Discussion: Searching Databases NURS 6052

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Discussion: Searching Databases NURS 6052

RE: Discussion – Week 4

In the treatment of pediatric depression, how does the use psychotherapy or play therapy in combination with pharmacologic treatment compare to the use of therapy alone affect PT outcome within 6 months of diagnosis?

The first search I tried was “treatment of childhood depression” and over 800 articles were found as a potential match.  The first three articles were relevant to my PICO(T) question but not exactly what I was looking for.  The search results after the first three were more specific to certain conditions such as childhood trauma and childhood cancer.  While these would be interesting to read, they will not help me answer my question.  I realized I needed to use more specific keywords in order to generate articles that relate more to my personal question of interest. To do this, I attempted to add the Boolean operator “and” and changed my search term to “pharmacologic treatment of childhood depression and play therapy.”  Unfortunately, I was completely unsuccessful and honestly was reminded that my greatest struggle of graduate school this far is my struggle when it comes to finding research and journal articles.  Thankfully, this week’s discussion post will be a helpful opportunity for me to practice and learn from fellow students. After my moment of frustration, I decided to give a new search term a try.  Again, using Boolen operators I changed the search to read “depression in children AND pharmacologic treatment OR play therapy.”  To my amazement, over 19,000 results were found and after digging through them I found several articles that would be helpful to me in my quest to answer my PICO(T) question.

The first article I read was Psychological treatments for depression in pre‑adolescent children (12 years and younger): systematic review and meta‑analysis of randomized controlled trials.  This article was from the database ESBCO Discovery service.  This article was helpful because it is a systematic review of 2,822 abstract and 124 full-text articles about the treatment of depression in the pediatric population (Forti-Buratti, Saikia, Wilkinson, and Ramchandani, 2016). This one article used Medline, PsycINFO, EMBASE, and Web of Knowledge databases to find relevant articles and studies.  This is incredibly helpful to me as I begin exploring treatment options to answer my PICO(T) question because they have done much of the searching for me.

The next article that I found helpful in my quest was from the Social Sciences Citation Index database. In this article, Understanding the Impact of Treatment on the Dimensions of Childhood Depression, the authors examined three clinical trials in which 269 patients were given a placebo and 261 patients were given the drug Fluoxetine (Isa, Bernstein, Trivedi, Mayes, Kennard, and Emslie, 2017).  The researchers used the Childhood Depression Rating Scale-Revised (CDRS-R) to develop a score to track the effectiveness of treatment for the children.  The overall finding is while both groups did see improvement in their scores over time, the group taking the Fluoxetine had much greater improvement in a faster amount of time.

Increasing the rigor and effectiveness of search criteria will be a process of continual learning.   In the article 7 steps to the perfect PICO search, Kathy Jensen recommends changing the natural language in the question into subjects’ descriptions, headings, or synonyms.  In my case, trying to different ways of saying pediatric depression was helpful in yielding different results.  Using the term depression in children actually seemed to be more effective than childhood depression and pediatric depression. It is interesting that something that is seemingly so simple can have a major impact on a student’s ability to find what they need when searching for articles.  Learning to restate search criteria and keywords will be essential to my growth as a student and as a PMHNP based on evidence-based practice. While much more research would need to draw a final conclusion for my PICO(T) question, this opportunity to search multiple databases is certainly helpful in making progress towards understanding the best methods of treating depression in childhood.

References

Isa, A., Bernstein, I., Trivedi, M., Mayes, T., Kennard, B., & Emslie, G. (n.d.). Understanding the Impact of Treatment on the Dimensions of Childhood Depression. JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY, 27(2), 160–166. https://doi-org.ezp.waldenulibrary.org/10.1089/cap.2015.0023

Jenson, Kathy. Seven Steps to the Perfect PICO Search. 9 Jan. 2018, health.ebsco.com/blog/article/seven-steps-to-the-perfect-pico-search.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: step by step: igniting a spirit of inquiry: an essential foundation for evidence-based practice. The American Journal of Nursing, 109(11), 49–52.

When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems. Discussion: Searching Databases NURS 6052

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.

To Prepare:

  • Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
  • Review the Resources for guidance and develop a PICO(T) question of interest to you for further study.

By Day 3 of Week 4

Post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Then, describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples. Discussion: Searching Databases NURS 6052

By Day 6 of Week 4

Respond to at least two of your colleagues on two different days and provide further suggestions on how their database search might be improved.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 4

To participate in this Discussion:

Week 4 Discussion

RE: Discussion – Week 4

In evidence-based practice gathering data and scientific evidence coupled with clinical experience, interpret best practice methods. Clinical inquiry through research is a way to understand and evaluate interventions and outcomes. PICOT is an acronym to help you formulate a clinical question and guide your search for evidence, and using this format can help you find the best evidence available in a quicker, more efficient manner (Bonsall, 2015).  PICOT stands for P: patient, population, interest, I: intervention, exposure, C: comparison, O: outcome, T: time (Melnyk & Fineout-Overholt, 2019). After developing a PICOT question research will be conducted through appropriate databases to yield articles relevant to the PICOT question.

PICOT Question:

In nurses with less than five years of experience (P) what is the effect of a workplace bullying intervention program (I) on a reduction in the incidence of workplace bullying (O) compared with no intervention (C) within a one-year period (T)?

The databases used were the Cumulative Index to Nursing and Allied Health Literature (CINHAL) plus full text and Medline plus full text. The CINHAL database yielded nine articles using search terms “bullying,” “intervention,” and  “nurse.” The Medline database produced ten articles using search terms “bullying,” intervention,” and “nurse.”  After receiving the results, I added search terms, “support,” “solutions,” on top of “nurse” and “bullying,” and it yielded fewer results.

Strategies I will utilize are; investigating database research, looking at the articles yielded, and finding keywords within and using them as Boolean operators. A few other strategies are brainstorming synonyms, expanding acronyms, and looking at subjects. Evidence-based practice is based on developing a PICOT question as a guide for research and part of clinical inquiry. Promoting clinical investigation in evidence-based practice allows scholars to understand and compartmentalize research processes to aid in successful navigation.

References

Bonsall, L. (2015, October). What is your question? Retrieved June 24, 2020, from https://www.nursingcenter.com/ncblog/october-2011/what-is-your-question

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer.

Hanrahan, K., Wagner, M., Matthews, G., Stewart, S., Dawson, C., Greiner, J., . . . Williamson, A. (2015). Sacred Cow Gone to Pasture: A Systematic Evaluation and Integration of Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 12(1), 3-11. doi:10.1111/wvn.12072

NURS_6052_Module03_Week04_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. 

Supported by at least three current, credible sources. 

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. 

At least 75% of post has exceptional depth and breadth. 

Supported by at least three credible sources. 

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s). 

One or two criteria are not addressed or are superficially addressed. 

Is somewhat lacking reflection and critical analysis and synthesis. 

Somewhat represents knowledge gained from the course readings for the module. 

Post is cited with two credible sources. 

Written somewhat concisely; may contain more than two spelling or grammatical errors. 

Contains some APA formatting errors.

Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately. 

Lacks depth or superficially addresses criteria. 

Lacks reflection and critical analysis and synthesis. 

Does not represent knowledge gained from the course readings for the module. 

Contains only one or no credible sources. 

Not written clearly or concisely. 

Contains more than two spelling or grammatical errors. 

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
First Response
Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. 

Responds fully to questions posed by faculty. 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. 

Demonstrates synthesis and understanding of learning objectives. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are fully answered, if posed. 

Response is effectively written in standard, edited English.

Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are answered, if posed. 

Provides clear, concise opinions and ideas that are supported by two or more credible sources. 

Response is effectively written in standard, edited English.

Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth. 

Responses posted in the discussion may lack effective professional communication. 

Responses to faculty questions are somewhat answered, if posed. 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth. 

Responses posted in the discussion lack effective professional communication. 

Responses to faculty questions are missing. 

No credible sources are cited.

Second Response
Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. 

Responds fully to questions posed by faculty. 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. 

Demonstrates synthesis and understanding of learning objectives. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are fully answered, if posed. 

Response is effectively written in standard, edited English.

Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are answered, if posed. 

Provides clear, concise opinions and ideas that are supported by two or more credible sources. 

Response is effectively written in standard, edited English.

Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth. 

Responses posted in the discussion may lack effective professional communication. 

Responses to faculty questions are somewhat answered, if posed. 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth. 

Responses posted in the discussion lack effective professional communication. 

Responses to faculty questions are missing. 

No credible sources are cited.

Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
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