the literature review on the theoretical perspective is referred to as

• UConn Library
• Literature Review: The What, Why and How-to Guide
• Introduction

Literature Review: The What, Why and How-to Guide — Introduction

• Getting Started
• How to Pick a Topic
• Strategies to Find Sources
• Evaluating Sources & Lit. Reviews
• Tips for Writing Literature Reviews
• Writing Literature Review: Useful Sites
• Citation Resources
• Other Academic Writings

What are Literature Reviews?

So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D.  The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.

Goals of Literature Reviews

What are the goals of creating a Literature Review?  A literature could be written to accomplish different aims:

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 

Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews .  Review of General Psychology , 1 (3), 311-320.

What kinds of sources require a Literature Review?

• A research paper assigned in a course
• A thesis or dissertation
• A grant proposal
• An article intended for publication in a journal

All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.

Types of Literature Reviews

What kinds of literature reviews are written?

Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.

• Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework:  10.1177/08948453211037398  

Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.

• Example : The effect of leave policies on increasing fertility: a systematic review:  10.1057/s41599-022-01270-w

Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.

• Example : Employment Instability and Fertility in Europe: A Meta-Analysis:  10.1215/00703370-9164737

Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts .  Journal of Advanced Nursing , 53 (3), 311-318.

• Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis:  10.1177/05390184221113735

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
• << Previous: Getting Started
• Next: How to Pick a Topic >>
• Last Updated: Sep 21, 2022 2:16 PM
• URL: https://guides.lib.uconn.edu/literaturereview

• USC Libraries
• Research Guides

Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Generative AI and Writing
• USC Libraries Tutorials and Other Guides
• Bibliography

A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE : Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

• << Previous: Theoretical Framework
• Next: Citation Tracking >>
• Last Updated: Apr 24, 2024 10:51 AM
• URL: https://libguides.usc.edu/writingguide

Research Methods

• Getting Started
• Literature Review Research
• Research Design
• Research Design By Discipline
• SAGE Research Methods
• Teaching with SAGE Research Methods

Literature Review

• What is a Literature Review?
• What is NOT a Literature Review?
• Purposes of a Literature Review
• Types of Literature Reviews
• Literature Reviews vs. Systematic Reviews
• Systematic vs. Meta-Analysis

Literature Review  is a comprehensive survey of the works published in a particular field of study or line of research, usually over a specific period of time, in the form of an in-depth, critical bibliographic essay or annotated list in which attention is drawn to the most significant works.

Also, we can define a literature review as the collected body of scholarly works related to a topic:

• Summarizes and analyzes previous research relevant to a topic
• Includes scholarly books and articles published in academic journals
• Can be an specific scholarly paper or a section in a research paper

The objective of a Literature Review is to find previous published scholarly works relevant to an specific topic

• Help gather ideas or information
• Keep up to date in current trends and findings
• Help develop new questions

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Helps focus your own research questions or problems
• Discovers relationships between research studies/ideas.
• Suggests unexplored ideas or populations
• Identifies major themes, concepts, and researchers on a topic.
• Tests assumptions; may help counter preconceived ideas and remove unconscious bias.
• Identifies critical gaps, points of disagreement, or potentially flawed methodology or theoretical approaches.
• Indicates potential directions for future research.

All content in this section is from Literature Review Research from Old Dominion University 

Keep in mind the following, a literature review is NOT:

Not an essay 

Not an annotated bibliography  in which you summarize each article that you have reviewed.  A literature review goes beyond basic summarizing to focus on the critical analysis of the reviewed works and their relationship to your research question.

Not a research paper   where you select resources to support one side of an issue versus another.  A lit review should explain and consider all sides of an argument in order to avoid bias, and areas of agreement and disagreement should be highlighted.

A literature review serves several purposes. For example, it

• provides thorough knowledge of previous studies; introduces seminal works.
• helps focus one’s own research topic.
• identifies a conceptual framework for one’s own research questions or problems; indicates potential directions for future research.
• suggests previously unused or underused methodologies, designs, quantitative and qualitative strategies.
• identifies gaps in previous studies; identifies flawed methodologies and/or theoretical approaches; avoids replication of mistakes.
• helps the researcher avoid repetition of earlier research.
• suggests unexplored populations.
• determines whether past studies agree or disagree; identifies controversy in the literature.
• tests assumptions; may help counter preconceived ideas and remove unconscious bias.

As Kennedy (2007) notes*, it is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the original studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally that become part of the lore of field. In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews.

Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are several approaches to how they can be done, depending upon the type of analysis underpinning your study. Listed below are definitions of types of literature reviews:

Argumentative Review      This form examines literature selectively in order to support or refute an argument, deeply imbedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to to make summary claims of the sort found in systematic reviews.

Integrative Review      Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication.

Historical Review      Few things rest in isolation from historical precedent. Historical reviews are focused on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review      A review does not always focus on what someone said [content], but how they said it [method of analysis]. This approach provides a framework of understanding at different levels (i.e. those of theory, substantive fields, research approaches and data collection and analysis techniques), enables researchers to draw on a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection and data analysis, and helps highlight many ethical issues which we should be aware of and consider as we go through our study.

Systematic Review      This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyse data from the studies that are included in the review. Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?"

Theoretical Review      The purpose of this form is to concretely examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review help establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

* Kennedy, Mary M. "Defining a Literature."  Educational Researcher  36 (April 2007): 139-147.

All content in this section is from The Literature Review created by Dr. Robert Larabee USC

Robinson, P. and Lowe, J. (2015),  Literature reviews vs systematic reviews.  Australian and New Zealand Journal of Public Health, 39: 103-103. doi: 10.1111/1753-6405.12393

What's in the name? The difference between a Systematic Review and a Literature Review, and why it matters . By Lynn Kysh from University of Southern California

Systematic review or meta-analysis?

A  systematic review  answers a defined research question by collecting and summarizing all empirical evidence that fits pre-specified eligibility criteria.

A  meta-analysis  is the use of statistical methods to summarize the results of these studies.

Systematic reviews, just like other research articles, can be of varying quality. They are a significant piece of work (the Centre for Reviews and Dissemination at York estimates that a team will take 9-24 months), and to be useful to other researchers and practitioners they should have:

• clearly stated objectives with pre-defined eligibility criteria for studies
• explicit, reproducible methodology
• a systematic search that attempts to identify all studies
• assessment of the validity of the findings of the included studies (e.g. risk of bias)
• systematic presentation, and synthesis, of the characteristics and findings of the included studies

Not all systematic reviews contain meta-analysis. 

Meta-analysis is the use of statistical methods to summarize the results of independent studies. By combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects of health care than those derived from the individual studies included within a review.  More information on meta-analyses can be found in  Cochrane Handbook, Chapter 9 .

A meta-analysis goes beyond critique and integration and conducts secondary statistical analysis on the outcomes of similar studies.  It is a systematic review that uses quantitative methods to synthesize and summarize the results.

An advantage of a meta-analysis is the ability to be completely objective in evaluating research findings.  Not all topics, however, have sufficient research evidence to allow a meta-analysis to be conducted.  In that case, an integrative review is an appropriate strategy. 

Some of the content in this section is from Systematic reviews and meta-analyses: step by step guide created by Kate McAllister.

• << Previous: Getting Started
• Next: Research Design >>
• Last Updated: Aug 21, 2023 4:07 PM
• URL: https://guides.lib.udel.edu/researchmethods

Get science-backed answers as you write with Paperpal's Research feature

What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 
• How to write a good literature review 
• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

• Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 
• Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 
• Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 
• Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 
• Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 
• Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

How to write a good literature review

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. 

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

Paperpal is an AI writing assistant that help academics write better, faster with real-time suggestions for in-depth language and grammar correction. Trained on millions of research manuscripts enhanced by professional academic editors, Paperpal delivers human precision at machine speed.  

Try it for free or upgrade to  Paperpal Prime , which unlocks unlimited access to premium features like academic translation, paraphrasing, contextual synonyms, consistency checks and more. It’s like always having a professional academic editor by your side! Go beyond limitations and experience the future of academic writing.  Get Paperpal Prime now at just US$19 a month!

Related Reads:

• Empirical Research: A Comprehensive Guide for Academics 
• How to Write a Scientific Paper in 10 Steps 
• Life Sciences Papers: 9 Tips for Authors Writing in Biological Sciences
• What is an Argumentative Essay? How to Write It (With Examples)

6 Tips for Post-Doc Researchers to Take Their Career to the Next Level

Self-plagiarism in research: what it is and how to avoid it, you may also like, measuring academic success: definition & strategies for excellence, what is academic writing: tips for students, why traditional editorial process needs an upgrade, paperpal’s new ai research finder empowers authors to..., what is hedging in academic writing  , how to use ai to enhance your college..., ai + human expertise – a paradigm shift..., how to use paperpal to generate emails &..., ai in education: it’s time to change the..., is it ethical to use ai-generated abstracts without....

Literature Review and Theoretical Perspective

• First Online: 24 June 2021

Cite this chapter

• Rongting Hou 4  

Part of the book series: A Sociological View of AIDS ((ASV))

106 Accesses

Sociology has a long past, a short present and an uncertain future, and so is emotional sociology.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info
• Durable hardcover edition

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Adam, B., Maticka-Tyndale, E., & Cohen, J. (2003). Adherence practices among people living with HIV. AIDS Care, 15 (2), 263–274.

Google Scholar  

Auerbach, J. D., Wypijewska, C., & Brodie, H. K. (Eds.). (1994). AIDS and behavior: An integrated approach . National Academies Press.

Ayala, G., Bingham, T., Kim, J., Wheeler, D., & Millett, G. (2012). Modeling the impact of social discrimination and financial hardship on the sexual risk of HIV among Latino and Black men who have sex with men. American Journal of Public Health, 102 (Suppl. 2), 242–249.

Article   Google Scholar  

Bao, Y., & Pan, S. (2015). Differences-seeking approach in qualitative method and its theoretical foundation. Sociological Review of China, 2 , 89–96.

Barbalet, J. M. (1998). Emotion, social theory, and social structure: A macrosociological approach . Cambridge University Press.

Bensley, L., Eenwky, J., & Simmons, K. (2000). Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking. American Journal of Preventive Medicine, 18 (2), 151–158.

Berger, J. (1988). Directions in expectation states research. In M. Webster & M. Foschi (Eds.), Status generalization: New theory and research . Stanford University Press.

Bolan, G., Ehrhardt, A. A., & Wasserheit, J. N. (1999). Gender perspectives and STDs. In K. K. Holmes, P. F. Sparling, P.-A. Ma˚rdh, S. M. Lemon, W. E. Stamm, et al. (Eds.), Sexually transmitted diseases . McGraw-Hill.

Bowser, B. (1989). Crack and AIDS: An ethnographic impression. Journal of the National Medical Association, 81 (5), 538–540.

Brooks, R., Martin, D., Ortiz, D., & Veniegas, R. (2004). Perceived barriers to employment among persons living with HIV/AIDS. AIDS Care, 16 (6), 756–766.

Burke, P. J. (1991). Identity processes and social stress. American Sociological Review, 56 , 836–849.

Burke, P. J., & Stets, J. E. (1999). Trust and commitment through self-verification. Social Psychology Quarterly, 62 , 347–366.

Cai, W., Feng, T., Tan, J., et al. (2005). A survey of the characteristics and STD/HIV infection of homosexuality in Shenzhen. Modern Preventive Medicine, 32 (4), 328–330.

Campbell, C. (1999). Women, families and HIV/AIDS: A sociological perspective on the epidemic in America . Cambridge University Press.

Book   Google Scholar  

CDC. (2012). Estimated HIV incidence in the United States, 2007–2010. HIV Surveillance Supplemental Report, 17 (4), 1–26.

CDC. (2013a). HIV in the United States: At a glance. CDC HIV/AIDS Fact Sheet, Nov., CDC, Atlanta, GA.

CDC. (2013b). HIV risk among adult sex workers in the United States . CDC HIV/AIDS Fact Sheet, Sept., CDC, Atlanta, GA.

CDC. (2013c). HIV among transgender people . CDC HIV/AIDS Fact Sheet, Nov., CDC, Atlanta, GA.

Cheng, B. (2013). The sociological significance of emotion. Shandong Social Sciences, 3 , 42–48.

Ciambrone, D. (2003). Women’s experiences with HIV/AIDS: Mending fractured selves . Hawthorne.

Collins, R. (1975). Conflict sociology: Toward an explanatory science . Academic Press.

Collins, R. (1981). Sociology since midcentury: Essays in theory cumulation . Academic Press.

Collins, R. (1990). Stratification, emotional energy, and the transient emotions. In T. D. Kemper (Ed.), Research agendas in the sociology of emotions . State University of New York Press.

Collins, R. (2004). Interaction ritual chains . Princeton University Press.

Cooley, C. H. (1902). Human nature and the social order . Scribner’s.

Davies, J. C. (1962). Toward a theory of revolution. American Sociological Review, 27 (1), 5–19.

Derlega, V., & Barbee, A. P. (1998). HIV social interaction . Sage.

Diaz, R., Ayala, G., & Bein, E. (2004). Sexual risk as an outcome of social oppression: Data from a probability sample of Latino gay men in three US cities. Cultural Diversity and Ethnic Minority Psychology, 10 (3), 255–267.

Du, J., Shen, T., Huang, L., et al. (2012). Study on the case management patient establishment of HIV infected populations in Wuhou District of Chengdu. Modern Preventive Medicine, 39 (4), 865–866.

Durkheim, E. (1965). The elementary forms of the religious life . Macmillan.

Ekman, P., & Friesen, W. V. (1975). Unmasking the face: A guide to recognizing emotions from facial clues . Prentice-Hall.

Espinoza, L., Hall, H., Hardnett, F., Selik, R., Ling, Q., et al. (2007). Characteristics of persons with heterosexually acquired HIV infection, United States 1999–2004. American Journal of Public Health, 97 (1), 144–149.

Ezzy, D., DeVisser, R., & Bartos, M. (1999). Poverty, disease progression and employment among people living with HIV/AIDS in Australia. AIDS Care, 11 (4), 405–414.

Farmer, P., Connors, M., & Simmons, J. (Eds.). (1996). Women, poverty, and AIDS: Sex, drugs and structural violence . Common Courage Press.

Ferrier, S., & Lavis, J. (2003). With health comes work? People living with HIV/AIDS consider returning to work. AIDS Care, 15 (3), 423–435.

Fontdevila, J. (2009). Framing dilemmas during sex: A micro-sociological approach to HIV risk. Social Theory and Health, 7 (3), 241–263.

Ghaziani, A. (2004). Anticipatory and actualized identities: A cultural analysis of the transition from AIDS disability to work. The Sociological Quarterly, 45 (2), 273–301.

Ghaziani, A., & Cook, T. (2005). Reducing HIV infections at circuit parties: From description to explanation and principles of intervention design. Journal of the International Association of Physicians in AIDS Care, 4 (2), 32–46.

Goffman, E. (1959). The presentation of self in everyday life . Anchor Books.

Goffman, E. (1961). Asylums: Essays on the social situation of mental patients and other inmates . Anchor Books.

Gordon, S. L. (1981). The sociology of sentiments and emotion. In M. Rosenberg & R. H. Turner (Eds.), Social psychology: Sociological perspectives . Basic Books.

Gordon, S. L. (1990). Social structural effects on emotions. In T. D. Kemper (Ed.), Research agendas in the sociology of emotions . State University of New York Press.

Guo, J. (2007a). Emotion as ‘subjective social reality’—A new sociological interpretation. Social Science Research, 3 , 95–100.

Guo, J. (2007b). The developmental path of Western sociological theories of emotions. Society , 27(5), 26–46.

Guo, J. (2007c). Three issues of and discussions on the sociology of emotions. Academic Forum, 6 , 155–160.

Guo, J. (2008). Sociology of emotion: Theory-history-reality . SDX Joint Publishing Company.

Guo, J. (2013). A brief study of the sociology of emotional capital. Shandong Social Sciences, 3 , 49–54.

Gupta, G. (2004). Globalization, women, and the HIV/AIDS epidemic. Peace Review, 16 (1), 79–83.

Hader, S., Smith, D., Moore, S., & Holmberg, S. (2001). HIV infection in women in the United States: Status at the millennium. JAMA, 285 (9), 1186–1192.

Hammond, M. (2004). The enhancement imperative and group dynamics in the emergence of religion and ascriptive inequality. In J. H. Turner (Ed.), Theory and research on human emotions . Emerald Group Publishing Limited.

Heidegger, M. (1977). On time and being (Joan Stambaugh, Trans.). Harper Torchbooks.

Heise, D. R. (1979). Understanding events: Affect and the construction of social action . Cambridge University Press.

Hochschild, A. R. (1975). The sociology of feeling and emotion: Selected possibilities. Sociological Inquiry, 45 , 280–307.

Hochschild, A. R. (1979). Emotion work, feeling rules, and social structure. American Journal of Sociology, 85 , 551–575.

Hochschild, A. R. (1983). The managed heart: Commercialization of human feeling . University of California Press.

Homans, G. C. (1961). Social behavior: Its elementary forms . Harcourt, Brace, and World.

Homans, G. C. (1974). Social behavior: Its elementary forms (Rev. ed.). Harcourt Brace Jovanovich.

Houser, J. A., & Lovaglia, M. J. (2002). Status, emotion, and the development of solidarity in stratified task groups. Advances in Group Processes, 19 , 109–137.

Izard, C. E. (1977). Human emotions . Plenum Press.

Jia, C. (2000). History of foreign sociology (Rev). China Renmin University Press.

Jing, J. (2006). Titanic’s Law: An analysis of AIDS risk in China. Sociological Research, 5 , 123–150.

Kemper, T. D. (1978). A social interactional theory of emotions . Wiley.

Kemper, T. D. (1981). Social constructionist and positivist approaches to the sociology of emotions. American Journal of Sociology, 87 (2), 336–362.

Kemper, T. D. (1987). How many emotions are there? Wedding the social and the autonomic components. American Journal of Sociology, 93 , 263–289.

Kemper, T. D. (1989). Romantic love and like and romantic love and love. In D. D. Franks & E. D. McCarthy (Eds.), The sociology of emotions: Original essays and research papers . JAI Press.

Kemper, T. D. (1990). Social structure and testosterone: Explorations of the socio-bio-social chain . Rutgers University Press.

Kipnis, A. (1997). Producing guanxi: Sentiment, self and subculture in a north China village . Duke University Press.

Lawler, E. J., & Yoon, J. (1993). Power and the emergence of commitment behavior in negotiated exchange. American Sociological Review, 58 , 465–481.

Lawler, E. J., & Yoon, J. (1996). Commitment in exchange relations: Test of a theory of relational cohesion. American Sociological Review, 61 (1), 89–108.

Lawler, E. J., & Yoon, J. (1998). Network structure and emotion in exchange relations. American Sociological Review, 63 (6), 871–894.

Lawler, E. J. (2001). An affect theory of social exchange. The American Journal of Sociology, 107 (2), 321–352.

LeDoux, J. E. (1996). The emotional brain: The mysterious underpinnings of emotional life . Simon & Schuster.

Levine, M. (1989). The motives of gay men for taking or not taking the HIV antibody test. Social Problems, 36 (4), 368–383.

Li, N. (2010). The success and bottleneck of NGOs in Chinese HIV/AIDS prevention and control. Chinese Medical Ethics, 23 (3), 123–125.

Liu, L., Liang, Y., & Zhou, Z. (2010). Explore on the model of HIV/AIDS comprehensive intervention among the female sex workers carried out by NGO. Preventive Medicine Tribune, 16 (7), 577–579.

Luhmann, N. (1995). Social systems (John Bednarz, Jr. & Dirk Baecker, Trans.). Stanford University Press.

Ma, D., & Zhang, B. (2013). A case of methamphetamine-induced mental disorder combined with AIDS. Medical Journal of Chinese People’s Health, 25 (2), 92–93.

Markovsky, B. N., & Lawler, E. J. (1994). A new theory of group solidarity. Advances in Group Processes, 19 , 109–137.

Marmor, M., Des Jarlais, D. C., Friedman, S. R., Lyden, M., & el-Sadr, W. (1984). The epidemic of acquired immunodeficiency syndrome (AIDS) and suggestions for its control in drug abusers. Journal of Substance Abuse Treatment, 1 (4), 237–247.

Marx, K. (1885). Capital (S. Moore & E. Aveling, Trans.). International Publishers.

Maryanski, A. (1986). African ape social structure: A comparative analysis . University of California, Irvine.

Maryanski, A. (1987). African ape social structure: Is there strength in weak ties? Social Networks, 9 , 191–215.

Maryanski, A., & Turner, J. (1992). The social cage: Human nature and the origins of society . Stanford University Press.

Massagli, M., Weissman, J., Seage, G., & Epstein, A. (1994). Correlates of employment after AIDS diagnosis in the Boston Health Study. American Journal of Public Health, 84 (12), 1976–1981.

McMahon, J., Tortu, S., Pouget, E., Hamid, R., & Neaigus, A. (2006). Contextual determinants of condom use among female sex exchangers in East Harlem, NYC: An event analysis. AIDS and Behavior, 10 (6), 731–741.

Mead, G. H. (1934). Mind, self and society . University of Chicago Press.

Mizuno, Y., Borkowf, C., Millett, G., Bingham, T., Ayala, G., & Stueve, A. (2012). Homophobia and racism experienced by Latino men who have sex with men in the United States: Correlates of exposure and associations with HIV risk behaviors. AIDS and Behavior, 16 (3), 724–735.

Mojola, S. (2011). Fishing in dangerous waters: Ecology, gender and economy in HIV risk. Social Science & Medicine, 72 (2), 149–156.

Mojola, S., & Everett, B. (2012). STD and HIV risk factors among US young adults: Variations by gender, race, ethnicity and sexual orientation. Perspectives on Sexual and Reproductive Health, 44 (2), 125–133.

Molm, L. D. (1997). Coercive power in social exchange . Cambridge University Press.

Myers, D. G. (1986). Social psychology . McGraw-Hill Companies.

Nicolosi, A., Leite, M. L. C., Musicco, M., Arici, C., Gavazzeni, G., & Lazzarin, A. (1994). The efficiency of male-to female and female-to-male sexual transmission of the human immunodeficiency virus: A study of 730 stable couples. Epidemiology, 5 (6), 570–575.

Nixon, S., & Renwick, R. (2003). Experiences of contemplating returning to work for people living with HIV/AIDS. Qualitative Health Research, 13 (9), 1272–1290.

Pan, S. (2001). New problems for sociology from AIDS research. Sociological Study, 2001 (4), 39–43.

Pan, S., & Huang, Y. (2007). “Subjective construction”: Methodological revolution in sexuality research and potential development in Chinese context. Sociological Study, 3 , 174–193.

Pan, S., Huang, Y., & Li, M. (2006). The “problems” of AIDS in China. Social Sciences in China, 1 , 85–95.

Pan, Z. (2005). Emotion sociology: A sociological perspective to study. Journal of Social Science of Human Normal University, 34 (4), 52–56.

Pareto, V. (1963). The mind and society: A treatise on general sociology . Dover Publications.

Parsons, T. (1966). Structure of social action: A study in social theory with special reference to a group of recent European writers . Free Press.

Potter, J., & Wetherell, M. (1987). Discourse and social psychology: Beyond attitudes and behaviour . Sage.

Ren, X., Jiang, Y., Shao, A., et al. (2005). An assessment of information need and supply for multi-sectoral response in HIV/AIDS prevention and control. Modern Preventive Medicine, 32 (9), 1224–1227.

Rhodes, T., Singer, M., Bourgois, P., Friedman, S., & Strathdee, S. (2005). The social structural production of HIV risk among injecting drug users. Social Science and Medicine, 61 (5), 1026–1044.

Ridgeway, C. L., & Johnson, C. (1990). What is the relationship between socioemotional behavior and status in task groups? American Journal of Sociology, 95 , 1189–1212.

Scheff, T. J. (1979). Catharsis in healing, ritual and drama . University of California Press.

Scheff, T. J. (1988). Shame and conformity: The deference-emotion system. American Sociological Review, 53 (3), 395–406.

Schneider, B. (1988). Gender, sexuality and AIDS: Social responses and consequences. In R. A. Berk (Ed.), The social impact of AIDS in the US. ABT Press.

Shane, M., & Shane, E. (1993). Self psychology after Kohut: One theory or many. Journal of the American Psychoanalytic Association, 41 , 777–797.

Shao, C., & Cao, N. (2005). Male to male sexual contact and sexually transmitted diseases. Chinese Journal of Dermatology, 38 (5), 259–261.

Shott, S. (1979). Emotion and social life: A symbolic interactionist analysis. American Journal of Sociology, 84 , 1317–1334.

Simmel, G. (1990). The philosophy of money (T. Botomore & D. Frisby, Trans.). Routledge.

Sobo, E. (1995). Choosing unsafe sex: AIDS-risk denial among disadvantaged women . University of Pennsylvania Press.

Song, H. (2014). A review of Western research on the anthropology of emotion. Social Sciences Abroad, 4 , 118–125.

Stanley, L. (1999). Transforming AIDS: The moral management of stigmatized identity. Anthropology & Medicine, 6 (1), 103–120.

Stryker, S. (2004). Integrating emotion into identity theory. In J. H. Turner (Ed.), Theory and research on human emotions . Emerald Group Publishing Limited.

Swidler, A., & Watkins, S. C. (2007). Ties of dependence: AIDS and transactional sex in rural Malawi. Studies in Family Planning, 38 , 147–162.

TenHouten, W. D. (1999). Explorations in neurosociological theory: From the spectrum of affect in time consciousness. In D. D. Franks & T. S. Smith (Eds.), Mind, brain, and society: Toward a neurosociology of emotion . JAI Press.

Thamm, R. (2004). Towards a universal power and status theory of emotion. In J. H. Turner (Ed.) Advances in group processes . Emerald Group Publishing Limited.

Timmons, J. C., & Fesko, S. L. (2004). The impact, meaning, and challenges of work: Perspectives of individuals with HIV/AIDS. Health and Social Work, 29 (2), 137–144.

Tönnies, F. (1957). Community and society (Charles P. Loomis, Trans.). Michigan State University Press.

Treichler, P. (1999). How to have theory in an epidemic: Cultural chronicles of AIDS . Duke University Press.

Turner, J. H. (1999). The neurology of emotion: Implications for sociological theories of interpersonal behavior. In D. D. Franks & T. S. Smith (Eds.), Mind, brain, and society: Toward a neurosociology of emotion . JAI Press.

Turner, J. H. (2000). On the origins of human emotions: A sociological inquiry into the evolution of human affect . Stanford University Press.

Turner, J. H. (2002). Face-to-face: Toward a sociological theory of interpersonal behavior . Stanford University Press.

Turner, J. H. (2007). Human emotions: A sociological theory . Routledge.

Turner, J. H., & Stets, J. E. (2005). The sociology of emotions . Cambridge University Press.

Van Brakel, J. (1994). Emotions: A cross-cultural perspective on forms of life. In D. D. Franks, W. M. Wentworth, & J. Ryan (Eds.), Social perspectives on emotion . JAI Press.

Wang, D., Ye, H., & Ye, H. (2007). A survey and analysis of blood safety and HIV issues. Journal of Clinical Hematology (Blood Transfusion & Laboratory Medicine Edition), 4 (5), 230–234.

Wang, M., & Liu, Q. (2006). Development of NGOs in the field of HIV prevention and treatment and related policy recommendations. Jiangsu Social Sciences, 4 , 130–134.

Wang, N. (2000). On the social approach to emotion—Research notes on emotional sociology. Sociological Study, 4 , 122–125.

Wang, P. (2013). The social stratification model of emotional sociology. Shandong Social Sciences, 3 , 55–59.

Wang, P. (2014). Social order and social control based on a sociological perspective of emotions. Tianjin Social Sciences, 2, 75–79.

Wang, R., Dong, L., Li, H., et al. (2013). Analysis on Xi’an NGOs’ participation in AIDS prevention and control. Chinese Journal of AIDS & STD, 19 (11), 828–831.

Watkins-Hayes, C. (2014). Intersectionality and the sociology of HIV/AIDS: Past, present, and future research directions. Annual Review of Sociology, 40 , 431–457.

Weber, M. (2010). Basic concepts of sociology (C. Hang, Trans.). Beijing Publishing House.

Weng, N. (2001). Socio-cultural constructs of AIDS. The First Chinese Conference on AIDS and STD Prevention and Control.

Weng, N. (2003). Socio-cultural dynamics of AIDS transmission. Sociological Studies, 5 , 84–94.

Weng, N., Du, J., Jin, L., & Hou, H. (2004). The flow of the heroin, sex, and blood and its products and the transmission of the venereal diseases and AIDS. Ethno-National Studies, 6 , 40–49.

Wentworth, W. M., & Yardly, D. (1994). Deep sociality: A bioevolutionary perspective on the sociology of human emotions. In D. D. Franks, W. M. Wentworth, & J. Ryan (Eds.), Social perspectives on emotion . JAI Press.

Weitz, R. (1987). The interview as legacy: A social scientist confronts AIDS. Hastings Center Report, 17 (3), 21–23.

Weitz, R. (1991). Life with AIDS. Rutgers University Press.

Wu, J., Yang, Y., Li, W., et al. (2004). Psychological needs of patients with HIV/AIDS. Chinese Journal of Public Health, 20 (7), 883–884.

Wu, Y., Zhang, F., & Shan, L. (2002). Care and psychological support: An important link in the prevention and control of HIV in China. Chinese Journal of AIDS & STD, 4 , 244–246.

Wyatt, G., Myers, H., Williams, J., Kitchen, C., Loeb, T., et al. (2002). Does a history of trauma contribute to HIV risk for women of color? Implications for prevention and policy. American Journal of Public Health, 92 (4), 660–665.

Xia, G., & Yang, X. (2006). Social gender, population mobility and HIV risk. Social Sciences in China, 6 , 88–99.

Yan, Y. (2003). Private life under socialism: Love, intimacy, and family change in a Chinese village, 1949–1999 . Stanford University Press.

Yang, M. M. (1994). Gifts, favors, and banquets: The art of social relationships in China . Cornell University Press.

Yelin, E., Greenblatt, R., Hollander, H., & McMaster, J. (1991). The impact of HIV-related illness on employment. American Journal of Public Health, 81 (1), 79–84.

Yu, X. (2000). HIV/AIDS-related mental health issues. Chinese Mental Health Journal, 14 (4), 247–250.

Zhang, H. (2013). Predicament and prospects of the research on anthropology of emotion. Journal of Guangxi University for Nationalities (Philosophy and Social Science Edition), 35 (6), 60–65.

Zhang, K., & Zhu, Z. (2005). Integrating gender perspective into the HIV/AIDS project. Collection of Women’s Studies, 6 , 30–33.

Zhang, N., & Wu, M. (2012). The involvement of NGOs in the prevention and treatment of AIDS: The case of Gansu Province. China Social Organization, 6 , 19–23.

Zhang, Y. (2005). HIV/AIDS prevention among Chinese minorities. Journal of Guangxi University for Nationalities (Philosophy and Social Science Edition), 27 (2), 32–37+52.

Zhao, D. (2014). A brief history of modern western philosophy (2nd edn). Peking University Press.

Download references

Author information

Authors and affiliations.

Inner Mongolia University of Science and Technology, Baotou, China

Rongting Hou

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Rongting Hou .

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Huazhong University of Science and Technology Press

About this chapter

Hou, R. (2021). Literature Review and Theoretical Perspective. In: A Sociological Study on Emotion Regulation in People Living with HIV/AIDS in China. A Sociological View of AIDS. Springer, Singapore. https://doi.org/10.1007/978-981-16-1494-1_2

Download citation

DOI : https://doi.org/10.1007/978-981-16-1494-1_2

Published : 24 June 2021

Publisher Name : Springer, Singapore

Print ISBN : 978-981-16-1493-4

Online ISBN : 978-981-16-1494-1

eBook Packages : Social Sciences Social Sciences (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Int J Environ Res Public Health

An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain

Reo j. f. jones.

1 School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA

2 School of Nursing and Health Innovations, The University of Portland, Portland, OR 97203, USA

Chloé O. R. Littzen

Associated data.

Not applicable to the content of this review article.

Chronic pain results from a complex series of biomechanical, inflammatory, neurological, psychological, social, and environmental mechanisms. Pain and pain-related diseases are the leading causes of disability and disease burden globally. Employing nature-based interventions for the treatment of pain is an emerging field. Current theory driving the suggested mechanism(s) linking the pain reducing effects of nature-based interventions is lacking. A two-step approach was taken to complete a theoretical review and analysis. First, a literature review was completed to gather a substantive amount of research related to theoretical frameworks on the topic of nature-based interventions and pain. Secondly, a theoretical analysis as proposed by Walker and Avant was completed to explore current theoretical frameworks accepted in the literature on nature-based interventions and pain. Stress reduction theory and attention restoration theory were the most common theoretical frameworks identified. Neither theoretical framework explicitly identifies, describes, or intends to adequately measure the concept of pain, revealing a limitation for their application in research with nature-based interventions and pain. Theoretical development is needed, as it pertains to nature-based interventions and pain. Without this development, research on nature-based interventions and pain will continue to use proxy concepts for measurement and may result in misrepresented findings.

1. Introduction

The International Society for the Study of Pain defines “pain” as an unpleasant sensory and emotional experience associated with tissue damage [ 1 , 2 , 3 ]. The experience of pain involves various complex pathways which have physiological and psychological implications [ 1 , 4 ]. Pain processing involves neural networks linked to the autonomic nervous system (ANS), through the sympathetic nervous system (SNS) wherein bundled neurons in the SNS (or ganglia) running along the spinal column receive pain signals [ 5 , 6 ]. Generally, there are two primary types of pain described in current medical literature: acute and chronic [ 7 ]. Acute pain may be induced by tissue injury and subsequent inflammation, a skeletal muscle spasm, or other complex nociceptive reactions to sympathetic nervous system activation [ 8 ]. Nociceptors, or nerve cell endings, initiate the perception of pain and relay the processing of “painful” stimuli to the central and peripheral nervous systems. In acute pain, the signals subside, and the relay turns off. However, the threshold for nociceptors to fire is reduced during inflammation or ongoing tissue injury, which can lead to heightened pain sensitivity (hyperalgesia) and chronic pain [ 8 ].

The transition from acute to chronic pain is associated with several physiological, psychological, and psychosocial predictors involving central nervous system (CNS) and peripheral nervous system (PNS) pathways involved in stress reactivity and activation of the hypothalamic-pituitary-adrenal (HPA) axis [ 9 ]. Chronic pain is often described as a state of stress, and the high incidence of stress, depression, and anxiety are hallmarks of pain-associated chronic illness [ 10 , 11 ]. The HPA axis plays a role in mediating the relationship between stress and pain [ 12 ]. It has been suggested that ongoing and unmitigated activation of the HPA axis and subsequent release of glucocorticoids is also a factor in pain chronicity and comorbidities of pain such as anxiety and depression [ 9 ]. Pain also adds stress to the human system, whether physical (homeostatic dysregulation) or emotional (perceived stress) [ 13 ].

1.1. Acute and Chronic Pain

Within this review, two types of pain are discussed—acute and chronic. Acute pain is defined as nociceptive pain caused by a specific injury or chronic illness (associated with SNS activation) and subsides after the stimulus ceases [ 7 ]. Chronic pain—the focus of this manuscript—is dynamic and results from a complex series of biomechanical, inflammatory, neurological, psychological, social, and environmental mechanisms [ 14 ]. Unmitigated, chronic pain can lead to treatment-resistant pain [ 15 ]. It is estimated that over 20% of adults within the United States (U.S.) suffer from chronic pain, and more than 8.0% adults in the U.S. have “high-impact” chronic pain, or persistent pain that can adversely impact daily life for six months or more [ 14 ]. Higher prevalence of chronic and high-impact pain is reported among women, older adults, and socially marginalized adults, as well as adults living in rural regions or on public assistance [ 14 ].

The Global Burden of Disease Study 2016 reported that pain and pain-related diseases are the leading causes of disability and disease burden globally [ 16 ]. Low back pain and headache disorders are among the top 10 causes of disability-adjusted life-years (DALYs)—a measure combining years of life lost due to premature mortality (YLLs) and years of life lost due to time living with illness or healthy life lost due to a disability (YLDs) [ 17 ]—amongst all age-groups [ 18 ].

Acute and chronic pain are different clinical states, but one can experience acute episodes of pain within a chronic pain disorder [ 15 ]. Chronic pain is not self-limiting and can arise from the additional burden of psychological distress associated with ongoing episodic issues of acute pain outlasting the healing process. It is also considered a disease state associated with pain-inducing chronic illness [ 15 , 19 ]. Left unmitigated, chronic pain can lead to complex pain disorders, such as chronic widespread pain or fibromyalgia, and associated conditions such as depression, anxiety, and psychological stress [ 20 ].

1.2. Nature-Based Interventions

For the purposes of this theoretical review and analysis, and to incorporate a working definition of nature-based interventions (NBIs) accepted in current literature, we propose the following: A comprehensive working definition of “nature” by researchers of nature contact and human health Bratman et al. (2021) will be used within this paper, whereas “nature” means properties that include various aspects of outdoor landscapes; and, that these landscapes are “encompassing elements and phenomena of Earth’s lands, waters, and biodiversity, across spatial scales and degrees of human influence, from a potted plant or a small urban creek or park to expansive, ‘pristine’ wilderness with its dynamics of fire, weather, geology, and other forces” [ 21 ]. NBIs are “nature-based”, such that they involve actual or simulated elements of nature, incorporating interventional strategies involving greenspaces—i.e., grassy fields, forested settings, parks, vistas, green foliage, and plant imagery, blue-spaces such as waterfalls or streams, and brown-spaces such as savannahs and desserts—all within the interventional setting [ 22 , 23 ].

One emerging field of study employing NBIs for health and wellness is on the connection between nature exposure and the mitigation, or treatment, of pain, stress, and the burden of chronic illness [ 24 , 25 , 26 , 27 ]. Several studies describe the pain-reducing effects of viewing “live” nature, as well as simulated nature, in the form of pictorial or virtual images of natural landscapes such as greenspaces in clinical settings for improved health and well-being, including reducing pain outcomes [ 27 , 28 , 29 , 30 , 31 , 32 ]. For example, early research demonstrates that exposure to greenspaces may reduce pain and its chronicity for individuals with arthritic conditions [ 27 , 33 , 34 , 35 , 36 ].

Potential pathways of pain reduction include evidence suggesting that forest aerosols, from common aromatic plants found in forests and greenspaces, may reduce inflammation and pain [ 37 , 38 , 39 ], especially when tested in environmentally controlled settings [ 40 , 41 ]. It is also known that simulated audio-visual nature scenes can reduce stress reactivity, improve PNS response, and decrease pain perception [ 32 , 42 ]. However, the theory driving the suggested mechanism(s) linking the pain-reducing effects of different types of NBIs, such as Shinrin Yoku, Greenspace Interventions, or simulated nature contact, and for whom those potential effects are most beneficial, is lacking.

In the discipline of nursing, theories are traditionally considered “organizations of concepts and evidence into conceptual structures that help practitioners and researchers see pattern and organization in their activities and make sense of what they observe and discover in the world” [ 43 ] (p. 7). Alternatively, theory is considered an “explanation of what is going on” [ 44 ] (p. 2). As it pertains to scholarly work, theory is the scaffolding upon which we build our knowledge. Without theory, we are unable to determine where we have been or where we are going. Theory enables us to build upon the important work of those that came before us and help us determine what roads have been left uncharted. To date, there has been a paucity of theory development focused on nature-based interventions in nursing. Outside of nursing, theories focused on nature-based intervention have been developed, but there has been general acceptance by application of these theories without critique of their adequacy for research focused on pain. Therefore, the purpose of this article is to complete a theoretical review and analysis, otherwise referred to as a theory critique, of the currently accepted theories within research on nature-based interventions and pain.

2. Materials and Methods

A two-step approach was taken to complete this theoretical review and analysis. First, a literature review was completed to gather substantive literature related to theoretical frameworks on the topic of nature-based interventions and pain. Secondly, a theoretical analysis was completed to explore the relevance of current theoretical frameworks accepted in the literature for application to future research on nature-based interventions and pain in the discipline of nursing.

2.1. Literature Review

A literature search was conducted from August 2020 to April 2022 via the databases PubMed, CINAHL, Scopus, and ScienceDirect. Key terms included “pain” and “greenspace” or “forest bathing” or “forest therapy” or “shinrin-yoku” or “nature therapy” or “nature-based intervention.” Inclusion criteria consisted of articles (a) in the English language; (b) peer-reviewed; (c) either guided by an applied theoretical framework or discussed theoretical concepts and hypotheses; (d) was an intervention study; and (e) in the discipline of nursing or psychology. The rationale for including articles from the discipline of psychology was because this is where the primacy of research on nature-based interventions has been completed. For the purpose of this integrative review, all levels of theory except for conceptual models and hypotheses were included in order to focus on the more conventionally accepted theories related to nature-based interviews and pain. Conceptual models, or hypotheses related to our findings will be discussed to advance theoretical thinking in the discipline of nursing. No time restrictions on articles were selected to provide a comprehensive overview.

2.2. Theory Analysis

The six-step method of theory analysis by Walker and Avant (i.e., origins, meaning, logical adequacy, usefulness, generalizability and parsimony, and testability) was applied to critique theoretical frameworks on the topic of nature-based interventions and pain [ 45 ]. According to Walker and Avant, analysis enables us to determine if a theory is valid and reliable while revealing its strengths and weaknesses. Examining the current state of theories within nature-based interventions and pain will also identify gaps for further theoretical development in nursing.

Twenty-eight articles were in the initial literature review. A total of 19 articles were removed as they did not meet inclusion criteria for the literature review in this theoretical analysis. These included studies that were either non-experimental observational, studies which did not describe or apply a theoretical foundation, or studies published earlier than 2010, resulting in a total of nine articles (see Table 1 ). From the remaining nine articles, a total of three focused on nature-based interventions and pain and applied a theoretical framework. One of these articles applies a theory unrelated to the concept of nature and pain. Across the nine articles, two substantive theories were demonstrated: Stress Reduction Theory (SRT) and Attention Restoration Theory (ART) [ 46 , 47 ]. Two of the articles mentioned Wilson’s Biophilia Hypothesis [ 48 ].

Articles included in the theoretical analysis based on the literature review.

No other theoretical frameworks were identified for the purpose of this review and critique. Some of the 19 articles which were originally removed are described in the background and discussion sections of this paper as they include reviews on nature contact and health outcomes pertaining to pain research, in addition to literature reviews on the theoretical foundations of nature contact and health outcomes.

The following paragraphs will focus on the theory critique of both SRT and ART, as it was demonstrated they were the substantive theoretical frameworks for nature-based interventions and pain, as well as a review of Biophilia as an interrelated hypothesis. To clearly indicate which articles either described a theoretical framework or applied theory in the development of their study and as a foundation for their analysis, we use the language “described” or “applied” in the column “Theoretical Framework.” The details of these articles, and their application of theory, are further summarized in this section.

3.1. Stress Reduction Theory

Roger Ulrich, an architect, and health science researcher credited for incorporating elements of the natural world such as foliage and views of greenspaces into evidence-based healthcare design, deductively developed the Stress Reduction Theory (SRT) during the 1980s and early 1990s [ 56 ]. Ulrich was inspired by the city planner and landscape architect Frederick Olmstead who wrote about the impact of viewing nature and its capacity to engage the individual without fatigue, to relieve the stresses of city life, to calm and yet energize the mind, and thusly, the body, and therefore nature was viewed as not only an antidote to stress but necessary to preserve and mold for leisure [ 57 , 58 ] The “nature” which Olmstead described was that of the mid-19th century Americas where urbanicity was just beginning to expand westward and much of the nature surrounding burgeoning cities was relatively pristine and organic.

Ulrich had a keen understanding of “overload” and “arousal,” theories stemming from the social and natural sciences of the 1960s and 1970s, which he broadly described as theories encompassing the concept that visual complexity, noise, intensity of movement, high levels of stimulation (e.g., being immersed in a bustling city), can overwhelm, and fatigue the human “perceptual system,” and lead to high levels of stress. Ulrich further noted that these theories implied that restoring one’s pre-stressed state was possible through passive engagement with the natural world and learned positive associations with elements of nature (e.g., plants, parks, wilderness, etc.). Early research into these psychological theories comparing physiologic excitement between urban and natural settings [ 56 , 58 ] is an interventional strategy from which much research on nature and health stems [ 59 ].

Ulrich pioneered studying the impact of the environment in healthcare settings on stress recovery, which inspired the development of his theory. In 1984, he studied post-surgical patients viewing scenes of nature through their hospital windows, and found that they recovered quicker, and were discharged sooner, than patients without such views of nature [ 31 ]. Ulrich posited that the observed stress recovery may be due to a psycho-evolutionarily based aesthetic and affective predisposition for natural scenery [ 58 , 60 ] The seminal work from which SRT originated involved a study wherein Ulrich and colleagues exposed 120 healthy undergraduate adult subjects (60 male and 60 female) in the United States to a stressful filmed event, then immediately exposed the stressed subjects to videos of nature or urban settings. Participants’ physiologic and psychologic stress recovery was faster for participants viewing nature videos than for those viewing urban settings [ 56 ]. Therefore, SRT stemmed from Ulrich’s extensive research on the hypothesis that outdoor or “natural” environments are less threatening and stressful than urban or built environments.

Within SRT, there are three primary concepts of focus—although they are not explicitly stated or visually modeled—stress, a natural environment, and an urban environment. Ulrich often described “stress” as it has been defined by environmental psychologists and researchers, who described the connection between environmental stress and health outcomes through pathways associated with evolutionary theory [ 56 , 60 , 61 ]. Therefore, in studies pertaining to stress recovery or reduction, Ulrich denotes stress as a process involving an individual’s psychological (cognitive appraisal of the stressor and subsequent emotional response), physiological (engagement of the nervous system and subsequent cardiovascular, neuroendocrine, and musculoskeletal systems), and behavioral (what an individual does to cope, or navigate the stress reaction) response to any situation or environment which threatens or challenges the individual’s well-being [ 56 ].

While Ulrich did not explicitly define nature in the development of SRT, within Ulrich’s work, “nature” is described as an outdoor environment or landscape with some inherent complexity consisting of “vegetation,” such as trees and flowers, and/or “water,” such as rivers and lakes, whereas “urban” environments consist of the “built” world, or cityscapes with limited nature [ 46 ]. It should be noted that Ulrich described nature in contrast to the built city environment, but natural environments could also be shaped by humankind (e.g., “pastoral parks,” or total “wilderness”) [ 56 ]. For example, within the seminal study that informed SRT, Ulrich employed “natural” landscapes vs. “urban” landscapes such that “nature vegetation” consisted of a setting dominated by trees… other vegetation… occasional light breeze in background… or “water” consisting of “a fast-moving stream; waves and ripples…” in contrast to “urban heavy traffic,” which consisted of a “commercial” scene involving “fast moving cars” throughout a city [ 56 ].

Within SRT, it is postulated that in the presence of a natural environment, there is an inverse association with stress, meaning that stress decreases and promotes stress recovery. Comparably, the reverse is true in the presence of an urban environment; where there is a positive association with stress, meaning that stress increases (or remains unchanged) in an urban environment and delays or prevents stress recovery.

Independent of their meaning, the concepts and statements demonstrate logical adequacy within SRT. No logical fallacies within the structure of SRT were detected. Moreover, how the theory has been described has promoted ease in predictability and testing across decades of research and disciplines. Practically speaking, SRT has usefulness in the sense that it promotes ease in connecting concrete concepts (natural and urban environments) with a measurable abstract concept (stress). Across disciplines, it has been demonstrated how SRT is practical as it pertains to stress recovery of participants. In nursing, there is a paucity of demonstrable practicality in the literature, but theoretically speaking, SRT has the potential of practical and predictable outcomes within nursing science. The generalizability of SRT is sound, meaning that it is easy to interpret what will occur from implementing and testing the theory (e.g., with nature exposure one should expect a decrease in stress). For parsimony, SRT can be simply stated without the essence being diluted. SRT has been empirically supported across the literature for decades [ 24 , 56 , 59 , 62 , 63 , 64 , 65 ]. Moreover, SRT promotes the development of hypotheses that can be subjected to ongoing empirical research.

3.2. Attention Restoration Theory

The Attention Restoration Theory (ART) was developed by psychology professors and researchers Rachel and Stephen Kaplan in the 1980s [ 47 ]. ART proposed that attention can be described in two ways, (a) voluntary-directed, focused, cognitively controlled attention, or (b) involuntary, where attention can be unconsciously directed to meaningful stimuli, such as elements of the nature, or the natural world [ 66 , 67 , 68 ]. According to Stevenson et al. [ 69 ], Kaplan and Kaplan applied the term “directed attention” to distinguish themselves from previous work on the concept of voluntary attention [ 70 ]. ART also suggests that involuntary attention can be improved by spending time in nature, “restoring” the cognitive capacity for focus, and ultimately reducing psychosocial stress. ART is rooted in four key properties described by Kaplan and Kaplan. One property is the role of “soft fascination,” how humans view nature as meaningful, such that aspects of the natural environment can capture attention effortlessly which has been correlated with perceived restorativeness in present day research on the calming effects of nature [ 47 , 71 ]. Other properties of ART include the extent to which one is immersed in the natural world, the concept of “being away,” from usual daily activities, and an individual’s compatibility with their environment (e.g., being exposed to a natural setting that one appreciates) [ 47 , 68 ]. Kaplan and Kaplan posited that the cognitive capacity for focus can be depleted but redirecting attention to nature can restore this cognitive capacity and increase attentional focus [ 47 , 68 ].

The primary concepts within ART include nature exposure (also referred to as a restorative environment), and attention (involuntary and/or directed). Nature exposure is defined as being exposed to a natural setting that one appreciates [ 47 , 68 ]. Involuntary attention is defined as where attention can be unconsciously directed to meaningful stimuli, such as elements of nature, or the natural world [ 67 , 68 ]. It has been reported in current research there is ambiguity around the concept of directed attention [ 69 ]. While not explicitly stated, it is implied that nature exposure is positively associated with attention, meaning that attention will increase with the presence of nature exposure.

Independent of their meaning, the concepts and statements demonstrate logical adequacy within ART. How the theory has been described has promoted some ease in predictability and testing across decades of research and disciplines, but it can be argued due to the complexity of the theory, as it is explained, some concepts appear to be supplemental and not intentionally measurable (e.g., directed attention) within empirical research. Moreover, both nature exposure and attention as concepts have been reported to be used interchangeably with other concepts (e.g., attention with concepts such as mental fatigue, concentration, or executive function) adding further confusion. Practically speaking, ART has usefulness in the sense that it promotes ease in connecting relatively concrete concepts (nature exposure) with a measurable abstract concept (attention). The generalizability or ART is somewhat sound, meaning that it is easy to interpret what will occur from implementing and testing the theory (e.g., with nature exposure one should expect an involuntary attention and thus a reduction in stress). For parsimony, ART can be stated simply; the addition of directed attention promotes unnecessary complexity and more so is applied in variable ways across empirical research [ 69 ]. ART has been empirically supported across the literature for decades [ 69 , 72 ]. Moreover, the SRT promotes the development of hypothesis that can be subjected to ongoing empirical research, although conceptual variability promotes limitations in testing.

4. Discussion

In our theoretical review, the most applied theoretical frameworks within nature-based interventions and pain research were SRT and ART. Through the theoretical analysis, we demonstrated that both SRT and ART are sound theoretical frameworks based upon the criteria proposed by Walker and Avant [ 45 ], yet a gap was identified relating to the concept of pain. Specifically, neither SRT or ART explicitly identify, describe, or intend to measure the concept of pain. This is of concern from a standpoint of scientific rigor as scientists applying these theories are using the concepts of attention or stress as proxy variables for pain. Additionally, scientists applying concepts of attention or stress to pain need to ensure that the psychologic and physiologic association between these different physical states and processes are well-defined, or that any overlap specific to the psychologic and physiologic pathways connecting attention, stress, and pain are explicitly defined and reflected within the research design, measures, and outcomes. This can be interpreted as a concern for construct validity, meaning that scientists are not actually measuring what they intend to measure [ 73 ]. From the patient perspective, developing and testing interventions for pain reduction (whether acute or chronic) without supportive knowledge or accurate dissemination is inherently unethical, though the intention to support pain reduction is caring-focused and a critical focus of nursing science and health care. Future theoretical development is needed to demonstrate the specific connection between nature-based interventions and pain, including the different pain pathways that may be impacted, as well as how these pathways are associated (i.e., psychological and physiological). Further, key suggested mechanisms inherent to nature-based interventions and which aspects of these interventions offer support for pain mitigation should be a primary focus analyzed within the literature [ 24 , 27 ].

Exposure to natural landscapes to improve health outcomes on the basis of SRT and ART has been the subject of much research, especially in regard to measuring cognition; emotionality; psychological well-being; managing symptoms of chronic illness [ 64 , 74 , 75 , 76 , 77 ] mitigating acute [ 30 , 52 ] and chronic pain, respectively [ 25 , 51 ]; attentional capacity as improved by exposure to nature [ 63 , 66 , 78 ] and the human capacity for perceiving restorativeness as a construct [ 79 , 80 ]. SRT and ART are paramount as they provide the underlying framework supporting the notion that contact with nature can decrease psychological and physiological stress, restore cognitive focus, and increase feelings of relaxation. SRT and ART are comprehensive theories; they can provide a conceptual basis for studying a variety of interventional strategies and health outcomes associated with the psychology and physiology of stress and well-being, although ART has some limitations as aforenoted.

Various types of exposure to nature (such as residential greenspace) may produce an “affective” benefit, such that moods, feelings, emotions, and/or stress responses can be positively impacted by greater contact with nature [ 81 , 82 , 83 , 84 ]. A myriad of potential mechanisms and effect modifiers may impact these benefits which is beyond the scope of this paper [ 82 ]. Exposure to nature has been shown to improve pain perception, but the specific mechanisms underlying this observed benefit remain somewhat unclear and are of primary focus in current research [ 27 , 28 , 85 ].

Of the articles included in this review, a total of three out of nine applied theory within their study backgrounds and design and offered some discussion of how these theoretical frameworks support the association between nature and pain reduction [ 29 , 52 , 53 ]. For example, Tanja-Dijkstra et al. [ 52 ] discussed a theory not analyzed in this article called the Elaborated Intrusion Theory [ 52 ], which they correlated with SRT in the sense that viewing nature inspires positive associations—and these positive associations can “intrude” a person’s thoughts, increasing the “value” of the nature-image and distracting from pain. The notion of “distraction” is somewhat related to the applied theories within Wells et al. [ 53 ] and Scates et al. [ 29 ], wherein ART is incorporated to explain how inhibitory mechanisms involved in directed attention could be “restored” by exposure to nature through soft fascination [ 53 ], and this improvement of directed attention invites a “positive distraction” from the experience and sensation of pain [ 29 ]. Scates et al. [ 29 ] additionally noted that SRT supported the notion that nature scenery reduces stress, which is a central pathway toward improving directed attentional focus. These conceptual and linguistic overlaps suggest that not only are there some emergent pathways linking these foundational theories, but that they need to be distinctly understood and clarified.

Each of the remaining six articles described ART, SRT, or aspects of the biophilia hypothesis within their study’s backgrounds [ 28 , 49 , 50 , 51 , 54 , 55 ]. For example, Verzwyvelt et al. [ 54 ] cited a study by Ulrich [ 86 ], which called for more nature and daylight exposure in hospital environmental design but did not explicitly discuss this literature in reference to the “biophilic environments” within their study [ 86 ]. In contrast, Verzwyvelt et al. [ 54 ] focused on Wilson’s biophilia hypothesis described in the next paragraph [ 87 ]. In Li et al. [ 28 ], authors provided some background on previous theories in pain research and gave considerable credence to the notion that there are major gaps linking pain relief to greenspace exposures, specifically the ideas of symptom distraction through redirected attention, immune-modulating phytoncides from exposure to trees, and negative ions in the air, among other concepts linking greenspaces to health. Li et al. (2021) also suggested that the pathways linking research on pain and nature to improved health outcomes is thus far relatively indirect, and while they do not cite a specific theory, they do suggest further study to bolster early research on the subject, as within Ulrich [ 31 ]. Lipponen et al. [ 55 ] also suggest that ART and SRT provide background pertaining to mechanisms and pathways associated with the benefits of nature-based interventions, but do not specifically integrate these theories into their study. Han et al. [ 51 ] cite ART within their reference list and suggest that mechanisms of forest therapy (related to Shinrin Yoku or forest bathing) may induce physical relaxation and feelings of “restoration” alongside activation of the parasympathetic autonomic nervous system for improved pain outcomes in chronic pain sufferers. Ali Khan et al. [ 50 ] also cited the work of Ulrich and the benefits of viewing nature for pain relief [ 31 ], but do not go into detail on the theory. Rather, their study emphasizes facets of ART and SRT, including how direct or indirect interaction with nature (in the form of plants and flowers) can improve mental health by decreasing anxiety, stress, and depression—comorbidities of pain; and such interaction with nature may also distract from the pain experience. Lechtzin et al. [ 49 ] also discuss the work of Ulrich and SRT and Ulrich’s seminal study on nature and pain in hospital settings [ 31 ], which inspired their nature-image selection for their study of nature’s calmative effects. While these six studies reference the work of ART, SRT, and biophilia with variable detail, they also highlight the fact that there are significant gaps connecting NBIs, theory, and pain research for health and well-being.

A Note on Biophilia Hypothesis

Although we did not include biophilia hypothesis in our theoretical analysis, we find it important for the reader to provide some background on this perspective. In 1986, biologist, naturalist, and author, E.O. Wilson defined “biophilia” as the “innate tendency to focus on life and life-like processes” [ 48 ] (p. 1). The biophilia hypothesis therefore suggests that not only do humans have an innate affinity for all living things such as the natural world, but also that this affinity is rooted in our personal evolutionary history, [ 88 ]. As human evolution occurred through interaction with the physical environment, or the natural world, it has been suggested that humans have a biologically based biophilic tendency to achieve a state of well-being in nature [ 89 , 90 ], as opposed to the urban and indoor environs, which are described as more stress-inducing in the current literature on biophilic design [ 48 ].

Criticism of biophilia as a working hypothesis is largely of semantic origin. Critics argue that the definition of biophilia is too broad, that there is a lack of research on the evolution of these biophilic genetic predispositions, or that the natural environments of which biophilia is concerned are too vast and varied [ 88 ]. However, biophilia as a hypothesis is open to change and development—E.O. Wilson wrote about it and its complexity over several years [ 48 , 91 ]. Biophilia, when applied to interventional research design, has been associated with significant positive health benefits [ 48 , 87 , 91 , 92 ]. In our literature review investigating experimental studies involving NBIs and their impact on pain, 2 out of 15 studies referenced biophilia as a direct influence on their study designs [ 49 , 54 ].

In Verzwyvelt et al. [ 54 ], a “biophilic” VR environment was used alongside a standard treatment “control” environment to decrease pain and stress during chemotherapy infusions for 33 adults with active cancers. Authors described their logic for designing the biophilic virtual environment in their study based on the idea that such an environment elicits innate positive associations between humans and elements of nature such as greenery, garden plants, and vistas of natural landscapes to improve mental health and overall patient outcomes [ 54 ]. Lechtzin et al. [ 49 ] randomly exposed 120 adults to one of three environmental conditions in an effort to determine the impact of nature’s sights and sounds on pain during a bone marrow aspirate procedure. Participants in the “nature arm” of the study were exposed to conditions that the researchers described as specifically designed based on biophilia and the work of Wilson—a “pastoral” scene of a natural landscape with foliage, water, and skyline along with paired nature sounds [ 49 ]. While neither study yielded significant results in pain reduction initially, the study by Verzwyvelt et al. [ 54 ] demonstrated patient satisfaction with the biophilic environments such that they were “enjoyable” and “fun.” Participants in the study by Lechtzin et al. [ 49 ] reported higher overall satisfaction with their procedure in the “nature arm” group. However, it is unclear to what extent biophilia influenced the results in these two studies, further bolstering the need to incorporate greater specificity in research linking concepts of biophilia directly with pathways involved in improving health outcomes.

As mentioned, the field investigating the impact of NBIs on pain and comorbidities of pain is growing. To fill theoretical gaps, it is essential that further research links the proposed mechanism(s) driving pain reducing effects of NBIs, and for whom those potential effects are most beneficial. Based on the findings of our review, some studies applying NBIs for pain relief either do not reference theory, or apply theories centered on the experience of pain without mentioning the inclusion of “nature” in the interventional design of the study [ 52 ]. In a recent integrative review, Stanhope et al. [ 27 ] proposed a conceptual framework linking greenspace to improved pain outcomes. Authors described greenspace exposures as encompassing increased potential for activity, increased sunlight, sociality, negative ions in the atmosphere, exposure to nature sights, nature, sounds, phytoncides or forest aerosols, and even the microbiome, alongside several proposed mechanisms of action linking these exposures to pain relief. Mechanisms of action, referred to as “ecophysiological linkage mechanisms,” included physiological and psychological facets of pain biology (e.g., stress, sleep, mental health, nociception, immune mediators, etc.) as pathways between greenspace exposure and improved pain outcomes [ 27 ] (p. 4). Based on the findings of this review, the work of Stanhope et al. [ 27 ], and emergent research on the field of nature-based interventions for improved pain outcomes, we believe a novel conceptual framework should be developed, applied, tested, and retested to formulate a working grand theory to support future research.

5. Strengths and Limitations

The narrow inclusion criteria for article selection in this theoretical review and analysis can be seen as both a strength and a limitation. As a strength, the narrow inclusion criteria promote a foundational understanding of the theoretical frameworks most often adopted or applied in nature-based intervention research and pain. Comparably, this narrow inclusion criteria can also be a limiting factor potentially peripheralizing theoretical frameworks that have been less widely adopted and applied. It is our hope that with this foundational theoretical review and analysis, scholars can use this article to continue to build an understanding of the theoretical frameworks potentially less widely accepted. Additionally, there is a dearth of theoretically grounded experimental literature on nature contact as an interventional strategy for pain mitigation or management. In this analysis, we aimed to highlight the theoretical underpinnings and working hypothesis informing this literature to date. A result of this endeavor was the discovery of a relatively limited number of articles investigating the impact of nature-based interventions on pain outcomes.

6. Conclusions and Future Theory Development

The literature review revealed that stress reduction theory and attention restoration theory are the most discussed and applied theoretical frameworks when studying nature-based interventions and pain. In analyzing both these theories, it was determined that neither identify, describe, or adequately measure the concept of pain, revealing a limitation for their application in research with nature-based interventions and pain. Theoretical development is needed, both within the discipline of nursing and externally, as it pertains to nature-based interventions and pain. Without development of theory focused on pain, knowledge production will focus on using proxy concepts to measure pain which may lead to inconsistent or inaccurate findings in nature-based intervention research on pain.

Acknowledgments

The authors would like to acknowledge Katherine Priddy for their editorial assistance.

Funding Statement

This research received no external funding.

Author Contributions

Conceptualization, R.J.F.J. and C.O.R.L.; methodology, R.J.F.J. and C.O.R.L.; validation, R.J.F.J. and C.O.R.L.; resources, R.J.F.J. and C.O.R.L.; writing—original draft preparation, R.J.F.J. and C.O.R.L.; writing—review and editing, R.J.F.J. and C.O.R.L.; visualization, R.J.F.J. and C.O.R.L.; project administration, R.J.F.J. and C.O.R.L. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

IRB approval is not applicable to the content within this review article, and was not required for disseminating the content within this article.

Informed Consent Statement

Data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.