validity, and applicability to patient care. The combination of these attributes gives the level of evidence for a study.  Many systems for assigning levels of evidence exist.  A frequently used system in medicine is from the  Oxford Center for Evidence-Based Medicine .  In nursing, the system for assigning levels of evidence is often from Melnyk & Fineout-Overholt's 2011 book,  Evidence-based Practice in Nursing and Healthcare: A Guide to Best Practice .  The Levels of Evidence below are adapted from Melnyk & Fineout-Overholt's (2011) model. 

Uses of Levels of Evidence : Levels of evidence from one or more studies provide the "grade (or strength) of recommendation" for a particular treatment, test, or practice. Levels of evidence are reported for studies published in some medical and nursing journals. Levels of Evidence are most visible in Practice Guidelines, where the level of evidence is used to indicate how strong a recommendation for a particular practice is. This allows health care professionals to quickly ascertain the weight or importance of the recommendation in any given guideline. In some cases, levels of evidence in guidelines are accompanied by a Strength of Recommendation.

About Levels of Evidence and the Hierarchy of Evidence : While Levels of Evidence correlate roughly with the hierarchy of evidence (discussed elsewhere on this page), levels of evidence don't always match the categories from the Hierarchy of Evidence, reflecting the fact that study design alone doesn't guarantee good evidence. For example, the systematic review or meta-analysis of randomized controlled trials (RCTs) are at the top of the evidence pyramid and are typically assigned the highest level of evidence, due to the fact that the study design reduces the probability of bias (Melnyk, 2011), whereas the weakest level of evidence is the opinion from authorities and/or reports of expert committees. However, a systematic review may report very weak evidence for a particular practice and therefore the level of evidence behind a recommendation may be lower than the position of the study type on the Pyramid/Hierarchy of Evidence.

About Levels of Evidence and Strength of Recommendation : The fact that a study is located lower on the Hierarchy of Evidence does not necessarily mean that the strength of recommendation made from that and other studies is low--if evidence is consistent across studies on a topic and/or very compelling, strong recommendations can be made from evidence found in studies with lower levels of evidence, and study types located at the bottom of the Hierarchy of Evidence. In other words, strong recommendations can be made from lower levels of evidence.

For example: a case series observed in 1961 in which two physicians who noted a high incidence (approximately 20%) of children born with birth defects to mothers taking thalidomide resulted in very strong recommendations against the prescription and eventually, manufacture and marketing of thalidomide. In other words, as a result of the case series, a strong recommendation was made from a study that was in one of the lowest positions on the hierarchy of evidence.

How to Read a Research Paper

Evaluating the evidence from medical studies can be a complex process, involving an understanding of study methodologies, reliability and validity, as well as how these apply to specific study types. While this can seem daunting, in a series of articles by Trisha Greenhalgh from BMJ, the author introduces the methods of evaluating the evidence from medical studies, in language that is understandable even for non-experts. Although these articles date from 1997, the methods the author describes remain relevant. Use the links below to access the articles.

Not all published research is worth considering. This provides an outline of how to decide whether or not you should consider a research paper.

This article discusses how to assess the methodological validity of recent research, using five questions that should be addressed before applying recent research findings to your practice.

This article and the next present the basics for assessing the statistical validity of medical research. The two articles are intended for readers who struggle with statistics

The second article on evaluating the statistical validity of a research article.

A set of questions that could be used to analyze the validity of qualitative research

Daly, J., Willis, K., Small, R., Green, J., Welch, N., Kealy, M., & Hughes, E. (2007). A hierarchy of evidence for assessing qualitative health research.  Journal of Clinical Epidemiology ,  60 (1), 43–49. doi:10.1016/j.jclinepi.2006.03.014

McBride, W. G. ‘‘Thalidomide and Congenital Abnormalities.’’ Letter to the Editor. The Lancet 2 (December 16, 1961): 1358.

Melnyk, B. M. (2011).  Evidence-based practice in nursing & healthcare: a guide to best practice  (2nd ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Slawson, D. C., & Shaughnessy, A. F. (1997). Obtaining useful information from expert based sources.  BMJ (Clinical Research Ed.) ,  314 (7085), 947–949.

Hierarchy of Evidence for Quantitative Studies

The pyramid below represents the hierarchy of evidence, which illustrates the strength of study types; the higher the study type on the pyramid, the more likely it is that the research is valid. The pyramid is meant to assist researchers in prioritizing studies they have located to answer a clinical or practice question. 

For clinical questions, you should try to find articles with the highest quality of evidence. Systematic Reviews and Meta-Analyses are considered the highest quality of evidence for clinical decision-making and should be used above other study types, whenever available, provided the Systematic Review or Meta-Analysis is fairly recent. 

As you move up the pyramid, fewer studies are available, because the study designs become increasingly more expensive for researchers to perform. It is important to recognize that high levels of evidence may not exist for your clinical question, due to both costs of the research and the type of question you have.  If the highest levels of study design from the evidence pyramid are unavailable for your question, you'll need to move down the pyramid.

While the pyramid of evidence can be helpful, individual studies--no matter the study type--must be assessed to determine the validity.

Hierarch of Evidence for Qualitative Studies

Qualitative studies are not included in the Hierarchy of Evidence above. Since qualitative studies provide valuable evidence about patients' experiences and values, qualitative studies are important--even critically necessary--for Evidence-Based Nursing. Just like quantitative studies, qualitative studies are not all created equal. The pyramid below  shows a hierarchy of evidence for qualitative studies.

Adapted from Daly et al. (2007)

Primary/Secondary/Tertiary Sources

Types of sources - primary, secondary and tertiary.

Types of Medical Literature

Medical literature is often classified based on how far removed the information is from the original source.

Primary Literature/Source Primary sources are original materials.  It is authored by researchers, contains original research data, and is usually published in a peer-reviewed journal. Primary literature may also include conference papers, pre-prints, or preliminary reports.

Secondary Literature/Source  Secondary literature consists of interpretations and evaluations that are derived from or refer to the primary source literature. Examples include review articles (e.g., meta-analysis and systematic reviews) and reference works. Professionals within each discipline take the primary literature and synthesize, generalize, and integrate new research.

Tertiary  Literature/Source Tertiary literature consists of a distillation and collection of primary and secondary sources such as textbooks, encyclopedia articles, and guidebooks or handbooks. The purpose of tertiary literature is to provide an overview of key research findings and an introduction to principles and practices within the discipline.

Adapted from the Information Services Department of the Library of the Health Sciences-Chicago, University of Illinois at Chicago.

One more way to look at it:   Six Degrees of Separation (or Six Degrees of Kevin Bacon)

• Primary Literature/Source:   someone talked to Kevin Bacon and wrote about it
• Secondary Literature/Source:   someone else read the above article and summarized it for a radio show
• Tertiary Literature/Source:   a magazine included a mention of the article in a summary of Kevin Bacon interviews
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In a First, an Orangutan Healed His Own Wound Using a Known Medicinal Plant

The primate named Rakus chewed up yellow root and applied it to an open facial wound, closing the sore within days

Christian Thorsberg

Daily Correspondent

In June 2022, a team of researchers observed a behavior never before witnessed in the animal world: A Sumatran orangutan named Rakus self-treated an injury using a medicinal plant.

At Gunung Leuser National Park, a rainforest reserve on the western Indonesian island of Sumatra, scientists heard from the treetops a series of “long calls,” a behavior that usually preempts assertions of male dominance or aggression. The next day, they saw Rakus with an open wound on his right cheek, just below his eye.

Days later, the team watched Rakus get to work—picking and chewing the stems and leaves of Akar Kuning ( Fibraurea tinctoria ), or yellow root. The plant is a climbing vine native to the region that local people use for its medicinal qualities to treat conditions such as diabetes, dysentery and malaria.

While hardly a staple of the orangutan diet—the team noted that yellow root is eaten only 0.3 percent of the time—Rakus consumed it anyway. He also chewed it, without swallowing, then spread its juices and poultice on his wound, where some flies had begun gathering. Rakus came back to the plant and ate it the next day, and soon, his wound was fully healed. This week, an analysis of the orangutan’s behavior was published in the journal Scientific Reports .

“[This] is the first observation of a wild animal actually treating his wound precisely with a medical plant,” Isabelle Laumer , a primatologist at the Max Planck Institute of Animal Behavior in Germany and the lead author of the study, tells National Geographic ’s Daryl Austin.

It took five days after treatment for the wound to close, and scientists saw no signs of infection after one month. Research on yellow root’s chemistry has shown the plant to have “antibacterial, anti-inflammatory, anti-fungal, antioxidant, pain-killing and anticarcinogenic properties,” the Guardian ’s Nicola Davis reports.

Sumatran orangutans are a critically endangered species—only 14,600 remain across the world, and the area surrounding Gunung Leuser’s Suaq Balimbing research station is home to Earth’s highest density of the creatures. But in 21 years of observing orangutans at this park, scientists have never seen an individual self-heal a wound using Akar Kuning.

Perhaps the primates do not get injured enough in the wild to need its healing properties, writes  Nature News ’ Gayathri Vaidyanathan. Or maybe Rakus, who is now 35 years old, is simply the only individual aware of the technique.

Whatever the reason, scientists agree the observation offers new insights into natural medicinal practices. 

“We often lose sight of the fact that modern medicine is derived from a very ancient system of knowledge that began millions of years ago in a variety of habitats about which our knowledge is only beginning to expand,” Mary Ann Raghanti , a biological anthropologist at Kent State University who was not involved in the study, tells National Geographic . 

Past research has shown Bornean orangutans self-medicating by rubbing their limbs with chewed plants, perhaps to alleviate sore muscles . And chimpanzees have been known to spread chewed insects over their wounds , though the effectiveness of this treatment is uncertain. Other animals engage in similar practices: Several species of birds rub themselves with ants—a technique called “anting”—to rid their bodies of parasites or feather mites, the New York Times ’ Douglas Main reports.

But the novelty of Rakus’s behavior comes both from his treatment of an external wound and Akar Kuning’s known healing qualities, which scientists have acknowledged as unique.

“It shows that orangutans and humans share knowledge,” says study co-author Caroline Schuppli , a primatologist at the Max Planck Institute of Animal Behavior, to Nature News .

The incident could shed light on the origins of self-medication for wounds, which was mentioned by humans in a medical manuscript dating to 2200 B.C.E., the Guardian writes.

“The fact that this has only been observed once in the study population leaves many questions unanswered about the origin of the behavior, but it adds to the idea that self-medication may have very deep evolutionary roots in our lineage,” Anne Pusey , an evolutionary anthropologist at Duke University who was not involved in the study, tells National Geographic.

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Christian Thorsberg | READ MORE

Christian Thorsberg is an environmental writer and photographer from Chicago. His work, which often centers on freshwater issues, climate change and subsistence, has appeared in Circle of Blue , Sierra  magazine, Discover  magazine and Alaska Sporting Journal .