Skip to Main Content

Evidence Synthesis & Systematic Review

This guide will help you get started with your next systematic review, scoping review, or other review types.

Other names for an Integrative Review

IR, Integrative Literature Review, Systematic Integrative Review

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)

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.

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.

See our Systematic Review Search Service for help conducting the search!

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)

Sample Integrative Review 1

dos Santos Damásio Silva, Darlan
Revista da Escola de Enfermagem da U S P
Volume: 49
Issue: 6
Page: 1023-1031

OBJECTIVE: Discussing the factors associated with major depression and suicide risk among nursing professionals. METHOD: An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. RESULTS: 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high level of education, low family income, work overload, high stress, insufficient autonomy and a sense of professional insecurity and conflict in the family and work relationship. CONCLUSION: Suicide risk was correlated with the presence of symptoms of depression, high levels of emotional exhaustion, depersonalization and low personal accomplishment; characteristics of Burnout Syndrome. Suicide risk among nursing professionals is associated with symptoms of depression and correlated with Burnout Syndrome, which can affect work performance.

Sample Integrative Review 2

Luckett, Tim
American journal of kidney diseases
Volume: 63
Issue: 5
Page: 761-770

BACKGROUND: Recent clinical practice guidelines have highlighted the importance of advance care planning (ACP) for improving end-of-life care for people with chronic kidney disease (CKD). STUDY DESIGN: We conducted a systematic integrative review of the literature to inform future ACP practice and research in CKD, searching electronic databases in April 2013. Synthesis used narrative methods. SETTING & POPULATION: We focused on adults with a primary diagnosis of CKD in any setting. SELECTION CRITERIA FOR STUDIES: We included studies of any design, quantitative or qualitative. INTERVENTIONS: ACP was defined as any formal means taken to ensure that health professionals and family members are aware of patients' wishes for care in the event they become too unwell to speak for themselves. OUTCOMES: Measures of all kinds were considered of interest. RESULTS: 55 articles met criteria reporting on 51 discrete samples. All patient samples included people with CKD stage 5; 2 also included patients with stage 4. Seven interventions were tested; all were narrowly focused and none was evaluated by comparing wishes for end-of-life care with care received. One intervention demonstrated effects on patient and family outcomes in the form of improved well-being and anxiety following sessions with a peer mentor. Insights from qualitative studies that have not been used to inform interventions include the importance of instilling patient confidence that their advance directives will be enacted and discussing decisions about (dis)continuing dialysis therapy separately from 'aggressive' life-sustaining treatments (eg, ventilation). LIMITATIONS: Although quantitative and qualitative findings were integrated according to best practice, methods for this are in their infancy. CONCLUSIONS: Research on ACP in patients with CKD is limited, especially intervention studies. Interventions in CKD should attend to barriers and facilitators at the levels of patient, caregiver, health professional, and system. Intervention studies should measure impact on compliance with patient wishes for end-of-life care.


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

Dhollande S, Taylor A, Meyer S, Scott M. Conducting integrative reviews: a guide for novice nursing researchers. J Res Nurs. 2021 Aug;26(5):427-438. 

Oermann, MH, Knafl, KA. Strategies for completing a successful integrative reviewNurse Author Ed. 2021; 31( 3-4): 65- 68. 

Whittemore R, Knafl K. The integrative review: updated methodology. Journal of Advanced Nursing. 2005; 52(5).