Rural Nursing: Searching for the State of the Science


  • Martha A. Williams Binghamton University
  • Jill A. Andrews Binghamton University
  • Karen L Zanni Binghamton University
  • Pamela S Stewart Fahs Binghamton University



Background: During the development of the strategic plan for the Rural Nurse Organization in 2009 a request was made for a comprehensive literature review regarding the state of the science of rural nursing. This request led to the collaboration on this project by doctoral students in the rural nursing program at Binghamton University.

Purpose: The purpose of this review was to identify the current state of the science of rural nursing, and the use of theoretical principles that guide this subcomponent of the discipline.

Methodology: An integrative review of the literature was conducted utilizing the methodology by Cooper (1998). Two hundred ninety five articles were identified with publication dates ranging from 1989 through 2010. From these, 107 were included in the review and analysis. Articles were evaluated for level of evidence and scientific merit. Data were categorized with sub-headings of rural definitions, theoretical frameworks, research focus, countries of origin and publication source.

Results: Forty-two percent of the articles reviewed provided no definition for the term rural. The remaining articles revealed no general agreement on the definition of rural. Although the majority of studies used some theoretical framework, the one prominent theory was rural nursing theory (Long & Weinert, 1989). Minimal testing of theory was evident in the literature. Disease management was the most common focus of research. There was a dearth of studies emanating from Asian and South American countries. The Online Journal of Rural Nursing and Health Care published the greatest number of articles included in this review.

Conclusions: There has been a proliferation of rural nursing research over the last two decades. The level of evidence revealed was low, predominantly level VI. The use of numerous and widely varied theories in the literature indicates that rural research is fragmented and lacks a solid theoretical foundation to guide research and practice. More robust research is needed to strengthen the body of knowledge and develop the specialty of rural nursing.

Key Words: Rural, Nurs*, Theory, Integrative Review, Research

Author Biographies

Martha A. Williams, Binghamton University

PhD student

Jill A. Andrews, Binghamton University

PhD student

Karen L Zanni, Binghamton University

PhD student

Pamela S Stewart Fahs, Binghamton University

Professor and Decker Endowed Chair of Rural Nursing


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