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Publication Status of Graduate Theses of Internal Disease Nursing: A Systematic Review

Introduction: Transforming master's theses into publication is important for sharing scientific knowledge. Aim: This study was conducted to determine the conversion rate of internal medicine nursing master's theses made in Turkey into scientific articles. Method: Between December 2019 and February 2020, the thesis database of the Council of Higher Education of the Republic of Turkey was used. All master theses are held, as a legal requirement, and were searched for "Internal Medicine Nursing" and "Nursing" master theses completed between 2004 and 2018. The publication rate of these theses was found by searching for the names of thesis author and supervisor on the following databases: PubMed, Thomson Reuters Web of Science, Google Scholar, Turkish Medline, and Turkish Academic Network and Information Center National Academic Network. Results: More than thirty (31.4%) of 616 theses included in the study were published in Science Citation Index, Science Citation Index Expanded and Social Sciences Citation Index, 3.5% in Emerging Sources Citation Index, 25.0% in other international refereed journals, 19.9% in national academic network and information center, and 20.2% in other national refereed journals. Conclusion: It was determined that less than half of the master's theses in the field of internal medicine nursing were published and that, of these published theses, less than half appeared in journals covered by Science Citation Index, Science Citation Index Expanded, or Social Sciences Citation Index. Solutions must be generated to promote the Science Citation Index, Science Citation Index Expanded, or Social Sciences Citation Index publication of master theses. SCI or SCI-E indexed journals have been found as follow: in the study by Özgen et al., 6.2% for theses in medicine, in Celikgün et al., 26.6% for theses in audiology, in Mayir et al., 22% of theses in general surgery, 11.4% of theses in the field of microbiology, and Koca et al., 23.2% of theses in orthopedics (Özgen et al., 2011; Celikgün, Derinsu, Çiprut, Torun & Kalcıoğlu, 2016; Koca et al., 2016; Mayir et al., 2016).


Introduction
The main indicator of scientific productivity, master theses is an important integral part of specialty training (Lovitts, 2005;Sipahi et al., 2014). The main purpose of thesis preparation is to equip the student to write a systematic scientific study and produce new information. Another purpose is sharing this information, contributing to the literature (Dhaliwal, Singh & Bhatia, 2010). The contribution of theses to the scientific world depends on them becoming articles in scientific journals. Unless published in the world of science, a study is not considered to have been carried out in scientific circles (Quiroz, Curiosa, Encarcion & Gayoso, 2010). For this reason, it is important to publish the theses in journals (Dhaliwal et al., 2010).
The publication rate of theses in various countries, including our country, is low (Sipahi et al., 2014). The Scientific and Technological Research Council of Turkey examined countries' publication and citation counts according to the various branches of science between 2010 and 2015. The most widely published sciences are Medical Sciences, Basic Sciences, Engineering Sciences, and Social Sciences. According to the world ranking, despite recent growth in master programs, there was a significantly lower performance in terms of dissemination in Turkey (The Scientific and  Technological Research Council of Turkey, 2015).
Just like all other branches of science, nursing can be developed through research. Therefore, nursing theses are considered an important source of knowledge production. As a result, there is an increase in the number of graduate programs in nursing. Scientific productivity is of key importance to increase the quality of nursing practices, provide higher quality care, increase scientific knowledge, and meet the needs and demands of the age. Internal medicine nursing, one of the more advanced study areas, is among the most demanded postgraduate branches of nursing with a steadily increasing number of thesis and scientific research (Yılmaz, Yazgan, Dur, Salman & Demir, 2017).

Aim
In the literature, no study has examined the publication rates of master theses in internal medicine nursing in Turkey. Therefore, the objective of this literature review study was to determine the rates at which Turkish internal disease nursing master theses were converted into scientific articles.

Research Questions
1. What is the publication status of internal disease nursing master's theses? 2. What is the rate of publication of theses that have been published in journals?
3. What is the distribution of internal medicine nursing theses according to subject areas?

The Type of Research
This study is a systematic review study.

Databases Used in Research
As a legal requirement, all master theses are held, the thesis database of the Council of Higher Education of the Republic of Turkey (CoHE). Therefore, the database was searched between December 2019 and February 2020 for "Internal Medicine Nursing" and "Nursing" master theses completed between 2004 and 2018. While scanning, Turkish keywords were preferred. In addition, the publication rate of these theses was found by searching for the names of thesis author and supervisor on the following databases: PubMed, Thomson Reuters Web of Science, Google Scholar, Turkish Medline, and Turkish Academic Network and Information Center National Academic Network.

Inclusion and Exclusion Criteria for the Research
Master theses which were from Internal Medicine Nursing and conducted between 2004 -2018 were included in this study.

Universe and Sample of the Research
This study determined 2000 master thesis records by scanning the keyword 'nursing' in the CoHE system. Among the 2000 records, there are 319 records reached by using the keyword 'internal disease nursing'. Among the remaining 1681 master's theses, there are theses made in internal disease nursing. However, these are specified only as 'nursing' instead of 'internal medicine nursing' in the specialization department. For this reason, 1681 records were examined by the researchers, and 297 theses were added to the sample in the field of internal disease nursing. Thus, among the 2000 nursing master's theses, 616 internal medicine nursing master's theses were reached.

The Evaluation of the Data
The publication rate of these theses was found by searching for the names of thesis author and supervisor on the following databases: PubMed, Thomson Reuters Web of Science, Google Scholar database, National Academic Network, and Information Center, and Turkish Medline. Theses published in journals indexed either in PubMed or Science Citation Index Expanded (SCI-E) were considered international publications.
Published studies are grouped according to the most frequently studied areas in internal medicine nursing, some symptoms such as pain, stress, sleep, and some concepts related to nursing care such as quality of life, occupational health, and self-care.

Results
In our search, six hundred and sixteen theses (616) were recorded. Of these, it was found that two hundred and fifty-two (40.9%) resulted in publications in various journals. The overall publication rate in international journals was seventy-nine (31.4%) in Science Citation Index (SCI), SCI-E and Social Sciences Citation Index (SSCI), nine (3.5%) in Emerging Sources Citation Index (ESCI), sixty-three (25.0%) in other international refereed journals. On the other hand, the overall publication rate in Turkish national journals was fifty (19.9%) in Turkish Academic Network and Information Center, and fifty-one (20.2%) in other national refereed journals (Table 1).
The majority of the theses were descriptive studies (75.5%), with the remainder, interventional (16.6%) and methodological studies (7.9%). When the overall publication rates of the thesis Çürük, G.N., Özgül, E., & Karadağ, S. research type were investigated, the publication rates of the descriptive studies were found to be one hundred and eighty-two (39.1%). Of these, the percentages were as follows: Turkish Academic Network and Information Center 23.6%, other national refereed journals 20.8%, SCI, SCI-E 23.6%, ESCI, 4.3%, and other international refereed journals, 27.4%. Publication rates of the interventional studies were found to be forty-five (44.1%), and of these, percentages were as follows; Turkish Academic Network and Information Center, 8.8%, other national refereed journals, 15.5%, SCI, SCI-E 57.7%, and other international refereed journals 17.7%. Publication rates of the methodological studies were found to be twenty-five (55.5%). Of these, percentages were national academic network and information center 12%, other national refereed journals, 24%, SCI, SCI-E, 40%, ESCI 4%, and other international refereed journals, 20% in Table 2.
When the research areas of the theses were investigated, the three most common areas were found to be endocrinology (17.6%), cardiology (14.4%), and oncology (13.1%), respectively ( Figure 1). According to Figure 1, other subjects were nursing concepts (e.g., pain, stress, sleep) and nursing care (e.g., the quality of care, the use of care method, patient's self-care, work health).

Discussion
Although master theses have scientific validity, their readership is limited. Because they remain in the university library where the thesis was written, in the original language, and maybe not accessible via databases. Publishing a master's thesis in well-known journals is the best way to reach a wider audience and gain recognition (Dhaliwal et al., 2010). Therefore, it is of great importance that master theses are published in terms of their accessibility on national and international platforms. Our findings show disappointing publication rates of master's theses in internal disease nursing (40.9%). In other studies, the publication rate of nursing theses was found to be similar to our findings. In the study conducted by Motamed-Jahromi and Dehghani between 1990 and 2010, 145 master theses in nursing were examined, reveal-ing a publication rate of 40.8% (Motamed-Jahromi & Dehghani, 2014). Yılmaz et al. (2017) examined 3870 nursing master theses and reported the publishing rate as 14.4% between 1977 and 2016. The causes of this inability to disseminate knowledge were stated as follows: graduate students' insufficient knowledge of scientific research and writing articles in the literature, lack of support for publication from the advisor, advisors not having enough time for graduate students, lack of motivation of the student, the researcher regarding the current publication as sufficient, inappropriate journal choice, insufficient foreign language knowledge, and inadequate support and encouragement (Randall, 2006;Arı, 2007). These may be the main reasons for the low publication rate of internal disease nursing master theses.
Our study determined that the majority (75.5%) of the theses made in the field of internal medicine nursing consisted of descriptive studies. To improve and maintain health, it is important to conduct descriptive research that examines the individual and the community's health-related behavior, beliefs, and values. Descriptive research can produce new insights into risk factors/causes of health problems, and new health events can be identified, contributing to planning health services (Metintaş & Atay, 2019). Similarly, our study is similar to the figure of 80% in the study conducted by Motamed-Jahromi and Dehghani (2014) in research conducted by Baggio, Rodrigues, Erdmann, Figueiredo, and Vieira (2014) again, descriptive studies made up the majority of nursing theses. In contrast, the rate of publication of theses published in our study in foreign indexed journals according to research types are as follows: interventional studies, 57.7%, methodological studies, 40.0%, and descriptive type studies, 23.6% (Baggio et al., 2014). Master's theses are expected to be completed and presented within a semester. Therefore, descriptive studies may be preferred because they are low-cost and easy to complete within a time limit.