Nursing Research

The first step in preparing to search for information is to decide if you have a background question or a foreground question. This will help you select the best resources to answer your question.

• Background questions ask for general knowledge - - the “who, what, when, why, where or how” about a single disease, drug, intervention or concept.  Background questions can involve a single fact, a recommended dose of a drug, a list of symptoms of a disorder, or standard treatments for a disease.  "What are the causes of migranes?" is an example of a background question.  In these cases, use the resources listed under Locate Background Information.
   
• Foreground questions ask for specific knowledge to inform clinical decisions or actions. Foreground questions are specific to the clinical case (patient). "In children, how does acetaminophren compare to ibuprofen in reducing fever?" is an example of a foreground question.  A foreground question is often referred to as the PICO question structure (Patient/Problem, Intervention, Comparison, Outcome).  Constructing your question using PICO helps you find an answer to your research question.  Use the resources listed under Find the Evidence to answer foreground questions.

Based on your patient's case, use PICO to develop a clear clinical question to help you find information. 

PICO helps you organize your thoughts and formulate a search strategy. Here is an example (courtesy of Univ. of Warwick Library) of how to use PICO components to break your research question down into parts (keywords or phrases). 

Clinical case: A pregnant woman with type 2 diabetes is concerned about the effect her current treatment may have on her pregnancy and unborn child.  You've heard that insulin pump therapy may be a more successful treatment than conventional insulin therapy.

Clinical question (want you want to answer): Are insulin pumps more effective than conventional therapies in managing type 2 diabetes in pregnant women?

P (Population/Patient/Problem) - Pregnant women with type 2 diabetes
I (Intervention) - Insulin pump therapy
C (Comparison) - Conventional insulin therapy
O (Outcome) - Improved management of glucose levels

Your PICO keywords or phrases can then be used to search for evidence-based research in databases.  For this example, a good search strategy might look like this:

• diabetes AND pregnancy AND "insulin pump" AND "insulin injections"  OR

• type 2 diabetes AND pregnancy AND "insulin infusion systems"

Place quotaton marks (" ") around phrases so that the keywords are searched in that exact order.  Try different synonyms of your keywords.  You may only need to use some of your PICO keywords.  Please note that different databases may require different methods to limit to specific populations. Also, evidence-based research may not be available for every clinical question.  

OTHER INFORMATION TO HELP YOUR SEARCH
As you prepare your search strategy and decide on the best sources to search, you may want to ask yourself these two additional questions:

1.  What type of question are you asking?     Diagnosis, Etiology, Therapy, Prognosis, Prevention, Harm
2.  What type of study (design/methodology) do you want to find?    

Watch the The Clinical Question tutorial for more information on these two questions.