OriginalScientificArticle
WellnessTourismResearch:BibliometricStudy
oftheScientificField
MilicaRančićDemir
UniversityofMaribor,Slovenia
milica.rancic1@um.si
MilaZečević
UniversityofLjubljana,Slovenia
mila.zecevic@ef.uni-lj.si
Thepaperpresentstheresultsofabibliometricanalysisofacademicresearchcover-
ingthefieldofwellnesstourism.Thepurposeofthearticleistoidentifythestructure
ofrelationshipsbetweentopicsthatwerecurrentinthepastandtopicsthatarecur-
rentnow.Theaimoftheresearchwastobetterunderstandthedevelopmentofthe
fieldofwellnesstourism,importantconstructs,authors,andresourceswiththehelp
ofbibliometricmethods.Fordetailedresearchofthefieldofliteratureonwellness
tourism, some two set bibliometric strategies were used: co-citation and keyword
co-occurrence.Inourbibliometricmappingofthewellnesstourismresearchfield,
we have investigated the scientific production of articles over the years, the most
importantjournalsinthefield,andkeywordco-occurrencepatterns.Theobtained
resultsofthestudyshowedasignificantincreaseinthenumberofpublicationsre-
latedtowellnesstourism.Whenitcomestotheimportanceofindividualjournals,
wehaveidentifiedthe20bestjournalsthathavepublishedthemostarticlesinthis
field. In wellness tourism research, we identified four clusters: health tourism re-
search,tourismresearch,wellnesstopics,andwellnesstourismresearch.
Keywords:wellnesstourism,bibliometrics,keywordco-occurrence,literature
review
https://doi.org/10.26493/2335-4194.15.53-63
Introduction
Themoderntimethatweliveinhasshapedwellness
toberegardedasapartofnichetourism,wheremod-
ern technologies are used to promote global aware-
ness of wellness, and its main focus has become the
bodyandthebraininordertoachievewellnessviathe
tourismexperience.Theconceptofwellnesstourism
hasnotalwayslookedlikeitdoestoday;itscharacter-
isticshavechangedovertime(Smith&Puczkó,2008).
Withtheverydevelopmentofwellnesstourismasan
industry, the scientific research area that deals with
thistopichasstartedtodevelopmoreandmore.Well-
nesstourismresearchinrecentdecadeshasgainedrel-
evanceduetotheincreasedeffortsandsearchforwell-
being by tourists (Rančić Demir et al., 2021). Never-
theless,theconceptofwellnessintourismisnotcom-
pletelynovel.Basicideasofwellnesstourismwereac-
tuallyresearchedinolderstudiesaswell,throughcer-
tainelementsofmedicalandhealthtourism.Thein-
creaseinresearchers’interestinwellnesstourismhas
causedchangesintheterminologyused.
Theaimoftheresearchistobetterunderstandthe
developmentofthefieldofwellnesstourism,themost
importantconstructs,andsourcesandauthors,using
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MilicaRaniDemirandMilaZeevi WellnessTourismResearch
bibliometric methods. In order to better understand
thedevelopmentofresearchinwellnesstourismlitera-
ture,wehavedecidedtoapplysciencemappingmeth-
odswhilestrivingtoanswerthefollowingquestions:
1.Haswellnesstourismresearchgrownovertime?
2. Whicharethemostrelevantjournalsforpublish-
ingwellnesstourismresearchstudies?
3. Which fields of wellness tourism have mostly
beenexploredintheexistingliterature?
Revealing the historical development of the well-
ness tourism research field is highly relevant for un-
derstandingpastresearchundertakings,andtobeable
tospotareasthathavebeenofspecialimportanceto
researchers over time. As tourism researchers often
seek inspiration in tourist interests and behaviours,
thisfieldreviewalsoimpliestheareasthathavebeen
of interest to tourists as well and have as such moti-
vated increased research efforts. To our knowledge,
this is one ofthe first studies thataim at providing a
bibliometricoverviewofthewellnesstourismresearch
literaturefield.
Thepaperfirstprovidesadetailedreviewofthelit-
erature,whichdefinesthebasicconceptsrelatedtothe
researcharea,suchaswellness,wellnesstourism,well-
nesstourists,wellnesshotel,andwellnessservice.Af-
terthat,areviewofbibliometricstudiesinthefieldof
tourismwasperformed.Thescientificresearchmeth-
odsusedinthepaperaredescribedindetail,andthen
theresults,discussion,andconclusionbasedonthere-
sultsarepresented.
LiteratureReview
Wellness
Wellnessusedtobeconsideredasan‘absenceofsick-
ness’ for a long time (Dunn, 1957). Many scholars
and organizations have provided definitions of well-
ness since the mid-20th century. While these defini-
tions are heterogeneous,the majority of them centre
onthefollowing:howhumansinteractwithwellness
andthewellnessdimensionality(Chietal.,2020).The
WorldHealthOrganizationhasalwaysdeemedwell-
nessas‘thefulfilmentofone’sroleexpectationsinthe
family, community, place of worship, workplace, and
othersettings,’andthishasbeenoneofthekeyfactors
of wellness (World Health Organization, 2006). It is
ratherchallengingtoprovideadefinitionandexplain
themeaningoftheword‘wellness’eventodayowing
tothefactthatitsnatureissosubjective.Therearedif-
ferentdefinitionsforthistermandthereasonwhythis
isthecasehastodowithwhopromotesthem(Rančić
Demiretal.,2021).
Wellness is sometimes used as another word for
well-beingbutisabroaderandmorecomplexconcept.
According to the definition provided by the World
HealthOrganization,healthentailsthefollowingde-
scription: ‘a state of complete physical, mental and
social well-being and not merely the absence of dis-
easeorinfirmity’(WorldHealthOrganization,2006),
and as such, involves both psychological, social, and
physical health (Kahneman & Krueger, 2006). Well-
being,ontheotherhand,denotesageneralsatisfaction
whenitcomestolife(uni-dimensionalmeasurement)
or being satisfied with its different areas (a multi-
dimensional approach). It should also be noted that
well-being massively contributes to health (Nawijn,
2010).
Thewellnessmodel,developedbyDr.BillHettler
(co-founderoftheAmericanNationalWellnessInsti-
tute) represents six dimensions of wellness: physical,
intellectual, emotional, spiritual, social, and occupa-
tional.Theemotionaldimensionistheleveltowhich
peopleareawareoftheir feelingsandable to control
them, including a realistic assessment of limitations.
Thephysicaldimensionrepresentslifehabitsthathelp
preventdisease,such ashealthyfood,physical activ-
ity,etc.Thespiritualdimensionisaconstanteffortin
searchofthemeaningofhumanexistence,whichre-
spectstheforcesofnatureintheuniverse.Theintel-
lectualdimensionistheinclusion ofthoughtsin cre-
ative mental activities while sharing personal poten-
tialwithothers.Thesocialdimensionisacontribution
to the collectivewell-being of the whole community,
coexistencewithothers,andnature.Theoccupational
dimensionreferstopersonallifesatisfactionthrough
work(Hettler,1980).
WellnessTourism
Not only are wellness and tourism old concepts, but
they have also been connected with the stimulation
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MilicaRaniDemirandMilaZeevi WellnessTourismResearch
of tourism development for a very long time. Also,
well-beingandguestwellnesswerethecentresofthe
development of spa tourism and the early stages of
theevolutionofinlandandcoastaltourismresortsin
a great number of countries, which involved hydro-
pathictreatments(Pageetal.,2017).
There are numerous ways to classify and define
healthandwellnesstourism.Healthtourism,inits
broadest sense, involves healing, medical and well-
ness tourism. Healing tourism is connected to the
actofpreventing,treating,andrehabilitating.Medical
tourism is about visiting another country so as to be
subjected to a medical procedure. Wellness tourism,
nevertheless, focuses on preserving good health us-
ingpreventiveactivities,andtheseincludeabalanced
diet,recreation,relaxation,etc.(Mueller&Kaufmann,
2001).
Mueller and Kaufmann (2001, p. 7) provided the
followingdefinitionofwellnesstourism:‘Thesumof
alltherelationshipsandphenomenaresultingfroma
journeyandresidenceby people whose mainmotive
is to preserve or promote their health. They stay in
aspecializedhotelthatprovidestheappropriatepro-
fessionalknow-howandindividualcare.Theyrequire
a comprehensive service package comprising physi-
cal fitness/beauty care, healthy nutrition/diet, relax-
ation/meditation,andmentalactivity/education.’
Medicaltourismisnormallydefinedasgoingtoan-
othercountryinsearchofmedicalinterventionsoas
to cure a sickness, which is very different from how
wellness tourism is perceived. The latter is seen as a
holisticwayofcontributingtowardsthebettermentof
one’shealthwithoutusingmedicines;itinvolvesboth
body andmind andtakesplacewhileoneisonholi-
day.Healthypeoplewhopursueahealthylifestyleare
its primarytarget,and are given the chance to enjoy
treatments such as spas and other therapy establish-
ments(Pageetal.,2017).
WellnessTourists
The focus of wellness tourists is on different pro-
grammesandtreatmentswhichcentreonthepreser-
vationandpromotionofhealth.Thesecanalsoinvolve
segmentssuchasthoserelatedtospirituality andso-
cial interaction. This is why the wellness tourism as-
pectscanberatherversatile(TežakDamijanić,2020).
Wellnesstouristsactivelyworkonfindingwaystoim-
prove their health. They are often motivated by the
desire to spend time outdoors, experience different
cultures,customs,andcommunitiesorotheractivities
offeredaspartofthewellnessservices(Smith&Kelly,
2006;Smith,2007).
AreportunderthenameofGlobal Wellness Tour-
ism Economy which comes from the Global Well-
ness Institute (Florida, usa) states that the wellness
tourismmarketcanbedividedintotwocategoriesof
visitors: primary wellness visitors, who are driven to
travel and select their destination because of what is
offeredtothem(e.g.theycanvisitawellnessresortor
take part in a yoga session); and secondary wellness
visitors,whosegoalistomaintainwellnessorpartici-
pateinitsactivitiesduringthecourseofanytravelling
experience (e.g. a person visiting a gym, enjoying a
massage,orchoosingtofocusonhealthyfoodduring
atrip).Secondarywellnesstravellersmakeupthema-
jority of this kind of tourism, as many as 89 of its
tripsand86offundsspentin2017(Yeung&John-
ston, 2018). The wide definition of this type of well-
nesstravelmakesupthevastvalueplacedonwellness
travel in this report, and involves almost all healthy
activities,e.g.swimmingorindulginginhealthyfood
whichisseenasaperipheralportionofatrip(Yeung
&Johnston,2018).
WellnessHotel
The gwi (GlobalWellnessInstitute)reportstatesthat
wellnessvisitorsinvestmoremoneyineverytripthan
average tourists. In the year 2017, internationalwell-
ness visitors spent on average $1,528 on every trip,
53 more than the regular international visitor. The
amountofmoneyspentbydomesticwellnessvisitors
isgreater,astheyspend$609oneverytrip,whichis
178 more thanthe typical domestic visitor. The re-
portfurtherexplainsthatthefactthatwellnessvisitors
are inclined to spend a lot of money on this indus-
tryprovidesitwithmanychancesto‘infusewellness
into their offerings and capture spending.’ It lists ex-
amplesthatincludeairportsandairlines,whichoffer
spatreatments,wellnesslessonsandthepossibilityto
select healthier food. In the meantime, ‘healthy ho-
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MilicaRaniDemirandMilaZeevi WellnessTourismResearch
tels’havenowbecomepopularandaccepted,within-
roomfitnessequipment,healthysnacksandcoopera-
tionwithwellnessbrands.Wecanseesomethingvery
similar in the cruise department,with travelsrelated
towellness,accordingtothe gwi (Yeung&Johnston,
2018).
Although wellness tourism has been increasingly
researched, the studies focusing on investigation of
wellness in different tourist settings (e.g. hotels) are
not frequent at all (Mueller & Kaufmann, 2001). A
wellnesshotelcentresonitsguestswhoareprimarily
motivatedbytheprospectofimprovingandboosting
theirhealthandwaysoflife.Italsoprovidesanexten-
siveservice packagein ordertofulfil theneedsofits
visitors,whocravephysical,mental,andenvironment-
relatedwellnessactivities(Chietal.,2020).
Inthepresenthotelmarket,thenumberofhotels
which maintain to be providing wellness-connected
servicesisgrowing.Wellnesshotelshavereceivedsig-
nificant attention from this industry, which leads to
the development of concrete products and services
whichwouldservetomeettheneedsofwellnesscus-
tomers.Thiscouldrefertosomethingsuchasin-room
yogaequipmentorthingsthattendtobemoreexper-
imental; an example in point could be a sensory de-
privation tank – an isolation tank used for restricted
environmentalstimulationtherapy.Nevertheless,the
occurrence of the wellness hotel has, to a large ex-
tent, not been neglected by scholars. Their attention
is mainly focused on hotels in order to address the
importanceofwellnesstourismgenerally,andnotthe
hotelsasunits.
WellnessService
Mueller and Kaufmann (2001) analysed the signifi-
canceofwellnessfacilitiesandservicesinthisareaof
tourism.Thepastseveraldecadeshaveseenarisein
thenumberofpeopletravellingabroadforwellnessin
the international tourism industry. It transpires that
the wellness tourism market surpassed the tourism
domainitselfinthelastseveralyears(Hanetal.,2017).
Thisgoestoshowthatinterestinobtainingahealthy
lifestylehasbeengrowingandwellnessisdeemedasa
vitalpartthatcanleadtoachievingthisverygoal(e.g.
massageandspa)(Kiatkawsin&Han,2017).
The past several decades have witnessed the rise
anddevelopmentofwellnessspatourism.Thishasall
beenadirectreactiontotheneedsofitstravellersand
their determination to contribute to their healthier
lifestyles.Touristsofallageshavebeenmoreandmore
willingtodowhatittakestoimprovetheirhealthusing
theservicesprovidedbythisbranchoftourism.They
aremotivatedbythefactthattheyaretheonesrespon-
siblefortheirownhealth.Inordertofulfiltheseneeds,
thefocusofthisdomainoftourismhasbeenonmain-
tainingboththephysicalandpsychologicalhealthof
theseindividuals,aswellasputtingastoptoanyhealth
conditions.Nowadays,internationalvisitorsaremore
activewhenitcomestofindingspaandmassagetreat-
mentsandwanttotakepartinthesekindsofactivi-
ties,somuchsothatithasbecomethemainpartof
how they experience tourism (Kucukusta & Guillet,
2014).
Wellnessisequatedwithlifestyle,anditdenotes‘a
specialstateofhealth,incorporatingtheharmonyof
body, mind, and spirit.’ On the other hand, the term
‘spa’ is seen as water/non-water-based facilities that
provideonewithdifferentkindsoftreatments/carefor
health, relaxation, and beauty (Hashemi et al., 2015).
Activities such as spa-visits and others are common
and prevailing during the holiday season. This sug-
gests that these activities are invariably connected to
thewaytouristsactortotourismactivities(Hanetal.,
2017).
BibliometricStudiesintheTourismResearch
Literature
Over the last decade, researchers have given exten-
siveefforttosystematizingandstructuringknowledge
intourismresearch.Inthisprocess,theuseofquan-
titative literature reviews techniques and bibliomet-
ricmethodswasverycommon.Intheirrecentstudy,
Rodríguez-López et al. (2020) provided an extensive
overviewof studies thatuse bibliometric methods in
researchingdifferentaspectsofleisure,sports,tourism
and hospitality. They have identified over 20 studies
conductedinthepast20years.Thoseincludestudies
conductedinthefieldofsportsresearch(e.g.Ciomaga,
2013;Lindahletal.,2015),adventuretourism(Chenget
al.,2018),sustainabilityintourism(e.g.Niñerolaetal.,
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MilicaRaniDemirandMilaZeevi WellnessTourismResearch
2019)andethicsintourismandhospitality(Köseoglu
etal.,2016).
In their research efforts in bibliometric analysis
and mapping of tourism research, authors have used
differentmethods.Intellectualstructureandresearch
networks in tourism have been mapped using co-
citation analysis (e.g. Benckendorff & Zehrer, 2013).
Researchershavebibliometricallymappedtheareasof
restaurant,foodandgastronomyliteratureintourism
and hospitality (e.g. Rodríguez-López et al., 2020;
Okumus et al., 2018), sustainable and eco-tourism
(Shashaetal.,2020;Ruhanenetal.,2015),hospitality
management (García-Lillo et al., 2016) and strategic
managementinhospitality(Köseogluetal.,2019).
Todate,theauthorsofthecurrentstudyhavenot
encountered a specific study that applies the biblio-
metricsapproachtowellnesstourismliterature.Nev-
ertheless, bibliometric studies have been undertaken
intheliteratureareasclosetowellnesstourism.De
la Hoz-Correa et al. (2018) researched past medical
tourism research and identified the future trends in
thisarea,focusingonco-wordanalysis.Inthisstudy,
the authors have identified a strong interconnection
between research in wellness tourism and medical
tourism.Theadditionalstudyprovidedadeeperfield
investigationofhealth tourism (Del Río-Rama et al.,
2018),focusingonspas,thalassotherapy,andthermal-
isminthehealthtourismcontext.
Methodology
Bibliometric methodsarecommonly usedto analyse
establishedinformationin aresearcharea,aswellas
hidden trends and associations, and to measure (to
some extent) descriptive knowledge available in the
literature.Theseapproachesarewellknownforusing
bibliographicdatafromcurrentdatabasesofpublica-
tions(e.g.Scopus,WoS).Inviewofthisinformation,
bibliometric strategiesare primarily used to evaluate
andbetterunderstandelementsandconnectionsbe-
tweenandwithin theresearchfields(Župič &Čater,
2015).Inthisinteraction,thesestrategiesuncoverhid-
den connections of creators, the significance and ef-
fectofdistributions,aspatternsandimportantthemes
in logical zones. The capacity to bring quantitative
meticulousnessintosubjectivewritinganditsassess-
menthavemadethesetechniquesestablishedandex-
tremely pertinent in logical field surveying. As well
asorganizingthecurrentinformationandfieldqual-
ities (creators, fundamental discourses, coordinated
efforts, and so on), bibliometric techniques are gen-
erallyutilizedforrecognizableproofofhiddenspaces
of examination, uncovering subjects as well as areas
of interest and patterns in research fields (Pritchard,
1969).
Visual bibliometric maps use charts and organi-
zations to portray the associations existing among
things.Hubs(i.e.nodes)andedgesareutilizedtopic-
ture theorganizations’fundamental fieldsofwriting.
Hubsaddressthethingsofsignificance(forexample,
articles,books,journals,authors,orkeywords),while
edges show the relations between the hubs. The size
ofthehubdemonstratesitsrecurrenceofappearance
in the dataset (bigger hubs show that the given item
was more regularly referenced in the dataset and as
such has more weight in data organization and pre-
sentation), while the thickness of an edge shows the
strengthof aconnectionbetweentwohubs. The dis-
tance between the hubs and bunches they structure
(generallysetapartbyshading)showstherecurrence
of their common presence in research introduced by
hubs(VanEck&Waltman,2014).
Forourinvestigationofthewellnesstourismlitera-
turefield,acoupleofbibliometricstrategieshavebeen
applied: co-citation and keyword co-occurrence. In
writing,co-citationinvestigationisclarifiedandchar-
acterizedastherecurrencewith whichtwounitsare
referredtotogether(Small,1973).Thebiggernumber
of things in which the two units are referred to to-
gether(co-cited)suggestsamoregroundedco-citation
connection between the two units (Small & Griffith,
1974).Thisexamination(itssubtypes)canbeutilized
forestimatinglikenessormorereferencedrecurrence
betweenauthors,sources,anddocuments.Whiledoc-
ument co-citation investigation makes associations
between explicit distributed reports (articles, books,
or other distributed material), sources reference ex-
amination recognizes inert relations between logical
journals(sources)referredtointhedataset(Župič&
Čater,2015).
Keyword co-occurrence is a procedure that aims
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MilicaRaniDemirandMilaZeevi WellnessTourismResearch
at building a theoretical construction of the field by
settingupconnectionsbetweenthewordsinarticles.
While co-citation utilizes meta-information (refer-
ences,authors,sources,andsoon)ofarticlestomake
associations between them, keyword co-occurrence
is a technique that utilizes the real substance of the
archivetoquantifysimilitudeandmakeanetworkbe-
tween pertinent catchphrases. The primary point of
thisexaminationistomakeanorganizationoftopics
andtheirconnections,addressingtheappliedspaceof
alogicalfield(Župič&Čater,2015).
BibliometricExaminationoftheField:Process
Portrayal
Duringtheprocessofgatheringmaterialsandmaking
adatasetforwellnesstourismbibliometricstudy,afew
standardstepsinbibliometricswerecarriedout(Župič
&Čater,2015):
1. Dataassortment:
•
Selectingpublicationsdatabase.Togatherdis-
tributionsandtheirmetadataforbibliometric
investigationforthisstudy,theScopusdataset
was consulted because of its exhaustiveness.
Scopus is an electronic scientific database. It
isevaluatedasanappropriateandcomprehen-
sivesourceofarticlesforsciencemappingand
bibliometricanalysis(Mishraetal.,2017).Ad-
ditionally,theScopusdatabaseismoreexten-
siveincomparisonwithothersimilardatasets.
•
Identification of significant articles. In order
to collect bibliographic records on wellness
tourism, searches in Scopus were conducted
in August 2020. Based on the previous us-
ageofkeywordsinpreviouswellnesstourism
studies, we have selected 6 combinations of
keywords for research item identification in
Scopus: ‘Wellness hotel*,’ ‘Wellness service*’
andhotel*,‘Wellnessservice*’andtouris*,
‘Wellnesscenter*’andhotel*,‘Wellnesscen-
ter*’andtouris*,and‘Wellnesstouris*.’For
thepurposeofthisresearch,onlyarticlesand
reviewswritteninEnglishweretakenintoac-
count.Alltitlesandabstractswerereviewed
forrelevanceandrelationtowellnesstourism.
Articleswithexplicitorcausalrelationtowell-
nesstourismweretakenintoaccountforthe
finaldatabase,whichconsistedof212items.
2. Datainvestigationandvisualization:
•
Creatingandsavingthemeta-information.To
conduct furtheranalysis,wedownloadedar-
ticles’metadata(titles,authors,abstracts,ref-
erences, etc.) in Bibtex and csv format, and
used it in the bibliometric analysis. In order
toanalysethegivendataset,weusedthepro-
grams vosviewer andbiblioshinypackagein
R,both ofwhicharefrequentlyusedinsuch
studies.
•
Cleaningandchanginginformation.Savedin-
formationwasscreenedandrectifiedforpos-
sibleduplicatevaluesorirregularities(forex-
ample, utilization of both journal abbrevia-
tionsandcompletenames).
•
Conducting investigation and obtaining re-
sults. After saving and adjusting steps, the
dataset was imported in the programs and
thecalculationsofdesiredanalysiswerecon-
ducted.
Results
WellnessTourismLiterature:AnnualScientific
Production
Thedevelopmentofwellnesstourismliteratureshows
an increase in the number of publications over the
years.Thefirstarticleswerepublishedinthe80sand
90s, where the focus of the research was on medical
characteristicsofwellnesstourismandhealthrehabil-
itation (e.g. Spivack, 1998). Publications in the early
2000s extensively researched wellness and spa offers
specificallyfordifferentregions,dominantlyinEurope
(e.g.Magdalini&Paris,2009;Lebe,2006).
A larger increase in the number of articles pub-
lished in wellness tourism literature can be noticed
from 2010 onwards (Figure 1). Under the influence
of the increase in general publicity of wellness and
its beneficial effects on health and well-being, scien-
tific research interests flourished. In the last decade,
attention has been increasingly paid to researching
the impact of wellness tourism on holistic consumer
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MilicaRaniDemirandMilaZeevi WellnessTourismResearch







        
Numberofpublications
Figure1 EvolutionintheNumberofPublications
wellness(Dilletteetal.,2021)andspiritualcharacter-
isticsofwellnesstourism(Öznalbant&Alvarez,2020;
Alkhmisetal.,2020),aswellastheconnectiontosus-
tainability(Wang,Huetal.,2020).
MostProminentJournals
When it comes to the relevance of individual jour-
nalsforpublishingwellnesstourismresearch,wehave
identifiedthetop20journalswhichhavepublishedthe
highestnumberofarticlesinthefield(Table1).Jour-
nals fromtourismdominatein this list, which is not
surprisingtakingintoaccounttheresearchareaofthis
bibliometricstudy.Someofthejournalsaregeograph-
icallydeterminedandpublishstudiesspecificforpar-
ticularregions(e.g.Scandinavia,Africa).
Outofthetop20journalsthatpublishwellness
tourismresearchmanuscripts,Tourism Recreation Re-
searchisthejournalwiththemostwellnesstourism-
relatedpublications(11),followedbyJournal of Hospi-
tality and Tourism Management and Journal of Travel
and Tourism Marketing (9 publications each). The
lowestnumber ofpublications in thetop 20 journals
was2.
KeywordCo-OccurrenceAnalysis
Analysisofthemostfrequentlyusedkeywordsidenti-
fied22keywordsthatweremarkedbyauthorsasrele-
vantfortheirresearchin5ormorepublications.Ac-
cordingtokeywordco-occurrenceanalysis,thesekey-
wordscanbeclassifiedinfourclusters(Figure2).
Inthefirst,thebiggestcluster,wecanobservekey-
words that are specific for wellness tourism research
ingeneral.Thesekeywordsarethefollowing:wellness
tourism, rural tourism, lifestyle, health, well-being,
Table 1 Top20JournalsthatPublishWellnessTourism
ResearchManuscripts
Journal Numberofpublications
TourismRecreationResearch 
JournalofHospitalityandTourismManagement 
JournalofTravelandTourismMarketing 
Tourism Review 
AfricanJournalofHospitalityTourismandLeisure 
AsiaPacificJournalofTourismResearch 
InternationalJournalofHospitalityManagement 
Journalof VacationMarketing 
TourismManagement 
ScandinavianJournalofHospitalityandTourism 
CurrentIssuesinTourism 
JournalofDestinationMarketingandManagement 
Tourism 
TourismManagementPerspectives 
Tourismos 
InternationalJournalofTourismResearch 
JournalofQualityAssuranceinHospitalityandTourism 
Sustainability 
Tourism Analysis 
ActaClinicaCroatica 
andqualityoflife.Thisclusterbrieflyrepresentssev-
eralrelevantconstructsinwellnesstourismliterature
suchaswell-being,qualityoflife,health,andlifestyle.
Thesecond-largestclustercontainskeywordsthat
stronglyconnecttotourismresearchinwellnesstour-
ism literature. The keywords tourism, lifestyle seg-
mentation, cluster analysis, motivation, satisfaction,
andpersonalhealthbelongtothiscluster,thatstrongly
connectswellnessresearchtoconsumerresearch,asit
captures research that aims at better understanding
themotivationandsatisfactionoftourists,aswellas
their segmentation (Lee et al., 2020; Chrobak et al.,
2020;Thawornwiriyatrakula&Meepromb,2020).
The third cluster represents wellness tourism re-
searchfocusingonhealthandmedicaltourism.Key-
words from this cluster are health tourism, medi-
cal tourism, health and wellness tourism, spa, and
AcademicaTuristica,Year15,No.1,April2022 |59

MilicaRaniDemirandMilaZeevi WellnessTourismResearch
Figure2 MapofKeywordCo-OccurrenceinWellness
Tourism Research
spa tourism. The importance of physical health for
overall individual well-being is well known and re-
searchinghealthtourismfromtheperspectiveofwell-
ness tourism is thereforesomewhat expected. In this
branchofwellnessresearch,spasandspatourismtake
one of the most important places due to their con-
nectionwithwellnessandrelaxationtreatsingeneral
(Chrobaketal.,2020;Dryglas&Salamaga,2018).Spa
facilitiesareimportantfortourists’well-being,loyalty,
andoverallpositivefeelinginhealthtourism(Huang
etal.,2019).
Finally, the fourth cluster accounts for wellness
tourismresearchspecificforwellnesselementsofthis
branch of tourism. The keywords wellness, innova-
tion,yoga,andspiritualtourismimplythatthisclus-
terisamongthenewestones,astheseasthesetopics
havebecomeheavilyresearchedinthepastfiveyears.
Researchersareextensivelytryingtoelaborateonthe
concepts of yoga, spiritual elements and the holistic
approach to vacation (including stress relievers and
mind relaxation) necessary for achieving wellness in
tourism(Kimetal.,2020;Dilletteetal.,2021;Telej&
Gamble,2019).
DiscussionandConclusion
Wellness tourism has recently managed to draw the
attention of researchers due to its fast development.
Whenitcomestothesupplyside,thefocusofresearch
has been on the potential limitations and strategies
ofdevelopmentforthewellnesstourismindustry.On
the other hand, when it comes to the demand side,
thefocushasbeenonthesocio-demographicandbe-
havioural aspects, the drive and the expectations of
visitors,andalsoelementsthatboosttheirwell-being
andaffectthewaydecisionsaremade(Wang,Xuetal.
2020).
Thereusedtobestressontherecoveryandrelax-
ationofourbody,whichwasnormallyachievedbyat-
tendingspasorgoingtotheseaside.Theemphasiswas
verysmallwhenitcametootheraspectsofourhealth,
suchasthemental,spiritual,andemotionalones.Even
thoughmedievalpilgrimagemightbeseenasanearly
formofspiritualtourism,itwasfoundedonconcrete,
organizedreligions,anditsdestinations.Modernso-
cietiesaremuchdifferentandaregraduallystartingto
beattractedtooptionsenablingthemtoengageinac-
tivitiescharacterizedbyphysical,spiritual,andmental
balanceandintegration(Smith&Puczkó,2008).
It is evident that wellness is a concept involving
multipledimensionsandthatitinvolvesbothphysical
andmentalhealth,alongwithsocialandenvironmen-
talelements.Before,whatwasmoreimportantwasto
cureproblemsconnectedtohealthusingconventional
ortraditionalmedicinethatwouldbeprescribedbya
doctor,while now, it has become more normal to at-
tempttohaveahealthylifeandprecludemedicalcon-
ditionsbytakingmeasuresintoourownhandswith-
out the help of a medical professional and thus be-
ing independent. The growing wellness business al-
lowspeopletheopportunitytouseallkindsofactivi-
tiesthatputourbody,mind,andsoulinbalance.
The Global Wellness Tourism Economy report
maintains that in 2015–2017, the department of well-
nesstourismincreasedby6.5yearlyfrom2015–2017
(whichismorethandoubletheincreaserateforgen-
eral tourism). Visitors went on 830 million wellness
tripsin2017,139millionmorethanin2015(Yeung&
Johnston,2018).
Considering the fact that the interest in wellness
tourism has been growing by the year, it is not sur-
prising that the same can be said for researchers in
thisfield.Thisis,ofcourse,directlyconnectedtonat-
uralandsocialchanges.Arapidwayoflifemeansthat
thereisaneedtorestandrelax,whichismosteffec-
tively achieved by engagingin wellness trips and ex-
60 | AcademicaTuristica,Year15,No.1,April2022

MilicaRaniDemirandMilaZeevi WellnessTourismResearch
periences. Also, the money gained through this type
oftourismhasgrownsignificantly.Inordertomain-
tainandimprovethistrend,thereneedstobeacon-
stant need for researching natural, social, economic,
cultural andother elements,which haveaneffect on
thecourseofwellnesstourism.
Ourstudyresultsshowanevidentincreasein the
number of publications related to wellness tourism.
Analysis of the annual scientific production of arti-
cles in the field of wellness tourism shows a signif-
icant increase in the number of publications in the
last ten years. Over 80 of the articles from this re-
search field have been published in the last decade.
This increasing trend is evident from the field’s be-
ginnings in the late 90s. The rise of the importance
of wellness and well-being in the lives of tourists is
followed by enlarged research efforts by academics,
resulting in a larger number of wellness tourism re-
searchitemsbeingpublished.Apartfromthis,wecan
observejournalsfrombothtourismandhospitalityin
the top 20 most important journals in the field, im-
plying thattheresearchis extensivelygatheringboth
perspectives of wellness tourism. Co-occurrence of
keywords analysis detected the patterns of connec-
tions between author keywords. We have identified
fourclusterswithinwellnesstourismresearch:health
tourism research, tourism research, wellness topics,
and wellness tourism research. Health tourism re-
searchcoversbothhealthandmedical-relatedtourism
topics,whiletourismresearchkeywordsmostlyfocus
onconsumerresearch(e.g.motivationforavisit,satis-
faction).Wellnesstopicsmostlyrefertopersonalwell-
ness (e.g. yoga, spiritual tourism), while the biggest
cluster, wellness tourism, depicts many relevant key-
wordsinthisresearchfield(e.g.well-being,qualityof
life).
ImplicationsandResearchLimitations
The findings of this wellness research bibliometric
study have several implications for both academics
and practitioners. Implications of this study for aca-
demicscanbeseeninansweringsomeoftheimpor-
tantissuesresearchersshouldtakeintoaccountwhen
researchingwellnesstourismandaidingresearchersin
understandingand detecting important patternsand
journals in this research field. When it comes to the
practicalpointofview,thisresearchidentifiesseveral
areasinwellnesstourisminwhichattentionisneeded
from practitioners as well. Keyword analysis showed
multipleaspectsofwellnessthatareprovidedspecifi-
callyfrompractice(e.g.venueslikespas).
While we aimed at conducting rigorous research,
thisstudyisnotwithoutlimitations.First,thedataset
was created using a single database (Scopus) in the
English language. This is a usual procedure in such
studies, but it brings certain limitations with it. The
inclusion of additional sources and articles in local
languagescouldidentifydifferentpatternsofresearch
and contribute to broader applicability and general-
izationoftheresultsobtained.
Additionally,thisstudyconductedaone-timeanal-
ysisofthewellnesstourismresearchfield.Replications
orrepetitionsofthisstudyatdifferentpointsintime
mightbeabletoidentifynewphenomena,researchin-
terests, and issues that are appearing in this research
topic.
Finally,thisstudyaimedatprovidinganoverview
of the wellness tourism research field. Future stud-
ies might benefit from in-detail studies of sub-fields
(e.g.spiritualwellnesstourism,well-beinginwellness
tourism). Such future researchendeavourscould en-
ableustomoredeeplyunderstandthechronological
development of this research field, as well as to un-
derstand trends and their shifts and emergence over
time.
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