key: cord-0451458-ge9wsxo3 authors: Vosner, Helena Blazun; Kokol, Peter; Zeleznik, Danica; Zavrsnik, Jernej title: Bibliometric Profile of Nursing Research in Ex Yugoslavian Countries date: 2021-07-27 journal: nan DOI: nan sha: c2d2251aab07800d66ec227249566eaaae7ba0f7 doc_id: 451458 cord_uid: ge9wsxo3 The development of modern nursing and consequently nursing research in Ex- Yugoslavia is about a century old. To profile the development, volume, and content of nursing research we completed a performance and spatial bibliometric analysis combined with synthetic content analysis to identify the most productive countries and institutions, most prolific source titles, country cooperation, publication production trends, the content of research and hot topics. The corpus was harvested from the Web of Science All databases and contained 1380 papers. Slovenia was the most productive country, followed by Croatia and Serbia. The synthetic content analysis demonstrated that nursing research in ex-Yugoslavian countries is growing both in scope and number of publications, notwithstanding the fact that research content differs between countries and it seems that each country is focused on their local health problems. A substantial part of the research is published in national journals in national languages however, it is noteworthy to note that some ex-Yugoslavian authors have succeeded in publishing their research in top nursing journals. The study also revealed substantial international cooperation especially among ex-Yugoslavian countries and European Union. The development of modern nursing and consequently nursing research in Ex-Yugoslavia is about a century old. The more intensive, however still slow development started in 1921 when first two schools in nursing were formed in Belgrade and Zagreb. More rapid development started after the Second world war with the raise of the quality and scope of the health services standards. In individual republics the more exhaustive development in nursing as a profession and nursing research started in: • 1899 in Serbia when the first school for midwives was founded at the Department of Gynecology and Obstetrics of the General State Hospital in Belgrade. However, there were no other schools for nurses in Serbia until the foundation of the School for Midwives of the Red Cross Society in 1921 (Vlaisavljević et al., 2014) • 1921 Croatia with the founding of the School for Nurse Assistants, however the roots go back to 1882 when Dr. Manšek published a book Voluntary Military Health Care Service (Kalauz et al., 2012) • 1927 in Slovenia with the establishmet of the Nursing School Graduate Organization at the Institute for Maternal and Child Health (Zbornica zdravstvene in babiške nege Slovenije, 2021) . However the establishment of the first midwifery school in Ljubljana in 1753 on the initiative of the Austrian Empress Maria Theresa dates even eralier and presents a big step also in the professionalization of the nursing profession is Slovenia. Single journals or country groups or wider region based bibliometric research profile studies are recently gaining in popularity . Onyancha and Onyango (O.b & Onyango, 2020) presented the employment of information and communication technologies for agricultural activities in Sub Saharan Countries, Bambo and Pouris (Bambo & Pouris, 2020) investigated the research profile of bioeconomy in South Africa, Lin et al (Gege Lin et al., 2018) analysed the research preferences in G20 countries, Živković and Panić (Živković & Panić, 2020) analysed the development of science and education in Balkan countries and Naruetharadhol and Gebsombut (Naruetharadhol & Gebsombut, 2020) examined the research on food tourism performed in Southeast Asia. Similar studies, however concerned with medical and health sciences were done for Caribbean and Latin American countries focusing on stroke (Alarcon-Ruiz et al., 2019) and COVID -19 (Espinosa et al., 2020) , Arab Region regarding mental health (Zeinoun et al., 2020) and COVID-19 (Zyoud, 2021) , Southeastern Europe focusing on Liver Transplatation (Mrzljak et al., 2020) , Armenia concerned with anaemia in children and adolescent (Awe et al., 2021) and Asia Pacific region concerned with palliative care (Cheong et al., 2018) . While there were also some similar studies focusing on nursing research (Benton & Brenton, 2020; Dardas et al., 2019; Thelwall & Mas-Bleda, 2020; Zhang et al., 2018) , no study has covered the ex-Yugoslavia countries region, thus the aim of this paper is to cover this gap. In that manner we performed a performance and spatial bibliometric analysis, and synthetic content analysis (Kokol et al., 2021) to identify the most productive countries and institutions, most prolific source titles, country cooperation, publication production trends, content and structure of research and hot topics. Bibliometrics is defined as the quantitative analysis of the bibliographic features of a body of literature like journals, monographs, reports, theses, conference papers and similar (Hawkins, 2001; Pritchard, 1969; Železnik et al., 2017) . One of its main advantages is the domain independence, and it has been already successfully used in nursing and healthcare . The various corpora of publications employed in this study were retrieved from the Web of Science (WoS) bibliographical database (Elsevier, Netherlands) on 6 th of June 2021. We used two bibliographic collections, namely the Core Collection (WoS CC) and All Databases (WoS AD). WoS AD covers more source titles, but it lacks some of the bibliometric attributes provided by WoS CC, like data for corresponding/first authors analysis or advanced bibliometric mapping. For both collections the search was performed by the Advance search command TS = Nursing, thus limiting the search to nursing topic papers. No additional search limitations were set. The full WoS CC based search corpus was used for the content analysis of the publications from the whole region. The corpus was then further partitioned into seven country corpora, one for each ex-Yugoslavian country. These corpora were used for the county specific research content analysis. The next corpus was formed by removing all publications where the corresponding/first authors affiliation was geographically not located in an ex -Yugoslavian country. This corpus was used to analyse and compare the publication bibliometric features per country. like average number of authors, citations, references or pages per paper. The WoS AD corpus was used for descriptive, spatial and thematic bibliometric analysis for the whole ex-Yugoslavia region. For the descriptive and spatial bibliometric analysis, we used WoS Refine function and MS Excel (Microsoft, United States of America (USA)). For the Excel based analysis publications meta-data was exported to Excel program, where trends' analyses of publication characteristics were performed. Synthetic content analysis using the triangulation of bibliometric mapping (based on author keywords) and thematic analysis Kokol et al., 2021) and country co-operation was performed with the help of VOSviewer software version 1.6.15 (Leiden University, Netherlands) (van Eck & Waltman, 2010). Hot topics were identified using the approach proposed by Kokol et al (Kokol et al., 2018) The search in WoS AD resulted in 1380 publications. Among them there were 1127 articles, 119 review papers, 21 editorials, 18 letters, 15 case reports, 15 clinical trials eight books and 308 other types of publications (please note that WoS can categorise a single publication in more than one category). The number of retrieved publications for of ex Yugoslavian countries is shown in Table 1 . The search in WoS CC resulted in1068 publications -686 of those have corresponding or first authors from ex-Yugoslavian countries. First nursing paper published in ex Yugoslavian countries indexed in WoS was published in 1991 by Croatian affiliated authors. The paper presented a study about chromosomal abnormalities among nurses occupationally exposed to antineoplastic drugs (Milkovickraus & Horvat, 1991) . After that the number of publications started to grow slowly till 2004, when the trend remained linear. but the growth rate become steeper. In 2020 we can note a slight decrease in productivity. According to the ratio between articles, reviews and conference papers and the linear trend of the literature we reason that nursing research is in the second of four stage of the Schneider scientific discipline evolution model (Shneider, 2009) . That means that the country specific nursing research terminology and methodologies are starting to be standardised, and that domain specific original knowledge generation is heading toward more intensive research productivity. The positive research productivity trend is the largest in Slovenia, and lowest in Kosovo and Montenegro. 1999 1998 1997 1996 1995 1994 1993 1992 1991 The geographical distribution of nursing research literature production of the countries from the region of ex-Yugoslavia is shown in the Table 2 . Slovenia was the most productive country, followed by Croatia and Serbia. Those three countries share of papers where the corresponding or first authors are affiliated to an institution from an ex-Yugoslavian country exceeds 60%. The literature production in the above three countries was substantially larger than in the rest of the region. Thematic analysis revealed that nursing research in Ex -Yu countries is concerned with following themes (Figure 2 The differences in the content and themes of nursing research between ex-Yugoslavian countries is shown in Table 6 . The analysis of the table reveals that each country has its own country specific research focus. The ex Yugoslavian countries were internationally extremely active (Fig 4. )they established a cooperation co-authorship network of 88 countries. Among ex-Yu countries. most coauthorship links were instituted by Serbia (n=66) followed by Croatia (n=63), Slovenia (n=61), North Macedonia (n=55), Bosna and Herzegovina (n=33), Montenegro (n=16) and. Kosovo (1). The strongest links between ex Yu countries were established between Slovenia and Croatia (n=32), and the strongest link between ex-Yu country and non ex Yu. Country between Croatia and England (n=40). It is also interestingly to note that the countries which established nursing schools early in the 20th century are significantly more scientifically productive than the countries which established them after the second world. This seems to be quite logical as nursing research is an important part of the .educational process, the process which also empowers nurses to perform the research (Tingen et al., 2009) . The ex Yugoslavian countries with higher economic determinants/indices are considerably more productive. This correspondence with outcomes of Kokols et al study about the relation between country and health determinants and nursing research productivity and also with the study of the research productivity of Arab countries regarding COVID-19 research (Zyoud, 2021) . Substantial part of the research is published in national journals in national languages; however it is noteworthy to note that some ex- To enable such publishing endeavours, not only international but interdisciplinary research must emerge in the region. Accordingly, policy makers in national and international funding agencies and bodies should put more focus on including nursing in interdisciplinary research grants calls. Additionally, the preparation of high quality nursing research publications requires significant effort and time, however it is worth doing because publishing in highimpact journals enables researchers to generate further funding and thus support collaborative research needed to achieve above goals and subsequently and most important improve region health determinants (Grant & Buxton, 2018) . Our study also showed that most of the research is performed at universities and clinical centres. Thus, to further alleviate above points the nursing research in the region should spread to all types of health care institutions. Our analysis demonstrated that ex Yugoslavian countries nursing research is growing both in scope and number of publications, notwithstanding the fact that research content differs between countries and that it seems that each country is focused on their local health problems. Given the increasingly global nature of nursing research, these findings highlight another need for region and EU policy makers and funding bodies, namely to allocate research funding in such manner that it will support the inclusion of ex-Yugoslavia countries nursing research into the broader scientific community. This will enable the translation of global nursing knowledge to the region and also enable region researchers to contribute to the global nursing knowledge development. On the other hand we shall not forget about the political, economic and cultural differences between ex-Yugoslavia countries, and that nursing research in the region should contribute to culturally appropriate nursing care that will improve health and well-being through the whole region. That means that for example Islamic patients should receive nursing care according to Islamic principles, beliefs, and values, not only in their home countries, but at least in their neighbouring countries, further emphasising the need for knowledge transfer between ex Yugoslavian countries and worldwide. Our study did have some limitations. First, the use of other bibliographic databases like Scopus might lead to different results than, due to the fact that different databases uses different categorisations and standards foe country and institution names, and also differ in the list of information titles covered Additionally, the synthetic content analysis was performed on information source abstracts and titles only; it is therefore possible that the results could have been different if the whole publications would be available for analysis. The synthetic content analysis enables the minimisation of the interpretative bias, however some bias is still possible and may affected the outcomes of the content analysis. On the other hand, the holistic bibliometric analysis has never been performed for the region of ex-Yugoslavian countries. The study also revealed several characteristics and specifics of ex-Yugoslavian countries nursing research, and enabled us to identify similarities and differences between countries, which is another strength of our study. Our study revealed some interesting facts about the nursing research in the ex Yugoslavia region, which might enable researchers, academics, clinical nurses, policy makers, funding agencies and government leaders to enhance efficiency of future studies and understand further applications of nursing research for improving health determinants and wellbeing. Understanding the nursing knowledge development in the region and differences between countries might be beneficial not just from the scientific point of view, but also to evidencebased policy-making. To improve the nursing research, researchers in the region especially from low and middle income countries must develop collaborations with researchers in highincome countries and also focus to integrate nursing research into interdisciplinary .knowledge development endeavours. Collaborative and interdisciplinary research not only contributes to a more comprehensive understanding of nursing science problems, but might contribute to building a shared base of data, innovations, evidence and research paradigms. Finally, we must state that more research funds should be dedicated to conducting research on this important topic. 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