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These questions are general in nature and provide foundational information on a single concept. Background questions cover:
What is the pathology of asthma?
What drugs are used to treat hypertension?
How do I perform a psychological assessment?
What education resources exist for patients with gestational diabetes?
How is hepatitis b diagnosed?
What does a normal heartbeat sound like?
These questions are best answered using the resources found in the Background Info page of this guide.
These questions bring together multiple concepts related to a specific clinical situation or research topic. They may be divided into two broad categories:
These questions are best answered using the resources found in the 6S/Foreground Info page of this guide.
Building an effective foreground question can be challenging. The following models will help:
P - Patient/Population
S- Situation
How do/does ___[P]____ experience _____[S]_____?
What is the experience of ____[P]___[S]____?
Ex. How do caregiver-spouses of Alzheimer patients experience placing their spouse in a nursing home?
___________________________________________________________________________
A quantitative approach can answer many different types of questions, but all can be formatted by following the PICO(T) Model outlined in two different ways below:
| Therapy | Etiology | Diagnosis | Prevention | Prognosis | |
|---|---|---|---|---|---|
| P: Population / Disease | Characteristics of a population (age, gender, ethnicity, etc.) with a specific condition or set of circumstances. Ex. African‑American males with type 2 diabetes. | ||||
| I/E: Intervention OR Exposure | Specific drug or procedural intervention | Exposure to certain conditions or risk behaviour | Specific diagnostic tool or procedure | Specific drug or procedural intervention | Specific drug or procedural intervention |
| C: Comparator | Alternative drug or procedural intervention | Absence of certain conditions or risk behaviour | Alternative diagnostic tool or procedure | Alternative drug or procedural intervention | Alternative drug or procedural intervention |
| O: Outcome | Management of disease/ condition | Development of disease/ condition | Effective diagnosis of condition | Prevention of disease/ condition | Occurrence or absence of new condition |
| T: Time Frame | The time it takes to demonstrate an outcome OR the period in which patients are observed. Ex. The six‑months following childbirth. | ||||
| Therapy What will we do? |
Etiology What increases risk? |
Diagnosis How do we identify? |
Prevention How do we avoid? |
Prognosis What happens next? |
|
|---|---|---|---|---|---|
| P: Patient/Problem Who? |
Community‑dwelling adults ≥ 65 y with chronic heart failure | Shift‑working nurses | Adults with suspected deep vein thrombosis | New graduate nurses | Stage II breast cancer survivors |
| I/E: Intervention / Exposure What? |
Home‑visiting nurse‑led education | Rotating night shifts | D‑dimer assay | Hand hygiene training program | High physical activity level |
| C: Comparator Vs. what? |
Standard outpatient follow‑up | No night shift work | Compression ultrasound | Standard orientation | Low physical activity level |
| O: Outcome What result? |
30‑day readmission rate | Incidence of obesity | Diagnostic accuracy | Hospital‑acquired infection rate | 5‑year survival rate |
| T: Time Frame When? |
6 months | 5 years | 1 week | 3 months | 5 years |
| Search Terms Keywords & Synonyms/Alternates |
“heart failure”; “congestive heart failure”; “elderly”; “older adults”; “home care”; “home health care”; “nurse-led education”; “patient education”; “readmission”; “hospital readmission” | “shift work”; “work schedule”; “circadian disruption”; “nursing”; “nurse”; “obesity”; “overweight”; “risk factors”; “contributing factors” | “deep vein thrombosis”; “DVT”; “blood clot”; “D‑dimer”; “sonography”; “ultrasound”; “diagnostic accuracy”; “sensitivity”; “specificity” | “hand hygiene”; “handwashing”; “aseptic technique”; “infection control”; “nosocomial infection”; “HAI”; “healthcare-associated infection”; “nursing education”; “training program” | “breast cancer survivors”; “physical activity”; “exercise”; “survival rate”; “prognosis”; “mortality”; “morbidity”; “follow-up studies” |
*Timeframes vary: acute care (days–weeks), chronic conditions (months–years). Usage of “T” is optional (PICO vs. PICOT).
In ___[P]___, do/does ___[I]___ result in ___[O]____ when compared with ___[C]___ over ___[T]____?
E.g.) In nursing home residents with osteoporosis, do hip protectors result in fewer injuries from slips, trips, and falls when compared with standard osteoporosis drug therapy over the course of their stay?
Are ___[P]___ with ___[I/E]___ over ____[T]____ more likely to ___[O]____ when compared with ___[C]___ ?
E.g.) Are female non-smokers with daily exposure to second-hand smoke over a period of ten years or greater more likely to develop breast cancer when compared with female non-smokers without daily exposure to second-hand smoke?
Is/are ___[I]___ performed on ___[P]___ more effective than ___[C]___ over ___[T]____in ___[O]____?
E.g.) Are self-reporting interviews and parent reports performed on children aged 5-10 more effective than parent reports alone over a four-week consultation process in diagnosing depression?
In ___[P]___, do/does ___[I]___ result in ___[O]____ when compared with ___[C]___ over ___[T]____?
E.g.) In emergency room visitors, do hand sanitizing stations result in fewer in-hospital infections when compared with no hand sanitizing stations over a year-long pilot period?
Do/does ___[I]___ performed on ___[P]___ lead to ___[O]___ over ___[T]____compared with ___[C]____?
E.g.) Do regular text message reminders performed on patients recently diagnosed with diabetes lead to a lower occurrence of forgotten insulin doses over the first six months of treatment compared with no reminders?