The Shift From Efficacy to Implementation Science (2020-2026) in Nursing Practice for Digital Mental Health: Scoping...

Nurses are pivotal as end users and implementers of digital mental health interventions (DMHIs). However, the successful translation of efficacious DMHIs into sustainable nursing practice is hindered by multifaceted implementation challenges.

This study aimed to systematically map and analyze the evolving research landscape of nurse-involved DMHIs to determine if a paradigm shift from efficacy testing to implementation science is occurring and characterize the methodological and thematic trends associated with this shift.

We conducted a scoping review integrated with a bibliometric analysis following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A comprehensive search of the Web of Science Core Collection, Scopus, and PubMed databases (January 2020 to April 2026) yielded 1014 eligible primary research studies. Studies were classified as "efficacy/effectiveness" or "implementation" research using a validated framework. We analyzed temporal trends and methodological designs and performed co-word thematic mapping.

Implementation research constituted the largest proportion of clearly classified studies (327/470, 69.6%), exceeding efficacy research (143/470, 30.4%). Implementation research demonstrated a significant growth trajectory from 2020 to 2025 (β=8.63 articles per year; P=.003), surpassing efficacy research in 2022. Implementation studies used more mixed methods (105/327, 32.1% vs 7/143, 4.9%; P<.001) and qualitative designs (92/327, 28.1% vs 2/143, 1.4%; P<.001). Thematic analysis revealed "nursing workflow integration" and "nurse-led implementation" as emerging motor themes.

This review provides robust evidence of an accelerating turn to implementation in digital mental health research in nursing. The field is moving beyond internal validity toward real-world implementation. Future efforts should focus on implementation-ready digital tools and embedding implementation science competencies into nursing education.