Systematic Reviews and Review Types: What is an Integrative Review?

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Other names for an Integrative Review

IR, Integrative Literature Review, Systematic Integrative Review

What is an Integrative Review?

“A review method that summarizes past empirical or theoretical literature to provide a more comprehensive understanding of a particular phenomenon or healthcare problem (Broome 1993). Integrative reviews, thus, have the potential to build nursing science, informing research, practice, and policy initiatives. Well-done integrative reviews present the state of the science, contribute to theory development, and have direct applicability to practice and policy.” 

“The integrative review method is an approach that allows for the inclusion of diverse methodologies (i.e. experimental and non-experimental research).”

An integrative review is best designed for:

  • Nursing 
  • review experimental and non-experimental research simultaneously
    • to define concepts
    • to review theories
    • to review evidence/point out gaps in the literature
    • to analyze methodological issues

Source: Whittemore et al. (2005)

What is an Integrative Review? Outline of Stages

Timeframe: 12+ months *Varies beyond the type of review. Depends on many factors such as but not limited to: resources available, the quantity and quality of the literature, and the expertise or experience of reviewers” (Grant et al. 2009)

Question: Formulation of a problem, may be related to practice and/or policy especially in nursing.

Sources and searches: Comprehensive but with a specific focus, integrated methodologies-experimental and non-experimental research.  Purposive Sampling may be employed. Database searching is recommended along with grey literature searching.  “Other recommended approaches to searching the literature include ancestry searching, journal hand searching, networking, and searching research registries.”  Search is transparent and reproducible.

Selection: Selected as related to problem identified or question, Inclusion of empirical and theoretical reports and diverse study methodologies. 

Appraisal: “How quality is evaluated in an integrative review will vary depending on the sampling frame.”  Limited/varying methods of critical appraisal and can be complex.  “In a review that encompasses theoretical and empirical sources, two quality criteria instruments could be developed for each type of source and scores could be used as criteria for inclusion/exclusion or as a variable in the data analysis stage.”

Synthesis: Narrative synthesis for qualitative and quantitative studies. Data extracted for study characteristics and concept.  Synthesis may be in the form of a table, diagram or model to portray results. “Extracted data are compared item by item so that similar data are categorized and grouped together.”  

The method consists of:

  • data reduction
  • data display
  • data comparison
  • conclusion drawing,
  • verification 

Source: Whittemore et al. (2005)

Limitations of an Integrative Review

  • The combination and complexity of incorporating diverse methodologies can contribute to lack of rigor, inaccuracy, and bias.
  • Methods of analysis, synthesis, and conclusion-drawing remain poorly formulated.
  • Issues related to combining empirical and theoretical reports.

Source: Whittemore et al. (2005)

Sample Integrative Review 1

dos Santos Damásio Silva, Darlan. Depression and suicide risk among Nursing professionals: an integrative review. Revista da Escola de Enfermagem da U S P. 2015. 49(6): 1023-1031. ISSN: 0080-6234.

Sample Integrative Review 2

Luckett, Tim. Advance Care Planning for Adults With CKD: A Systematic Integrative Review. American journal of kidney diseases. 2014. 5: 761-770. ISSN: 0272-6386

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