Digital Mental Health in Nursing Practice: A Scoping Review and Bibliometric Analysis of the Shift from Efficacy to Implementation Science (2020-2026)
ABSTRACT
Background:
Nurses are pivotal as end-users and implementers of digital mental health interventions (DMHIs). However, the successful translation of efficacious DMHIs into sustainable nursing practice is hindered by multifaceted implementation challenges.
Objective:
This study aimed to systematically map and analyze the evolving research landscape of nurse-involved DMHIs to determine if a paradigm shift from efficacy testing to implementation science is occurring, and to characterize the methodological and thematic trends associated with this shift.
Methods:
We conducted a scoping review integrated with bibliometric analysis, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A comprehensive search of the Web of Science Core Collection (2020-2024) yielded 496 eligible primary research studies. Studies were classified as “efficacy/effectiveness” or “implementation” research using a validated framework. We analyzed temporal trends, methodological designs, and performed co-word thematic mapping.
Results:
Implementation research constituted 41.3% of the literature, surpassing efficacy/effectiveness research (35.9%). A significant annual increase in the proportion of implementation studies was observed (β=2.8%, P=0.018). Methodologically, implementation studies employed significantly more mixed-methods (25% vs 8%, P<0.001) and qualitative designs (20% vs 2%, P<0.001) compared to efficacy studies. Thematic analysis revealed “nursing workflow integration,” “task-shifting,” and “nurse-led implementation” as key, emerging motor themes with high centrality and density.
Conclusions:
This review provides robust empirical evidence of a decisive “implementation turn” in nursing digital mental health research. The field is moving beyond a primary focus on internal validity to actively investigate the determinants of successful real-world integration. To accelerate the effective adoption of DMHIs, future efforts must focus on developing implementation-ready digital tools, embedding implementation science competencies into nursing education, and designing pragmatic studies that address nurse-identified barriers.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.