Outcomes of interventions for nurse leaders' well-being at work: A quantitative systematic review

Community-based health programme for nurses and midwives: A mixed methods evaluation

AIM

To evaluate a community-based psychological health and well-being programme for nurses and midwives.

DESIGN

Mixed methods programme evaluation.

METHODS

Four studies were included: observational descriptive study (cross-sectional survey) of the health, well-being and experiences of previous programme participants (Study 1); observational exploratory prospective cohort study (longitudinal survey) of health, well-being and experiences of participants who engaged in the programme from 2020 to 2023 (Study 2); qualitative descriptive study (interviews) of experiences and perceptions of nurses and midwives who have engaged with the programme as participants or clinicians (Study 3); observational descriptive study (cross-sectional survey) of experiences and perceptions of programme stakeholders (Study 4). Surveys included validated measures. Data were collected online. Descriptive, repeated measures and thematic analyses were conducted.

RESULTS

One-hundred and fifteen participants completed Study 1: 20% (n = 23) reported stress in the severe-to-extremely severe category; 22% (n = 25) reported psychological distress in the moderate-to-severe category. Thirty-one programme participants were followed in Study 2: the effect of the programme on participant well-being over time was not significant. Sixteen programme participants and eight programme clinicians were interviewed (Study 3). Experiences of nurses and midwives engaging with the programme were highly positive and strong attributes of the programme included (1) shared professional experience of clinicians and participants which supported a common language and facilitated understanding, and (2) effective programme leadership, and autonomy and flexibility in the clinicians' role which enabled and supported a positive working experience. Thirty-nine broader stakeholders participated in a cross-sectional survey (Study 4). All stakeholders reported high satisfaction with the programme. Participants considered the programme being 'by nurses and midwives, for nurses and midwives' critical to the programme's success and value.

CONCLUSIONS

The community-based psychological health and well-being programme developed, led and delivered by nurses and midwives, for nurses and midwives, was a highly valued resource.

IMPACT

Levels of stress and burnout in the health workforce are high. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives. A programme delivered by nurses and midwives, for nurses and midwives, was considered critical to programme success. Programme leadership, and autonomy and flexibility in the programme clinicians' roles, facilitated and supported a positive working experience for programme clinicians.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

Quality and safety in patient care is directly impacted by the well-being of nurse and midwives. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives.

REPORTING METHOD

Survey findings were reported according to STROBE (von Elm et al. in Lancet, 370:1453-1457, 2007) and qualitative findings according to COREQ (Tong et al. in International Journal for Quality in Health Care, 19(6):349-357, 2007).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

How relational leadership can enhance nurses' well-being and productivity

Leadership is an essential skill in nursing and has a fundamental role in ensuring high-quality patient care and the effective functioning of healthcare systems. Effective nursing leadership is vital to support nursing teams as they negotiate the challenges confronting the profession, such as ageing populations and the increased use of healthcare technology. This article discusses various relational leadership styles that can be used to promote nurses' health and well-being and enhance productivity. The author also explores the benefits and challenges of implementing relational leadership in nursing.

Effectiveness of intervention programs aimed at improving the nursing work environment: A systematic review

BACKGROUND

The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment.

AIM

To determine whether measures designed to improve the work environment for nursing professionals are effective.

METHODOLOGY

Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre-/post-measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool.

RESULTS

A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive-behavioral techniques, stress management, channeling anxiety and physical well-being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement.

CONCLUSIONS

Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy.

IMPLICATION FOR NURSING AND NURSING POLICY

This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety.

Organizational factors to optimize mental health nurses' wellbeing in the workplace: An integrative literature review

Mental health nursing is a privilege and a rewarding profession. There has been a call for transformational change in mental health services to improve outcomes for the people of New Zealand, with mental health nurses integral to this. However, with predicted nursing shortages, high levels of burnout, and increasing demands in the workplace, an organizational focus on wellbeing for mental health nurses is needed to sustain the workforce, implement change and improve outcomes for people using mental health services. An integrative review of the literature was undertaken to explore how organizations can optimize mental health nurses' wellbeing in the workplace and to identify measures for organizations to support mental health nurses' wellbeing with a focus on New Zealand. Seven articles were included in this review after a search, data extraction and evaluation. Data were synthesized and categorized using thematic analysis. The findings indicate organizations can invest in several initiatives to enhance mental health nurses' wellbeing in the workplace. These include professional development, skills to build resilience, enabling time to reflect on practice, enhancing professional supervision, having the right managerial support and focusing on individual's strengths. Organizations need to prioritize mental health nurses' wellbeing by embedding the practical strategies this review identified and by addressing organizational barriers to wellbeing. Organizations should consider implementing multileveled organizational wellbeing initiatives to nurture and grow the New Zealand mental health nursing workforce which in turn will contribute to quality care and enable mental health nurses to have long meaningful careers. Time, investment and resources are essential for these initiatives to be effective.

Well-being in acute care nurse managers: A risk analysis of physical and mental health factors

BACKGROUND

Nurse managers have experienced tremendous stress during the COVID-19 pandemic, contributing to negative psychological outcomes. Positive professional well-being is a construct that can be promoted to mitigate poor psychological outcomes and burnout in nurses. Little is known about the health, healthy behaviors, effects of stress on homelife, and well-being of nurse managers in the United States (U.S.).

AIMS

The aims of the study were to explore nurse managers' well-being related to self-reported stress and health perceptions and habits.

METHODS

A sample of 80 (41% response rate) nurse managers responded to a cross-sectional web-based survey sent via email in a southwestern U.S. 13-hospital system. Nurses answered 39 quantitative questions about demographics, well-being (9-item Well-Being Index [WBI]), perceptions of stress affecting homelife, and perceptions of health and health-related behaviors.

RESULTS

Mean WBI (2.9 [2.7]) indicated risk for poor psychological outcomes. Managers (75%) reported stress from work affected their personal lives and a decline in overall health during the pandemic. Most (80%) reported burnout and emotional problems. Nurse managers had 8.1 times increased risk of poor WBI scores if stress from work affected their personal life than if they reported no spillover stress into their personal life (OR = 8.1, 95% CI [2.6, 25.0]).

LINKING EVIDENCE TO ACTION

Findings from this study add a nuanced understanding of nurse managers' well-being. The strongest risk factor for poor WBI scores was stress levels affecting personal life. Interventions to improve well-being in nurse managers are needed. Limitations are the convenience sampling, limited geographic location, and response rate of <50%. Further research is needed to support nurse managers in stress reduction and development of boundaries that prohibit the spillover effect of workplace stress. Organizations may consider a combination of administrative support and changes as well as provision of on-the-job training of interventions that support individual well-being.

A systematic review of the relationships between nurse leaders' leadership styles and nurses' work-related well-being

AIM

This systematic review aimed to summarize current research knowledge about the relationships between nurse leaders' leadership styles and nurses' work-related well-being.

BACKGROUND

Due to the global shortage of nurses, it is essential for nurse leaders to maximize staff retention and work-related well-being.

METHODS

Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published between 1 January 2012 and 31 December 2020 were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. Seventeen cross-sectional and follow-up studies with surveys were retained for inclusion and evaluated with the Critical Appraisal of a Survey instrument. The data were summarized narratively.

RESULTS

Three core themes of leadership styles: destructive, supportive and relationally focused, were identified, with statistically significant direct and indirect connections between nurses' work-related well-being. Well-being was mainly assessed in terms of burnout. Effects of leadership styles on work-related well-being were reportedly mediated by trust in leader, trust in organization, empowerment, work-life conflict, relational social capital, emotional exhaustion, affectivity, job satisfaction and motivation.

CONCLUSION

Nurse leaders' leadership styles affect nurses' work-related well-being. In developing intervention studies and providing training on work-related well-being, the impact of the indirect effects and the mediating factors of the leadership styles should be acknowledged.

Nurse leaders' work-related well-being-Relationships to a superior's transformational leadership style and structural empowerment

AIMS

To describe how nurse leaders' work-related well-being is related to a superior's transformational leadership style and structural empowerment.

BACKGROUND

The demanding role of nurse leader means that these professionals experience emotional exhaustion and challenges with work-life balance. They can also be influenced by the leadership style of their own superiors.

METHODS

A cross-sectional questionnaire using two internationally validated scales, namely, the Transformational Leadership Scale and Conditions For Work Effectiveness Questionnaire-II, was used. Statistical methods were applied during data analysis.

RESULTS

A total of 155 nurse leaders participated completed the questionnaire. The participants' work-related well-being scores ranged from 8 to 10. The participants felt that their superiors employ transformational leadership. The dimension of feedback and rewards received the lowest scores, whereas the nurse leaders reported moderate overall empowerment levels. A nurse leader's work-related well-being was positively correlated with structural empowerment and their superior's leadership style.

CONCLUSIONS

Despite the fact that nurse leaders reported relatively high levels of work-related well-being, more attention should be paid on the feedback and rewards and on the support of superiors as they positively influence the work-related well-being.

IMPLICATIONS FOR NURSING MANAGEMENT

Transformational leadership should be supported in organisations and through education as it strengthens work-related well-being and structural empowerment of nurse leaders.

Structural and psychological empowerment of students obtaining continuing leadership education in Finland-a national survey

BACKGROUND

In nursing, empowerment may be deemed one's potential to gain power, achieve goals and promote one's skills to advance positive changes in the working environment, or decentralization of authority. Empowerment is associated with nurses' and nurse leaders' satisfaction, performance and organizational commitment, as well as burnout, emotional exhaustion and intentions to leave the profession. Research on nurse empowerment in relation to continuing education is sparse.

OBJECTIVES

This study describes the structural and psychological empowerment levels of students beginning a collaboratively implemented continuing leadership education program.

DESIGN

Cross-sectional electronic survey.

SETTINGS

National, continuing nursing leadership education program (37 ECT) organized by five universities that provide masters level education to nurse leaders in Finland.

PARTICIPANTS

Students (N = 85) working at nine healthcare organizations across the service system as current or prospective nurse leaders and enrolled in the continuing leadership education program.

METHODS

The Conditions of Work Effectiveness Questionnaire and the Work Empowerment Questionnaire were each used to measure structural and psychological empowerment, respectively. The data were collected between October 2019 and February 2020.

RESULTS

A total of 69 students participated (response rate 81 %). Moderate levels of both structural and psychological empowerment were observed. In structural empowerment, the strongest dimension was access to opportunity (4.1, SD 0.7), whereas access to support was the weakest (2.7, SD 0.7). The strongest psychological empowerment dimension was verbal empowerment (8.5, SD 1.9) and the weakest was outcome empowerment (7.0, SD 1.6).

CONCLUSIONS

Nurses and nurse leaders seem to lack the status and power required to impact their organizations, possibly causing them to apply for nursing leadership education. Nurse leaders should be given opportunities for continuing leadership education to improve empowerment and, as a result, staff outcomes.

Bem-estar no trabalho: influência do clima organizacional entre trabalhadores hospitalares

Introdução: Bem-estar no trabalho (BET) é uma temática em florescimento que interessa a gestores e acadêmicos. O objetivo do estudo foi analisar a influência do clima organizacional no BET de profissionais de saúde de hospital. Método: Foi utilizada uma amostra de conveniência de 182 trabalhadores de diferentes cargos. Resultados: Os resultados da regressão múltipla padrão mostraram que a variável preditora trouxe contribuição significativa para todas as dimensões de BET, sendo maior poder explicativo para afeto positivo (r2 = 0,39, p < 0,005) e a contribuição significativa oriunda das dimensões liderança (β = 0,25; p < 0,005), equipe (β = 0,16; p < 0,005) e desenvolvimento (β = 0,21; p < 0,023). Discussões: Sendo assim, quanto melhor a relação entre a equipe e quanto mais os trabalhadores são estimulados a participarem dos processos, mais eles se sentem motivados. Para isso, é muito importante que o líder reconheça e oriente todos a alcançar estes objetivos. Conclusões: Os achados são cotejados com a literatura.

A comprehensive evaluation of factors affecting nurse leaders' work-related well-being

PURPOSE

This study aims to describe nurse leaders' experiences of work-related well-being and its association with background variables, working conditions, work engagement, sense of coherence and burnout.

DESIGN/METHODOLOGY/APPROACH

An electronic survey design was used. Data was collected between December 2015 and May 2016 with an instrument that included demographic questions and four internationally validated scales: the Utrecht Work Engagement Scale, QPS Nordic 34+, the shortened Sense of Coherence scale and the Maslach Burnout Inventory. Data was analysed using statistical methods.

FINDINGS

A total of 155 nurse leaders completed the questionnaire, giving a 44% response rate. Most of them worked as nurse managers (89%). Participants' work-related well-being scores ranged from 8 to 10. Statistically significant relationships were found between participants' work-related well-being and their leadership skills, current position, sense of coherence and levels of burnout. In addition, there were statistically significant relationships between work-related well-being and all dimensions of working conditions.

ORIGINALITY/VALUE

This study underlines the fact that work-related well-being should not be evaluated based on a single factor. The participants' perceived work-related well-being was high, although almost half of them reported always or often experiencing stress. The results suggest that nurse leaders may have resources such as good leadership and problem-solving skills, supportive working conditions and a high sense of coherence that prevent the experienced stress from adversely affecting their work-related well-being.

Effects of Holy Name Meditation on the Quality of Life of Hospital Middle Manager Nurses in Korea: A 6-Month Follow-Up

BACKGROUND

Nurses experience poor quality of life due to workload and role stress. In this study, a spirituality-based intervention was administered to nurse managers.

METHOD

A total of 45 nurse managers participated in the study; 24 were assigned to the experimental group, and 21 were assigned to a control group. The Holy Name Meditation Program was provided solely to the experimental group. Pretest, posttest 1 (5 weeks after the intervention), posttest 2 (12 weeks after the intervention), and posttest 3 (24 weeks after the intervention) data were gathered on seven variables, including spiritual well-being, spiritual needs, job satisfaction, leadership, burnout, depression, and self-efficacy.

RESULTS

The experimental group showed significant improvement in spiritual well-being (p < .001), spiritual needs (p = .029), and job satisfaction (p = .005) until the 24-week follow-up. Burnout (p < .001), depression and anxiety (p = .034), and self-efficacy (p = .024) showed significant improvement until the 12-week follow-up. Depression and anxiety (p = .053) showed decreasing tendency until the 24-week follow-up.

CONCLUSION

Evidence suggests this program promotes spiritual and psychosocial well-being of nurse managers. [J Contin Educ Nurs. 2020;51(5):215-224.].

Authentic Connections Groups: A Pilot Test of an Intervention Aimed at Enhancing Resilience Among Nurse Leader Mothers

BACKGROUND

Nurse leaders who are mothers are at significant risk for experiencing stress, burnout, and occupational fatigue. Authentic Connections (AC) Groups is an intervention shown to be effective for fostering resilience among at-risk moms, including physicians; however, it has not previously been tested with nurse leaders.

AIMS

Our aims were to test the feasibility and acceptability of the AC Groups intervention with nurse leader mothers and examine its effects on participant resilience, as measured by increased self-compassion and decreased distress, depression, perceived stress, and burnout.

METHODS

A randomized controlled trial design was employed for this pilot study, with 36 nurse leaders at Mayo Clinic. AC participants attended group sessions for an hour per week for 12 weeks. Control group members were provided 1 hr per week of free time over 12 weeks. Multiple self-report psychological measures were completed at baseline, post-intervention, and 3-month follow-up.

RESULTS

The AC Groups intervention was feasible and well-received by nurse leaders. Session attendance rates averaged 92%. Despite the small n's, repeated measures of Analysis of Variance showed significantly greater improvements (p < .05) for participants in the AC Groups than control condition for depression, self-compassion, and perceived stress, with large effect sizes ( η p 2 0.18-0.22). In addition, effect sizes for anxiety and feeling loved approximated the moderate range ( η p 2 0.05 and .07).

LINKING EVIDENCE TO ACTION

The AC intervention shows promise as a feasible intervention for mitigating nurse leader mothers' stress by positively impacting indices of well-being, including depression, self-compassion, and perceived stress. Given, the prevalence of stress and burnout among nurse leaders, the effectiveness of the AC intervention in fostering resilience in this population has significant implications for research and practice. Further research is warranted with larger numbers from multiple sites, longer follow-up periods, and biomarker measures of stress.

Risk and Protective Factors of Well-Being among Healthcare Staff. A Thematic Analysis

The purpose of this study was to identify physical and psychosocial working conditions to improve well-being at work among healthcare staff. This is a potent area of inquiry given the relationship between healthcare staff well-being and service quality and other key organizational characteristics. However, while numerous studies in this area have used a quantitative methodology, very few have applied qualitative methodologies gathering subjective descriptions of the sources of well-being, providing in so doing significant data to explore in depth the factors that influence well-being in healthcare systems. We gathered qualitative data analyzing open-ended questions about risk and protective factors of well-being at work. The sample was made of 795 professionals answering an online questionnaire. Answers were coded and analyzed using the thematic analysis with an inductive approach (data-driven). We identified four themes strongly affecting professional well-being in health-care staff: Interactions, Working Conditions, Emotional Responses to Work, and Competence and Professional Growth. Our findings suggest possible strategies and actions that may be effective in helping to calibrate case-specific support and monitoring interventions to improve health and well-being of healthcare staff. We also discuss the implications of the study and suggest possible avenues for future empirical research.

Investigating work-related stress among health professionals at different hierarchical levels: A cross-sectional study

Aim

To determine the extent of stress at work among health professionals working in upper-, middle- and lower-management positions and those not working in management positions.

Design

Cross-sectional design and randomly selected hospitals, nursing homes and home care organizations.

Methods

The study sample included nursing staff and midwives, physicians, medical-technical and medical-therapeutic professionals at all hierarchical levels (N = 8,112). Data were collected using self-report questionnaires and analysed using multiple regression models.

Results

Health professionals in upper- and middle-management positions reported higher quantitative demands, severe work-private life conflicts (p < .05) as well as less role clarity in middle-management positions (B = -1.58, p < .05). In lower-management positions, health professionals reported higher physical (B = 3.80, p < .001) and emotional demands (B = 1.79, p < .01), stress symptoms (B = 1.81, p < .05) and job dissatisfaction (B = -1.17, p < .05). Health professionals without management responsibilities reported the poorest working conditions in relation to various stressors, job satisfaction (B = -5.20, p < .001) and health-related outcomes (e.g. burnout symptoms: B = 1.89, p < .01).

Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review

BACKGROUND

Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown.

OBJECTIVE

To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses.

METHODS

A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed.

RESULTS

Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change.

CONCLUSIONS

Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses' health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.

Bibliometric mapping of intensive care nurses' wellbeing: development and application of the new iAnalysis model

BACKGROUND

Intensive care nurse wellbeing is essential to a healthy healthcare workforce. Enhanced wellbeing has widespread benefits for workers. Bibliometrics enables quantitative analysis of bourgeoning online data. Here, a new model is developed and applied to explore empirical knowledge underpinning wellbeing and intensive care nurse wellbeing in terms of size and impact, disciplinary reach, and semantics.

METHODS

Mixed methods bibliometric study. Firstly, a new model coined 'iAnalysis' was developed for the analysis of published data. Secondly, iAnalysis was applied in two studies to examine wellbeing and ICU nurse wellbeing. Study one explored data from a title search with search terms [wellbeing OR well-being], identifying 17,543 records with bibliographic data. This dataset included 20,526 keywords. Of the identified records, 10,715 full-text manuscripts were retrieved. Study two explored data from a topic search with search terms [(intensive OR critical) AND (nurs*) AND (wellbeing OR well-being)], identifying 383 records with bibliographic data. This dataset included 1223 author keywords. Of the identified records, 328 full-text manuscripts were retrieved.

RESULTS

Once data were collected, for size and impact, WoS Clarivate Analytics™ and RStudio™ were used to explore publication dates, frequencies, and citation performance. For disciplinary reach, RStudio™ (with the Bibliometrics™ package & Vosviewer™ plugin) was used to explore the records in terms of country of publication, journal presence, and mapping of authors. For semantics, once the bibliographic data was imported to RStudio™ (with the Bibliometrics™ package & Vosviewer™ plugin) keyword co-occurrences were identified and visualised. Full-text manuscripts were imported to NVivo™ to explore word frequencies of both the keywords and full-text manuscripts using the word frequency search. For both studies, records were predominantly published in the past 5 years, in English language, and from USA. The highest keyword co-occurrence for study one was "health and well-being", and for study two, "family and model".

CONCLUSIONS

Terms commonly associated with 'illbeing', as opposed to 'wellbeing', were highly prevalent in both study datasets, but more so in intensive care nurse wellbeing data. Intensive care nurse wellbeing was virtually absent in this literature. The iAnalysis model provided a practice-friendly tool to explore a large source of online published literature.

An analysis of current practices in undertaking literature reviews in nursing: findings from a focused mapping review and synthesis

BACKGROUND

In this paper we discuss the emergence of many different methods for doing a literature review. Referring back to the early days, when there were essentially two types of review; a Cochrane systematic review and a narrative review, we identify how the term systematic review is now widely used to describe a variety of review types and how the number of available methods for doing a literature review has increased dramatically. This led us to undertake a review of current practice of those doing a literature review and the terms used to describe them.

METHOD

We undertook a focused mapping review and synthesis. Literature reviews; defined as papers with the terms review or synthesis in the title, published in five nursing journals between January 2017-June 2018 were identified. We recorded the type of review and how these were undertaken.

RESULTS

We identified more than 35 terms used to describe a literature review. Some terms reflected established methods for doing a review whilst others could not be traced to established methods and/or the description of method in the paper was limited. We also found inconsistency in how the terms were used.

CONCLUSION

We have identified a proliferation of terms used to describe doing a literature review; although it is not clear how many distinct methods are being used. Our review indicates a move from an era when the term narrative review was used to describe all 'non Cochrane' reviews; to a time of expansion when alternative systematic approaches were developed to enhance rigour of such narrative reviews; to the current situation in which these approaches have proliferated to the extent so that the academic discipline of doing a literature review has become muddled and confusing. We argue that an 'era of consolidation' is needed in which those undertaking reviews are explicit about the method used and ensure that their processes can be traced back to a well described, original primary source.