Foreground questions are specific and relevant to the clinical issue. Foreground questions must be asked in order to determine which of two interventions is the most effective in improving patient outcomes. For example, "In adult patients undergoing surgery, how does guided imagery compared with music therapy affect analgesia use within the first 24 hours post-op?" is a specific, well-defined question that can only be answered by searching the current literature for studies comparing these two interventions.
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question: A Key Step in Evidence-Based Practice. AJN, American Journal of Nursing, 110(3), 58-61.
|Search strategy worksheet:|
|Combined evidence pyramid:|
|Nursing model at McGill:|
An easy way to start your search is the find one or two relevant articles and use these to see what keywords you might use to find others like them.
You can also look to see how these articles are indexed. To do this, search for one of the articles by title in the database you wish to search. View the full record to see what subject headings have been assigned and add these subject headings to your search.
Librarians call this "pearl growing".
Google Scholar or Scopus are good places to start growing pearls, but you can do this in any database that uses subject headings.
Tip for building your Medline search:
In Google Scholar, view all versions of the relevant article you have found and view the version that has the link "ncbi.nlm.nih.gov". This will bring you to Pubmed, where you can click on "MeSH terms" to see what subject headings were used in Medline.
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