Introduction

Background

Scientific research plays a critical role in nursing by improving patient care, advancing healthcare practices, and shaping health policies. Evidence-based practice, analytical thinking, and effective patient care are integral components of this dynamic profession [1]. The field relies heavily on continuously generating and applying scientific knowledge to improve outcomes across diverse healthcare environments. As nursing research evolves to address complex health issues, it is essential to uphold the highest ethical and scientific standards in the literature [2].

Retraction procedures are essential for preserving the integrity of the scientific record. They are implemented to amend the literature when errors, misconduct, or ethical violations are identified after publication [3], thereby sustaining trust in science and ensuring the credibility and reliability of the body of knowledge. While retractions have significant implications for researchers, journals, and institutions, they also provide an opportunity to review and improve research practices, thus promoting transparency and accountability in scientific inquiry [4].

Objectives

The current study examines the characteristics, trends, and underlying reasons for the retraction of nursing articles in the scientific literature. It aims to clarify the distribution, geographic origins, journal outlets, and causes for retraction, thereby offering insights into maintaining scientific integrity in nursing. This understanding may guide initiatives to enhance research methodologies and uphold ethical standards within the discipline.

Methods

Ethics statement

This study did not involve human or animal subjects; therefore, institutional review board approval and informed consent were not required.

Study design

This was a literature database-based bibliometric study.

Study setting

Articles classified as “retracted publications” in the nursing field were searched without temporal constraints. The data were updated as of November 25, 2024.

Data sources/measurement

Publications on PubMed (https://pubmed.ncbi.nlm.nih.gov/) were identified using the search terms “retracted publication” [publication type] [pt] AND “nursing.” Papers not explicitly related to the nursing field were excluded.

The bibliographic data for the retracted publications were exported to a Microsoft Excel file (Microsoft Corp) and included the article title, digital object identifier (DOI), authors, publication date, retraction date, interval between publication and retraction (in months), journal title, article type, country of the corresponding author, and reason for retraction. Citation statistics for the retracted articles were obtained from the Scopus database [5] and categorized into total citations and those recorded after the retraction date. Additionally, the Altmetric toolbar was used to analyze online attention by calculating the Altmetric Attention Score (AAS) based on weighted ratings from several platforms, using an algorithm developed and updated in real time by Altmetric [6].

The following framework was used to categorize the reasons for retraction [4]:

• • Error: Issues stemming from defective study design, inadequate data collection, or erroneous data display and reporting.

• • Fraud: Falsification or fabrication of data, values, instances, or images.

• • Author disagreements and conflicts: Instances where publications occur without the author’s consent or knowledge, involve fictitious contributors, or arise from disputes between authors and funding sources.

• • Duplication: Repeated publication of identical content.

• • Ethical issues: Cases lacking ethics committee approval or informed consent from study participants.

• • Issues with peer review: Concerns related to the peer review process, including fraudulent or biased evaluations.

• • Plagiarism: Unauthorized use of another’s intellectual property, including documents, research plans, tables, figures, or theories; self-plagiarism is also included.

• • Unknown: Instances in which the reason for retraction is not explicitly stated.

Publications with multiple reasons for retraction were categorized under each applicable reason. Two researchers (BFK and AA) independently evaluated all the data and compared their findings. In cases of discrepancy, they collaborated to reach a consensus. Research data are available in Dataset 1.

Statistical analysis

Descriptive statistics were used to present the data. The data were entered into Microsoft Excel and are reported as counts, percentages, and medians (with minimum to maximum values).

Results

A total of 866 publications were initially identified on PubMed using the specified search settings. Publications unrelated to the nursing discipline were excluded, and retraction notes were examined. Additionally, papers lacking accessible information were removed from the analysis, resulting in 457 papers for further evaluation. The earliest retracted article appeared in 2007 (n=3), with the peak recorded in 2023 (n=359). No retracted publications were identified prior to 2007 (Fig. 1).

The median interval between publication and retraction was 14.7 months (range, 0.30–148.93 months). Among the retracted publications, 427 (93.4%) were research articles and 30 (6.6%) were review articles.

The retracted articles originated from 21 different countries (Suppl. 1). Analysis based on the corresponding author’s country revealed that the top three countries were China (n=398), the United States (n=9), and Iran (n=7) (Fig. 2).

Retracted publications were found in 62 journals (Suppl. 2). The five journals with the highest number of retractions were Computational and Mathematical Methods in Medicine (n=93), Journal of Healthcare Engineering (n=87), Evidence-Based Complementary and Alternative Medicine (n=78), Contrast Media Molecular Imaging (n=26), and BioMed Research International (n=24).

The reasons for retraction are detailed in Fig. 3.

Discussion

Key results

This study highlights key patterns in the retraction of nursing-related papers, offering critical insights into scientific integrity within the field. Retractions began in 2007 and peaked with 359 retracted articles in 2023. A significant portion of these publications originated from China. The leading causes for retraction were peer review issues, fraud, and ethical concerns. Retracted articles received an average of 3.63 citations, with nearly half of these citations occurring after the retraction, underscoring the continued diffusion of flawed material.

Interpretation/comparison with previous studies

Retractions in the nursing field began in 2007 and peaked in 2023, with a notable increase from 2022 onward. In contrast to these findings, some reports indicate a slight global decline in retracted papers over the past few years [7]. However, other studies have observed an upward trend in retractions over time [8]. The overall increase in published papers may drive this trend. Increased awareness of retraction practices among editors, researchers, readers, reviewers, and publishers [9], improved documentation, and easier identification of retractions through software may also contribute. Furthermore, the pressure to publish in prestigious journals may lead some researchers to adopt unethical practices, and competitive pressures within the scientific community may further fuel the rise in retractions [10].

The median interval between publication and retraction was 14.7 months, though published intervals may vary [11]. The goal should be to minimize this gap to prevent the dissemination of misleading or erroneous information.

Most of the retracted publications were research articles, likely reflecting their predominance within the overall literature.

China stands out prominently in the country-based analysis, a finding that aligns with observations in other disciplines [12]. As a major producer of scientific papers and a significant contributor to global research, Chinese academic institutions have faced scrutiny regarding research misconduct [13]. Intense competition within the scientific community may contribute to unethical behavior among researchers due to heightened pressure.

Peer review issues were the primary reason for retraction, followed by fraud and ethical concerns. Similar causes, including scientific misconduct, duplication, and peer review deficiencies, have been reported across various fields and countries [4]. These findings highlight the responsibility of editors, reviewers, and publishers to address shortcomings in the peer review process. Flaws such as fraudulent or biased evaluations and inadequate reviewer expertise compromise the integrity of the review process and the reliability of published findings. Editors can safeguard this process by enforcing clear criteria, selecting experienced reviewers, and requiring disclosure of conflicts of interest. Tools such as plagiarism detection software and statistical validation algorithms can further assist reviewers in identifying potential misconduct. Publishers should promote regular training initiatives for editors, reviewers, and researchers on ethical standards and emerging concerns in peer review [14].

The considerable number of citations received after retraction indicates that retracted publications continue to influence scientific discourse, potentially perpetuating misinformation [11]. This underscores the need for database tools that clearly flag retracted publications and for increased awareness among researchers regarding the importance of source verification.

The relatively low median AAS suggests limited public and social media engagement with retracted nursing publications. However, occasional high scores (41, 39, and 29) may reflect heightened public interest in controversial or widely debated studies, thereby emphasizing the broader societal impact of flawed research.

Limitations

This analysis relied on PubMed, potentially excluding retracted nursing papers indexed in other databases. Inconsistencies in the formatting of retraction notes across journals may also affect the findings. Moreover, the results may not be generalizable to other fields with different publication practices and ethical challenges. These analyses represent a snapshot in time.

Conclusions

This study emphasizes the significant challenges in retracting nursing publications, with peer review deficiencies, fraud, and ethical concerns emerging as the primary causes. The rapid increase in retractions in recent years suggests improved detection mechanisms while also revealing systemic issues in research integrity. The geographic clustering of retractions, predominantly in China, and their concentration in specific journals indicate areas requiring targeted improvement. Addressing these challenges demands rigorous peer review processes, enhanced ethical oversight, and comprehensive strategies to prevent fraud, ultimately safeguarding the integrity of nursing research and promoting quality patient care and sound healthcare policies.

Notes

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Funding

The authors received no financial support for this article.

Data Availability

Dataset file is available from the Harvard Dataverse at https://doi.org/10.7910/DVN/PHV1I1.

Dataset 1. Research data for bibliographic info and citation frequencies of 457 papers collected from PubMed.

kcse-368-dataset-1.xlsx

Supplementary Materials

Fig. 1.

Distribution of retracted publications in the field of nursing over time.

Fig. 2.

The top three countries by number of retracted publications.

Fig. 3.

The number of retracted publications according to reasons. Multiple reasons were possible.

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Figure & Data

References

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