Bibliometric analysis of literature regarding ostomy research based on the Web of Science database

Web of Science is a journal citation information source that is currently recognized as having the most authoritative academic and international influence; it was launched by Thomson ISI Company. It is indexed by the SCI Expanded (SCIE), Social SCI (SSCI), and the Arts and Humanities Citation Index (A&HCI) and can be used as independent retrieval to retrieve publications.

HistCite is a free citation map analysis software developed by Dr. Eugene Garfield in 2001; its main function is to analyze and integrate the literature so that the results can graphically reflect the relationship among a field of perplexing literature. It not only can quickly locate the latest and most important literature, authors, source journals, and cross-disciplines but also can help readers quickly visualize the field of historical development to meet the huge demand of readers. The analysis of the Citation Index in this study involves the addition of Web of Science basic index data retrieval (such as author, year of publication, countries, institutions, journals) and the research direction including the number of records in the literature focus (Recs), local citation number (LCS), total citations (GCS), local citation reference (LCR), and the total number of citations (CR) as a measurement index.

In the Web of Science database search, the topic word was selected as "Ostomy" in the retrieval strategy, with a time limit of 2016; language and literature types were not restricted in the search. A total of 1, 262 articles were retrieved on June 24, 2017. When information was exported, the "record and reference" were selected and saved as plain text to the specified path.

Web of Science, with bibliometric analysis and visual analysis software HistCite and Excel software, was used to conduct a comprehensive analysis of the information retrieval and mining data from published years, source journals, research direction, authors, institutions, countries, and regions. A citation chronological chart explored the development trend of related research stoma and popular information.

A total of 1,262 articles with SCI-related stoma research from 1910 to 2016 were found in 48 countries and regions involving nine kinds of languages (English, 1,217 [96.43%]), 11 types of literature Qournal articles, 848 articles [67.19%]), 321 magazines, 1,347 research institutions, and 4,048 first authors and coauthors. One of the most active countries was the USA, and the author with the highest number of publications was "Grant". The publication titled "Living with a stoma: a review of the literature" was most frequently cited.

Based on the related literature, publication year and national area were analyzed; overall, the results showed that the global annual productivity appeared to have an increasing trend. Especially from 2010, stoma research began an active period and reached a peak in 2016 (Table 1; Figure 1). The USA ranked the first in the world, with most publications regarding stoma, with a total of 645 articles; Canada, Turkey, and other countries in this field were also more active. China ranked the 15th in the world with 17 published articles (Table 2).

Figure 1

The SCI articles about stoma research were distributed in 321 journals during 1910–2016. Among the top 10 journals, 626 articles were published, accounting for 49.6% of the total amount of literature. The Journal of Wound Ostomy and Continence published by Nursing had the most publications regarding stoma (Table 3). For the impact factor of journal, in addition to Gastroenterology having a high impact factor (18.382), the impact factor of the journals mostly ranged from 1 to 3, reflecting that the field is still evolving, and it is possible to achieve significant development.

The results of this study showed that there were some crossover between the articles published in the

SCI journals and other disciplines, as summarized in Table 4. Among the interdisciplinary subjects, the largest quantity is surgery (478 articles), then nursing, followed by gastrointestinal hepatology, pediatrics, general medicine, and dermatology.

From 1910 to 2016, a total of 4,048 first authors and coauthors were involved in research related to stoma and published SCI articles. The author "Grant" was the most prolific author; other authors in the top 10 are listed in Table 5. Furthermore, this study used the HistCite Graphs Maker automatic drawing function according to the LCS or GCS quantity of total literature. The system automatically numbers the literature and presents different relationships in different sizes of circles and different pointing arrows (the greater the circle, the higher the citation frequency of the articles, the arrow line indicates the reference relationship of the different literature, and the arrow points to the referenced document) to form this study citation chronological chart. Through a chronological chart, No. 211 (Figure 2 was labeled 1, titled "Living with a stoma: a review of the literature") had the biggest circle, and the arrow pointed to the publication that played an important role in the research of stoma. No. 391 (marked as 2, titled "Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy") had the second largest circle size; this article also should arouse the reader's attention (Figure 2; Table 6).

Figure 2

From 1910 to 2016, the study of stoma showed a trend of continuous growth, so the study of stoma has been performed by international scholars. Although the origins of the global study of ostomy were relatively early, the concern in the field of nursing began in 1990,⁶ only 27 years ago. From the total number of documents and cited frequency, America's research in this field was in the lead position; China ranked 15th with 17 articles, but compared with some international counterparts in Europe and America, there is still a big gap, and future research should continue to expand its breadth and depth to improve China's international influence in this field. As far as publishing journal was concerned, Journal of Wound Ostomy and Continence Nursing ranked the first in published article quantity, accounting for 28.5% of the total published articles in the world; this journal had a more authoritative position in this field that was of significant reference to domestic scholars who were conducting research related to ostomy and provided the

basis for the whereabouts of the submission. The analysis of the most prolific author and frequently cited articles can show the basic trend of the development of a research field.⁷⁸ This study showed that the author with the most published related stoma studies was "Grant" (a total of 46 articles were cited by the first author and the coauthors, and the total number of citations was 456 times) who played an important role in this field. The article titled "Living with a stoma: a review of the literature" had the highest citation frequency and was the core literature in this field with important reference significance for the related research.

Through analysis and reading of the core literature, important interdisciplinary subjects of ostomy research were surgery and nursing, indicating that a large number of related studies were carried out around ostomy techniques and pre- and postoperative care; this direction has been the focus and a hot spot in the field. Furthermore, reading core literature showed that a study on the high degree of concern about stoma was mainly focused on the problem of stoma complications, including peristomal skin damage, bad smell, limited physical activity, and sex change, followed by social and psychological problems, quality of life of patients with colostomy, patients with stoma, nurses, and stoma-related scale.^910111213 Therefore, domestic researchers can begin academic research on issues such as stoma complications, psychological care of ostomy patients, specialized ostomy care, and continuity of care in the future.

In summary, the research literature regarding stoma has seen continuous growth from 1910 to 2016. Compared with American and European counterparts, there is still a big gap, and the depth and breadth of the study need to be further deepened. The development of any discipline cannot be separated from scientific research¹⁴; to make great progress in stoma-related research, multidisciplinary collaboration should be emphasized. In addition, researchers should focus on the study of problems such as complications around colostomy, psychological problems of colostomy patients and continuing care of specialists, and the construction of effective intervention models.