Global Trends of the Published Nursing Studies Focused on Epilepsy: A Bibliometric Analysis

Özlem Özdemir; İlknur Metin Akten

doi:10.4274/ArchEpilepsy.2026.26264

Abstract

Objective

Epilepsy is a health problem characterized by seizures that reduce an individual’s quality of life. Nurses play a key role in the management of epilepsy. This study aimed to identify the focus areas and global trends in nursing research published in the field of epilepsy.

Methods

The study was a bibliometric analysis. The data were obtained from the Web of Science Core Collection Database on March 4, 2026. Analyses were carried out with the VOSviewer program and the R-Bibliometrix package.

Results

A total of 469 nursing studies conducted on epilepsy were published between 2000 and 2025. According to Bradford’s Law, the 3 most prolific journals were Epilepsy & Behavior, Seizure-European Journal of Epilepsy, and Journal of Neuroscience Nursing. The most prolific country was the USA, and the institution with the most contributors was Indiana University. The author with the highest productivity was Janice M. Buelow. The keywords focused mainly on epilepsy, nurses, and seizures. “Self-management” and “attitude” were the trending topics. Thematic analysis showed that the motor theme included “seizures”, “education”, “status epilepticus”, “intellectual disability”, “epilepsy surgery”, and “management”; the niche themes included “care”, “neurology”, and “nurses”; and the basic themes included “epilepsy”, “self-management”, “primary care”, “nurse”, “children”, “quality of life”, “knowledge”, “attitude”, and “awareness”.

Conclusion

This bibliometric study provided an integrative and comprehensive review of global nursing research on epilepsy.

Keywords:

Epilepsy, nurse, bibliometric

MAIN POINTS

• In nursing studies focusing on epilepsy, the United States has made the greatest contribution, and Indiana University has been the leading institution.

• The trending topics in published global nursing studies were “epilepsy self management” and “attitude”.

• The prominent themes identified were “guidelines” and “care.” The importance of evidence-based nursing practices was particularly emphasized.

INTRODUCTION

Epilepsy is a chronic neurological disorder characterized by seizures and affecting individuals of all ages worldwide.^{1, 2} A global burden of disease study (2021) reported 51.7 million epilepsy patients on a global scale, with a global age-standardized prevalence of 658 per 100.000 people.³ An international meta-analysis also reported a lifetime incidence of epilepsy of 7.6 per 1,000 people.⁴

As a chronic disease, epilepsy requires long-term monitoring and treatment.⁵ Nurses actively participate in educating patients and families about the importance of medication adherence, avoidance of seizure triggers, and lifestyle changes to reduce seizure frequency.⁶ They also play leading roles in meeting the needs of patients and their families by providing person-centered and holistic care.⁷ Nurses also contribute significantly to improving the quality of epilepsy care through ongoing management, patient education, seizure assessment, and screening for, and intervention in, psychological disorders.⁸ Nurses play a crucial role in providing high-quality care, education, and support to individuals with epilepsy.⁹

In epilepsy, recurrent seizures affect individuals neurobiologically, cognitively, psychologically, and socially.¹ This adversely affects both the physical and mental health of individuals with epilepsy and reduces their quality of life.¹⁰ For this reason, a comprehensive understanding of the impact of epilepsy on the individual is necessary for effective care.⁶ Epilepsy nurses play a key role in reducing the impact of epilepsy on individuals and their families.⁷ In this process, nurses provide emotional support and counseling, helping patients cope with social stigma, anxiety, and depression.⁶

Bibliometric analysis is widely used to understand the dynamics of research in the health field.¹¹ Bibliometric analysis is an important tool for understanding previous studies, identifying potential study areas, and guiding future studies.¹²

Nurses play important roles in epilepsy care. The present study aimed to examine nursing research on epilepsy from a bibliometric perspective and to address a gap in the literature.

• What is the annual change in publications in nursing research on epilepsy?

• Which countries, institutions, and journals were the most prolific in nursing research on epilepsy?

• Which authors, countries, institutions, and cited journals were the most influential nursing research on epilepsy?

• What were the results of the citation analysis in nursing research on epilepsy?

• What were the most frequently used keywords in studies in nursing research on epilepsy?

• What was the development process of studies conducted in nursing research on epilepsy?

METHODS

The data for this study were obtained from the Web of Science Core Collection (WoSCC) because it is comprehensive and globally accessible.¹³ The data search and export were performed on March 4, 2026, at 22:00. To avoid the effects of WoS database updates on the analysis, all downloads were completed on a single day. The study strategy was created using medical subject headings and Boolean operators. The search was executed as follows: [(TS = (“epilepsy”) OR TS = (“seizure”)] AND TS = (“nurs*”). Initially, 1440 documents were retrieved. A year-based filter was applied to cover the period from 2000 to 2025. The WoS category was limited to “nursing”, and irrelevant records were excluded. Only articles indexed in SCI-Expanded and SSCI and published in English were included. Review articles, conference abstracts, editorial materials, presentations, and duplicate publications were excluded. Early access articles were excluded because bibliometric data were incomplete, resulting in 469 documents. Figure 1 presents the PRISMA flowchart illustrating the publication selection process.

The suitability of each document was independently assessed and agreed upon by two researchers. Since all analyses are based on quantitative data, the results may exhibit a high degree of objectivity.

Ethical Considerations

Ethics committee approval was not obtained because no human subjects were used in the study.

Data Analysis

All document settings were exported from the WoSCC database in BibTeX and tab-delimited file formats. The data cleaning was performed on these files before the analyses, which were conducted using VOSviewer 1.6.20 for Microsoft Windows and the R Bibliometrix package with the Biblioshiny plugin in RStudio.

The data on the descriptive parameters of the articles obtained from WoSCC will be used in the analysis of the study. The dataset did not contain substantial missing bibliographic metadata that would negatively affect the analysis results.

VOSviewer is free software used to visualize bibliometric network data and create maps.¹⁴ Bibliometrix is an R-based tool for scientific mapping and quantitative research in the fields of bibliometrics and scientific measurement. Biblioshiny, a variant of Bibliometrix, generates summaries of annual scientific output related to a selected research topic, including the most prolific authors, the most frequently used keywords, the most popular journals, and international collaborations.¹⁵ A keyword co-citation visualization was created in RStudio using the Bibliometrix package with the biblioshiny plugin. VOSviewer and Biblioshiny were used to efficiently identify co-cited authors, keywords, and related knowledge maps, enabling effective visualization and analysis of network data.

RESULTS

The bibliometric analysis included 469 studies on epilepsy in the field of nursing. This section presents a publication analysis based on the number of publications over time, countries, institutions, journals, authors, citations, and keyword co-occurrence frequency.

Annual Publications and Trends

Publication volume is a critical indicator for evaluating the focus areas. The annual scientific output from 2000 to 2025 is shown in Figure 2. The number of publications was 16 in 2000, but decreased in 2001 (7 publications), 2002 (8 publications), 2005 (7 publications), and 2006 (8 publications). The number of publications began to increase in 2010 (12 publications) and continued to rise in 2012 (16 publications) and 2013 (20 publications). However, a decrease was observed in 2014 (10 publications). An increase in the number of articles published on epilepsy nursing was again observed in 2015 (18 publications), 2017 (24 publications), 2019 (31 publications), and 2025 (40 publications) (Figure 2).

Analysis of Countries and Institutions

Country Analysis

The network map of the top countries is shown in Figure 3. Figures 3A-C show, respectively, a map of countries’ scientific publications between 2015 and 2025, a network map of these countries, and a map of inter-country collaborations. The USA is the most active country in this research area (Figure 3A). It is followed by the UK, Türkiye, China, and Canada. These five countries, in particular, can significantly influence epilepsy studies in the nursing field (Figure 3B). The three countries with the most publications were the USA (164 publications), the UK (70 publications), and Türkiye (40 publications). When publications per country per year are examined, Türkiye (40 publications) and China (34 publications) have produced epilepsy studies in the field of nursing in recent years.

With respect to maximum cooperation, the three countries with the highest total link strength (TLS) were the USA (32 links; 1385.87 TLS), the UK (32 links; 1174.42 TLS), and Canada (30 links; 489.13 TLS). Cooperation between England and Scotland is also notable (30 links; 289.46 TLS). Beyond Scotland, England frequently partners with Wales, the USA, Germany, and France (Figure 3C).

Analysis of Institutions

The network map of the institutions is shown in Figure 4. Figure 4 provide an evaluation of the institutions, including citations and bibliographic links. Bibliometric network maps among the institutions were created using VOSviewer software. The top three contributing institutions are Indiana University (15 publications), Atatürk University (8 publications), and the University of Colorado (7 publications) The three most-cited institutions are the University of Edinburgh (699 citations), University College London (UCL) (501 citations), and Indiana University (245 citations).

The most collaborative institutions were King’s College London (14 links; TLS, 147.00) and Columbia University (14 links; TLS, 137.33) (Figure 4B).

Analysis of Journals and Cited Journals

Journal Analysis

The journal analysis, including publications, citations, co-citation patterns, and key journals, is presented according to Bradford’s Law (Figure 5A-C). This law is one of the most important in bibliometrics. The three most prolific journals were Epilepsy & Behavior (94 publications), Seizure-European Journal of Epilepsy (52 publications), and Journal of Neuroscience Nursing (27 publications) (Figure 5D). The top three journals cited most often by the studies included in the analysis were Epilepsy & Behavior (1518 citations), Seizure-European Journal of Epilepsy (712 citations), and Epilepsia (422 citations).

General information on the 9 most productive journals is presented in Table 1. The three most productive journals are, respectively, Epilepsy & Behavior (94 publications, H-index: 125), Seizure-European Journal of Epilepsy (52 publications, The most productive journals were (H-index: 101) and Journal of Neuroscience Nursing (27 publications, H-index: 41) (Table 1). Almost all of the most productive journals (n=8) had impact factors above 2.0 in 2024.

Distribution by Authors and Co-cited Authors

A comprehensive analysis of author contributions was conducted using the R package Bibliometrix and the VOSviewer program to identify the most prolific authors in epilepsy-related nursing. The results, including the network map of authors, citation analysis, and bibliographic linkage between authors, are shown in Figure 6A and 6B.

A total of 2152 authors contributed to 469 publications. The three most prolific authors were Buelow, Janice M. (12 articles); Miller, Wendy R. (9 articles); and Von Gaudecker, Jane (6 articles). The top most-cited authors were Buelow, Janice M. (239 citations), Kyngäs, H. (201 citations), and Miller, Wendy R. (132 citations). The two author pairs with the strongest links were Buelow, Janice M. and Miller, Wendy R. (link strength: 81.57) and Buelow, Janice M. and Shore, Cheryl P. (link strength: 65.14).

Keyword Analysis

Keywords are frequently used and article-specific terms related to the field.¹⁶ A total of 1212 keywords were used in the publications included in the bibliometric analysis. Figure 7A and 7B show the keyword analysis, including the network map of author-keyword occurrences and trending topics based on keywords.

Based on the network map of the author’s keywords, each node within the clusters represents a keyword. Nodes with relationships are connected by lines. The thickness of the lines increases with the density of the relationship. The red cluster is the central cluster with high centrality, and the word “epilepsy” is at the center of the cluster. This indicates that it is the most commonly used. The word “epilepsy” is related to all the words in the clusters. The strongest relationship is between the words “nurse” in the red cluster and “seizures” in the blue cluster (Figure 7).

Figure 7C shows trends in nursing studies on epilepsy over the last 25 years. Trending topics have changed over time. A minimum word frequency of 8 was accepted, and the annual word count was set at 5. The most popular topics were “specialist nurse” and “primary care in the early years,” whereas topics such as “self-management” and “attitude” have become more popular in recent years.

The thematic map of epilepsy-focused nursing studies based on author keywords is shown in Figure 8. The thematic map depicts the most important issues in the field, according to the author’s keywords. The purpose of creating the thematic map is to understand the current state of research in the field and to analyze its future direction. The thematic map comprises 4 quadrants, with the x-axis indicating centrality and the y-axis indicating density. Centrality emphasizes the importance of a theme, whereas intensity measures the development of that theme.Motor themes are highly developed, intense, and central and are located in the upper-right quadrant. Niche themes are well-developed and highly specialized but have low centrality to the overall structure of the field and are shown in the upper-left quadrant. The basic themes indicate that the primary, cross-referenced, and underlying themes are likely related through minimal network development and are shown in the lower-right quadrant.Emerging or diminishing themes represent underdeveloped, low-intensity, central themes in the lower-left quadrant.¹⁷^,¹⁸

The thematic evolution map of epilepsy-focused nursing studies between 2000 and 2025 (Sankey diagram) is shown in Figure 9. The thematic evolution map plays an important role in examining the development of themes. In the visualization, the thickness of connections representing flows indicates the strength of the relationship, while cluster sizes indicate the frequency of keyword usage.¹⁹

DISCUSSION

This study conducted a bibliometric analysis of 469 articles on epilepsy in the field of nursing. The analysis included scientific documents from sources indexed in the largest database. The results of this study quantified the scientific output of nursing research on epilepsy, including document sources, authors/researchers, institutions/affiliations, countries, keywords, subjects, and themes.

Although the number of published articles has fluctuated, the overall trend in recent years has been upward, highlighting that epilepsy care is an area of interest for nurse researchers and that the subject remains important.

In this field, the most active countries by number of articles, in order, were the USA, the UK, Türkiye, China, and Canada. The top three countries with the most publications were the USA, the UK, and Türkiye. The top three countries with the most collaborations were the USA, the UK, and Canada. The economic size of countries is closely related to their article productivity. The results of the present study consistently showed that developed countries are influential in publication distribution. Developed countries have more research resources, research institutions, and data sets than developing countries, and conduct more comprehensive studies.²⁰^,²¹ Funding for epilepsy research in developing countries faces significant obstacles; the majority of available resources are generally allocated to infectious diseases, leaving a limited share for epilepsy.²² In addition to economic strength, factors such as the existence of specialized epilepsy nursing programs²³^,²⁴ and epilepsy center networks²⁵may also have contributed to the increased number of epilepsy nursing studies in the USA. In developing countries, specialized healthcare professionals, such as epilepsy nurses, are available in limited numbers, even in private clinics.²⁶Variations in healthcare systems in both developed and developing countries create challenges for epilepsy care and education.²⁷ Epilepsy nursing research may be underrepresented within healthcare systems due to factors such as shortages of specialist personnel, structural limitations, disparities in education, and limited funding for epilepsy research. Furthermore, the inclusion of a developing country such as Türkiye in the ranking was noteworthy.

The top three contributing institutions were Indiana University, Atatürk University, and the University of Colorado. The most cited institutions were the University of Edinburgh, UCL, and Indiana University, which show that these institutions conducted significant research on epilepsy in nursing. The three most prolific authors were Janice M. Buelow, Wendy R. Miller, and Jane Von Gaudecker. It can be argued that these authors made valuable contributions to epilepsy nursing.

Bradford’s Law showed that the three most productive journals were Epilepsy & Behavior, Seizure-European Journal of Epilepsy, and Journal of Neuroscience Nursing. The three most cited journals were Epilepsy & Behavior, Seizure-European Journal of Epilepsy, and Epilepsia. These journals are reputable in their respective fields and publish research on epilepsy.²⁸ They are among the leading fundamental journals.

Scientific knowledge is disseminated to members of the profession through articles published in the scientific literature.²⁹ Among the nine most prolific journals, epilepsy-focused journals constitute the vast majority, followed by nursing-focused journals. Researchers may prioritize publishing their studies in these journals. These journals appear to have potential to publish nursing studies on epilepsy.

Keywords are a concise summary of an article’s content. Analyzing keywords helps to identify thematic trends in publications.³⁰^,³¹ Bibliometric analysis, based on keyword density, revealed that the three most frequently used keywords, are epilepsy, nurse, and seizures, indicating that the literature focuses on nursing care for individuals with epilepsy and that nurses play a significant role in seizure management.

Although the most popular topics in the early years were “specialist nurse” and “primary care”, topics such as “self-management” and “attitude” have become popular in recent years. Self-management is crucial for prognosis, quality of life, and physical and mental health in individuals with epilepsy.³² Nursing practices positively contribute to facilitating self-management in individuals with epilepsy.³³^,³⁴ Given that self-management is a significant area in epilepsy, a chronic disease, the importance of nurses’ effective role in enhancing self-management has become better understood and has received greater attention in recent years.

Negative attitudes towards individuals with epilepsy are common in many societies.³⁵ It is essential for nurses to exhibit positive attitudes, as negative attitudes toward individuals affect the sustainability of healthcare services.³⁶ Studies of attitudes in nursing regarding epilepsy have become a topic of interest in recent years.

The thematic map groups nursing studies on epilepsy and identifies the motor themes as “seizures”, “education”, “status epilepticus”, “intellectual disability”, “epilepsy surgery”, and “management”. These topics are key, highly developed, and central to epilepsy nursing. The central position of motor themes within the thematic structure highlights their strategic role in shaping clinical decision-making processes and guiding ongoing research in the field.³⁷ “Chronic diseases”, “communication”, and “adherence” are also highlighted as central issues in nursing research on epilepsy. Nurses play crucial roles in educating patients and their families about the importance of medication adherence.³⁸ Adherence to treatment for epilepsy, a chronic disease, is extremely important. Considering that nurses maintain constant communication with patients throughout this process, these issues are regarded as central, defining, and well-developed topics that guide the field’s development.

In niche themes “care,” “neurology,” and “nurses,” it was noted that nursing research on epilepsy studies is shifting towards these areas. Niche themes such as these have a high degree of development but low centrality, indicating that although they are well developed in certain areas, they are less central to nursing and epilepsy. “Antiepileptic drugs,” “elderly,” and “prevalence” were niche areas that were either declining or developing. Although the topic of “the elderly” seems to be relatively well-defined in research, the prevalence of drug use in this group suggests that further studies are needed.

“Epilepsy, self-management, primary care, nurse, children, quality of life, knowledge, attitude, and awareness” were identified as basic themes. These basic themes are considered highly important but are poorly developed, suggesting a need for further research and development. Additionally, self-management and attitudes were prominent topics, highlighting areas that still require further study.

The thematic evolution map also shows that concepts in the research area have transformed over time. Recently, the prominent themes have been “guidelines” and “care,” reflecting current issues in the field. Nurses have recently focused on evidence-based guidelines in caring for individuals with epilepsy.

Study Limitations

The study had some limitations. The bibliometric analysis used only the WoSCC database; other databases, such as Scopus and PubMed, were excluded. This may have led to the exclusion of some publications related to epilepsy and nursing. Furthermore, the search strategy focused on specific keywords. This may have limited the study by excluding studies that used similar terminology. Another limitation was the inclusion of only English-language articles indexed in SSCI/SCIE, which might have led to incomplete data analysis.

Citation time bias may have affected the results, as older publications naturally receive more citations. Additionally, authors and institutions that cite their own work may introduce self-citation bias, thereby affecting the interpretation of scientific impact.

CONCLUSION

This bibliometric study provides an integrated and comprehensive perspective on epilepsy and nursing. Publication numbers fluctuated over time, showing an upward trend in recent years. The most productive country was the USA, with Indiana University the top contributing institution. The most productive journal was Epilepsy & Behavior. According to this bibliometric analysis, guidelines and nursing care in studies related to epilepsy appear to have the potential to become focal topics in the coming years.

Ethics

Ethics Committee Approval: Ethics committee approval was not obtained because no human subjects were used in the study.

Informed Consent: Bibliometric analysis.

Authorship Contributions

Surgical and Medical Practices: Ö.Ö., İ.M.A., Concept: Ö.Ö., İ.M.A., Design: Ö.Ö., İ.M.A., Data Collection or Processing: Ö.Ö., İ.M.A., Analysis or Interpretation: Ö.Ö., İ.M.A., Literature Search: Ö.Ö., İ.M.A., Writing: Ö.Ö., İ.M.A.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.

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