Ci a ion: Cuella -Pompa, L.;
Rod íguez-Gómez, J.Á.; No o-Muñoz,
M.M.; Rod íguez-No o, N.;
Rod íguez-No o, Y.M.; Ma ínez-
Albe o, C.-E. Desc ip ion and
Analysis o Resea ch on Dea h and
Dying du ing he COVID-19
Pandemic, Published in Nu sing
Jou nals Indexed in SCOPUS. Nu s.
Rep. 2024,14, 655–674. h ps://
doi.o g/10.3390/nu s ep14020050
Academic Edi o : Richa d G ay
Recei ed: 15 Decembe 2023
Re ised: 25 Feb ua y 2024
Accep ed: 11 Ma ch 2024
Published: 22 Ma ch 2024
Copy igh : © 2024 by he au ho s.
Licensee MDPI, Basel, Swi ze land.
This a icle is an open access a icle
dis ibu ed unde he e ms and
condi ions o he C ea i e Commons
A ibu ion (CC BY) license (h ps://
c ea i ecommons.o g/licenses/by/
4.0/).
A icle
Desc ip ion and Analysis o Resea ch on Dea h and Dying
du ing he COVID-19 Pandemic, Published in Nu sing Jou nals
Indexed in SCOPUS
Le icia Cuella -Pompa 1,*, José Ángel Rod íguez-Gómez 2, Ma ía Me cedes No o-Muñoz 2,
Na alia Rod íguez-No o 2, Yu ena M. Rod íguez-No o 3and Ca los-En ique Ma ínez-Albe o 4
1
Ins i u o de In es igación en Cuidados del Ilus e Colegio de En e me os de San a C uz de Tene i e, Calle San
Ma ín, 63, 38001 San a C uz de Tene i e, Spain
2Depa amen o de En e me ía, Facul ad de Ciencias de la Salud, Sección de En e me ía y Fisio e apia,
Uni e sidad de La Laguna, S a. Ma ía Soledad, s/n, Apa ado 456, C. P., 38200 San C is óbal de La Laguna,
Spain; [email p o ec ed] (J.Á.R.-G.); [email p o ec ed] (M.M.N.-M.); n [email p o ec ed] (N.R.-N.)
3Hospi al Uni e si a io Nues a Seño a de la Candela ia, Ca e e a Gene al del Rosa io, 145,
38010 San a C uz de Tene i e, Spain; [email p o ec ed]
4Escuela de En e me ía Nues a Seño a de Candela ia, Ca e e a Gene al del Rosa io, 145,
38010 San a C uz de Tene i e, Spain; [email p o ec ed]
*Co espondence: [email p o ec ed]
Abs ac : Aim: To o e an o e all pic u e o he esea ch published ega ding he di e en aspec s
o dea h and dying du ing he COVID-19 pandemic in jou nals co e ing he ield o nu sing in he
Scopus da abase. Design: bibliome ic analysis. Me hods: The me ada a ob ained we e expo ed
om Scopus o subsequen analysis h ough Bibliome ix. Using he VOS iewe co-wo d analysis
unc ion, he concep ual and hema ic s uc u e o he publica ions was iden i ied. Resul s: A o al
o 119 pape s we e e ie ed, wi h he pa icipa ion o 527 au ho s. The publica ions we e ound
in 71 jou nals co e ing he nu sing a ea. The main lines o esea ch e ol ed a ound he keywo ds
“pallia i e ca e” and “end-o -li e ca e” in ega d o he e hical, psychological, and o ganiza ional
challenges aced by he heal h p o essionals who ca ed o hese pa ien s. Conclusion: The esul s
ob ained o e a ange o da a and images ha cha ac e ize he scien i ic p oduc ion published on
his opic, coming o he conclusion ha , due o he mul i ace ed and mul idisciplina y app oach o
he expe ience o dea h, ca e, and accompanimen in he dying p ocess, bibliome ic maps imp o e
he comp ehensi e unde s anding o he seman ic and concep ual s uc u e o his ield o esea ch.
This s udy was e ospec i ely egis e ed wi h he OSF Regis ies on he 14 Ma ch 2024.
Keywo ds: nu ses; pallia i e ca e; a i ude o dea h; dea h; bibliome ics; knowledge disco e y
1. In oduc ion
Bibliome ics, as a discipline, allows o he desc ip ion and e alua ion o scien i ic
publica ions in any ield o knowledge [
1
]. This makes i possible o de ine he s a e o
esea ch, as well as analyze he di e en cha ac e is ics o scien i ic ac i i y and p edic
ends h ough he analysis o di e en indica o s ha a e es ablished om he nume ical
da a ex ac ed om academic and scien i ic publica ions [
2
], such as he equency o
publica ion, au ho ship, collabo a ion, ci a ion o co-ci a ion by coun ies, ins i u ions, e c.
Thus, i is also possible o analyze he hema ic de elopmen o he concep ual s uc u e o
a ield h ough he analysis o keywo ds. Based on hese conside a ions, his s udy ocused
on he analysis o publica ions on dea h and dying du ing he COVID-19 pandemic ha
we e published in nu sing jou nals indexed in Scopus.
The heal h c isis caused by he pandemic ep esen ed a g ea challenge o heal h sys-
ems globally due o he d as ic consequences caused by he sudden hospi al o e load. This
scena io inc eased he p essu e on heal hca e p o essionals, wi h he wo kload esul ing in
Nu s. Rep. 2024,14, 655–674. h ps://doi.o g/10.3390/nu s ep14020050 h ps://www.mdpi.com/jou nal/nu s ep
Nu s. Rep. 2024,14 656
inc eased s ess, physical and emo ional exhaus ion, ea , loneliness, he isk o con agion
and dea h [
3
–
5
], which led o, acco ding o da a om 44 coun ies, he In e na ional Council
o Nu sing announcing a he end o 2020 ha as many nu ses had died om COVID-19 as
du ing he Fi s Wo ld Wa [6].
The heal h p o essionals had o dedica e hemsel es ull ime o hei ca e ac i i ies.
In his con ex , o he common ac i i ies, including esea ch, we e elega ed o he back-
g ound [7]. This was made clea in a s udy in which he au ho s ound a ma ked inc ease
in nu sing publica ions ela ed o COVID-19 in he i s mon hs o 2021 compa ed o wha
was published du ing 2020 when he wo s s age o he pandemic occu ed [7].
Di e en bibliome ic s udies, whe e he keywo ds o he publica ions on nu sing
p oduc ion h oughou he pandemic we e analyzed, ag ee ha , in he i s s age, he
esea ch was ela ed o opics on co ona i us in ec ion, in ec ion con ol and heal h and
nu sing policy, a e which he ocus changed o he e ec s o he pandemic on men al
heal h and quali y o li e, as well as issues ela ed o nu sing educa ion, ypes o online
aining, nu sing s uden s, and new expe iences o emo e assis ance [8–10].
Al hough dea h is pa o he li e cycle [
11
], he da a on he impac expe ienced by
heal h p o essionals and he la ge numbe o dea hs associa ed wi h COVID-19 we e
equen ly discussed in he media [
12
,
13
]; howe e , he di e en aspec s o he p ocess o
dea h and dying du ing his pe iod do no seem o ha e been de eloped in he scien i ic
li e a u e. Fu he mo e, he e do no seem o be any bibliome ic s udies add essing his
issue, al hough he e a e se e al bibliome ic publica ions on COVID-19 in ela ion o
nu sing [10,14].
Nu ses mus p o ide ca e o bo h pa ien s and amily membe s, and hey ha e o
deal wi h dea h and he ea o acing his [
15
]. On he o he hand, due o he ele ance o
bibliome ic esea ch in iden i ying, unde s anding and p omo ing p oblem sol ing [
16
],
his s udy aims o p o ide a mo e p ecise pic u e o he quan i y and cha ac e is ics o
in e na ional scien i ic p oduc ion published in he jou nals co e ing he ield o nu sing in
he Scopus da abase, examining all issues ela ed o he p ocesses o dea h and dying.
2. Ma e ials and Me hods
The e a e wo me hodological ca ego ies o he de elopmen o bibliome ic s ud-
ies [
17
], which a e scien i ic pe o mance and scien i ic mapping. Pe o mance analysis
is, by i s e y na u e, desc ip i e. I has been es ablished as he dis inguishing ea u e o
bibliome ics analyses because i concen a es on he con ibu ions made by he con ibu-
o s (au ho , jou nal, ins i u ion, coun y, e c.) o a pa icula ield o knowledge wi hin a
gi en discipline [
18
]. The maps o science, ocus on he analysis o he connec ions be ween
hese con ibu ions in e ms o he analysis o annual p oduc ion, ci a ions, co-ci a ions,
co-wo ds, o co-au ho ship. The combina ion o hese analyses wi h ne wo k analysis
makes bibliome ics an indispensable ool o p esen ing he bibliog aphic and in ellec ual
s uc u e o a esea ch a ea [19,20].
2.1. Aims
•
To de elop a s a is ical-desc ip i e analysis o he publica ions e ie ed wi h he
sea ch.
•To analyze he main indica o s using Bibliome ix 4.1.4.
•
To isualize he main concep s and ocuses o in e es in he esea ch based on he
analysis o co-wo ds in VOS iewe 1.6.16.
2.2. S udy Desing
This is an explo a o y, desc ip i e, longi udinal, and e ospec i e s udy abou he
di e en aspec s o he p ocess o dea h and dying du ing he COVID-19 pandemic. I
was conduc ed h ough wo bibliome ic ools o analyze he publica ions o he jou nals
o nu sing indexed in he Scopus da abase. E hical app o al was no equi ed o his
Nu s. Rep. 2024,14 657
s udy as i did no in ol e he use o da a om human pa icipan s, elying solely on
bibliog aphic da a.
2.3. In o ma ion Sou ces
The Scopus da abase was selec ed, as i is a undamen al sou ce o in o ma ion o
he e alua ion o he esea ch and also con ains all he bibliog aphic da a a ailable. The
eco ds we e downloaded in May 2023.
Fi s ly, a sea ch s a egy was designed o ob ain he co pus o in o ma ion using he
ollowing ields: i le, abs ac and keywo ds. The sea ch was limi ed o he yea s 2020–2023
and he subjec a ea “Nu sing”. The sea ch s a egy and he esul s a e shown in Table 1.
Table 1. Sea ch s a egy pe o med in Scopus on 9 h May 2023.
No. Que y Resul s
#5
(LIMIT-TO ((PUBYEAR, 2023) OR LIMIT-TO (PUBYEAR, 2022)
OR LIMIT-TO (PUBYEAR, 2021) OR LIMIT-TO (PUBYEAR,
2020)) AND LIMIT-TO (SUBJAREA, “NURS”))
119
4 #1 AND #2 AND #3 665
3
TITLE-ABS-KEY (g ie OR be ea emen OR mou ning OR “End
o li e ca e” OR end-o -li e OR “end o li e” OR “End o li e
decision-making” OR suicide OR “T auma ic Dea h” OR
dea h- ela ed OR “Dea h and Dying” OR “A i ude o dea h”
OR “Dea h educa ion”)
253,309
2
TITLE-ABS-KEY ( hana ology OR eligion OR eligious OR
spi i ual OR spi i uali y OR philosophy OR an h opology OR
sociology OR socializa ion OR cul u al OR e hical OR legal OR
ins i u ional OR “Li e Span” OR “Legal Aspec s” OR
“His o ical Pe spec i es” OR “Con empo a y Pe spec i es” OR
“P o essional Issues”)
2,695,503
1
TITLE-ABS-KEY (pandemic OR co id-19 OR sa s-co -2 OR
“Se e e Acu e Respi a o y Synd ome Co ona i us 2” OR
“NCOV” OR “2019 NCOV” OR 2019-nco OR “No el
Co ona i us” OR “Co ona i us disease 2019”)
570,295
2.4. Bibliome ic Da a Analysis
The analysis pa ame e s included he da a co esponding o p oduc ion by coun ies,
au ho s, jou nals, and ins i u ions. In addi ion, he main concep s and ocuses o in e es
we e iden i ied h ough he co-occu ence analysis o he indexed keywo ds (IKs), which
a e e ms chosen by Scopus and s anda dized based on he ocabula y o he Else ie
hesau us [21].
The me ada a ob ained we e expo ed om Scopus, in x o ma , o subsequen anal-
ysis h ough Bibliome ix, an open-sou ce p og am, de eloped in R, which p o ides a se
o ools o he scien ome ic analysis o he li e a u e. This p og am allows o he analysis
o a ious bibliome ic indica o s wi hin a co pus o bibliog aphic in o ma ion [22,23].
In he same way, using he VOS iewe co-wo d analysis unc ion [
24
,
25
], he con-
cep ual and hema ic s uc u e o he publica ions was iden i ied by means o he g aphic
ep esen a ion o he di e en lines o esea ch [
26
,
27
]. Labeled and densi y maps we e
chosen om he ypes o ep esen a ions a ailable. The o me uses labels wi h he names
o each e m, and he sizes o hese labels a e p opo ional o hei weigh ( equency).
Densi y maps a e cha ac e ized by he ep esen a ion o nodes in colo s anging om blue
o g een and yellow o ed. These colo s e lec he densi y o he ela ionships be ween he
e ms (co-occu ence). When he densi y o co-occu ence is highe , he hue on he map
will be close o ed; in con as , wi h g ea e dispe sion and, he e o e, less co-occu ence,
he hue on he map will u n blue [25].
Nu s. Rep. 2024,14 658
VOS iewe combines isualiza ion and clus e ing echniques o a o he analysis;
hus, o he posi ioning o he IKs on he map, he VOS ( isualiza ion o simila i ies)
echnique was used [
28
], which builds a simila i y ma ix om he ma ix o co-occu ence,
using he Associa ion S eng h measu e as a simila i y index o no malize he bibliome ic
ne wo k [
29
]. The Associa ion S eng h is based on he no maliza ion o co-occu ence
alues and is applied so ha hese alues adequa ely ep esen he analyzed co pus and
acili a e clus e ing.
As a phase p io o he analysis in VOS iewe , he ile wi h he keywo ds was sub-
jec ed o a no maliza ion p ocess wi h he aim o cleaning he in o ma ion collec ed o
imp o e i s quali y. In his p ocess, he duplica e elemen s and hose ha ep esen ed he
same concep (bu we e w i en di e en ly) we e uni ied, while hose ha con ained e o s
in w i ing we e co ec ed. A hesau us was hen c ea ed wi h his da a, which was hen
uploaded o VOS iewe o p omo e cla i y in he ep esen a ion o he maps. Likewise,
some e ms used in he sea ch s a egy (COVID-19, co ona i us, pandemic, e c.) we e
dispensed wi h, as well as hose e ms e e ing o ypes o publica ion (a icle o clinical
a icle, e c.) and he s udy design ( e iew, quali a i e esea ch, su eys, ques ionnai es,
e c.). Simila ly, high- equency IKs wi h ze o inpu in o he ep esen a ion, such as he
keywo ds human o humans, we e emo ed om he analysis. Finally, in his case, due o
low equency, he names o coun ies (USA, Canada) we e also elimina ed.
Se e al ials we e ca ied ou whe e di e en equency h esholds we e es ed un il
i was e i ied ha he map wi h he bes isualiza ion c i e ia was ob ained by limi ing
he equency pa ame e o
≥
4 appea ances. Thus, i was possible o dis inguish he
hema ic s uc u e o he analyzed esea ch mo e clea ly based on he eigh y- wo mos
equen e ms.
A clus e ing algo i hm was execu ed [
30
], using he VOS echnique, ha posi ions
and classi ies he keywo ds o be mapped. This algo i hm allows o di e en esolu ion
pa ame e s depending on he alue p o ided o hei con igu a ion; hus, a low esolu ion
pa ame e simul aneously implies a dec ease in he numbe o gene a ed clus e s and
ice e sa. A e se e al es s applying di e en esolu ion alues, and once he di e en
es esul s we e analyzed, i was decided ha he esolu ion pa ame e should be kep
wi h a alue o 1, which is con igu ed by de aul in VOS iewe . The minimum size o he
clus e s was con igu ed o a alue
≥
3 IK, gua an eeing a minimum o consis ency in he
hema ic g oups.
3. Resul s
3.1. Desc ip i e Analysis
A o al o 119 [
31
–
149
] wo ks we e e ie ed by he sea ch s a egy in Scopus. The com-
ple e me ada a, expo ed om Scopus, is a ailable in he supplemen a y ma e ial a ached
o his publica ion (File S1) [
31
–
149
]. The da a ob ained showed ha hese documen s we e
published in 71 jou nals in he nu sing a ea, ea u ing he pa icipa ion o 527 au ho s. An
amoun o 549 signa u es we e coun ed, which comes o an a e age o 4.43 au ho s pe
documen . The e we e 89 egis e ed a icles and 14 e iews in addi ion o less- equen
documen a y ypology. The Uni ed S a es and he Uni ed Kingdom we e, espec i ely, he
coun ies wi h he highes numbe o publica ions. Table 2shows an o e iew o he main
esul s o he analysis.
The mos p oduc i e yea was 2021, wi h 45 publica ions. In 2020, 19 wo ks we e
published, and 16 e e ences ha e been egis e ed o da e (9 May) in Scopus in 2023 ela ed
o he subjec o s udy.
Nu s. Rep. 2024,14 659
Table 2. Main In o ma ion abou he collec ion, om Biblioshiny o Bibliome ix.
Desc ip ion Resul s
Main In o ma ion abou Da a
Timespan 2020:2023
Sou ces (Jou nals, Books, e c.) 71
Documen s 119
A e age yea s om publica ion 1.6
A e age ci a ions pe documen s 7.4
A e age ci a ions pe yea pe doc 2.3
Re e ences 4191
Documen Types
a icle 89
book 2
book chap e 3
edi o ial 6
le e 2
no e 3
e iew 14
Documen Con en s
Keywo ds Plus (ID) 750
Au ho ’s Keywo ds (DE) 350
Au ho s
Au ho s 527
Au ho Appea ances 549
Au ho s o single-au ho ed documen s 12
Au ho s o mul i-au ho ed documen s 515
Au ho s Collabo a ion
Single-au ho ed documen s 12
Documen s pe Au ho 0.23
Au ho s pe Documen 4.43
Co-Au ho s pe Documen s 4.61
In e na ional co-au ho ships (%) 22.7
Collabo a ion Index 4.81
3.2. Jou nals Analysis
B ad o d’s law is a use ul ool o analyzing he dis ibu ion o in o ma ion, as
well as o be e unde s and i s s uc u e and how he di e en aspec s o a opic a e
ela ed o one ano he . Taking his in o accoun , he p esen analysis es ablished ha ,
o he 71 jou nals epo ed, he Jou nal o Pain and Symp om Managemen (Q1) wi h
11 publica ions
[57,62,65,70,77,81,87,99,103,109,124],
he Jou nal o Pallia i e Medicine (Q2)
wi h 10 [
59
,
71
,
89
,
91
,
93
,
96
,
98
,
131
,
148
], he Jou nal o Religion and Heal h (no JCR) wi h
7 [
58
,
63
,
67
,
78
,
107
,
112
,
118
], Nu sing E hics (Q1) wi h 6 [
39
,
56
,
69
,
73
,
75
,
104
], Jou nal o Med-
ical E hics (Q1) wi h 4 [
53
,
100
,
102
,
106
] and BMJ Suppo i e and Pallia i e Ca e (no JCR)
wi h 3 publica ions [
68
,
85
,
97
] we e he cen al sou ces, wi h accoun ing o only 8.5% o he
o al. See Figu e 1.
All he abo e-men ioned jou nals a e on he hema ic a ea o nu sing, which includes
gene al nu sing; p oblems, e hics and legal aspec s; medical and su gical nu sing; and
oncology nu sing, ga he ed om he Scopus da abase.

Nu s. Rep. 2024,14 660
Nu s. Rep. 2024, 14, FOR PEER REVIEW 6
Figu e 1. B ad o d’s Law, applied o a icles on dea h and dying published in he Scopus nu sing
jou nals be ween 2020 and 2023.
All he abo e-men ioned jou nals a e on he hema ic a ea o nu sing, which includes
gene al nu sing; p oblems, e hics and legal aspec s; medical and su gical nu sing; and
oncology nu sing, ga he ed om he Scopus da abase.
The heme add essed in he pape s published by hese six cen al jou nals e ol ed
a ound end-o -li e ca e, pallia i e ca e, pa ien digni y, and he e hical challenges in c i i-
cal ca e and end-o -li e ca e du ing he pandemic. In addi ion, suppo o g ie , dea h
anxie y, men al heal h in ela ion o s ess, as well as he mo al con lic s expe ienced by
nu ses in he mids o he si ua ion gene a ed by he heal h c isis, we e also add essed.
Se e al s udies ha e been de eloped on he pe spec i e o nu sing s uden s and medical
esiden s in ega d o dea h and dying and he e hical challenges ela ed o end-o -li e
ca e. O he issues de eloped had o do wi h spi i uali y and eligion as coping s a egies
in he mids o he heal h eme gency si ua ion.
3.3. Au ho ship and P oduc i i y Analysis
The mos p oduc i e au ho s we e Be y R. Fe ell and William E. Rosa, each wi h
h ee co-au ho ed publica ions [51,114,124]. Two pape s we e published by 3.4% o he
au ho s, while 96.2% o he au ho s had only one publica ion. These esul s co espond o
he p emise o Lo ka’s Law ega ding he unequal dis ibu ion o p oduc i i y. This law
s a es ha a ew au ho s publish mos o he pape s on a esea ch opic, while he majo i y
publish a minimum numbe o s udies. See Table 3.
Table 3. Au ho P oduc i i y Using Lo ka’s Law.
Documen s W i en
No. o Au ho s
P opo ion o Au ho s
1
507
0.962
2
18
0.034
3
2
0.004
3.4. Scien i ic P oduc ion by Coun ies
Only 10.5% (Uni ed S a es, Canada, Spain, and Uni ed Kingdom) ou o a o al o 38
coun ies published app oxima ely 49% o he wo ks. See Figu e 2.
Figu e 1. B ad o d’s Law, applied o a icles on dea h and dying published in he Scopus nu sing
jou nals be ween 2020 and 2023.
The heme add essed in he pape s published by hese six cen al jou nals e ol ed
a ound end-o -li e ca e, pallia i e ca e, pa ien digni y, and he e hical challenges in c i ical
ca e and end-o -li e ca e du ing he pandemic. In addi ion, suppo o g ie , dea h anxie y,
men al heal h in ela ion o s ess, as well as he mo al con lic s expe ienced by nu ses
in he mids o he si ua ion gene a ed by he heal h c isis, we e also add essed. Se e al
s udies ha e been de eloped on he pe spec i e o nu sing s uden s and medical esiden s
in ega d o dea h and dying and he e hical challenges ela ed o end-o -li e ca e. O he
issues de eloped had o do wi h spi i uali y and eligion as coping s a egies in he mids
o he heal h eme gency si ua ion.
3.3. Au ho ship and P oduc i i y Analysis
The mos p oduc i e au ho s we e Be y R. Fe ell and William E. Rosa, each wi h
h ee co-au ho ed publica ions [
51
,
114
,
124
]. Two pape s we e published by 3.4% o he
au ho s, while 96.2% o he au ho s had only one publica ion. These esul s co espond o
he p emise o Lo ka’s Law ega ding he unequal dis ibu ion o p oduc i i y. This law
s a es ha a ew au ho s publish mos o he pape s on a esea ch opic, while he majo i y
publish a minimum numbe o s udies. See Table 3.
Table 3. Au ho P oduc i i y Using Lo ka’s Law.
Documen s W i en No. o Au ho s P opo ion o Au ho s
1 507 0.962
2 18 0.034
3 2 0.004
3.4. Scien i ic P oduc ion by Coun ies
Only 10.5% (Uni ed S a es, Canada, Spain, and Uni ed Kingdom) ou o a o al o
38 coun ies published app oxima ely 49% o he wo ks. See Figu e 2.
Nu s. Rep. 2024,14 661
Nu s. Rep. 2024, 14, FOR PEER REVIEW 7
Figu e 2. Dis ibu ion o publica ions acco ding o he coun y o he co esponding au ho .
3.5. Ins i u ional Scien i ic P oduc ion
Bibliome ix pe o ms a disambigua ion ask wi h he goal o cleaning he da a o
accoun o single ins i u ions. The ambigui y in his case e e s o he di e en ways o
ep esen ing he ins i u ional names in he bibliog aphic me ada a, which can in ol e
misspellings o he w i ing o ac onyms o abb e ia ions o he name, which makes hem
seem di e en when hey e e o he same ins i u ion.
O he 234 ins i u ions, he 10 mos ele an we e selec ed (see Table 4). Se en we e
uni e si ies, while he es we e medical cen e s o hospi als.
Table 4. F equency o publica ion o he 10 mos p oduc i e ins i u ions in he analyzed pe iod.
A ilia ion
F eq.
Uni e si y o Cali o nia, San Diego
12
Massachuse s Gene al Hospi al
10
Uni e si y o To on o
10
King’s College, London
9
Maas ich Uni e si y Medical Cen e
9
Mayo Clinic
9
Maas ich Uni e si y
8
Icahn School o Medicine a Moun Sinai
7
The Ohio S a e Uni e si y
7
Uni e si y o Michigan Medical School
7
3.6. Main Topics
O he 119 documen s eco e ed, 14.3% [17] did no ha e IKs, so hey we e no in-
cluded in he analysis.
A e applying he clus e ing algo i hm, wi h a esolu ion pa ame e o one, i e clus-
e s we e gene a ed ha e lec ed he deg ee o simila i y be ween he IKs. The clus e s
we e isualized by a labeled bibliome ic map and a bibliome ic densi y map.
The size o he clus e s in he labeled bibliome ic map was de e mined by di e en
ac o s, such as he numbe o IKs wi hin each g oup, as well as he equency and he
weigh o simila i y index. The colo o each clus e was andomly assigned by he p o-
g am (see Figu e 3). The i e clus e s ep esen ed on he map de ined he main opics
published in Scopus nu sing jou nals in he de ined pe iod and on he subjec s ela ed o
dea h and dying in imes o pandemic.
0
5
10
15
20
25
30
35
40
USA
Canada
Spain
UK
F ance
Japan
Aus alia
Aus ia
China
Denma k
I eland
I aly
Ne he lands
Swi ze land
A gelia
Chile
E hiopia
Geo gia
Ge many
India
Co esponding au ho ’s coun y
Single Coun ies Publica ion Mul iple Coun ies Publica ion
Figu e 2. Dis ibu ion o publica ions acco ding o he coun y o he co esponding au ho .
3.5. Ins i u ional Scien i ic P oduc ion
Bibliome ix pe o ms a disambigua ion ask wi h he goal o cleaning he da a o
accoun o single ins i u ions. The ambigui y in his case e e s o he di e en ways o
ep esen ing he ins i u ional names in he bibliog aphic me ada a, which can in ol e
misspellings o he w i ing o ac onyms o abb e ia ions o he name, which makes hem
seem di e en when hey e e o he same ins i u ion.
O he 234 ins i u ions, he 10 mos ele an we e selec ed (see Table 4). Se en we e
uni e si ies, while he es we e medical cen e s o hospi als.
Table 4. F equency o publica ion o he 10 mos p oduc i e ins i u ions in he analyzed pe iod.
A ilia ion F eq.
Uni e si y o Cali o nia, San Diego 12
Massachuse s Gene al Hospi al 10
Uni e si y o To on o 10
King’s College, London 9
Maas ich Uni e si y Medical Cen e 9
Mayo Clinic 9
Maas ich Uni e si y 8
Icahn School o Medicine a Moun Sinai 7
The Ohio S a e Uni e si y 7
Uni e si y o Michigan Medical School 7
3.6. Main Topics
O he 119 documen s eco e ed, 14.3% [
17
] did no ha e IKs, so hey we e no included
in he analysis.
A e applying he clus e ing algo i hm, wi h a esolu ion pa ame e o one, i e
clus e s we e gene a ed ha e lec ed he deg ee o simila i y be ween he IKs. The clus e s
we e isualized by a labeled bibliome ic map and a bibliome ic densi y map.
The size o he clus e s in he labeled bibliome ic map was de e mined by di e en
ac o s, such as he numbe o IKs wi hin each g oup, as well as he equency and he
weigh o simila i y index. The colo o each clus e was andomly assigned by he p og am
(see Figu e 3). The i e clus e s ep esen ed on he map de ined he main opics published
in Scopus nu sing jou nals in he de ined pe iod and on he subjec s ela ed o dea h and
dying in imes o pandemic.
Nu s. Rep. 2024,14 662
Nu s. Rep. 2024, 14, FOR PEER REVIEW 8
Figu e 3. Labeled bibliome ic map whe e he 82 analyzed IKs a e ep esen ed. The labels and he
size o he ci cles e lec he weigh o he IK, while he colo o he ci cles shows he hema ic g oup
which each IK belongs o. VOS iewe assigns he colo o he clus e s au oma ically by applying he
VOS algo i hm, as explained in he me hods sec ion.
The ollowing sec ion p o ides a de ailed desc ip ion o he con en s o each clus e .
Table 5 displays he mos signi ican IKs wi hin each clus e , along wi h hei equency
o appea ance and co esponding hema ic g oup colo .
Table 5. IKs wi h he g ea es weigh wi hin each clus e ( he colo co esponds o he di e en
iden i ied hema ic g oups).
Clus e
Colo
Indexed Keywo ds
Occu ences
1
Psychology
15
1
G ie
12
1
Be ea emen
11
1
Pneumonia, i al
11
2
Adul
28
2
Aged
19
2
Religion
14
2
Epidemiology
11
3
End-o -li e ca e
28
3
Heal h ca e pe sonnel
15
3
In ensi e ca e uni s
12
3
In e pe sonal communica ion
10
4
Spi i ual ca e
13
4
Pe sonal expe ience
6
4
Mo ali y
5
4
Dying
5
5
Pallia i e he apy
35
5
Pallia i e ca e
26
5
Child
5
5
Pallia i e nu sing
4
Clus e 1 ( ed): in gene al, publica ions we e ound on amily, social, and heal hca e
suppo in he ace o loss and mou ning, as well as e hical, cul u al, and psychological
ac o s ela ed o a i udes owa ds dea h and ad anced ca e planning.
Figu e 3. Labeled bibliome ic map whe e he 82 analyzed IKs a e ep esen ed. The labels and he
size o he ci cles e lec he weigh o he IK, while he colo o he ci cles shows he hema ic g oup
which each IK belongs o. VOS iewe assigns he colo o he clus e s au oma ically by applying he
VOS algo i hm, as explained in he me hods sec ion.
The ollowing sec ion p o ides a de ailed desc ip ion o he con en s o each clus e .
Table 5displays he mos signi ican IKs wi hin each clus e , along wi h hei equency o
appea ance and co esponding hema ic g oup colo .
Table 5. IKs wi h he g ea es weigh wi hin each clus e ( he colo co esponds o he di e en
iden i ied hema ic g oups).
Clus e Colo Indexed Keywo ds Occu ences
1 Psychology 15
1 G ie 12
1 Be ea emen 11
1 Pneumonia, i al 11
2 Adul 28
2 Aged 19
2 Religion 14
2 Epidemiology 11
3 End-o -li e ca e 28
3 Heal h ca e pe sonnel 15
3 In ensi e ca e uni s 12
3
In e pe sonal communica ion
10
4 Spi i ual ca e 13
4 Pe sonal expe ience 6
4 Mo ali y 5
4 Dying 5
5 Pallia i e he apy 35
5 Pallia i e ca e 26
5 Child 5
5 Pallia i e nu sing 4
Nu s. Rep. 2024,14 663
Clus e 1 ( ed): in gene al, publica ions we e ound on amily, social, and heal hca e
suppo in he ace o loss and mou ning, as well as e hical, cul u al, and psychological
ac o s ela ed o a i udes owa ds dea h and ad anced ca e planning.
Clus e 2 (g een): publica ions on spi i uali y and he eligious pe spec i e in he ace
o anxie y, anguish, dep ession, and s ess, as well as he ole o empa hy, human ela ions,
and coping beha io s in he men al heal h o adul s and he elde ly, in addi ion o he
de elopmen o ca e by heal h pe sonnel and he p oblema ic issue o suicide in nu ses.
Clus e 3 (blue): his co e s he o ganiza ional and adminis a i e poin o iew
ega ding ca e o he c i ically ill and hose a end o li e in in ensi e ca e uni s om he
pe spec i e o heal h pe sonnel, pa icula ly nu ses, in ela ion o policies, p ocedu es,
heal h ca e sys ems and se ices, as well as access o he apeu ic measu es o alle ia e
su e ing in c i ical pa ien s when aced wi h he challenge o communica ion wi h he
pa ien and he amily in he mids o con inemen and s ic isola ion measu es du ing
he pandemic.
Clus e 4 (yellow): Publica ions on dea h and dying om a clinical, spi i ual and
psychosocial pe spec i e. The p oblema ic issue o he well-being o pa ien s in ega d
o he con ol o symp oms and complica ions de i ed om COVID-19, as well as he
si ua ion o loneliness and isola ion du ing he dying p ocess in he pe iod o he pandemic;
he pe sonal expe iences o bo h pa ien s and hei amilies ega ding he medical ca e
ecei ed; spi i ual ca e in his en i onmen , he impo ance o aining nu sing s a in
spi i ual ca e, and he esou ces and ba ie s o p o iding spi i ual ca e o expe iences
wi h spi i uali y in clinical p ac ice we e some o he issues add essed, in addi ion o he
psychosocial pe spec i e o ca e in he mids o mobili y and accompanimen o dying
pa ien s’ es ic ions.
Clus e 5 (pu ple): IKs ela ed o di e en aspec s o pallia i e ca e we e included in
his clus e .
Di e en nuclei ela ed o he mos de eloped hemes we e iden i ied in he bibliome -
ic densi y map (see Figu e 4). The ields wi h he g ea es IK impac we e iden i ied in he
cen e o he map (in ed), and se e al oci o in e es we e ound. These cen al g oups a e
connec ed o one ano he by di e en b idge nodes, as well as wi h he es o he g oups
on he pe iphe y o he map, which p esen less in e ac ion (in yellow, g een, and blue).
Nu s. Rep. 2024, 14, FOR PEER REVIEW 9
Clus e 2 (g een): publica ions on spi i uali y and he eligious pe spec i e in he ace
o anxie y, anguish, dep ession, and s ess, as well as he ole o empa hy, human ela-
ions, and coping beha io s in he men al heal h o adul s and he elde ly, in addi ion o
he de elopmen o ca e by heal h pe sonnel and he p oblema ic issue o suicide in
nu ses.
Clus e 3 (blue): his co e s he o ganiza ional and adminis a i e poin o iew e-
ga ding ca e o he c i ically ill and hose a end o li e in in ensi e ca e uni s om he
pe spec i e o heal h pe sonnel, pa icula ly nu ses, in ela ion o policies, p ocedu es,
heal h ca e sys ems and se ices, as well as access o he apeu ic measu es o alle ia e
su e ing in c i ical pa ien s when aced wi h he challenge o communica ion wi h he
pa ien and he amily in he mids o con inemen and s ic isola ion measu es du ing
he pandemic.
Clus e 4 (yellow): Publica ions on dea h and dying om a clinical, spi i ual and psy-
chosocial pe spec i e. The p oblema ic issue o he well-being o pa ien s in ega d o he
con ol o symp oms and complica ions de i ed om COVID-19, as well as he si ua ion
o loneliness and isola ion du ing he dying p ocess in he pe iod o he pandemic; he
pe sonal expe iences o bo h pa ien s and hei amilies ega ding he medical ca e e-
cei ed; spi i ual ca e in his en i onmen , he impo ance o aining nu sing s a in spi -
i ual ca e, and he esou ces and ba ie s o p o iding spi i ual ca e o expe iences wi h
spi i uali y in clinical p ac ice we e some o he issues add essed, in addi ion o he psy-
chosocial pe spec i e o ca e in he mids o mobili y and accompanimen o dying pa-
ien s’ es ic ions.
Clus e 5 (pu ple): IKs ela ed o di e en aspec s o pallia i e ca e we e included in
his clus e .
Di e en nuclei ela ed o he mos de eloped hemes we e iden i ied in he biblio-
me ic densi y map (see Figu e 4). The ields wi h he g ea es IK impac we e iden i ied
in he cen e o he map (in ed), and se e al oci o in e es we e ound. These cen al
g oups a e connec ed o one ano he by di e en b idge nodes, as well as wi h he es o
he g oups on he pe iphe y o he map, which p esen less in e ac ion (in yellow, g een,
and blue).
Figu e 4. Bibliome ic densi y map showing he 82 analyzed IKs. The colo s close o ed show he
a eas wi h he highes densi y o IKs co-occu ences; he colo s close o yellow and g een show he
a eas wi h he lowes densi y IKs co-ocu ences.
Figu e 4. Bibliome ic densi y map showing he 82 analyzed IKs. The colo s close o ed show he
a eas wi h he highes densi y o IKs co-occu ences; he colo s close o yellow and g een show he
a eas wi h he lowes densi y IKs co-ocu ences.
Nu s. Rep. 2024,14 670
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