Similar to many countries in the world, nursing has long held a place in the historical fabric of civilization in the People's Republic of China.1 At present, there are more than 4 million nurses in China; however, the professionalization of nursing is relatively recent, and similarly to many European countries the past two decades have seen an advancement in educational levels for nurses up to and including PhD.2 This positive development for nursing arose after the development of the People's Republic of China, however, the exact number of nurses educated to PhD level is not clear. Professional development is ongoing, with desires for increased education and specialism in response to rapidly changing health trends, technological advances, and population changes.3 Indeed, health care reform, and nurses’ key role in this, is high on political agendas in China.4
In the reports of the 19th National Congress of the Communist Party of China, Chinese President Xi Jingping pointed out that “people's health is an important symbol of national prosperity and strength”. He made a series of important decisions and plans for implementing the healthy China strategy. Nursing staff play an important role in the process of realizing the goal of “meeting the needs of multi-level and diversified health services” in healthy China
Within this context, much is done to strengthen the work environment for nurses. Leadership is key in this regard and Chinese nursing has a big commitment to the growth and development of nursing leadership. The Chinese Nursing Association, for example, hosts an annual
However, beyond this, there is little systematic understanding of the patterns and trends of research that are published by Chinese nursing scholars. As a result, this article aimed to provide a brief overview of general patterns and trends in publications from China in nursing journals and suggest ways in which this information could be utilized to develop a successful publication pathway for Chinese nurses in the future.
The materials utilized for this analysis were items listed in Scopus.7 Scopus is a large international online abstract and citation repository developed by Elsevier and launched in 2004.8 This database hosts more than 24,000 active titles from 5,000 publishers, across the life, social, physical, and health sciences, all of which are rigorously scrutinized by an independent review board before selection and later on an annual basis.8
Using a sophisticated metadata architecture, the Scopus database provides detailed information on each title (e.g., citations), journals, and authors. Scopus data analytics include quality measures for each title such as
Scopus provides a database search engine with both basic and advanced functions.7 Due to the “rich meta-data” provided for all indexed contents, the users are allowed to conduct precise searches.8 The basic search engine permits a “document search” under three categories: documents, authors, or affiliations.7 Within these searches, detailed metadata are available to further categorize and limit the search within any of the aforementioned fields. The analytics and search facilities of metadata permit researchers to visualize, compare, and export data to assess research trends. Scopus provides access to graphical displays, charts, and tables, which can be manipulated to view specific parameters. This permits the disclosure of patterns and trends, and new insights that may be easily communicated with others.8 Following the initial search, the results can be further broken up into several categories to provide the in-depth analysis (e.g., year, source, author, and country or territory).8 The following analytics were used in this study:
Although Scopus includes a
The author performed two searches using the Scopus database7 in August 2019. The initial search was by
The author subsequently searched for items according to
Top-ranking nursing journals 2018.
Rank | Full journal title | Journal impact factor (2018) |
---|---|---|
1 | 3.570 | |
2 | 2.831 | |
3 | 2.540 | |
3 | 2.540 | |
5 | 2.515 | |
6 | 2.510 | |
7 | 2.500 | |
8 | 2.497 | |
9 | 2.442 | |
10 | 2.433 | |
11 | 2.421 | |
12 | 2.386 | |
13 | 2.376 | |
14 | 2.349 | |
15 | 2.286 | |
16 | 2.129 | |
17 | 2.079 | |
18 | 2.063 | |
19 | 2.048 | |
20 | 2.022 |
The items isolated from this search (
To provide a more in-depth understanding of patterns and trends within these 43 items, the author used a theoretical framework. This framework, derived from Weberg et al.'s14 outline of the leadership role in nursing (Table 2), provided a template for determining broad categories of the items in terms of the domains of leaderships discussed, described, or analyzed in this article.
Weberg et al.'s domains of nursing leadership.
Domain of nursing leadership |
---|
Navigating the care networks and creating the context for professional practice |
Policy, legislation, licensing, and professional nurse roles |
Staffing, scheduling, and patient care assignments |
Becoming a professional nurse |
The person of the leader the capacity to lead |
Applying the practices of leadership |
Principles of ethical decision-making |
Change and innovation |
Conflict skills for the clinical leader |
Leadership and practice partnerships |
Managing your career |
Resources for healthcare excellence |
Delegation and supervision |
Negotiation |
Accountability and ownership |
Using the Scopus analytics to analyze patterns and trends is highly reliable insofar as manual data entry was not required, thus reducing the risk, error, or missing data. Scopus is an extensive database with sophisticated analytics.8 Its rigorous internal peer-reviewed system assures the validity and creditability of the items, which are further re-evaluated every year.8 The analytical capability of Scopus provides the capacity for analysis of international and interdisciplinary patterns and trends, which are not always available in other databases. Comparing a smaller database with the Web of Science,9 the smaller database can provide comprehensive and reliable data15,16 and it also has a more detailed and sophisticated database search engine compared with that provided by the Web of Science.12
Weberg et al.'s14 domains of nursing leadership framework (Table 2) were previously pilot-tested for analyzing leadership patterns and trends and provided informative data.17 The emerging patterns identified within this pilot testing were largely in keeping the previously identified trends, thus indicating reliability and consistency.17 In addition, the general patterns identified in this current study were also largely consistent with previous findings.17
The number of articles categorized as
Impact factor, ranking of sources, and CiteScore (that are cited most frequently) in the category of “nursing” cited in Scopus in August 2019.
Journal title | Web of Science categories (ranking) | Journal impact factor (2018) | Scopus CiteScore (2018) |
---|---|---|---|
Peripheral Vascular Disease (5th) and Clinical Neurology (20th) | 6.058 | 4.94 | |
Nutrition & Dietetics (17th) | 4.170 | 4.51 | |
Nutrition & Dietetics (46th) and Food Science & Technology (33rd) | 3.197 | 3.78 | |
Agriculture and Multidisciplinary Science (9th); Chemistry and Applied Science (23rd); and Food Science & Technology (43rd) | 2.422 | 2.75 | |
Not listed | None | 0.05 | |
Not listed | None | 0.05 |
The majority of published papers were categorized as research articles (
Top five authors from China (those who published most frequently) in the category of “nursing” cited in Scopus in August 2019.
Author | Affiliation | Title* | ORCID ID | Number of publications | |
---|---|---|---|---|---|
Department of Applied Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong | Chair, Professor of Service Leadership Education | 58 | 112 | ||
Department of Food Science & Nutrition, Zhejiang University, Hangzhou, China | Professor of Nutrition | 36 | 93 | ||
Vanderbilt Ingram Cancer Center, Department of Medicine, Nashville, USA | Co-Lead of the Cancer Epidemiology Research Program | 109 | 77 | ||
Vanderbilt University School of Medicine, Nashville, USA | Ingram Professor of Cancer Research; Professor of Medicine/Co-Lead of the Cancer Epidemiology Research Program | 97 | None | 65 | |
Shanghai Jiao Tong University, Department of Pediatric Surgery, Shanghai, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China; Shanghai Institute of Pediatric Research, Shanghai, China | Professor of Medicine | 19 | None | 58 |
Note:
Titles only if available.
There were 43 publications affiliated to China, which were published in the
A selection of five authors from China who published most frequently in the
Author | Affiliation | Title | Scopus author identifier | ORCID ID | Number of publications | |
---|---|---|---|---|---|---|
School of Nursing, Fudan University, Shanghai, China | School of Nursing, Faculty Member | 4 | 57191886208 | None | 2 | |
Fudan University, Shanghai, China and Fudan University, A Joanna Briggs Institute Centre of Excellence, Shanghai, China | Professor, School of Nursing, Fudan University, Shanghai, China | 6 | 56174094600 | None | 2 | |
School of Nursing, Harbin Medical University, Affiliated Hospital & College of Nursing, Harbin, China | Professor, The 2nd Affiliated Hospital & College of Nursing, Harbin Medical University, Harbin, China | 5 | 55587486800 | None | 2 | |
Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China | Dean and Professor; Director of WHO Collaborating Center for Nursing Policy-Making and Quality Management | 9 | 50761197600 | None | 2 | |
PLA Stroke Care and Research Centre, The Second Artillery General Hospital PLA, Beijing, China | Not listed | 4 | 55341814100 | None | 2 |
In terms of topics, according to Weberg et al.'s14 outline of the leadership role in nursing, the main focus of these Chinese papers in the
An outline of patterns and trends in papers from the People's Republic of China published in the
Domain of nursing leadership | Number of papers (%) |
---|---|
Navigating the care networks and creating the context for professional practice | 13 (30.23%) |
Policy, legislation, licensing, and professional nurse roles | 9 (20.93%) |
Staffing, scheduling, and patient care assignments | 7 (16.27%) |
Becoming a professional nurse | 4 (9.30%) |
The person of the leader the capacity to lead | 4 (9.30%) |
Applying the practices of leadership | 3 (6.97%) |
Principles of ethical decision-making | 2 (4.65%) |
Change and innovation | 1 (2.32%) |
Conflict skills for the clinical leader | 0 (0.00%) |
Leadership and practice partnerships | 0 (0.00%) |
Managing your career | 0 (0.00%) |
Resources for healthcare excellence | 0 (0.00%) |
Delegation and supervision | 0 (0.00%) |
Negotiation | 0 (0.00%) |
Accountability and ownership | 0 (0.00%) |
All papers from China in | 43 (100%) |
Source: Weberg et al.14
Overall, there has been a steady increase year by year in publications categorized as
This is an important finding as both Peking and Fudan Universities are ranked in the top five universities in China, and they feature among the best in the world (24th and 109th ranks, respectively).19 Government plans to develop Chinese universities into top-class international universities are ongoing, with the recent development of the
It is interesting to note that although categorized as
A closer examination of the trends also revealed that the top five authors (those who published most frequently) in the category of “nursing” did not appear to be affiliated to nursing schools or a nursing professor. This may be due in part to the limited number of nursing scholars with PhD,2 however, a deeper analysis of activity within one specific nursing journal, namely the
As effective leadership and management play an important part both in the development of nursing as a discipline and as a science and in the professionalization of nursing, exploring scholarly output about nursing management provides additional information about nursing scholars’ activities. In keeping with general trends in the journal, the majority of these papers were research articles.17 However, very few literature reviews and there were no editorials or something that differs from the usual pattern of publication in this journal.17 Again a top-ranking university (Fudan University17) featured highly. Of note, the
In terms of topics (according to Weberg et al.'s14 outline of the leadership role in nursing), two of the main foci of these Chinese papers in the
China, similar to the rest of the countries in the world, is facing unprecedented demographic and technological changes for the future. The consistently changing nature of health care requires a skilled workforce who can provide evidence-based practice. Nurses are required to understand and use research, and fundamentally nursing scholars ought to be leading and driving research and evidence-based practice in the field.23,24 There is clear evidence of scholarly activity in nursing in China, both in the published literature and anecdotally in practice. However, nursing scholars need to do more to increase dissemination and ensure that nursing professors are leading and driving nursing research,18 albeit in a multidisciplinary context. There is also a need for increased exposure of Chinese nursing scholarship in high-ranking nursing journals. Ongoing governmental activity20 will likely support capacity building within the nursing profession, and targeted efforts to accelerate PhD numbers among nurses and publication would likely have a positive influence on the impact of the profession internationally.18 Nursing scholars can also contribute to raising their profile by registering for an ORCID ID9 that can be linked to their work. This is especially useful to identify single researchers where there are similarities in names or where there are changes in affiliation or names/titles.
The large population in China makes it an exceptional forum for research and development, particularly in the field of nursing management. Researchers ought to continue to focus on their strengths about policy, legislation, licensing, and professional nurse roles, becoming a professional nurse and principles of ethical decision-making, and they also seek to research in areas such as delegation and supervision, negotiation, accountability and ownership leadership, and practice partnerships and managing your career and resources for healthcare excellence to address current gaps. In China, patients and staff numbers in hospitals can be up to (and sometimes more than) 10 times the size of those in the UK or USA, rendering a remarkable opportunity for nursing research and especially for the understanding, application, and evaluation of nursing management. The numbers of staff on duty per clinical area far outweigh many hospitals internationally and thus offer a unique and valuable insight into patient care and management. Although journal citations have a rich contribution to the measurement of quality of scholarship11,15,16 and are therefore an important component of building excellence in terms of university rankings,21 the potential bias of database repositories toward Western journals could likely negatively impact on perceptions of quality research. Additional measures to support Chinese scholars to publish peer-reviewed publications within these high-ranking journals are needed and the number of Chinese journals currently listed needs to be increased. However, English is considered the “language of health science,”23 thus English as a second language may be a barrier for Chinese scholars5 and resources and investment in translation and publication support are likely to be a requirement for facilitating future success in addition to other capacity-building measures.
A single author collected the data. However, both Scopus and Web of Science analytics are comprehensive and reliable, cross-checking of individual results was not required. Furthermore, given the level of sophistication of these analytical tools manual cross-checking would not be feasible. The analysis of patterns and trends using Weberg et al.'s framework,5 although consistent with other trends,17 could have benefited from cross-checking in terms of reliability. However, the purpose of this phase of the research was exploratory. It was largely for information purposes to provide broad guidance to authors and editors regarding patterns and trends, potential information, and gaps in the published research. Absolute reliability with regard to emerging trends was not required.
The broad categorization of journals within the category of nursing with the Scopus database7 limits the generalizability of the findings. Furthermore, while the overarching findings of the first phase of this research were interesting in terms of the patterns and trends that emerge, it is difficult to have full confidence in the findings in terms of an accurate picture of nursing scholarship in China, given the broad conceptualization of nursing within the database.7
Although the majority of data presented were largely reliable, it might be useful for analytics to support greater thematic analysis within journals for the future, and the categorization of nursing within Scopus would benefit as it is more focused on nursing-specific journals.