From new kid on the block to leading journal: a review and reflection on the first 20 years of the European Journal of Cardiovascular Nursing

Abstract

Background

This year marks the 20th birthday of the European Journal of Cardiovascular Nursing (EJCN). The official journal of the Association of Cardiovascular Nursing and Allied Professionals, is now recognized as one of the leading nursing and allied professional journals.

Aims

This article reflects on the developments and impact of the journal over its 20-year lifespan.

Methods and results

We present a descriptive account of the journal from inception (2002) until present day (2021), using data provided by the EJCN editorial office and extracted from published and available information. In the last 20 years, the EJCN has published 20 volumes, 106 issues, and 1320 papers from 79 countries. The volume and quality of papers has been consistently increasing, culminating in a 2020 impact factor of 3.908, the highest in its history, ranking second for nursing science. Papers are predominantly patient focused with a range of research methods that cover an extensive range of cardiovascular conditions. Authors who contributed to the first issue continued their contribution; 293 articles in total.

Conclusion

The EJCN has evolved into a leading journal of cardiovascular care. As the journal enters its next era, with a new Editor-in-Chief, it is appropriate to have reflected on the phenomenal contribution of the outgoing Editor-in-Chief, and the editorial team, over the last 20 years.

Introduction

This year marks the European Journal of Cardiovascular Nursing (EJCN) 20th birthday. The EJCN was established as the European Society of Cardiology (ESC) official journal for the Working Group of Cardiovascular Nursing under four editors, Tiny Jaarsma, Bengt Fridlund, David R. Thompson, and Simon Steward back in 2002. Although at that time two journals existed that were specifically dedicated to results of nursing research (Journal of Cardiovascular Nursing and Progress in Cardiovascular Nursing), there was a need for journal that was dedicated to the advancement of knowledge in the field of cardiovascular nursing and the promotion of evidence-based clinical practice. The 20th birthday is a significant milestone not only for the journal but also for the Editor-in-Chief Professor Tiny Jaarsma, who has been at the helm for the entirely of the journal’s lifespan and who is handing over the baton at the end of this month. A phenomenal editorial team has grown and cultivated a journal now ranked number 2 in nursing journals (of 122). This paper, from the Association of Cardiovascular Nursing and Allied Professionals (ACNAP) Science Committee, takes a descriptive and reflective look at the achievements of the team, and the journal, over this 20-year period. Using data kindly provided by the editorial office and extracted from published and available information (to August 2021), it is intended to provide a ‘walk down memory lane’, reflecting on the achievements and impact of the journal and giving thought to what the future holds.

The facts and figures

The scope and structure of the journal

The EJCN is one of the 17 distinguished periodicals in the ESC publishing family. From the outset, the EJCN has been a peer-reviewed international journal working to the mission of the Working Group of Cardiovascular Nursing (2002–2006), Council of Cardiovascular Nursing and Allied Professionals (CCNAP) (2006–2018) and the ACNAP (2018–ongoing)—that is to promote excellence in cardiovascular nursing and allied professions through practice, education, and research. Thus, the journal is dedicated to the advancement of knowledge and in the promotion of evidence-based clinical practice in cardiovascular care. When established, the team consisted of four editors and a small international editorial advisory board of reviewers. However, over the last 20 years, this team has grown to a core editorial team comprising 3 editors and 11 handling editors, supported by managing editors. In addition, the team also includes two senior consulting editors, three consulting editors, two statistical advisors, a post-publication editor, a social media editor, and an editorial board with 33 international members. The reviewer database counts >900 reviewers. Over the EJCN lifespan, the journal has been managed by three publication houses, Elsevier (2002–2012), Sage (2012–2021), and currently Oxford University Press (2021).

Submissions, acceptance rates, and types of papers

In the last 20 years there have been 20 volumes, 106 issues, and almost 10 000 printed pages in the EJCN. Overall, 3191 submissions from 79 countries have been received, of which 1060 (33.2%) were accepted.

The journal has consistently grown with continuously increasing submission rates (Figure  1), while maintaining acceptance rates up to 37% in recent years. Most submissions originate from Sweden (n = 320), USA (n = 293), China (n = 234), UK (n = 222), and Australia (n = 194), while more recently, the journal has enjoyed submissions from researchers in countries that have not previously submitted their work to EJCN, for example Turkey, Iran, and Japan. This also reflects the reach of the journal, which is now viewed worldwide with around 250 000 online downloads now occurring annually.

It is of no surprise that the focus of published papers in a nursing and allied professional journal lies firmly on patients [n = 934 (70.8%)]. Certainly, those involving informal care-givers remain low but are also increasing [n = 29 (2.2%)], with some exploring organizational factors [n = 12 (0.9%)] and healthy populations [n = 13 (1.0%)]. To date, the emphasis has been on adult cardiovascular care [n = 1108 (83.9%)], although some paediatric [n = 11 (0.8%)] and adolescent [n = 9 (0.7%)] work is also featured.

The vast majority of submissions have been original papers (n = 2600) (Figure  2) with the EJCN-publishing papers across a broad range of research methodologies. This includes review, qualitative, quantitative, and more recently mixed method approaches (Table 1), reflecting the breadth and depth of nursing and allied professional research expertise. Just over a quarter (n = 366) of all published papers were observational studies, 192 (14.4%) were randomized controlled trials or intervention studies, and 140 (10.6%) were reviews. Qualitative and mixed methods accounted for 138 (10.5%) and 19 (1.4%) of all papers, respectively. As expected for an official journal of the ESC family, the reporting of ESC guidelines and official statements has also featured, with anticipated increases in such papers in future years. To further innovate and strengthen the scientific prowess of the journal, a ‘methods corner’ was established in 2020 to address common misconceptions of established methods as well as to consider novel research approaches.¹ To date, 14 methods corner papers have been published addressing a broad range of topics. These include examining the challenges associated with conducting rapid reviews,² an overview of various tips for conducting video, telephone, online chat, and email interviews in qualitative research,³ and novel approaches to engaging in research such as flash mob studies.⁴

As well as covering a range of research methods, a broad scope of clinical specialities within cardiovascular care have been covered in the journal (Table 2). Heart failure, cardiac rehabilitation, secondary prevention, chronic cardiac care, and nursing education in cardiovascular care are prominently featured, while areas such as congenital heart disease, palliative cardiology, and cardiogenetics are emerging. Furthermore, unlike other journals, there is an excellent mix of both acute and chronic cardiovascular care including primary and secondary prevention.

Impact

Impact: impact factor and journal ranking

As shown in Figure  3, the impact factor has trended in an upward trajectory, culminating in a ‘career high’ of 3.908 in 2020. Furthermore, the EJCN has consistently been ranked in the top 10 for nursing since 2010, only dropping outside of that in 2019 (ranked 11 out of 121 nursing journals).

Impact: highly cited papers

Research impact includes policy, service, and societal impact as well as research-related impact,⁵ but from the perspective of a journal, the papers considered most impactful are often those that are highly cited. The top 5 papers from the EJCN (Table 3) have been cited over 2500 times with the most cited paper comprising most of those citations (1713). This paper, a position paper, from Ekman et al.⁶ entitled ‘Person-centered care—Ready for prime time’, advocated person-centred care in ‘long-term conditions’ providing case examples in patients with cardiovascular disease. It not only offers case studies as examples but also provides simple routines to facilitate and safeguard the transition to person-centred care. Equally, the important distinction between ‘patient-centred care’ and ‘person-centred care’ was highlighted and person-centred care continues to be supported and promoted as a key component in the care of long-term conditions to date. Therefore, this paper had wide-spread appeal and value both within and outside of cardiovascular care. Three of the other top papers were reviews. The commonality between these four papers is that they have summarized, synthesized, and explored the literature and offered evidence-based opinion on the future directions in their topic areas, namely person-centred care, the global burden of disease, caregivers’ contributions to heart failure self-care, and risk factors of delirium after cardiac surgery. Such papers that present ‘facts and figures’ have become the ‘go to’ for scientific evidence in these areas and, in this case, represent four very different aspects of care.

Impact: first edition vs. 2021

While so much has changed in the journal’s lifespan, some aspects have not evolved in perhaps the way we may have anticipated. The increasingly important roles of nurses and allied professionals in improving the quality of healthcare, being more involved in-patient education, interdisciplinary research and management and policy, remain at the heart of our professional ambitions which were reflected over 20 years ago in the very first Editorial.¹¹

The first issue in February 2002, included seven special papers and four original papers, mainly focused on expanding and increasing responsibility of roles for nurses in areas such as congenital heart disease, cardiac rehabilitation, coronary heart disease and heart failure, featured research on fatigue and sexual problems in heart failure patients, coronary heart disease prevention, and experiences and needs of patients after myocardial infarction. These remain issues we are grappling with, albeit in perhaps a slightly different context. Certainly, advanced clinical roles and increasing the nursing and allied professional voice and contribution within interdisciplinary teams remain modern-day challenges, as do secondary prevention, engagement, and effectiveness of cardiac rehabilitation and psychosocial and quality of life factors of recovery from cardiovascular events. The modern-day twists include the ageing population with more complex needs, increased and constantly evolving technology and drug therapy, the use of technology and the concept of ‘digital-health’, global health and access to services, psychosocial influences in health and recovery are now more considered and accepted, as well as having to now consider the impact of SARS-CoV-2 (COVID-19) on both health and healthcare delivery.

A particularly important part of the ACNAP mission is to increase the engagement and involvement of allied health professionals. This was certainly reflected in the mission of CCNAP, which shifted the focus of the working group from ‘nursing science’ to that of nursing and allied health professionals, covering a broader field of cardiovascular nursing and healthcare-related topics.¹² This remains a key point of ACNAP’s vision and activity in 2021. When comparing the authorship of the first issue with that of December 2020, the proportion of papers written by allied professionals is considerably different [2002 2/16 (12.5%) vs. 2020 5/12 (41.7%)]. This represents EJCN's understanding of the increasing complexities of cardiovascular care, due to an ageing population globally, where comprehensive interdisciplinary consideration and strategy are necessary to achieve optimal cardiovascular health. Of particular interest to note, is that the majority of the contributing authors of the first issue are still very active in the field and indeed the journal. Of the 21 authors who contributed to this issue, nine are part of the current editorial board, as 14 of the 16 first authors are also part of the editorial board. In addition, of the top 10 authors who have contributed to most articles in the journal, 5 of these authors published in the first issue of the journal. Overall, authors of the first issue have contributed to 293 articles published in EJCN making an extraordinary contribution to the journal but also cardiovascular care in the last 20 years. These remarkable statistics are testament to the beginnings and continuity of dedication to raise the EJCN to one of the most scholarly nursing journals of its time.

Summary and conclusion

Although described as ‘the new kid on the block’ by the editors in the very first issue,¹¹ the EJCN is obviously no longer the ‘new kid’ but a leading, innovative, and influential journal in nursing and allied professional cardiovascular care. Since the first volume in February 2002, an incredible 1320 quality papers have been published elevating the journal to a career high impact factor (3.908) and ranking second in nursing science. As would be expected, the journal has moved with the times in the last 20 years, especially with regard to developing and increasing its electronic offer and global visibility. This evolution will undoubtedly continue into the new era capitalizing on recent innovations, for example the introduction of a post-publication strategy, and the use of social media to promote papers, the journal, and the Association it officially represents. Certainly, as the seventh Association of the ESC, the elevation of CCNAP to ACNAP in 2018 created a new wealth of opportunity to partner and work with other Associations and with that comes the opportunity for the EJCN to work more collaboratively with other ESC journals. The ambition is that as ACNAP becomes more influential, so too will the papers generated in terms of joint statements and guidelines, which will have a publishing home at EJCN and so further increase the journals’ impact, both from an academic but also clinical practice and societal perspective. EJCN also will follow developments in making research available for a large audience and explore possibilities for open access. Moving into this new era, the history of the journal is in safe hands as the new Editor-in-Chief, Dr. Philip Moons, was involved in the journal from the journal’s inception and is one of its top contributors.

Prof. Jaarsma, Editor-in-Chief since the journal’s inception, hands over the baton at this historic milestone, having dedicated 20 years to the progression of nursing and allied professional cardiovascular care through the journal. This, in-itself, is immense, but she leaves the journal as a globally recognized, high ranking journal, within a family of prestigious ESC journals. This is certainly something to be recognized and celebrated.

Acknowledgements

We would like to acknowledge the following individuals for their help in collating information for this paper: Prof. Tiny Jaarsma, Editor-in-Chief European Journal of Cardiovascular Nursing; Ms Rebecca Lane, Publisher, Oxford University Press; and Mr Adam Tocock, Specialist librarian, Barts Health Knowledge and Library Services, St Bartholomew’s Hospital.

Funding

No funding was received for this work.

Conflict of interest: none declared.

Data availability statement

The majority of the data underlying this article were provided by the European Journal of Cardiovascular Nursing by permission. Data will be shared on request to the corresponding author with permission of the European Journal of Cardiovascular Nursing.

References