Journal of Nursing Research h VOL. 17, NO.
2, JUNE 2009
Trend Analysis of Nursing Intervention
Studies Published by Taiwan Nurses
Association Between 1954 and 2006
Hsiao-Ling Yang & Meei-Fang Lou* & Pei-Ching Liu** & Lee-Fen Ni***
Hao-Yuan Chang**** & Yueh-Chih Chen*****
Downloaded from https://journals.lww.com/jnr-twna by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3tjcLwhL8g9b+eUqbDWfDgzHrYQzFmo8gD7WEGg5c7oE= on 03/19/2020
ABSTRACT
This study reviewed historical nursing intervention studies in
Taiwan and analyzed results based on sample characteristics,
methodology characteristics, and content characteristics.
Historical studies were split into four groups, G1970, G1980,
G1990, and G2000, based on the decade in which they were
published. A comparison was then made to identify signifi-
cant differences between G2000 and other groups. A total of
103 nursing intervention studies were analyzed in this study.
Results included sample characteristics of studies conducted
primarily by single-disciplinary research teams, although
multidisciplinary studies showed a growth trend across
decades, with the number of multidisciplinary studies signifi-
cantly greater in G2000 than in other decades. Nursing prac-
tice was the main area of research, clients were the major
participants studied, and hospitals provided the principal re-
search setting. No statistical difference was noted in the
abovementioned variables. In terms of methodology charac-
teristics, questionnaires were used most frequently to collect
data. A quasi-experimental design was the primary research
design employed. Although the number of experimental de-
signs has increased significantly in recent years, most
studies specified their inclusion criteria. Reliability and validity
of instruments were more clearly specified in recent decade
groups than in earlier decade groups. Methodology rigor has
improved in recent years, achieving a statistically significant
difference between G2000 and other groups in all categories,
with the exception of instrument validity. In terms of content
characteristics, health education was the leading intervention
type. Most interventions were categorized as tertiary preven-
tion, with perceptual outcome used most often as the out-
come indicator. However, no statistical differences in content
dimension variables were identified between G2000 and other
groups. In summary, the number of nursing intervention re-
search cases has risen, and research methodology rigor has
improved in recent decades. However, no statistically signifi-
cant differences in sample characteristics and content char-
acteristics between the most recent and earlier decade
groups were found. Suggestions for future domestic nursing
intervention studies based on study findings are made at the
conclusion of this article.
KEY WORDS:
trend analysis, nursing intervention, sample characteristics,
methodology characteristics, content characteristics.
102
Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
Introduction
Nursing research is a cornerstone of the nursing profes-
sion. Nursing intervention studies provide important
evidence-based nursing knowledge for the nursing practice
(Anderson, 1999; Mitchell, 2006; Youngblut & Brooten,
2000). Although the quantity of articles published by
nurses in Taiwan in the past decade has increased steadily
(Huang, Ho, & Chuang, 2006), few review studies have
been conducted to identify research article publishing
trends. Seven previously published articles are known by
the authors to address the issue of nursing research devel-
opment in Taiwan. Five focused on analyses of overall
research trends, whereas the remaining two addressed the
particular topics of health education, home care, and self-
care. In terms of the overall research trend analysis, Wei
(1982) and Lee, Wang, and Liu (1995) reviewed articles that
were published in The Journal of Nursing during the periods
1962Y1981 and 1982Y1992, respectively. General trends
identified included (a) ‘‘nursing practice’’ was the main area
targeted by nursing research and (b) descriptive and
correlation studies were the two principal types of nursing
RN, MSN, Instructor and Doctoral Student, Department of Nursing,
College of Medicine, National Taiwan University;
*RN, PhD, Associate Professor, Department of Nursing, College of
Medicine, National Taiwan University;
**RN, MSN, Lecturer, Nursing Department of Mackay Medicine,
Nursing and Management College & Doctoral Student, Department
of Nursing, College of Medicine, National Taiwan University;
***RN, MSN, Lecturer, Chang Gung Institute of Technology &
Doctoral Student, Department of Nursing, College of Medicine,
National Taiwan University;
****RN, BSN, Doctoral Student, Department of Nursing, College of
Medicine, National Taiwan University;
*****RN, PhD, Professor, Hungkuang University & Professor
Emeritus and Adjunct Professor, Department of Nursing, College of
Medicine, National Taiwan University.
Received: October 7, 2008 Revised: December 2, 2008 Accepted:
February 3, 2009
Address correspondence to: Yueh-Chih Chen, No. 1, Jen-Ai Rd.
Sec. 1, Taipei 10051, Taiwan, ROC.
Tel: +886 (2) 2312-3456 ext. 88424#104; Fax: +886 (2) 2341-2231;
E-mail: ychichen@ntu.edu.tw
Trend Analysis of Nursing Intervention Studies
research conducted during both periods. Experimental stud-
ies accounted for less than 20% of studies in the sample, and
(c) the questionnaire was the main data collection method.
Physical measurements were rarely used. Chen (1995) ob-
tained similar results in a summary of articles published in
Taiwan nursing journals between 1986 and 1991.
Hsu et al. (2003) analyzed nursing research trends in
their study of proposals submitted to the National Science
Council. They found the foremost research area to be
medical and surgical nursing, with nursing education
ranked second to last. Finally, Huang et al. (2006) ex-
amined nursing research performance in Taiwan from
1991 to 2004 based on data available on the ISI Web of
Knowledge Web site. Results showed that the number of
articles published had grown significantly in more recent
year periods and reflected greater collaboration and higher
impact factors.
In terms of literature reviews targeting particular topics,
Hsiao and Huang (2003) reviewed literature related to
health education published between 1992 and 2001 in
Taiwan. Their findings indicated patient education to be
the most common research topic, the hospital to be
the most common site used to recruit cases, and ques-
tionnaires to be the primary data collection tool. The
researchers found methodologies employed during the
latter (1997Y2001) period to be more rigorous than
the earlier period (1992Y1996). Yeh, Yen, and Lu (2000)
examined homecare nursing studies in Taiwan and found
that studies focused mainly on four issue areas, including
cost-effectiveness, home and caregiver, nursing care prob-
lems, and other. Although there have been some wonder-
ful review articles, little remains known about trends in
nursing intervention research in Taiwan.
Developing and providing high-quality nursing inter-
ventions to address clinical problems and produce positive
health outcomes are at the core of professional nursing
(Whittemore & Grey, 2002). In 1990, the National Center
for Nursing Research convened a taskforce of nursing
scientists to discuss nursing studies related to clinical
interventions and outcome assessments (U.S. Depart-
ment of Health and Human Services, 1992). Until recently,
scholars still identified determining the impact or effec-
tiveness of nursing interventions as a Top 5 research
priority of the 21st century (Hinshaw, 2000; Kim, Oh,
Kim, Yoo, & Ko, 2002). On the basis of the above
findings, it is not difficult to recognize the importance of
nursing intervention studies.
The Taiwan Nurses Association (TWNA) was the first
nurses’ association established in Taiwan. Improving nursing-
related academic research is one of the major aims of the
organization. The TWNA publishes three academic jour-
nals, including The Journal of Nursing, The Journal of
Nursing Research, and The Journal of Evidence-Based
Nursing. Although a large number of nursing academic
journals are now published in Taiwan and nursing studies
from Taiwan are increasingly being accepted for publica-
Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
VOL. 17, NO. 2, JUNE 2009
tion in other countries, the TWNA’s journals still hold a
representative and influential position in the eyes of nursing
professionals in Taiwan. Because most articles published are
provided by domestic contributors, articles reflect trends
and issues in contemporary nursing practices in Taiwan
(TWNA, 2008a). TWNA has 57,886 registered members,
representing about 53% (Chan, 2008) of employed nurses
in Taiwan. Each TWNA member regularly receives at least
one TWNA journal (TWNA, 2008b). Such facts demon-
strate the significant influence these professional journals
have on the nursing practice in Taiwan.
The purpose of this study was to offer a trend analysis
of nursing intervention research published by the TWNA.
We focused our attention on the characteristics of samples,
methodologies, and content of intervention studies exam-
ined in the hope that results will provide important insight
into the general status of nursing intervention research in
Taiwan.
Methods
Articles used in this study were obtained from three
academic journals published by the TWNA during the
period 1954Y2006. All articles published in these three
academic journals were screened manually with regard to
title and article abstract. Inclusion criteria used to select
articles for inclusion were (a) original research and (b)
investigation of nursing intervention manipulated with the
goal of affecting outcomes.
Content analysis was carried out by four trained coders.
Each research was coded using a series of variables cate-
gorized into three dimensions. Dimensions and variables
are shown in Figure 1. Every variable was split into several
attributes and given an operational definition based on
content analysis of data and references. Due to the limited
capacity of printed pages, we used the single intervention-
type variable as an example to illustrate how work was done
in this study. The intervention-type dimension contained
four attributes, each of which is described as follows:
1. health education: using teaching and learning princi-
ples to help participants attain an ideal health outcome;
2. administration: changing principles, practices, and
processes of health organizations or clinical practices
to achieve study aims;
3. psychosocial support: to empower participants by
offering emotional or mental intervention; and
4. psychoeducation: to combine health education and
psychosocial support in an intervention.
Interrater reliability was used to evaluate rigor. Two
well-trained coders evaluated attributes independently
according to the operational definition of each variable
within each article. The number of items achieving mutual
agreement was summed and then divided by the total
number of ratings for each variable. Interrater reliability
achieved 94.2% to 100% in this study. After accomplish-
ing content analysis and extracting data units from
103
Journal of Nursing Research Hsiao-Ling Yang et al.

Figure 1. Dimensions and variables analyzed in this study.

nursing intervention studies, data were processed using
Microsoft Excel and SPSS 15.0 for Windows. Frequency,
percent, and chi-square were used to analyze data. There
were no intervention studies published before 1969, so we
divided studies into four year groups, 1970Y1979 (G1970),
1980Y1989 (G1980), 1990Y1999 (G1990), and 2000Y2006
(G2000), to analyze publication trends. Furthermore, we
combined G1970, G1980, and G1990 as G1970Y1990 to com-
pare with G2000 and then to explore the differences among
the abovementioned variables in these two groups.
Results
A total of 103 publications were included in this study, all
published after 1969. The number of publications in-
creased rapidly from 5 in G1970 to 49 in G2000 (Figure 2).
The average number of publications per year can be
described as follows: there were 0.5 publications per year
in the G1970 group, 1.5 per year in the G1980 group, 3.4
per year in the G1990 group, and 7.0 per year in the G2000
group. Distribution and change of variables are shown in
the next sections.
Table 1). We further compared differences between studies
conducted before 2000 (G1970Y1990) and after (G2000). The
portion of research done by multidisciplinary teams
was significantly higher in the G2000 group (# 2 = 4.099,
p = .043).
Research areas
On the basis of the study of Wei (1982), studies were
allocated into one of three research area categories,
including nursing practice, nursing education, and nursing
administration. Nursing practice was the main research
area targeted in each decade studied, accounting for 89
(86.4%) articles. Nursing education was the next most
prominent research area addressed (7.8%), although there
were no intervention studies related to nursing education
identified prior to the 1990s. Nursing administration was
the least frequently studied area (Table 1). No significant

Sample Characteristics
Research team
Although most studies (67.0%) were conducted by
research teams representing a single discipline, the number
of multidisciplinary studies was found to have increased Figure 2. Number and cumulative total of intervention
steadily over time (from none in G1970 to 42.9% in G2000; research studies published in the four decade groupings.

104

Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
Trend Analysis of Nursing Intervention Studies VOL. 17, NO. 2, JUNE 2009

TABLE 1.
Sample Characteristics of Intervention Studies of the Four Decade Groupings
G1970 G1980 G1990 G2000 Total
Variables n % n % n % n % n %

Research team
Single disciplinary 5 100.0 13 86.7 23 67.6 28 57.1 69 67.0
Multidisciplinary 0 0.0 2 13.3 11 32.4 21 42.9 34 33.0
Research areas
Nursing practice 5 100.0 13 86.7 30 88.2 41 83.7 89 86.4
Nursing education 0 0.0 0 0.0 3 8.8 5 10.2 8 7.8
Nursing administration 0 0.0 2 13.3 1 2.9 3 6.1 6 5.8
Research participants
Clients 4 80.0 13 86.7 24 70.6 31 63.3 72 69.9
Caregivers 1 20.0 0 0.0 3 8.8 6 12.2 10 9.7
Nurse staffs 0 0.0 2 13.3 7 20.6 7 14.3 16 15.5
Nurse students 0 0.0 0 0.0 0 0.0 5 10.2 5 4.9
Research settings
Hospitals/Institutions 3 60.0 12 80.0 29 85.3 40 81.6 84 81.6
Participants’ homes 0 0.0 1 6.7 2 5.9 3 6.1 6 5.8
Community 2 40.0 2 13.3 3 8.8 6 12.2 13 12.6

differences were found in terms of research area between experimental design was significantly higher in G2000 than
G2000 and G1970Y1990 (# 2 = 0.810, p = .667). in G1970Y1990 (# 2 = 4.097, p = .043).

Research participants Inclusion criteria

Clients were the major study participant type, accounting
for 63.3% to 86.7% of the total. Nursing staffs ranked
second in all groups. Nursing students were not targeted
in studies until 2000, accounting for only five in total
(Table 1). There was no statistical difference in terms of
study participant type between G2000 and G1970Y1990 (# 2 =
6.812, p = .078).
More than 60% of articles reported inclusion criteria,
with those in G1970 reporting inclusion criteria least. More
than 86% of the studies in G2000 clearly described
inclusion criteria (Table 2). This study found a statistically
significant difference in terms of inclusion criteria between
G2000 and G1970Y1990 (# 2 = 5.946, p = .015).

Research settings Data collection methods

More studies were done in hospitals/institutions (60.0%
to 85.3%) than in communities (8.8% to 40.0%) or
participants’ homes (Table 1). No statistical differences
were found in terms of research settings between G2000
and G1970Y1990 (# 2 = 0.025, p = .988).
The questionnaire was the method used most frequently
(40.0% to 91.2%) to collect research data. Physical mea-
surement was the second most frequently used method.
Interview and observation were methodologies rarely
utilized (Table 2).

Methodology Characteristics
Research design
The quasi-experimental method was the major method
used in all year groups (53.3% to 100.0%). The number
of studies employing the true experimental design grew
from none in G1970 to nine (18.4%) in G2000 (Table 2). To
identify whether the proportion of true experimental
design had increased significantly in recent years, we
combined the quasi-experimental design and others into
a non-true experimental design category for comparison
with the true experimental design category. Results
showed that the proportion of studies employing the true
Instrument reliability
Instrument reliability was described in about 54.4% of
articles, with studies in the G2000 illustrating such re-
liability more clearly than those in the G1970Y1990 group
(Table 2). The difference between G2000 and G1970Y1990
was statistically different (# 2 = 6.345, p = .012).
Instrument validity
A majority (59.2%) of articles failed to describe instru-
ment validity adequately (Table 2). Although the situation
realized some improvement in G1990 and G2000, no sta-
tistically significant difference was identified between
G2000 and G1970Y1990 (# 2 = 1.414, p = .234).

105

Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
Journal of Nursing Research Hsiao-Ling Yang et al.

TABLE 2.
Methodological Characteristics of the Intervention Studies of the Four
Decade Groupings
G1970 G1980 G1990 G2000 Total
Variables n % n % n % n % n %

Research design
True experimental 0 0.0 2 13.3 1 2.9 9 18.4 12 11.7
Quasi-experimental 5 100.0 8 53.3 32 94.1 38 77.6 83 80.5
Others 0 0.0 5 33.3 1 2.9 2 4.1 8 7.8
Inclusion criteria
Well reported 2 40.0 12 80.0 21 61.8 42 86.0 77 74.8
Poorly reported 3 60.0 3 20.0 13 38.2 7 14.0 26 25.2
Data collection methodsa
Interview 1 20.0 1 6.7 2 5.9 1 2.0 5 4.9
Observation 0 0.0 4 26.7 3 8.8 6 12.2 13 12.6
Physical measurement 2 40.0 6 40.0 3 8.8 16 32.7 27 26.2
Questionnaire 2 40.0 9 60.0 31 91.2 37 75.5 79 76.7
Instrument reliability
Well reported 0 0.0 3 20.0 20 58.8 33 67.3 56 54.4
Poorly reported 5 100.0 12 80.0 14 41.2 16 32.7 47 45.6
Instrument validity
Well reported 0 0.0 1 6.7 15 44.1 20 40.8 36 35.0
Poorly reported 5 100.0 14 93.3 19 55.9 29 59.2 67 65.0

Note. aMultiple-answer variables. The total number of publications in each group was used as the denominator.

Content Characteristics (54.7%) followed by primary prevention (39.5%). There

Intervention type
Intervention type categorizes the intervention approach
used in article research. We modified the work of
Abraham, Chalifoux, Evers, and de Geest (1995) and
separated intervention type into the four categories of
health education, administration, psychosocial support,
and psychoeducation. Health education represented the
principal intervention type (43.7%) followed closely by
administration. Psychosocial support and psychoeduca-
tion together accounted for less than 10% of the articles
analyzed (Table 3). Analyzing the relationship between
intervention type and time series, diversification of inter-
vention was observed in the most recent group, although
no statistically significant difference was observed between
G2000 and G1970Y1990 (# 2 = 3.088, p = .378).
Prevention level
This variable referred to the classification of preventive
medicine as addressed by Leavell and Clark (1965), who
defined preventive medicine as, ‘‘the science and art of
preventing disease, prolonging life and promoting physical
and mental health and efficiency’’ (p. 11). Prevention levels
are demarcated based on the disease process and include
primary prevention, secondary prevention, and tertiary
prevention. Only 86 articles were analyzed because the
variable was not suited for use on 17 intervention articles. In
general, most interventions addressed tertiary prevention
were some interesting changes observed between groups.
The G1970 group included only primary prevention. Tertiary
prevention studies became increasingly prevalent in G1980
and G1990, with the number of articles addressing primary
and tertiary prevention almost equal in G2000 (n = 20 and
19 each; Table 3). The resurgence in primary research in the
latter group is likely due to a positive reassessment of the
value of primary prevention. Research into secondary pre-
vention was rare. There was no statistically significant dif-
ference between G2000 and G1970Y1990 (# 2 = 2.937, p = .23).
Outcome measurement
This variable is modified from the work of Sidani and
Braden (1998), who divided outcome measures into four
types, including clinical end points, functional status,
perceptual outcomes, and financial outcomes. We added
‘‘knowledge, attitude, and behavior’’ (KAB) to the list of
outcome measurement variables based on our content
analysis findings.
This is a multiple-answer variable due to the fact that
there is usually more than one kind of outcome measure-
ment used in research work. Clinical end points (41.7%)
and perceptual outcomes (42.7%) were the most frequently
used outcome measurements, whereas financial outcomes
were least frequently used. The prevalence of the percep-
tual outcome type of measurement increased from 0% in
the G1970 to 51.0% in the G2000 group. Knowledge,
attitude, and behavior represent the third most frequently

106

Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
Trend Analysis of Nursing Intervention Studies VOL. 17, NO. 2, JUNE 2009

TABLE 3.
Content Characteristics of the Intervention Studies of the Four
Decade Groupings
G1970 G1980 G1990 G2000 Total
Variables n % n % n % n % n %

Intervention type
Health education 3 60.0 7 46.7 17 50.0 18 36.7 45 43.7
Administration 2 40.0 7 46.7 9 26.5 24 49.0 42 40.8
Psychosocial support 0 0.0 0 0.0 5 14.7 5 10.2 10 9.7
Psychoeducation 0 0.0 1 6.7 3 8.8 2 4.1 6 5.8
Prevention level
Primary 4 100.0 4 30.8 6 22.2 20 47.6 34 39.5
Secondary 0 0.0 1 7.7 1 3.7 3 7.1 5 5.8
Tertiary 0 0.0 8 61.5 20 74.1 19 45.2 47 54.7
Outcome measurementa
Clinical end points 3 60.0 11 73.3 7 20.6 22 44.9 43 41.7
Functional status 0 0.0 1 6.7 5 14.7 10 20.4 16 15.5
Perceptual outcomes 0 0.0 4 26.7 15 44.1 25 51.0 44 42.7
Financial outcomes 0 0.0 1 6.7 2 5.9 3 6.1 6 5.8
KAB 3 60.0 6 40.0 16 47.1 14 28.6 39 37.9

Note. KAB = knowledge, attitude, and behavior.

a
Multiple-answer variables. The total number of publications in each group was used as the denominator.

used outcome measurement in the early groups, although
the prevalence decreased gradually through successive
decade groups (Table 3).
Discussion
We conducted an overview of nursing intervention studies
in three nursing academic journals published by the
TWNA to identify development trends in Taiwan-based
nursing intervention research. We found that the quantity
of nursing intervention studies has increased dramatically.
This result is similar to the finding of Lee et al. (1995),
who analyzed trends in research published in The Journal
of Nursing from 1982 through 1992, and that of Huang
et al. (2006), who examined nursing research performance
in Taiwan from 1991 to 2004. Our study offers an addi-
tional confirmation of the growth in the body of nursing
research conducted in Taiwan.
In terms of sample characteristics, the number of mul-
tidisciplinary intervention studies has increased over time,
which agrees with the work of Huang et al. (2006) and
reflects the emphasis on multidisciplinary studies as a re-
search approach in recent years. The increasing number of
multidisciplinary nursing intervention studies identified
echoes the trend of research development mentioned
above and demonstrates the evolution of domestic nurs-
ing intervention research. Furthermore, interventions per-
formed by a multidisciplinary team can provide more
comprehensive client care. However, most of the research-
ers remain unable to specify the details of cooperation in
such an intervention program. We strongly recommend
that, to apply nursing interventions in clinical settings
more easily while preserving the fidelity and integrity of
the intervention program, researchers conducting multi-
disciplinary studies should elaborate collaboration process
details. Similar to previous domestic study results (Chen,
1995; Lee et al., 1995; Wei, 1982), clinical practice was
the main research area identified in this study. Also con-
sistent with the results of domestic and overseas survey
results (Ailinger, Najera, Castrillon, & Manfredi, 2005;
Chen, 1995; Hsiao & Huang, 2003; Leino-Kilpi & Suominen,
1998), the client was the major participant of nursing
intervention studies analyzed. This is a feasible result in
light of the direct caregiving responsibilities of most
nurses. Nursing intervention research was found to only
rarely address nursing administration or nursing educa-
tion. However, those were still very important. The advent
of the National Health Insurance system in Taiwan in
1995 changed the landscape for the nursing profession in
terms of workforce and workload due to rising hospital
costs. Furthermore, the issue of how to raise the nurse
retention rate was addressed to ameliorate the problematic
issue of high nursing turnover (Yin, Yang, & Liu, 2001).
Only a few studies have so far been made addressing in-
terventions designed to reduce nursing turnover. In
summary, nursing administrators require more evidence-
based nursing administration to cope with changes in the
medical system and nursing workforce. Similarly, im-
provement of nursing education is a worldwide trend,
due to changes in population structures, diseases, and
globalization (Lee, Lu, Yen, & Lin, 2004). Nursing ed-
ucation accreditation in Taiwan started in 2005. Many
nursing schools undertook curricula reform at the same
time. The effects of curricula reform must be evaluated

107

Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
Journal of Nursing Research
and regarded as a reference for educational reform in
other schools. Most nursing intervention research was con-
ducted in hospitals or institutions and rarely in commu-
nities or participants’ homes. This may be because the
hospital is the main practice location for nurses. However,
average hospital stays have shortened significantly since
National Health Insurance implementation. On the basis
of study findings and systemic changes, we suggest con-
ducting a greater number of community and home-based
nursing intervention studies.
In terms of methodology, statistically significant in-
creases in the proportion of studies using experimental
research designs and the reporting of inclusion criteria and
of research instrument reliability evidence an improvement
in quality of nursing intervention studies done in recent
years. Our finding differs from Hsiao et al. (2003), who
reviewed health education research published between
1992 and 2001 and found no statistically significant dif-
ference between the first and second halves of this period
and no significant change in research design, reliability, or
validity descriptions. This may due to the fact that the
journals and the topics used in that study differed from ours
and/or the fact that times studied in the two studies were
different. The longer time span covered by this research
allowed us to better identify trends in research methodol-
ogy. Although overall methodology quality is rising, the
proportion accounted for by true experimental research
designs remains low (below 20%). Evidence-based nursing
has been advocated in recent years. Therefore, conducting
better designed true experimental research and random-
ized controlled trials should be the next goal of domestic
nursing intervention research. Similarly, although the
reliability and validity of data collection methods of articles
covered by our study were well reported in more recent
decade groups, there remains considerable room for im-
provement. Domestic nursing intervention research should
take care to use instruments with good reliability and va-
lidity to evaluate intervention outcomes.
In terms of content, health education was most fre-
quently employed as the nursing intervention method.
This demonstrates the important role function for nurses
of delivering health education (Bastable, 2008). Every in-
tervention study reflects the theoretical concepts of its
authors and presents the contribution of the nursing
profession to healthcare. Nursing intervention type variety
has increased in recent years, and it seems reasonable to
conclude that the role function of nursing is expanding.
In terms of prevention level in these studies, primary
prevention was the only type identified in G1970, whereas
tertiary prevention became the main prevention level type
identified in G1980 and G1990. In G2000, the number of
primary preventions was similar to that of tertiary
preventions. This finding may result from the expansion
of medical institutions and medicalization in Taiwan from
1980 (Chen, 2004), which led nursing care to focus
mainly on disease treatment and rehabilitation. However,
108
Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
Hsiao-Ling Yang et al.
health promotion, delivered at the primary prevention
level, is again being increasingly valued due to changes in
disease types and client health demands (Wang et al.,
2008). Healthcare providers also increasingly realized that
it was health promotion and disease prevention, rather
than disease treatment, which were critical, making peo-
ple healthier and lowering medical costs (Irvine, 2007;
McGinnis, Williams-Russo, & Knickman, 2002). There-
fore, we would like to propose increasing the prevalence
of nursing intervention studies addressing primary preven-
tion due to the contribution of such to general health
maintenance and healthcare cost control.
Clinical end points and perceptual outcomes were
measurements most frequently used in articles covered in
this study. This result agrees with that of French (1997). In
addition, offering cost-effective healthcare does not mean
compromising on quality, a variable that was estimated
by the National Institute of Nursing Research (2001).
Although financial outcomes have rarely been used as
outcome indicators in past studies, such should be treated
as an important outcome variable in the future.
Limitations and Suggestions
Our study was limited by its focus on only three academic
journals in Taiwan. The material was quite comprehensive,
although we did not include articles published in other
domestic or foreign journals. This may result in presenting
only a partial picture of nursing intervention research in
Taiwan. We suggest that future studies include and analyze
more nursing intervention studies retrieved from other
domestic or international journals to capture the whole
picture of the developing process of nursing intervention
studies in Taiwan. Also, future researchers should examine
whether significant differences exist in the methodologies
used in articles published in different journals. Furthermore,
future research should explore further the differences
between domestic and foreign nursing intervention studies
to assess how nursing intervention in Taiwan compares with
that practiced in other countries.
The aim of this study was to identify nursing interven-
tion research trends in Taiwan. However, research devel-
opment was affected by the structure of the population,
development of academic nursing education, and re-
search environment, among other factors (Leino-Kilpi &
Suominen, 1998). Our review did not relate analysis re-
sults to these issues, which represents a limitation. Thus,
we suggest that future studies analyze social and historical
backgrounds to assess their influence on nursing interven-
tion trend studies. Such may provide further insight on
how to improve future intervention studies.
Conclusions
This study reviewed 103 nursing intervention studies from
three journals published by the Taiwan Nursing Association
Trend Analysis of Nursing Intervention Studies
between 1954 and 2006. We analyzed trends in sample,
methodology, and content characteristics in these studies
and also compared the differences of said characteristics
between studies conducted before and after 2000. The
number of published intervention articles has increased,
and methodological rigor has improved in recent years. In
particular, more true experimental studies have been con-
ducted. Furthermore, the number of multidisciplinary
studies increased significantly in the recent decade group,
revealing that nurse scholars are collaborating with other
disciplines more often than previously. However, no pro-
found changes were observed between sample and con-
tent characteristics in intervention studies, which may
indicate that changes in society at large may not have been
adequately captured (Leino-Kilpi & Suominen, 1998;
Wang et al., 2008). Future nursing intervention studies
should relate their research design to environmental
changes to fulfill the health needs of people in Taiwan.
Acknowledgments
The authors are grateful to Chia-Ling Yang, Huey-Fen
Wang, and Yu-Chien Liao for their assistance with data
collection, which contributed greatly to the accomplish-
ment of this study.
References
Abraham, I. L., Chalifoux, Z. L., Evers, G. C. M., & de Geest, S.
(1995). Conditions, interventions, and outcomes in nursing
research: A comparative analysis of North American and
European/International journals (1981Y1990). International
Journal of Nursing Studies, 32(2), 173Y187.
Ailinger, R. L., Najera, R. M., Castrillon, M. C., & Manfredi, M.
(2005). Nursing research in Latin America: 1988Y1998.
Revista Latino-Americana de Enfermagem, 13(6), 925Y928.
Anderson, C. A. (1999). What is the state of the science?
Nursing Outlook, 47(6), 241.
Bastable, S. B. (2008). Nurse as educator: Principles of teaching
and learning for nursing practice (3rd ed.). Sudbury, MA:
Jones and Bartlett.
Chan, S. H. (2008). Current situation of medical facilities,
medical personnel, and medical services. In Department of
Health, Executive Yuan, Taiwan, ROC (Ed.), Health statistics
in Taiwan 2006 (1st ed., p. 49). Taipei, Taiwan, ROC: Depart-
ment of Health, Executive Yuan.
Chen, M. S. (2004). A comparative analysis of the health care
reform in China and Taiwan. Paper presented at the 99th
Annual Meeting of the American Sociological Association,
San Francisco, CA.
Chen, W. S. (1995). Current trends of nursing research in
Taiwan: From 1987Y1991. Journal of Living Science, 1,
264Y289. (Original work published in Chinese)
French, B. (1997). British studies which measure patient out-
comes, 1990Y1994. Journal of Advanced Nursing, 26(2),
320Y328.
Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
VOL. 17, NO. 2, JUNE 2009
Hinshaw, A. S. (2000). Nursing knowledge for the 21st century:
Opportunities and challenges. Journal of Nursing Scholar-
ship, 32(2), 117Y123.
Hsiao, Y. C., & Huang, S. J. (2003). Analysis of literature on
applied health education in nursing research in Taiwan,
1992Y2001. The Journal of Nursing, 50(2), 48Y56. (Original
work published in Chinese)
Hsu, N., Liao, W. E., Lee, L. L., Lai, C. F., Lee, R. P., Lai, H. L.,
et al. (2003). Current and future trends in nursing research:
Analyzing the research plans applied from National Science
Council. Tzu Chi Nursing Journal, 2(4), 37Y45. (Original work
published in Chinese)
Huang, Y. L., Ho, Y. S., & Chuang, K. Y. (2006). Bibliometric
analysis of nursing research in Taiwan 1991Y2004. The Journal
of Nursing Research, 14(1), 75Y81.
Irvine, F. (2007). Examining the correspondence of theoreti-
cal and real interpretations of health promotion. Journal of
Clinical Nursing, 16(3), 593Y602.
Kim, M. J., Oh, E. G., Kim, C. J., Yoo, J. S., & Ko, I. S. (2002).
Priorities for nursing research in Korea. Journal of Nursing
Scholarship, 34(4), 307Y312.
Leavell, H. R., & Clark, E. G. (1965). Preventive medicine for the
doctor in his community, an epidemiologic approach. New
York: McGraw-Hill.
Lee, S., Lu, Y. C., Yen, W. J., & Lin, S. C. (2004). Future trends in
nursing education in Taiwan in the light of globalization.
The Journal of Nursing, 51(4), 27Y32. (Original work pub-
lished in Chinese)
Lee, Y. Y., Wang, C. J., & Liu, S. Y. (1995). Trend analysis of
nursing research published in the Journal of Nursing:
1982Y1992. The Journal of Nursing Research, 3(2), 161Y170.
(Original work published in Chinese)
Leino-Kilpi, H., & Suominen, T. (1998). Nursing research in
Finland from 1958 to 1995. Journal of Nursing Scholarship,
30(4), 363Y367.
McGinnis, J. M., Williams-Russo, P., & Knickman, J. R. (2002).
The case for more active policy attention to health promo-
tion. Health Affairs, 21(2), 78Y93.
Mitchell, P. H. (2006). Research and development in nursing
revisited: Nursing science as the basis for evidence-based
practice. Journal of Advanced Nursing, 54(5), 528Y529.
National Institute of Nursing Research. (2001). Current research
perspectives 1996Y2001. Retrieved April 3, 2008, from http://
www.ninr.nih.gov/
Sidani, S., & Braden, C. J. (1998). Evaluating nursing inter-
ventions: A theory-driven approach. Thousand Oaks, CA:
Sage.
Taiwan Nurses Association. (2008a). About JNR. Retrieved
April 3, 2008, from http://www.twna.org.tw/twna_eng/
un10_open/welcome.asp#
Taiwan Nurses Association. (2008b). Membership. Retrieved
November 4, 2008, from http://www.twna.org.tw/frontend/
un10_open/welcome.asp# (Original work published in
Chinese)
U.S. Department of Health and Human Services. (1992). Patient
outcomes research: Examining the effectiveness of nursing
practice. Proceedings of the State of the Science Conference
(NIH Publication No. 93-3411). Bethesda, MD: National
Institute for Nursing Research.
109
Journal of Nursing Research
Wang, H. H., Day, G. I., Lin, Y. P., Chou, L. T., Wung, C. H. Y.,
Wang, Y. W., et al. (2008). Healthy people 2020. Taipei,
Taiwan, ROC.: Department of Health, Executive Yuan.
(Original work published in Chinese)
Wei, L. L. (1982). A retrospective study of nursing research over
the last two decades. The Journal of Nursing, 29(1), 11Y21.
(Original work published in Chinese)
Whittemore, R., & Grey, M. (2002). The systematic develop-
ment of nursing interventions. Journal of Nursing Scholar-
ship, 34(2), 115Y120.
110
Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.
Hsiao-Ling Yang et al.
Yeh, L., Yen, C. H., & Lu, C. Y. (2000). Literature review of
home care nursing in Taiwan 1988Y1997. The Journal of
Health Science, 2(4), 309Y321. (Original work published in
Chinese)
Yin, T. J. C., Yang, K. P., & Liu, L. F. (2001). Evaluation of the
effects of hospital nurse retention programs in Taiwan. The
Journal of Nursing Research, 9(3), 247Y258. (Original work
published in Chinese)
Youngblut, J. M., & Brooten, D. (2000). Moving research into
practices: A new partner. Nursing Outlook, 48(2), 55Y56.
護理介入型研究趨勢分析 Journal of Nursing Research VOL. 17, NO. 2, JUNE 2009

1954-2006年發表於台灣護理學會所發行之期刊中的
護理介入型研究趨勢分析
楊曉玲　羅美芳*　劉佩青**　倪麗芬***　張皓媛****　陳月枝*****

摘　要： 對護理介入型研究進行回顧，針對樣本、方法學及內容特徵等三面向進行趨勢分析，
依研究發表時間分四組（G1970、G1980、G1990及G2000）分析各變項的分布，並比
較2000年之前與之後發表的研究在各變項中的差異。共103篇研究進入分析，樣本特徵
方面，研究團隊以單一學門為主，但跨領域研究有增加趨勢，G2000組顯著比前三組
有較多的跨領域研究；研究領域以護理實務為主；研究對象主為具健康照顧需求的個
案；醫院是主要研究場所，上述變項之分佈近年來無顯著改變。方法學方面，資料收
集以問卷為主；研究設計以類實驗為主；大部分研究詳述選樣條件及工具的信效度，
除了工具的效度外，其它變項均達統計上顯著提升。內容特徵方面，衛教是主要的介
入措施；介入措施多為三級預防；自覺感受是常用的結果測量方法，不同年代組內容
特徵無顯著差異。總之，近年來護理介入型研究的數量及方法學嚴謹度增加，但研究
樣本及內容面向無顯著改變，本研究基於研究發現提出未來護理介入型研究發展方向
之建議。

關鍵詞： 趨勢分析、護理介入措施、樣本特徵、方法學特徵、內容特徵。

國立臺灣大學醫學院護理學系講師暨國立臺灣大學護理學研究所博士班研究生　*國立臺灣大學醫學院護理學
系副教授　**馬偕醫護管理專科學校護理科講師暨國立臺灣大學護理學研究所博士班研究生　***長庚技術學
院講師暨國立臺灣大學護理學研究所博士班研究生　****國立臺灣大學護理學研究所博士班研究生　*****弘
光科技大學講座教授暨國立臺灣大學護理學系名譽教授 兼任教授
受文日期：97年10月7日　修改日期：97年12月2日　接受刊載：98年2月3日
通訊作者地址：陳月枝　台北市仁愛路一段1號

111

Copyright @ 2009 Taiwan Nurses Association. Unauthorized reproduction of this article is prohibited.