Navigate the links below to jump to a specific section of the page:

• Definition
• When is an Integrative Review methodology appropriate?
• Outline of Stages
• Methods and Guidance
• Examples of Integrative Reviews
• Supplementary Resources

"An integrative review is a specific review method that summarizes past empirical or theoretical literature to provide a greater comprehensive understanding of a particular phenomenon or healthcare problem" (Broome, 1993). Thus, integrative reviews have the potential to build upon nursing science, informing research, practice, and policy initiatives.

An integrative review method is an approach that allows for the inclusion of diverse methodologies (i.e. experimental and non-experimental research) and have the potential to play a greater role in evidence-based practice for nursing (Whittemore & Knafl, 2005).

Characteristics:

• An integrative review is best designed for nursing research
• The problem must be clearly defined
• The aim of an integrative review is to analyze experimental and non-experimental research simultaneously in order to:
  • define concepts
  • review theories
  • review evidence/point out gaps in the literature
  • analyze methodological issues

When to Use It: According to Toronto & Remington (2020), Whittmore & Knafl (2005), and Broome (2000) an integrative review approach is best suited for:

• A research scope focused more broadly at a phenomenon of interest rather than a systematic review and allows for diverse research, which may contain theoretical and methodological literature to address the aim of the review.
• Supporting a wide range of inquiry, such as defining concepts, reviewing theories, or analyzing methodological issues.
• Examining the complexity of nursing practice more broadly by using diverse data sources.

The following stages of conducting an integrative review are derived from Whittemore & Knafl (2005).

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 & Booth, 2009).

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

Is your review question a complex intervention?  Learn more about Reviews of Complex Interventions.

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 

The following resources are considered to be the best guidance for conduct in the field of integrative reviews.

Methods & Guidance

• Hopia, H., Latvala, E., & Liimatainen, L. (2016). Reviewing the methodology of an integrative review. Scandinavian journal of caring sciences, 30(4), 662–669. doi: 10.1111/scs.12327
• Russell C. L. (2005). An overview of the integrative research review. Progress in transplantation, 15(1), 8–13. doi: 10.1177/152692480501500102
• Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of advanced nursing, 52(5), 546–553. doi: 10.1111/j.1365-2648.2005.03621.x

Reporting Guideline

There is currently no reporting guideline for integrative reviews.

• Collins, J. W., Zoucha, R., Lockhart, J. S., & Mixer, S. J. (2018). Cultural aspects of end-of-life care planning for African Americans: an integrative review of literature. Journal of transcultural nursing, 29(6), 578–590. doi: 10.1177/1043659617753042
• Cowdell, F., Booth, A., & Appleby, B. (2017). Knowledge mobilization in bridging patient-practitioner-researcher boundaries: a systematic integrative review protocol. Journal of advanced nursing, 73(11), 2757–2764. doi: 10.1111/jan.13378
• Frisch, N. C., & Rabinowitsch, D. (2019). What's in a definition? Holistic nursing, integrative health care, and integrative nursing: report of an integrated literature review. Journal of holistic nursing, 37(3), 260–272. doi: 10.1177/0898010119860685
• Kim, J., Kim, Y. L., Jang, H., Cho, M., Lee, M., Kim, J., & Lee, H. (2020). Living labs for health: an integrative literature review. European journal of public health, 30(1), 55–63. doi: 10.1093/eurpub/ckz105
• Luckett, T., Sellars, M., Tieman, J., Pollock, C. A., Silvester, W., Butow, P. N., Detering, K. M., Brennan, F., & Clayton, J. M. (2014). Advance care planning for adults with CKD: a systematic integrative review. American journal of kidney diseases, 63(5), 761–770. doi: 10.1053/j.ajkd.2013.12.007
• Shinners, L., Aggar, C., Grace, S., & Smith, S. (2020). Exploring healthcare professionals' understanding and experiences of artificial intelligence technology use in the delivery of healthcare: an integrative review. Health informatics journal, 26(2), 1225–1236. doi: 10.1177/1460458219874641
• Silva, D., Tavares, N. V., Alexandre, A. R., Freitas, D. A., Brêda, M. Z., Albuquerque, M. C., & Melo, V. L. (2015). Depressão e risco de suicídio entre profissionais de Enfermagem: revisão integrative [Depression and suicide risk among nursing professionals: an integrative review]. Revista da Escola de Enfermagem da U S P, 49(6), 1027–1036. doi: 10.1590/S0080-623420150000600020
• Stormacq, C., Van den Broucke, S., & Wosinski, J. (2019). Does health literacy mediate the relationship between socioeconomic status and health disparities? integrative review. Health promotion international, 34(5), e1–e17. doi: 10.1093/heapro/day062

• Broome M.E. (1993). Integrative literature reviews for the development of concepts. In Rodgers, B. L., & Knafl, K. A. (Eds.), Concept development in nursing (2nd ed., pp. 231-250). W.B. Saunders Company.
• da Silva, R. N., Brandão, M., & Ferreira, M. A. (2020). Integrative Review as a Method to Generate or to Test Nursing Theory. Nursing science quarterly, 33(3), 258–263. doi: 10.1177/0894318420920602
• Garritty, C., Gartlehner, G., Nussbaumer-Streit, B., King, V. J., Hamel, C., Kamel, C., Affengruber, L., & Stevens, A. (2021). Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews. Journal of clinical epidemiology, 130, 13–22. doi: 10.1016/j.jclinepi.2020.10.007
• Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health information and libraries journal, 26(2), 91–108. doi: 10.1111/j.1471-1842.2009.00848.x
• Hopia, H., Latvala, E., & Liimatainen, L. (2016). Reviewing the methodology of an integrative review. Scandinavian journal of caring sciences, 30(4), 662–669. doi: 10.1111/scs.12327
• Russell C. L. (2005). An overview of the integrative research review. Progress in transplantation, 15(1), 8–13. doi: 10.1177/152692480501500102

• Toronto, C. E., & Remington, R. (2020). A Step-By-Step Guide to Conducting an Integrative Review. Springer International Publishing AG. doi: 10.1007/978-3-030-37504-1

• Torraco, R. J. (2005). Writing integrative literature reviews: guidelines and examples. Human Resource Development Review, 4(3), 356–367. doi: 10.1177/1534484305278283
• Whittemore. (2007). Rigour in Integrative Reviews. In Webb, C., & Roe, B. (Eds.), Reviewing Research Evidence for Nursing Practice (pp. 149–156). Blackwell Publishing Ltd. https://doi.org/10.1002/9780470692127.ch11
• Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of advanced nursing, 52(5), 546–553. doi: 10.1111/j.1365-2648.2005.03621.x