An Investigation of Pediatric Nursing Theses and Dissertations (2000–2021): A Descriptive Study

Introduction

Postgraduate nursing theses and dissertations have a rich history in the nursing field (Woods, Phillips, and Dudash, 2020). They serve as the primary source of knowledge and guide the production and development of new research. WHO mentioned that nurses are considered the core of the healthcare system, and the nursing profession can advance by developing related research, which is regarded as the building block of any profession (WHO, 2016). Generally, theses review previous literature and highlight knowledge gaps while shaping research questions (Litvinova, et al., 2018). Scientific theses play an important role in producing and developing new research focused on nursing care for patients and children in various aspects of healthcare. The analysis of theses can help graduate nursing students learn the academic steps involved in writing and developing nursing research (Robinson, 2001).

The qualified nursing care requires a solid foundation of scientific evidence-based knowledge and practices, approved by a number of published research and theses that address patients’ needs (Alomari, et al., 2023). These theses and research contents need to be evaluated to determine their benefit for individuals’ health and meet community health needs (Hellesø, 2018).

The early 20th century witnessed significant growth in research publication, especially in developed nations, while other countries began systematically examining the status of nursing research (Parahoo, 2014). In contrast, nursing research development in the Middle East and the Arab world remains relatively nascent and lags behind developed countries. This gap persists despite limited studies analyzing the state of nursing research in Arab nations (Al-Husaini, Sun, and Larson, 2016; Sweileh, et al., 2019). Recently, academic institutions in Arab countries have demonstrated growing interest in research activities, recognizing their importance for professional development and improving international university rankings (Sweileh, et al., 2019).

Pediatric nursing theses and dissertations, as essential parts of nursing research that focus on the quality of care for children and their families, need to be aligned with emerging issues and trends in pediatrics. These studies are important to meet community needs and improve child health, starting from the health of newborns to healthy adolescents (Masic, et al., 2009). They should focus on all aspects of children’s health, particularly since many biological and psychosocial factors over time can have harmful effects on children’s growth and development (Reis, et al., 2018). Clinical research can enhance the efficacy of care, reduce mortality and morbidity rates, and increase satisfaction among nurses and patients (Alomari, et al., 2023).

Insufficient and unserious research related to pediatric nursing can influence the evidence-based practice and direct care of children. However, research in pediatric nursing serves as the cornerstone for providing advanced care and solving health problems (Hareket, and Kartal, 2021). Scientific research in academic education focuses on understanding the problem to find possible solutions through introducing changes (Inam, 2016). Nevertheless, writing and publishing research articles remain the main concern for postgraduate students. Assessing nursing research can increase opportunities for Arabian researchers to study and promote their research related to healthcare and education (Sweileh, et al., 2019).

Globally, the nursing profession is recognized as the foundation of healthcare systems. Professional development in nursing, as in other fields, requires the production and dissemination of high-quality research (12 Figueiredo, and Amendoeira, 2014). Scientific research serves as both the lifeblood of knowledge advancement and the cornerstone of professional practice, ultimately enhancing patient care quality, improving community health outcomes, and reducing healthcare costs (Khalaf, and Sun, 2018).

Nursing research in the Middle East, including Iraq, is gradually evolving, though it still lags behind European and American standards. The notable scarcity of studies analyzing nursing research outputs, particularly in pediatric nursing, has motivated this investigation to systematically describe and analyze their characteristics. This study aims to address existing knowledge gaps while aligning with contemporary trends in pediatric nursing. Notably, the first regional analysis of nursing research in the Middle East was published only in 2013 (Khalaf, 2013).

The Bachelor of Nursing program was first established in Iraq in 1962 at the University of Baghdad’s College of Nursing under WHO supervision (Al-Da’mi, and Boyle, 2012; Alzuheri, Alibrahemi, and Hussein, 2018), building on a robust educational foundation (Garfield, and McCarthy, 2005). This was followed by the introduction of the Master’s program in 1991 and the PhD program in 2001 at the same institution, marking the beginning of advanced nursing research through postgraduate theses and dissertations. There is a need to understand and analyze the information and recommendations of students’ theses at the College of Nursing in the University of Baghdad; therefore, we decided to analyze their prepared studies from 2000-2021. The number of nursing graduate theses and their product will improve nursing care services provided in different healthcare institutions in Iraq. The recent growth in postgraduate thesis production can be attributed to several factors: (1) the expansion of pediatric nursing programs, (2) greater awareness of childhood health needs, and (3) increased demand for specialized pediatric care. Additional contributing factors include government support for postgraduate education, a growing pediatric population, and the historical context of conflict and instability, which collectively highlighted the need for developing a stronger knowledge base in pediatric nursing.

The main purpose of this study is to provide an overview of pediatric nursing theses and dissertations (2000-2021), to evaluate their alignment with global trends in the field of pediatric nursing, to avoid duplication of research efforts, and to identify knowledge gaps in child healthcare. The findings will provide actionable insights to guide evidence-based practice, enhance research quality, and demonstrate the clinical relevance of graduate research in improving pediatric health outcomes.

Methodology

Descriptive study was carried out in the library of the College of Nursing, University of Baghdad, from September 2022 to January 2023. The study population comprised all available MSc and PhD theses (n=145) specializing in pediatric nursing, completed between 2000 and 2020. This comprehensive analysis aimed to systematically identify and synthesize research priorities in pediatric nursing through examination of these original graduate works.

Ethical approval was obtained from both the Dean’s Office and the Research Ethics Committee at the College of Nursing. To maintain confidentiality, all researcher and supervisor identifiers were removed from the study results, while retaining data on publication outputs derived from theses. Publication records were verified through systematic searches of international databases including Google Scholar, PubMed, and ResearchGate. Thematic analysis was conducted, with theses categorized into distinct themes and subthemes based on their research objectives and subject matter.

Five themes and seventeen subthemes were derived from the studied theses.

The study employed a validated checklist tool developed by Balaghafari et al. (2016) to systematically analyze the theses across multiple dimensions, including: study design, degree level (MSc/PhD), research topics, supervisors’ and advisors’ specialties, alignment between research topics and supervisor expertise, page length, and study duration. Quantitative analysis was performed using descriptive statistics, with results presented through appropriate tabular and graphical representations.

Result

In the current study (145), these in the specialty of pediatric nursing during the period 2000-2001 were described.

Figure 1 demonstrates a significant increase in completed pediatric nursing theses in recent years, with peak production occurring in 2020 (21%) and 2021 (19%). In contrast, thesis completion rates were substantially lower prior to 2011, indicating notable growth in postgraduate research output over the past decade.

Figure 1. The Annual Distribution of Pediatric Nursing Theses from 2000 to 2021

Table 1 reveals that 38.6% of the analyzed theses focused on children and families in terms of examining their self-care practices, health education, knowledge-attitude-practice (KAP) assessments, and psychosocial burdens.

Figure 2 illustrates that quasi-experimental designs were employed in 40% of the postgraduate theses, followed by descriptive correlational designs at 33.1%.

Concerning the target population in pediatric nursing theses, Figure 3 represents the distribution of study samples. Notably, nurses constituted the sample population in 40.7% of these studies, representing the most frequently examined group.

The analysis revealed several key findings regarding postgraduate nursing theses:

Supervision Alignment: 71.1% of theses were closely aligned with their supervisors’ specialties.

Consultation Practices: Most studies utilized expert consultations, with 97.9% involving English language experts and 67.6% employing biostatisticians.

Methodological Approaches:

• 30.3% of studies employed pre-test/post-test designs

• A significant majority (93.1%) lacked application of theoretical frameworks

Thesis Characteristics:

• MSc theses ranged from 88-150 pages

• PhD dissertations spanned 100-200 pages

Figure 2. The distribution of Theses According to Study Design

Figure 3. The distribution of the Target Population

Discussion

The current study included 145 MSc and PhD theses and dissertations in the specialty of pediatric nursing, spanning seven periods from 2000 to 2021. The findings in Figure 1 show that the number of completed theses increased annually, with postgraduate theses tripling in number over the last seven years. The highest percentage of pediatric nursing theses (87, 60%) was achieved in the 2015–2021 period, while the lowest percentage (21, 14.5%) was recorded in the 2000–2006 period.

The increase in the number of nursing faculty members and research supervisors in recent years has contributed to greater student guidance in the nursing specialty. This growth may be attributed to the need to expand the undergraduate nursing student base in Baghdad and to enhance nursing qualifications to support advanced nursing roles. Additionally, academic requirements and competition could be contributing factors.

Al-Jashamy et al. (2014) found in their study on Iraqi publication trends that the number of nursing publications increased annually after 2005. Similarly, Sweileh et al. (2019) documented a noticeable rise in published nursing research across Arab countries, linking this trend to the growing number of nursing faculty and increased research collaboration. alaghafari et al. (2016) also observed an annual increase in completed theses at Mazandaran University in their study

Among the postgraduate theses, five major themes and seventeen subthemes were identified (Table 1). The most prominent theme focused on children and their families’ needs, particularly in areas such as self-care, health education, knowledge-attitude-practice (KAP), and psychosocial support (38.6%). Specific attention was given to the psychosocial burdens of hematological diseases and self-care management of endocrine disorders, especially diabetes mellitus. The selection of these research themes may be attributed to the rising number of children admitted to hematology units in Iraqi pediatric hospitals. According to the World Health Organization (WHO, 2021), approximately 400,000 children aged 0–19 years are diagnosed annually with various cancers in low socioeconomic countries. Additionally, the researchers’ empathy and the burden of care likely motivated these studies, aiming to alleviate challenges faced by Cacogenic children.

The Centers for Disease Control and Prevention (CDC Archive, 2022) reported a growing number of new diabetes mellitus diagnoses among individuals under 20 years of age. Globally, the rising prevalence of diabetes-related health problems—including in Iraq—has further emphasized the need to address this issue in pediatric nursing research. Numerous studies have investigated metabolic disorders, which account for a significant proportion of these cases (Balaghafari, et al., 2016; Al-Husaini, Sun, and Larson, 2016).

The results presented in Figure 2 indicate that the quasi-experimental design was the most frequently used research methodology (40%), followed by descriptive-correlational design (33.1%). Quasi-experimental designs are widely employed in nursing research to evaluate the effectiveness of specific interventions on participant groups and achieve study objectives. This approach has gained increasing global recognition in recent years.

Quasi-experimental designs are particularly valuable in nursing research as they enable investigators to:

• Examine targeted interventions

• Improve various aspects of nursing care

• Advance nursing practice

• Enhance patient outcomes (Handley, et al., 2018)

Several nursing studies have successfully utilized quasi-experimental designs to develop and evaluate nursing interventions, with many demonstrating significant improvements in experimental groups (Melender, Salmela, and Pape, 2020). These findings align with Bahar et al.’s (2020) observation that the majority of nursing theses in Turkey employed quasi-experimental designs, while qualitative approaches were less common, reflecting broader trends in nursing research methodology

Regarding descriptive studies in nursing research, Al-Husaini, Sun, and Larson (2016) conducted a scoping review of nursing research in Middle Eastern and North African countries, reporting that 75.2% of published studies employed quantitative designs, predominantly descriptive and cross-sectional approaches. Similarly, Jahromi and Dehghani (2014) found that more than half of the nursing theses at an Iranian college of nursing and midwifery utilized descriptive designs in their methodological analysis. These findings are consistent with Nashwan et al.’s (2017) overview of nursing research, which revealed that 63% of reviewed studies adopted quantitative methodologies. However, regional variations exist, as Khalaf and Sun (2018) reported that in Jordan, half of the published nursing studies relied on qualitative designs, with descriptive, correlational, and cross-sectional approaches being most common. In contrast, quasi-experimental (7.3%) and true experimental (2.1%) designs were significantly less prevalent in Jordanian nursing research.

Figure 3 illustrates that nurses constituted the most frequently studied sample in pediatric nursing theses (40.7%), while children, adolescents, and families collectively represented more than half of the research participants across various health-related studies. The predominant focus on nurses as participants likely stems from their pivotal role in providing direct care to children and families, as well as the opportunity to identify key challenges in nursing practice. Additionally, nurses are often more accessible and willing to participate in research, particularly when studies align with their professional roles and concerns. Luck et al. (2017) noted that while recruiting nurses as research participants can be challenging, aligning study objectives with nurses’ clinical context and priorities can facilitate enrollment. However, Goncalves et al. (2019) emphasized the importance of incorporating patient-centered outcomes into nursing research to equip postgraduate students with evidence-based practices tailored to patient needs. This perspective is supported by Nashwan et al. (2017), who found that most nursing studies focus on clinical practice issues affecting hospitalized patients.

Table 2 demonstrates that the majority of postgraduate theses (71.1%) were supervised by specialists in the field, while a smaller proportion (30%) were supervised by general practitioners. Specialized supervision plays a crucial role in helping students refine their research topics and enhance their scholarly contributions. This approach fosters effective communication between supervisors and students, facilitating clear objectives, in-depth insights, and sustained motivation (Hamzavi, et al., 2013). Balaghafari et al. (2016) found in their assessment of nursing and medical theses that 99.38% of supervisors were well-matched to the thesis subject matter, indicating strong alignment between supervisory expertise and research topics. This high alignment rate may be attributed to the growing number of specialized nursing supervisors. Furthermore, the annual increase in thesis supervision reflects advancements in academic education and institutional commitment to supporting students across specialized fields (Motamed-Jahromi, and Dehghani, 2014). Notably, 90.2% of theses exhibited appropriate alignment between research topics and supervisory expertise. Teacher involvement in academic research is essential for promoting action research and enhancing the quality of scholarly work through critical perspectives (Inam, 2016). Additionally, the majority of PhD and MSc theses received consultation from English language experts (97.9%) and biostatisticians (67.6%). For non-native English speakers, such expert support is invaluable in achieving high-quality academic writing. Language specialists assist students in refining their academic style and polishing their final manuscripts (Nashwan, et al., 2024).

The length of theses ranged from 88-150 pages for MSc dissertations to 100-200 pages for PhD dissertations. These page requirements are stipulated by the University of Baghdad’s academic writing guidelines, which mandate the inclusion of all essential scientific content, research methodology, appendices, and official authorization documents to support the research process. Hugelius (2021) stated that most universities set a range of numbers for accomplish post graduates` theses according to the policy of that academic institute; these guidelines ensure the consistency and compliance of students. Theses need to be limited to a certain number of pages to maintain subject clarity and direct presentation of their research.

Regarding data collection methods, Table 2 demonstrates that pediatric nursing theses and dissertations employed various approaches, with pretest-posttest tools being the most common (30.3%), followed by questionnaires (28.3%). As expected, the choice of data collection methods primarily corresponds to the research design employed. This finding aligns with the predominance of quasi-experimental and descriptive designs identified in the current study’s analysis of pediatric nursing research.

The analysis revealed a striking lack of theoretical frameworks in the examined theses, with 93.1% failing to incorporate any theoretical paradigm in their research design. This finding aligns with Khalaf and Sun’s (2018) observation that 92.4% of published nursing studies similarly lacked theoretical grounding. The absence of theoretical foundations appears widespread, as Nashwan et al. (2017) reported that only 14% of nursing research developed theories or conceptual frameworks. Bahar et al. (2020) further corroborated this trend, finding that nursing models were utilized in merely 10.9% of theses, highlighting a significant gap in theoretical application within nursing education. However, Dantas et al. (2022) emphasized in their scoping review that developing and applying child-focused nursing theories could substantially enhance clinical management of pediatric health. Theoretical frameworks serve as essential guides for research planning and structural organization (Dhaliwal, Singh, and Bhatia, 2010), suggesting their incorporation could strengthen both the rigor and applicability of nursing research.

Only 47.6% of defended theses and dissertations were subsequently published as journal articles. This low publication rate may reflect several challenges:

• Lack of sustained follow-up and motivation for publication

• Difficulties in the publication process faced by researchers

• Limited journal receptiveness to dated research topics

This finding aligns with broader regional trends in academic productivity. Al-Jashamy et al. (2014) reported that Iraq ranked 91st out of 238 countries in research documentation according to the 2012 Hirsch Index, though international collaborations and citations showed gradual improvement post-2012 (Al-Jashamy, Haidar, and Al-Saraj, 2014; Hoz, et al., 2021). Supporting evidence comes from Woods et al. (2020), whose bibliometric analysis revealed that 9.4% of published nursing articles cited at least one thesis or dissertation. Additionally, Abdul-Majeed et al. (2021) documented a notable increase in Iraqi citations and publications by 2019 based on Scopus data, suggesting positive momentum in research dissemination.

Conclusion

This study represents one of the first comprehensive analyses of pediatric nursing theses and dissertations conducted at the College of Nursing, which analyzes the theses and dissertations in the specialty of pediatric nursing. It highlights the postgraduate study features, to guide and motivate future researchers in updating according to the global trends and issues, and avoid repetition of previous subjects. The importance of publishing such studies is to develop a nursing database and expand evidence-based practices. This study can be recommended for supervisors at nursing colleges to encourage the postgraduate students to focus on the new trends and issues related to pediatric nursing topics.

Authors’ Contribution

Adraa Hussein designed the concept, analized the data, and wrote the paper. Zahid Waheed Ahjil wrote the paper. All authors read and approved the final version of the work.

Funding

None.

Conflict of Interest

None.

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