The narrative methodology is inherently subject

The gap

Evidence profile

Stated in the limitations section of the source papers, classified as general, spanning 3 journals. Those papers have been cited 1 times in total.

Supporting evidence — 3 representative gaps

• Ethical Governance, Medico-Legal Accountability, and Clinical Decision-Making in Nursing Practice: A Systematic Review of Awareness, Ethical Challenges, and Institutional Determinants (2026) · International Journal For Multidisciplinary Research · doi

  While the present systematic review provides important insights into ethical and medico-legal challenges in nursing practice, certain limitations should be acknowledged to ensure balanced interpretation of the findings. First, the review included only studies published in the English language. Consequently, relevant evidence published in other languages may not have been captured, particularly from regions where nursing ethics and medico-legal practices are influenced by distinct cultural and healthcare frameworks. This may have introduced a degree of language and publication bias. Second, considerable heterogeneity existed among the included studies in terms of study design, sample characteristics, clinical settings, and outcome assessment methods. Because of this methodological diversity, quantitative meta-analysis was not feasible, and the findings were synthesized narratively. Although narrative synthesis allowed broader conceptual interpretation, it may limit statistical comparability across studies. IJFMR260378424 Volume 8, Issue 3, May-June 2026 13 International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] Another important limitation relates to the predominance of cross-sectional and self-reported studies within the available literature. Ethical awareness, moral distress, and medico-legal practices were frequently assessed through self-administered questionnaires, which may be influenced by recall bias, social desirability bias, and subjective interpretation. Therefore, the reported levels of awareness and ethical competence should be interpreted cautiously. Additionally, many studies were conducted within specific institutional or regional settings, limiting the generalizability of findings across different healthcare systems. Ethical decision-making in nursing is strongly shaped by organizational culture, legal frameworks, resource availability, and sociocultural values; therefore, variations across countries and institutions are expected. The review also identified a relative scarcity of longitudinal and interventional research examining long- term outcomes of ethics education, institutional reforms, and policy-based interventions. Most available evidence remains descriptive in nature, highlighting the need for stronger analytical and implementation- oriented research in this field. Despite these limitations, the review synthesizes a broad and internationally relevant body of evidence that contributes meaningfully to the understanding of ethical governance, professional accountability, and medico-legal preparedness in nursing practice. The findings therefore provide a valuable foundation for future research, policy development, and institutional strengthening.

  generalstated in limitationsevidence 5/5
  Keywords: ethical legal review medico nursing ijfmr interpretation evidence bias across institutional important practice limitations included
• The Effectiveness of Intervention with Intimate Partner Violence Perpetrators: An Umbrella Review (2026) · Journal of Family Violence · cited 1× · doi

  Despite these contributions, some limitations should be noted. The primary limitation is the lack of meta-analyses published in languages other than English, Portuguese, and Spanish, which restricts a more comprehensive understand- ing of PIPs in different countries. Secondly, most of the study samples included in the meta-analysis were composed of males, which did not allow for the generalization of results to women. Thirdly, most primarily studies included in the meta-analyses reveal low methodological quality, with a small number of RCTs, which might impact the results of the different meta-analyses. Fourth, most of the included meta-analyses were rated as providing weak or, at best, sug- gestive evidence, limiting the overall robustness of the find- ings. Fifth, the absence of key statistical data in many of the meta-analyses prevented the conduct of a second-order meta-analysis, thereby constraining our ability to deliver more robust and conclusive results. Sixth, the exclusion of grey literature may have reduced the comprehensiveness of the evidence base and increased susceptibility to publication bias. Finally, the meta-analyses varied in their inclusion and exclusion criteria, which may have contributed to the incon- sistencies observed across findings.

  generalstated in limitationsevidence 5/5
  Keywords: meta analyses included different evidence exclusion despite contributions limitations noted primary limitation lack published languages
• ERIOPERATIVE CORTICOSTEROID USE IN MANDIBULAR THIRD MOLAR SURGERY: A NARRATIVE REVIEW OF EFFECTS ON POSTOPERATIVE PAIN, EDEMA, AND TRISMUS (2026) · Archiv Euromedica · doi

  The narrative methodology is inherently subject to selection bias, and no formal quality assessment of the included studies was performed. The included studies are heterogeneous in terms of dosage, route of administration, timing of administration, and outcome measurement. This heterogeneity limits direct comparison between studies. Future systematic reviews and meta-analyses using standardized protocols are needed to strengthen the evidence base.

  generalstated in limitationsevidence 5/5
  Keywords: administration oral routes route assessment included dosage timing outcome direct comparison protocols evidence corticosteroids surgical

Questions about this gap