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Detail an appropriate search strategy using relevant databases to identify an article on evidenced based practice in the healthcare setting
Literature search has been a vital aspect of students' academic life, especially with the advance of technology. Burns and Grove (2005) define literature searching as an organised search system which identifies information relevant to the topic of interest. Moreover, searching has an essential role in supporting clinicians who want to keep up with the development of evidenced-based practice in the health professions . The term 'evidenced-based practice' has come to be used to refer to the combination of evidences which improve the quality of information in relation to clinical and patient interests (De Brun & Pearce-Smith, 2009). In order to find the best medical resources, a good search technique is required for finding information more efficiently, otherwise the researcher could waste lots of time and find nothing. The aim of this essay is to describe an appropriate search strategy by defining databases and the reasons for choosing the a particular one for this assignment . The essay will then go on to describe the search steps used to identify an article on Children Diabetes.
Primarily, the fundamental part of searching is formulating a well-searchable question in order to be capable of sourcing an answer in the chosen database. For De Brun and Pearce-Smith (2009) 'database' refers to systemic reviews containing an electronic collection of information that is organised and accessible. There are various search engines in which research could be undertaken and each one of them identifies information and data in its own way. Although there are a range of databases available, the one that has been chosen for this particular essay is Pubmed. The reason for choosing this database is due to the fact that the Internet is a place where all sorts of information can be obtained, whether from experts or not. In other words, there is no guarantee of validity or the reliability of the data. Therefore, information about healthcare topics should be taken from trustworthy sources. Nordenstrom (2007) stated that Pubmed is one of the primary medical information sources which is connected to the major medical database 'MEDLINE' and accessed via the National Library of Medicine. Moreover, it allows people to access data easily and free of charge. In addition, it contains assessed evidenced-based practice articles. However, Pubmed requires following up an appropriate search techniques.
A search strategy is a technique which includes lists of databases and applicable terms which could be the key part of the research (De Brun & Pearce-Smith, 2009). As mentioned previously, formulating the question is the essential part of a search strategy, the question used during this essay is 'What are the reasons of developing diabetes in children?'. Breaking down the question into identified keywords builds smaller, more manageable questions which lead to an effective search strategy. De Brun and Pearce-Smith (2009) suggested that PICO is the common method in managing the question. Problem, Intervention, Comparison and Outcome is what PICO stands for, respectively. This means that the problem is the diabetes, the intervention is the standard treatment, for example, regulate the insulin by medicine, the comparison is the alternative treatment, for instance, balanced diet and finally, the outcome is the expected results from the treatment which can be a decrease in insulin level in the blood. Due to the fact that databases are controlled by computers, the search will result in words which have been typed in by the resaercher. Nordenstrom (2007) suggested that at first, searching as wide as possible to make sure the articles of interest are included, was the best approach. For example, entering the keyword diabetes in the query box returns a large number of articles.
The next step can be searching by using a thesaurus which De Brun and Pearce-Smith (2009) defined as words with an accompanying selection of synonyms or phrases which can be useful in finding the relevant articles. An example of this technique is using 'high insulin level' or 'Metabolic syndrome' instead of diabetes. In using this technique it is noticeable that the search results have been reduced significantly.
Terminology is an essential element in the medical field and changing a letter in a term could change the meaning of the diagnosis. The thread step search technique involves using truncation and wildcards, where appropriate, these are shortcuts and they can save time when using keywords. Truncation is the use of symbols, such as asterisks (*) in order to reduce search steps; in contrast however, this technique may increase the number of articles. Wildcards involve the use of the question mark (?) , to differentiate between different English spellings and it is also useful in dealing with plurals. Though it is interesting to note that Pubmed does not use wildcards (De Brun & Pearce-Smith, 2009). One such case of truncation is when using the word child. Here the stem of the word is used and any suffux is removed , adding asterisks instead so the search term becomes child*. The system will look for information that refers to child, children, childhood, etc.
The fourth step in strengthening the search is combining words, this is popularly known as Boolean logic. Terms that are used in a search can be more relevant to the formulated question by joining words with: and, or, not, with, brackets and inverted commas. Using AND in a search will display articles that contain both words; for instance, Diabetes and Children. The system will search for articles that contain both words. However, when using OR instead of AND, the results will include articles with either word or both of them; whereas, using NOT will restrict the search. For example, searching about children NOT young people (De Brun & Pearce-Smith, 2009).
The final step of the search strategy is limitation, this is done by filtering the search results. The limitation process is a search using particular structural units such as age, publication years, abstracts only or full text, etc. Using a search limit in researching diabetic children was done by choosing, articles with abstracts only and published within five years. The Pubmed system reduced the number of articles by retrieving with reference to the selected limits. In using this technique, the number of results fell from 11501 articles to a manageable number of 30.
Metabolic syndrome in childhood and adolescence by Barkai and Paragh (2006) has been chosen as a good article because diabetes is increasing globally among young people. This increase is caused mostly by poor health, excess food which leads to an increase in the level of obesity, and finally, the lack of exercise. Therefore, insulin resistance deficiency will occur (Silink & Kida ,2003).
In conclusion, a good search strategy is the key to obtaining high quality information in evidence-based practice. A clear question, choosing appropriate databases, lists of keywords and synonyms, using truncations and wildcards, combining Boolean operators and applying limits to the results are the principles for successfully finding articles on evidenced-based practice.