Abstracts

ORIGINAL ARTICLES

Nursing research and bibliographic citation models

Jordi Piqué Angordans^I; Ramón Camaño Puig^I; Carmen Piqué Noguera^II

^ISenior Lecturer, University of Valencia, Spain, e-mail: jordi.pique@uv.es, ramon.camano@uv.es

^IIJunior Lecturer, Faculty of Philology, Translation and Communication, University of Valencia, Spain

ABSTRACT

This research focuses on the analysis of how nursing journals publish their papers. Basically, two models are analyzed, Vancouver, by the International Committee of Medical Journal Editors, and APA by the American Psychological Association. Their advantages and disadvantages are discussed. In view of how research papers are currently published and how research is judged, the authors propose that nursing journals adopt their own model, irrespective of how medical professionals publish.

Descriptors: nursing research; bibliography; periodicals; scientific and technical publications

INTRODUCTION

Scientific tradition sometimes causes certain inertia and imitation, difficult to avoid and which, in the case of nursing, is related to medicine due to the influence this profession has traditionally exerted over it. Thus, it is not surprising that medicine has led a large part of nursing research to publish according to the Vancouver model. This model got its name after the meeting of journal editors held in Vancouver, Canada in 1978, which created the International Committee of Medical Journal Editors. In this meeting, editors agreed on the unification of how professionals should write and cite in the medical area. Initially, mainly biomedical sciences journals adhered to the group and a list of 300 journals⁽¹⁾ was published, while only the Nursing journal was included.

The Vancouver model was implemented in nursing in part because there was work already done and also due to a certain editorial inexperience, which led to the adoption of the new publishing model, without previous analysis by professionals responsible for several of these journals. It is important to appoint other considerations however, for example regarding the meaning and use of citations. Campanario⁽²⁾ describes the subjacent principle of every citation: "if a document cites another document, both acquire a conceptual relationship", that is, through citations we acknowledge and accept that our publications are closed linked to the references included. Hence, this relation demands an attitude of respect to whom is cited and to what is cited, which is supposed to be consulted at least in its main lines and not only through titles and abstracts obtained in bibliographic searches, which unfortunately is sometimes observed. However, for this respect to be real and not fictitious, a critical evaluation is also needed to clarify why some authors are cited and not others, since to support and strengthen views expressed⁽³⁾, one should cite research not only easily accessed but also well interpreted and evaluated by the author. This is what research using the APA model proposed by the American Psychological Association and, in some cases, the Harvard model, very similar to APA, aim at.

The Vancouver model format presents a number between brackets, or as a super index, for each bibliographic entry that is added in the order they appear in text, in the complete list of references at the end⁽¹⁾. In fact, there is available software that easies the task and speeds up the study presentation. However, the abundance of bibliographic citations on one hand, and the word scarcity in their evaluations on the other, are due to the generalized idea that the more bibliographic entries the greater the impact produced, even if none of the citations are evaluated. Another factor might be the economic limitation, usually excessive, imposed by publishers on the number of total words of articles. All these tend to excessively reduce previous and necessary evaluation and/or critique of previous literature, which favor second and third hand citations and increase the chances that errors may filter through prestigious studies for having "copied" a wrong bibliographic information in its beginning.

Criticism is very explicit when referring to minimum standards regarding previous literature review that appears in the article introduction, in a separate section or in the article discussion. As stressed by Swales⁽⁴⁾, it is not about creating anything new, gaps should be identified in the previous literature, what others initiated in a given area should be researched and continued and data sources other researchers have used should also be investigated.

When one examines several professional journals in the area of health sciences, different ways to use and cite bibliography are found, that is, different forms of attributing to each respective author information extracted through bibliographic search. The main models of bibliographic citation currently used are analyzed in this study in terms of their utility and pertinence, aiming to distinguish which could be the most adequate to be used in nursing research. It is intended that nursing professionals pay more attention to the analysis and evaluation of previous literature and also to propose the unification of referencing and citing criteria in nursing so that it may answer its research needs, which do not necessarily have to be the same used in other areas.

MATERIAL AND METHOD

This study is based on the analysis of citation systems used by nursing journals contained in three databases:

- Twenty-two journals of free access in the Directory of Open Access Journals (DOAJ) in the Nursing section (Table 1);

- The first 20 Spanish journals according to the most recent list published in the CUIDEN ranking (Table 2);

- The 36 nursing journals, which until 2006, were in the ISI impact factor list (Table 3).

In the first group, 22 journals listed in the DOAJ were analyzed, aiming to assess the model of references used and the most significant differences that could be observed. However, only the first 20 journals from the second database according to ranking CUIDEN were used, due to the fact that they almost unanimously elected the Vancouver standard of biomedical journals. In the ISI list, we analyzed the 36 journals that appeared in 2006 and which offered greater variability in the model used. Also, to illustrate the differences in the citations used in the two models, a comparative analysis of the application of both reference systems, APA and Vancouver, was carried out, based on the original articles published in journals contained in the databases this study focused on.

RESULTS

The first database searched was the Directory of Open Access Journals⁽⁵⁾, in which 22 nursing journals were analyzed, presented in Table 1.

Table 1 shows that 15 of the journals only publish according to the Vancouver model (68.2%), three of which (13.6%) accepted a few articles in another model (APA, Harvard), while the rest (18.2%) directly defend the APA model: three are from the United States and one from Chile (Cienc Enferm). It must be pointed out that many journals that publish according to the Vancouver standards are linked to some medical laboratory or biomedical database (BioMed, Medline, Surgical Materials Testing Laboratory etc.), which also seems reasonable in journals originated from health institutions, as is the case of the majority of Latin-American journals except for the Chilean (nº 3), which publishes according to the APA model. Many nursing professionals, regardless of their individual work, jointly publish with medical teams, who opt to publish in medical journals and sometimes in multidisciplinary journals with the highest possible impact, which usually does not occur with journals exclusively from the nursing area⁽⁶⁾. The Index Enferm journal was the one in which more freedom of style was observed, where the editorial board, even advising to use the Vancouver model, frequently accepts articles following other models.

The Group of Documentary Studies Index Foundation has published several studies related to nursing journals in the Spanish and Portuguese language area and also the list of CUIDEN impact indicators, through which some significant information can be inferred. Table 2 presents the distribution of the first 20 Spanish journals in 2006 according to the Rc_h⁽⁷⁾ index.

As observed in Table 2, most Spanish nursing professionals follow the Vancouver model, according to the standards of each journal, except for Cultura dos Cuidados (nº 10), which publishes according to the APA model, besides others that occasionally accept it (nº 15 and 16).

It would be unfair, however, to sample only nursing journals included in the DOAJ (Table 1) or only and exclusively Spanish journals in the Index Foundation (Table 2) to obtain representative results. Not because they are free access journals or because some of them are electronic, whose impact is questioned⁽⁸⁾, but because of other factors, for instance, data that appear in Journal Citation Reports according to Table 3.

Thirty-six nursing journals included in the ISI list, out of more than 50 that will possibly appear in the next list, were analyzed according to the impact factor (2006) (Table 3) to see to what extent they follow the trend showed in Tables 1 and 2. According to Table 3, 20 (55.6%) out of the 36 nursing journals in this list follow the APA model and 16 (44.4%) follow the Vancouver model.

The importance nursing publications have recently had made Thompson Scientific announce the expansion of nursing journals coverage in an article published in the press on September 7^th 2006. As stated in the press release "being indexed by ISI Web of Knowledge is an important indicator of the impact and influence of a scientific journal in its respective field." It is evident that nursing researchers have taken the initiative to give nursing this autochthonous nature, especially in countries where there are high education degrees up to the doctoral level. This is what is proposed here and has considerably and concretely advanced in the United States. It is significant that there are no Spanish journals in the ISI list so far and that only recently the inclusion of the Brazilian Rev Latino-am Enfermagem was announced.

REASONS TO ELECT THE MODEL

Most nursing journals in the ISI index employ a reference system more related to the Social Sciences like the APA model and which is proposed in this article, not because one wants to abdicate one's education but because one wishes to contribute to the improvement of research quality and to the result and selection of bibliographic material. A comparative example obtained in nursing journals included in databases mentioned above should be sufficient to show the difference.

See below Table 4 in which the authors of Spanish language elect the described and different models.

The first example from the journal Gerokomos follows the Vancouver model and its authors include in the first paragraph six bibliographic items, another six in the second and one in the third; a total of 13 bibliographic citations. However, these are not critically evaluated, some are repetitive and others unnecessary. On the other hand, the text in the APA model, also from the nursing area, without any bibliographic fanfare as the theme itself does not require this, suffices with three bibliographic citations. Moreover, the second text seems very wise because it quotes authors' exact words in a context where paraphrasing would also appear redundant. The only advantage found in the Vancouver model is the schematization of information, though the question is whether this is what an incipient science like nursing needs. We do not believe so.

The Vancouver model is directly contradicted by Swales'⁽⁴⁾ recommendation that defends a mixed procedure, which would be considerably reinforced in the analysis of citations, increasing techniques of textual analysis. This author asks a series of questions that should be considered at the moment of including citations in the article section review of the literature, for example: whether the citation was evaluated or criticized; whether it quotes the author directly; whether it refers to a theory or simply to a concept; whether author and year are represented between parentheses, and if it directly reproduces words or proposes an alternative to it. The following example⁽¹²⁾, an excerpt from a medical article, confirms this lack of evaluation or critique in the Vancouver model.

On the one hand, as shown in this example, the accumulation of studies that "say something" related to the study in question is not sufficient to include them if this has not been based on evaluation. On the other hand, the qualitative analysis of this paragraph cannot answer any of the questions asked in literature⁽¹³⁾. We can argue, as one of the referees in the first version of this article did, that what Swales⁽⁴⁾ proposed can also be done with the Vancouver model. Indeed, but only in theory, since in practice one tends to reduce the part of the previous literature evaluation to a minimum. A direct quotation, as suggested by Campanario⁽²⁾, should somehow involve the cited author, though it is not always possible if one does not explicitly mention the author, which happens in both models. Consider the following example in which the Vancouver model is used, a direct quotation with page indication from the journal Online Braz J Nurs⁽¹⁴⁾.

As can be observed, the page follows the citation number (7:364) and refers to an article from its bibliography. However, this interesting innovation does not appear in the Vancouver form, which shows that, one can do it, which in turn leads to the question about the possibility of incorporating this model into the previous example⁽¹²⁾. The article cited above⁽¹⁴⁾ besides indirect quotations, contains another 17 direct quotations, although none of the names of their respective authors appear. It is worth pointing out, as did Skelton⁽¹⁵⁾, that there was a process in medical research where "people got lost", mentioning the fact to the detriment of the author. On the other hand, the use of ambiguous verbs and expressions, such as "to indicate", "to suggest", "who knows", "perhaps", "possibly", and "probably", one maintains an unsteady and temporary attitude, at the same time as one avoids going "beyond the evidence", as suggested by Skelton e Edwards⁽¹⁶⁾.

Unfortunately, academic writing manuals devote little space to previous review and evaluation of literature, a section considered essential in the presentation of scientific studies. Granjel et al.⁽¹⁷⁾ are very explicit and dedicate chapters to the access and treatment of bibliography information. However, they impose limits to the introduction section since, as they argue, it is not a place to inform "the content of research but a place to inform the study objectives and claims"(our translation)⁽¹⁷⁾. Norman⁽¹⁸⁾ on the other hand, uses only one paragraph to indicate that a good introduction should only include necessary information and references, presented in a logical order, to justify the study, and that the introduction is not the place to review the literature or to show how much the author knows about the subject. This little information is understandable since this manual mainly answers grammatical aspects of scientific research in English. However, both manuals favor the publication of any literature review more or less comprehensive in the so-called review articles. Day⁽¹⁹⁾, in turn, highlights the fact that a literature review should be "exhaustive and appropriate", that is, it should contribute to a better understanding of the context in which our own study has been structured. "No researcher - says Day⁽¹⁹⁾ - can investigate a problem without understanding the context" and, for that, a good literature review should be included. In previous research⁽²⁰⁾, following the Swales' model, the article structure that directly addresses the need for a literature review related to the study itself was presented through four concrete informative units: (i) reference to previous research, (ii) to its limitations, (iii) to the advantages of the research itself and (iv) how this investigation is a continuation of previous research⁽²⁰⁾. For that, evaluation is needed and not simply mechanically repeating what other researchers have said; as Day advises, "Evaluate - don't regurgitate" ⁽¹⁹⁾.

FINAL CONSIDERATIONS

The nursing profession has greatly developed in recent years. It is no longer considered a mere technical vocation or a simple occupation to be compared to law, medicine or pedagogy. Consequently, several nursing journals have become influential publications worldwide in the area of health sciences.

It is clear that the evident development of research in the nursing area has favored changes in the use of one of the models. Hence, in the United States for instance, which already have years of graduate nursing research, many of the important journals (see Table 3) have significantly worked out of the biomedical area and published according to the APA model. It is precisely because of this reason that similar change is expected in the production of research based on the introduction of nursing undergraduate and graduate programs, especially in countries like Spain and Brazil, where scientific development represents a crucial factor in professional and social advancement⁽²¹⁾. On the one hand, the incorporation of nursing schools to universities is a relatively recent fact. This late incorporation only recently encouraged research at doctoral and postdoctoral level. On the other hand, the definitive incorporation of undergraduate and postgraduate programs, which are in a period of experimentation and changes, especially in Europe, should definitely encourage the generalization of research among nursing professionals. This has been one of the main reasons research groups, mainly in the nursing area, are not as numerous as one would desire. In an article addressing publications related to health, Paraje et al.⁽²²⁾ analyzed the global production of articles in the area and Spain was in the tenth place. The implementation of undergraduate programs, according to the European Union guidelines, should enhance research groups, as well as projects presented and approved by the Ministry, and the publication of articles in journals of impact.

In an editorial note in the Gac Sanitaria, Fernández and Plasència⁽²³⁾ address readers and ask at the same time: "can we count on your citations as well?" with which they give, once more, excessive emphasis to the importance of mutual citation so as to increase the respective impact index. It is thought that nursing, poorly represented in committees of national research, should somehow propose a different model to value published works and promote higher quality publications. It is not sufficient to complain when one is personally affected because one's research has not been satisfactorily valued. One step further is necessary and it is achieved through the encouragement of more independent work groups. Nursing activity frequently sees itself diluted in larger groups, related or not to hospitals, but because they belong to a concrete unit, they are usually subject to a work style and cannot say a word so as to give a nursing touch which research in this area requires.

After the difficulties faced in the nursing profession related to the medical category, it does not seem adequate that nursing publishes in a certain way because this was determined in a meeting of editors of medical journals in Vancouver (Canada). It is thought that, given its idiosyncrasy, much more oriented to sociology than to biomedicine, nursing should take a turn for its own method of research and publication style. However, regardless of this reason, which by itself would suffice, one has to understand that the alternative APA is more reliable in citations and gives credit to whom deserves it, besides being more accessible in terms of bibliographic recovery. In other words, Vancouver seems to favor quantity in the same way APA introduces qualitative elements in relation to the evaluation of the mentioned references.

Recebido em: 7.11.2007

Aprovado em: 26.2.2009

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