Letter to the Editor – Mackie

By Benjamin Mackie In   Issue Volume 23 No. 2 .

Dear Editor

Recently, Clifford (2014) conducted a literature review of compassion fatigue and burnout in military health professionals. As noted by the author, the recent Dunt Review highlights the issue of Post-traumatic Stress Disorder (PTSD) has raised the awareness and public debate of this service related  injury.  Moreover, the authors focus of discussion in relation to health professionals is worthy of a broad review of the literature. Regrettably, the methodological rigour in which this review was conducted is not consistent with current best practice guidelines making interpretation of the conclusions difficult. Of significance is that only one database were used to search the literature, the findings of this search are not reported, no  quality  appraisal  of  the articles which were included in the review were detailed or process for analysis reported. I recommend that any author wishing to submit a literature review for publication consider undertaking an integrative review.

The integrative review has been identified as a robust tool for synthesizing available literature on a given topic (Williams, 2012). It is used as a tool of Evidence Based Practice (EBP) (de Souza et al., 2010) and allows for the combination of diverse methodologies (e.g. experimental and non-experimental research in order to fully understand the area of interest (Whittemore and Knafl, 2005). Assessing rigour is an important step in the integrative review process and should be addressed in a meaningful way (Whitemore and Knafl, 2005). While there exists no clear agreement on jointly appraising the methodological quality of diverse methods, recent guidance has been emerged: the Mixed Method Appraisal Tool (MMAT) (Pluye et al., 2009). A further tool to guide authors in reporting the findings of their review can be found via the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).

My intention in outlining these points is not to detract from the significant work undertaken by Clifford (2014), but to offer future authors guidance in how to develop a review and have their work recognised as being trustworthy, rigorous and valid.

Regards, Ben Mackie

Lecturer of Nursing, University of Southern Queensland



De Sousa, M. T., Da Silva, M. D., & De Carvalho, R. (2010). Integrative review: What is it? How to do it? Einstein, 8,  102-106. Clifford, K. Who Cares for the Carers? Literature Review of Compassion Fatigue and Burnout in Military Health Professionals. JMVH, 2014. 22(3): p.  53-63. Pluye, P., et al., A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews. Int J Nurs Stud, 2009. 46(4): p. 529-46. Whittemore, R. and K. Knafl, The integrative review: updated methodolgy. Journal of advanced Nursing, 2005. 52(5): p. 546-553. WIlliams, M., Rural Professional Isolation: An Integrative Review. Journal of Rurual Nursing and Health Care, 2012. 12(2).

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