Many nursing students understand that a literature review needs references but are less certain about what they are supposed to do with those references. A common mistake is to read one article, write a paragraph about it, move to the next article and repeat the process. That produces a list of study summaries rather than a literature review.
A strong nursing dissertation literature review is organised around ideas, themes, debates and evidence patterns. You normally bring several relevant sources into the same section or paragraph so that you can show where studies agree, where they differ, how strong the evidence is and what remains uncertain. This theme-led approach is consistent with practical health and social care literature-review guidance that emphasises moving from a focused question through searching, appraisal, analysis and discussion rather than treating sources as isolated summaries (Aveyard, 2023).
This guide explains how to write a literature review in a nursing dissertation, which sources to use, how to structure the chapter, how to discuss and integrate studies, and how to plan the literature review word count.
What is the literature review supposed to do?
The literature review is not simply background information and it is not an annotated bibliography. Its job is to show what is already known about your nursing problem, how that knowledge was produced, where the evidence is strong or weak, and why your dissertation question is still worth asking (Aveyard, 2023).
By the end of the chapter, the reader should understand:
- the main evidence relevant to your nursing topic;
- the important themes or debates in that evidence;
- which findings are consistent and which are conflicting;
- the strengths and weaknesses of the available studies;
- how the evidence relates to nursing practice, patients or services; and
- the gap, uncertainty or problem that leads into your dissertation.
For a broader overview of how this chapter connects with the rest of the dissertation, see the nursing dissertation structure guide.
The most important rule: do not write one source at a time
This is the point that causes the most confusion.
Weak approach: Paragraph 1 explains Study A. Paragraph 2 explains Study B. Paragraph 3 explains Study C.
Stronger approach: Paragraph 1 makes one analytical point and uses Studies A, B and C together to test that point.
The literature review should therefore be theme-led or argument-led, not author-led.
You may occasionally spend several sentences on one particularly important study, especially when its method or result needs close evaluation. However, that study should still be connected with the wider body of evidence rather than treated as an isolated mini-book-report.
Step 1: start with the dissertation question, not with random reading
Before searching, write down the exact question your literature review needs to help answer. A focused question makes it easier to decide which evidence belongs in the chapter and which evidence is only interesting but not useful.
For intervention questions, PICO may help. For qualitative questions, PICo or SPIDER may be more suitable. Scoping questions may fit PCC. The framework is a tool rather than a compulsory formula, so use the one that matches the type of evidence you need.
If the question itself is still too broad, use the nursing research question guide before building the review.
Step 2: identify what type of literature review your university expects
Not every dissertation uses the term “literature review” in exactly the same way. In a primary research dissertation, the literature review normally establishes what is already known and leads to the study rationale. In a literature-based dissertation, the review may itself be the main research method and will usually require a more explicit search, screening, appraisal and synthesis process.
A systematic review also has different reporting expectations from a traditional narrative or integrative literature review. PRISMA 2020, for example, provides reporting guidance for systematic reviews, including how studies are identified, selected and reported (Page et al., 2021).
Always follow the dissertation handbook and marking rubric before copying a structure from another university.
Step 3: choose the right sources
A literature review becomes stronger when each type of source is used for the job it is best suited to do. Selecting relevant literature, appraising it and then analysing it as a connected body of evidence are central stages of the review process (Aveyard, 2023).
| Source type | Best use in a nursing literature review | How heavily to rely on it |
|---|---|---|
| Peer-reviewed primary research | Core evidence about interventions, experiences, associations, outcomes and clinical problems | Usually the main evidence base |
| Systematic reviews and meta-analyses | Understand the state of the field, identify patterns and locate important primary studies | Very useful, but do not let them replace primary studies when primary evidence is required |
| Clinical guidelines | Show current recommended practice and connect research with clinical decision-making | Use for practice context, not as a substitute for research evidence |
| Professional bodies | Standards, professional expectations and nursing-specific context | Useful when directly relevant |
| Government and public-health reports | Prevalence, service data, policy context and population-level statistics | Useful mainly for context and significance |
| Textbooks | Definitions, established theory and introductory concepts | Use sparingly in the analytical core of the review |
| Websites and general webpages | Only when the organisation is authoritative and the information genuinely belongs there | Avoid using ordinary webpages as substitutes for scholarly research |
For nursing topics, useful databases commonly include CINAHL and MEDLINE/PubMed. Depending on the topic, you may also need Embase, PsycINFO, Scopus, Web of Science or the Cochrane Library. The exact databases should match the research question rather than being chosen simply because they are available.
For a reproducible search process, see the systematic review search strategy guide.
Step 4: decide which articles deserve to stay
Do not collect sources only because the title contains your keyword. Ask whether each article actually contributes evidence to the dissertation question.
Check:
- population or patient group;
- clinical setting;
- intervention, exposure or phenomenon;
- outcomes or experiences studied;
- research design;
- date and relevance to current practice;
- country or healthcare context where this matters; and
- methodological quality.
A recent article is not automatically a strong article, and an older article is not automatically unusable. Seminal theory or landmark research may remain relevant, while clinical evidence may need to be more current because practice, treatments and services change.
Step 5: build an evidence table before writing
Trying to remember what twenty or thirty papers said usually leads to repetition and weak comparison. Build a simple evidence table so that the studies become comparable.
| Study | Population/setting | Design | Main finding | Strength/limitation | Theme |
|---|---|---|---|---|---|
| Study A | Who and where? | RCT, cohort, qualitative, etc. | What was found? | What affects confidence? | Which idea does it support? |
| Study B | Who and where? | Design | Finding | Quality issue | Theme |
The table is a planning tool. It helps you see agreements, contradictions, gaps and methodological differences before you start drafting. A fuller example is available in the nursing evidence table guide.
Step 6: group the literature into themes, not authors
Once the evidence table is complete, ask what patterns appear across the studies. These patterns become the main sections of the review.
For example, a literature review on medication adherence among adults with long-term conditions might be organised around:
- patient knowledge and health literacy;
- treatment burden and side effects;
- nurse-patient communication;
- family and social support;
- digital reminders or self-management interventions; and
- health-system barriers.
Each theme should answer part of the research question. Avoid creating themes only because several papers happen to mention the same word.
Step 7: structure the literature review chapter
A common structure is:
- Opening of the chapter: Explain the purpose, scope and organising logic of the review.
- Brief context: Define essential concepts and establish why the nursing problem matters.
- Main thematic sections: Compare and critically evaluate evidence under several clear themes.
- Cross-theme synthesis: Explain the overall pattern, disagreements and limits of the evidence.
- Research gap or rationale: Show exactly what remains uncertain or under-researched.
- Chapter summary: State what the literature collectively shows and how this leads to the next chapter.
The exact number of themes depends on the question and word count. A small number of well-developed themes is usually more useful than many shallow sections.
Step 8: write paragraphs around a nursing claim
A useful literature-review paragraph can be built around this sequence:
Point → supporting evidence → comparison or contrast → appraisal → interpretation → link to the review question.
The paragraph should begin with the idea you want to establish, not simply with an author name.
Weak study-by-study writing
Study A found that nurse-led education improved adherence. Study B found that education improved patient knowledge. Study C found no significant improvement in adherence.
This tells the reader what three studies reported, but it does not explain the relationship between them.
Stronger integrated writing
Nurse-led education may improve medication self-management, although the effect appears to depend on what the intervention contains and how adherence is measured. Studies A and B both reported improvements following structured education, but Study B measured knowledge rather than actual medication-taking behaviour. Study C found little change in adherence despite improved understanding, suggesting that knowledge alone may not overcome practical barriers such as treatment burden or side effects. Confidence in a simple education-effect relationship is therefore limited, and the evidence supports examining both informational and behavioural components of nursing interventions.
The second version uses the sources together. It compares outcomes, evaluates what was actually measured and ends with an interpretation rather than a list.
How many sources should be used in one paragraph?
There is no universal number. A paragraph may use two sources when directly comparing two important studies, or several sources when explaining a well-established evidence pattern. The goal is not to maximise citations. The goal is to include enough evidence to support, challenge and qualify the point being made.
As a practical check, if most body paragraphs discuss only one author, the chapter is probably too descriptive. If a paragraph contains a long string of citations but never explains how the studies relate, it may be over-cited but still under-analysed.
How to integrate several sources without making the paragraph confusing
Use reporting language that shows the relationship between studies.
| Relationship | Useful wording |
|---|---|
| Agreement | Similarly, consistent with, this pattern was also reported, converging evidence suggests |
| Contrast | In contrast, however, unlike, this finding was not replicated, evidence remains mixed |
| Qualification | This effect was stronger among, the association was limited to, the finding should be interpreted cautiously because |
| Methodological explanation | This difference may reflect, the studies used different measures, the samples were not directly comparable |
| Synthesis | Taken together, collectively, across the evidence, the overall pattern suggests |
These phrases should not be inserted mechanically. Their purpose is to make the intellectual relationship between sources visible.
How to discuss sources critically
Critical discussion means asking how much confidence the reader should place in a finding and whether the evidence really supports the conclusion being drawn.
Depending on the design, consider:
- sample size and sampling method;
- representativeness;
- randomisation and allocation where relevant;
- measurement validity and reliability;
- attrition or missing data;
- confounding;
- researcher reflexivity in qualitative work;
- analysis quality;
- transferability to the nursing population of interest; and
- whether the authors’ conclusion goes beyond the data.
Critical appraisal tools such as CASP and JBI can help structure this judgement, but a checklist score is not the final analysis. You still need to explain what the limitation means for the evidence (Critical Appraisal Skills Programme, n.d.; Aromataris et al., 2024). See the critical appraisal guide for a step-by-step approach.
Do not criticise every paper for the same reason
A common literature-review habit is to end every paragraph with “the sample was small, therefore more research is needed.” This becomes repetitive and often adds little.
Instead, identify limitations that materially change interpretation. A small qualitative sample may be appropriate for an in-depth study. A small sample in a quantitative study intended to detect a modest effect may create a more serious precision problem. Critique should therefore be design-sensitive.
How to use systematic reviews without allowing them to take over the chapter
Systematic reviews are valuable because they show the wider evidence landscape and can help you locate important primary studies. They are especially useful at the beginning of the project when you are mapping the field.
However, if your dissertation expects analysis of primary research, do not write the whole literature review from systematic reviews alone. Go back to the original studies when you need to examine sample characteristics, methods, measures or findings in detail.
Cochrane guidance also emphasises transparent synthesis rather than informal vote-counting of how many studies were statistically significant (McKenzie and Brennan, 2024).
How to handle conflicting findings
Conflicting evidence is not a problem to hide. It is often where the strongest analysis begins.
If two nursing studies reach different conclusions, compare:
- patient characteristics;
- clinical settings;
- sample sizes;
- intervention intensity;
- outcome definitions;
- measurement tools;
- follow-up periods;
- healthcare systems; and
- risk of bias or methodological quality.
If the reason for the disagreement is unclear, say that the evidence remains inconsistent. Do not invent an explanation that the studies themselves cannot support.
How to move from the literature review to the research gap
The research gap should be the conclusion of your evidence analysis, not a sentence added at the end because dissertations are expected to have one.
A defensible gap might be:
- a population that has rarely been studied;
- a lack of evidence from a particular nursing setting;
- inconsistent results across studies;
- weak or outdated measurement;
- limited long-term follow-up;
- poor methodological quality;
- a lack of qualitative evidence explaining patient experience; or
- evidence from one healthcare system that may not transfer to another.
The nursing dissertation research gap guide explains how to turn these patterns into a precise gap statement.
How long should a nursing dissertation literature review be?
There is no universal percentage for a nursing dissertation literature review. Your university handbook, assessment brief and marking rubric take priority. The appropriate length depends on the dissertation design, the total word limit and whether the literature review is a supporting chapter or the main research method.
For a primary research dissertation, the literature review needs enough space to establish the evidence base, critically synthesise the most relevant literature and justify the study without crowding out the methodology, results and discussion chapters. In a literature-based dissertation, substantially more of the overall word count may be devoted to searching, appraisal, synthesis and interpretation because the literature itself is the principal evidence base.
If your university does not provide a chapter allocation, create a provisional word budget only after listing every required section. Then adjust the literature-review allocation according to the marking weight and the amount of analysis needed. Treat any percentage found online as an example rather than a rule. Also check whether tables, quotations, appendices and references count towards the stated word limit.
How much background information should be included?
Include only enough background to help the reader understand the research problem and the later analysis. Long sections defining common nursing concepts or describing a condition in textbook detail can consume the word count without advancing the argument.
A useful test is: Does this information help explain the evidence, the nursing problem or the research gap? If not, it may belong in a shorter introductory section or may not be needed at all.
Common mistakes that weaken nursing literature reviews
- Writing one article per paragraph.
- Using mostly textbooks or websites instead of research studies.
- Describing findings without evaluating the methods.
- Listing many citations without explaining their relationship.
- Ignoring evidence that disagrees with the preferred argument.
- Using old evidence when important contemporary evidence is available.
- Criticising every study using the same generic limitation.
- Organising the chapter by author names rather than themes.
- Repeating background information from the introduction.
- Claiming a research gap that the review has not demonstrated.
A simple workflow you can follow
Question → Search → Screen → Extract → Group → Compare → Appraise → Interpret → Identify the gap → Edit.
If you follow this sequence, drafting becomes easier because you are no longer trying to invent the structure while simultaneously reading the literature.
Final literature review checklist
- Does the chapter answer a clearly defined nursing question?
- Are the strongest sections organised around themes or arguments rather than individual authors?
- Is primary research used where primary research is required?
- Are systematic reviews, guidelines and policy documents used for the correct purpose?
- Do major paragraphs compare more than one source where appropriate?
- Are agreements and contradictions explained?
- Does critical appraisal affect the strength of the conclusions?
- Is the nursing relevance of the evidence clear?
- Does the research gap emerge logically from the evidence?
- Does the chapter avoid repeating material already covered elsewhere in the dissertation?
How this guide was prepared
This guide was developed as educational guidance for nursing students using established literature-review and evidence-synthesis sources. Its methodological basis includes Aveyard’s practical health and social care literature-review guidance, the JBI Manual for Evidence Synthesis, Cochrane guidance on synthesis and PRISMA 2020 reporting guidance (Aveyard, 2023; Aromataris et al., 2024; McKenzie and Brennan, 2024; Page et al., 2021). These sources inform the principles in this article, but your own university handbook and supervisor guidance should take priority where local requirements differ.
Related Nursing Guides
- Nursing Dissertation Chapter 2 Structure: Literature Review Checklist
- How to Choose a Nursing Dissertation Methodology: Design Decision Guide
- How to Fix a Weak Nursing Dissertation Discussion Chapter
Conclusion
To write a strong literature review in a nursing dissertation, stop thinking of the chapter as a sequence of article summaries. Start with the nursing question, select evidence deliberately, build an evidence table, group studies into themes and then write paragraphs that compare, evaluate and interpret several sources around one point. Background information should support this analysis rather than replace it. The final sections should show what the evidence collectively means and why an important research gap or nursing problem remains.
References
- Aveyard, H. (2023) Doing a Literature Review in Health and Social Care: A Practical Guide. 5th edn. Maidenhead: Open University Press.
- Aromataris, E., Lockwood, C., Porritt, K., Pilla, B. and Jordan, Z. (eds.) (2024) JBI Manual for Evidence Synthesis. JBI. Available at: https://jbi-global-wiki.refined.site/space/MANUAL
- Critical Appraisal Skills Programme (n.d.) CASP Checklists. Available at: https://casp-uk.net/casp-tools-checklists/
- McKenzie, J.E. and Brennan, S.E. (2024) ‘Chapter 12: Synthesizing and presenting findings using other methods’, in Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J. and Welch, V.A. (eds.) Cochrane Handbook for Systematic Reviews of Interventions, Version 6.5. Cochrane. Available at: https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-12
- Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., Brennan, S.E., Chou, R., Glanville, J., Grimshaw, J.M., Hróbjartsson, A., Lalu, M.M., Li, T., Loder, E.W., Mayo-Wilson, E., McDonald, S., McGuinness, L.A., Stewart, L.A., Thomas, J., Tricco, A.C., Welch, V.A., Whiting, P. and Moher, D. (2021) ‘The PRISMA 2020 statement: an updated guideline for reporting systematic reviews’, BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
