1. Nursing:
Searching for evidence
Sharon Karasmanis
Faculty Librarian (Health Sciences)
s.karasmanis@latrobe.edu.au
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2. The Research Question
• You cannot conduct an effective search without a well
formulated question.
• Think about the concepts within your research question
• Identify and list the keywords and their synonyms that
identify the concepts
• Consider the ‘level of evidence’ to be sought – the research
methodologies that will help eliminate bias
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3. Levels of Evidence
EBM Pyramid copyright 2006 Trustees of Dartmouth College and Yale University. All rights reserved.
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4. Developing a search strategy: PICO
1. Break the research question down into concepts:
• Population
• Intervention
• Comparison Intervention
• Outcome
• Research / Study design (Level of evidence)
2. Identify for each facet:
• Synonyms
• Spelling variants
• Subject headings
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5. Formulating a PICO concept map will help
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6. Example in PICO Map (or concept map)
P I C O R
Falls
Elderly
Strength
training
None Reduction of
falls
Therapy
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Does strength training reduce the incidence of falls in the elderly?

7. Databases
• Electronic Indexes that help you identify journal
articles in your research area
• NO single database indexes every journal possible
in a subject area - only those that match their
selection criteria
• Efficient, effective and less biased searching
therefore requires multiple database searching
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8. Types of databases
• Citation databases:
Entries have the citation, subject headings and often an abstract, sometimes they
link to full text. Examples: CINAHL, Embase, MEDLINE
• Full Text databases:
Entries have the citation and abstract and in most cases the full text of an article.
Examples: Health & Medical Complete (Proquest), Informit Health
• Pre-appraised evidence databases:
– The Cochrane Library is a multi-database resource which varies in output e.g.
the Cochrane Database for Systematic Reviews contains complete systematic
reviews
– Clinical Evidence - summarises the current state of knowledge and uncertainty
about the prevention and treatment of clinical conditions, based on thorough
searches and appraisal of the literature.
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9. Accessing Nursing databases
• On Campus:
– Library Web Page
> A-Z Databases/Journals
> Subject Area - Health Sciences
> Nursing and Midwifery
• Off Campus: authentication as a La Trobe University
student required:
– University username and password
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10. Generic search tips
• Spelling - paediatric or pediatric, use the hash: p#ediatric
• Truncation (*) - nurs* will find nurse, nurses, nursing
• Wildcard (?) - randomi?ed will pick up randomized and
randomised, or organi?ation etc.
• phrase searching, use quotes - “Acquired brain injury”
“Quality of life” “Type 2 diabetes” etc.
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11. Linking terms: BOOLEAN operators
• AND - retrieves records containing both of
two terms:
– Back pain AND exercise
• OR - retrieves records containing any of the
terms:
– Back pain OR back ache
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12. Systematic Searching
• Systematic searches are a combination of using
the terminology of the database (Subject
Headings) combined with free text or keyword
searching
• While there may be some overlap, you will also
find many different articles when using both ways
of searching for the same concept.
• Comprehensive systematic searching requires
subject heading and keyword searching!
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13. Systematic searching: Why use both methods?
Controlled Vocabulary (Subject Searching) Keyword Searching
MEDLINE, Embase, CINAHL (amongst others) are
indexed by subject experts who assign a subject
heading (or ‘tag’) that best describes the article.
These subject headings are from a fixed list of
terms that are arranged in a hierarchical structure
that show the relationships between terms. This
allows searching at various levels of specificity.
Words not taken from a specific list. Can use
words that you would normally use when
searching. Need to account for variations for
spelling, terminology & clinical descriptions.
More efficient & precise way of searching where
you retrieve only those records which list the
subject heading for your concept.
Broader way of searching where you will retrieve
records which mention your keywords but may or
may not be specifically about your concept.
Searches only the subject field. Searches words used by the author in other fields
such as the title or abstract.
Provides consistency in the description of the
content of the articles.
Useful for searching for a specific term or phrase
when there is not an appropriate subject heading.
Do not need to think of synonyms for your topic. Useful for searching topics that use new concepts
or terminology (subject headings take a while to
be developed)
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14. Database aids:
Controlled vocabulary & scope notes
• Subject Headings (Controlled vocabulary or Thesauri): used
to overcome differences in individual authors’ use of
terminology. e.g. back pain (CINAHL and MEDLINE), backache
(Embase)
– Click on the Subject Heading, scroll down to the ‘used for’.
Provides ideas for other keywords to use!
• Scope note: describes how the term is used in the database,
the “scope” of the term; the history of the indexing
• ‘Exploding’ a term: results will include the ‘exploded’ term
(e.g. back pain) plus the conceptually narrower terms in the
tree (low back pain)
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15. Limits available in the databases
For example:
• Clinical Queries
• Date of publication
• Language
• Publication types
– CINAHL e.g. clinical-trial; masters-thesis; research; review;
systematic-review
– MEDLINE - e.g. controlled clinical trial; meta analysis; randomised
controlled trial; review literature; review, academic; review
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16. Increasing and decreasing results
• For more hits:
– Broaden your question
– Find more search terms or different
combinations of words
– Use truncation *
– Link more terms with OR
– Combine free text and subject heading (or
thesaurus) searches
– Use ‘explode’ to select all subheadings
– Search longer time span
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17. Increasing and decreasing results
• For less hits:
– Narrow your question
– Use more specific terms in free text (keywords)
– Use subject heading (thesaurus) search rather
than free text
– Use more specific thesaurus headings and
subheadings
– Link more terms with AND
– Use database ‘limits’
– Search shorter time span
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18. Search results – finding the full text!
• Some databases will have the Full Text Finder icon
• If not, search the Journals from the Library home page and
follow the links to the full text:
– sometimes the article may only be in print copy in the Library
• If not held by the Library, request the article via Document
Delivery Services
www.lib.latrobe.edu.au/document-delivery/
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19. Cochrane Library
• To access a variety of search options, click on Search, Search Manager or
Medical Terms (MeSH) to be directed to the appropriate search tab.
• Further information at: latrobe.libguides.com/healthdatabases >
Cochrane
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20. La Trobe University Library 20

21. Google Scholar - scholar.google.com/
• Search scholarly literature for articles, theses,
books, abstracts, professional societies, online
repositories, universities and other web sites
across the world of scholarly research.
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22. Help!
• Nursing and Midwifery LibGuide
latrobe.libguides.com/nursing_midwifery
• Critical Appraisal LibGuide
latrobe.libguides.com/criticalappraisal
• EndNote LibGuide
latrobe.libguides.com/endnote
• Research Help Desk: 9479 2718
• Student Learning Advisers: Available in the library during semester
• Ask a Librarian: latrobe.libanswers.com/
• Live Chat: www.lib.latrobe.edu.au/chat/ 11am – 5pm
• Faculty librarians: www.lib.latrobe.edu.au/melbourne/faculty-libs.php
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