Nursing: NEW! Nursing Research

What is a search strategy? Why do I need one?

A search strategy is an organized group of words that are used to look for information in a library catalog or database. A good search strategy will help you to find useful information that is relevant to the topic of your assignment.


How do I create a search strategy?

There are four steps to creating a good search strategy:


Step 1: Summarizing

Read the assignment carefully. Make notes of what you are being asked to find, and any other requirements related to the sources of information you will need. Write down the research topic into one to two sentences, and make notes about the additional requirements.

Example

Research Question: Do women of childbearing age who take folic acid supplements have reduced neural tube defects in their infants compared to those who do not take these supplements?

Additional Requirements: peer reviewed articles published in the last 20 years.


Step 2: Finding Search Terms

Look at the research question, and underline or highlight the most important words and ideas. In the example below, these words are highlighted in yellow.

Example

Do women of childbearing age who take folic acid supplements have reduced neural tube defects in their infants compared to those who do not take these supplements?


Step 3: Make a List

Write down the words you identified in a list - this is your first search strategy! You can type these words into a library catalogue or database to start searching.

Example

• women of childbearing age

• folic acid

• supplements 

• infants

• neural tube defects 

Step 4: Brainstorm

Next, brainstorm alternative words that you can use in place of your search terms. This can be synonyms - words or phrases that means exactly or nearly the same as another word or phrase in the same language - broader or narrower terms, and even alternative spellings.

Example

• women of childbearing age > pregnancy, maternal, prenatal, 

• folic acid > folate, vitamin B9, folacin, 

• supplements > supplementation, 

• infants > newborns, neonates, 

• neural tube defects > NTDs, spina bifida, anencephaly, 

Some search terms will have many alternative, and others may only have one or two. This is okay! At this stage, you are brainstorming and trying new ideas. This does not have to be perfect, and there are no right or wrong words.


How do I find these words?

There are a few things you can do to help with the brainstorming process in step 4:

• Work in a group and share ideas

• Use a dictionary, thesaurus or encyclopedia - in print or online

• Do a Google search for synonyms of your word - try typing "synonyms for", followed by your word

• Use the Library's search - type in your first search strategy and look at the results. See what other words are being used by researchers and add the relevant ones to your list.

Most importantly, be patient with yourself! Brainstorming is one of the most challenging parts of research, and it takes time and work. This is okay!


What do I do with these words?

Combine these words in different ways in a library catalogue or database to find information. Make sure that you have one word for each idea in your research question.

Examples

• women of childbearing age folic acid supplements infants neural tube defects

• prenatal folic acid supplementation newborns NTDs

• pregnancy folate supplementation infants neural tube defects 

There is no right or wrong way to combine these words, as long as you have one word for each idea.


What's next?

Look at the tabs labelled Basic Searching and Advanced Searching for more help with using search terms in the Library's search or in a database.

What is basic searching?
When you are using a library search or searching a database, “basic searching” means that you are using one search box and a few carefully selected words to find information. The Catalyst search box on the Library’s homepage is used for a basic search:

What is Catalyst?
Catalyst is the Library’s search tool. It searched all of the Library’s resources all at once, including the physical books on the shelves and the electronic content in all of the Library’s databases. 

What is a database?
A database is an organized collection of information that can be searched. Databases can hold different kinds of information, including journal articles, newspaper articles, eBooks, and streaming videos.

How do I do a basic search?
A basic search is done using the following steps:

Step 1: Preparing to Search
Before you search, you need to create a search strategy. A search strategy is an organized group of words that are used to look for information in a library catalog or database. A good search strategy will help you to find useful information that is relevant to the topic of your assignment. You can learn more about this process in the tab labelled Creating a Search Strategy.

Step 2: The First Search
Visit www.loyalistlibrary.com and find Catalyst. Take the words you brainstormed when you created your search strategy, and start typing them into Catalyst. Use only one word for each idea in your research question: 

HINT! Do not include words like "journal", "article", "peer-reviewed", "scholarly", or the name of the program or course. Including these words will provide a lot of results that are not relevant.

Step 3: The Search Results
On the next screen are the results. In the centre of the screen are the resources that Catalyst has found that include your search words. On the right side of the screen are filters that allow you to narrow down the list of results. At the top of the screen is a reminder to sign into your library account. 



Why should I sign in?
Signing in helps in two ways:

1. Signing in gives you access to electronic resources, including journal articles, eBooks, and streaming videos. If you are off campus and cannot access what you need, make sure you are signed in.
2. Signing in gives you access to all of the extra features in Catalyst that help you with your research.

What is my library login information?
Your library login is the same as your MyLoyalist login. When you are signed in, your name shows up in the top right corner of the screen:


 

Step 4: Filtering
It is very common to get a large number of results the first time you search, especially if the search terms are very broad. Narrow down the list of results by using the filters located on the left side of the screen. These include publication date, peer-reviewed articles, formats, subjects and more. The filters you pick might depend on the requirements of the assignment, so make sure to verify what the requirements of the assignment are. Pick as many or as few filters as you need and click the green button that reads Apply Filters to add them to your search:


 

Step 5: Reading
To access any resource in the list of results, click on the title. This will open a new page with more information, including a call number for printed books, or a link for any electronic resources:

Step 6: Saving, Sharing and Citing
Save any library resource or the search itself, including any filters, by using the pin icon and Save Query feature. You will need to sign in to your library account to use this feature.

Once a resource or a search have been saved, click on your name in the top right corner and choose My Favourites. This opens a new page where you can see any saved resources and saved searches. Clicking on a saved search causes Catalyst to run the search again, with all search words and filters in place:

There are also tools to email, print, and share this screen, which are a great way to share resources for a group project

Finally, there is a tool to help with citations. Click the Citation button and choose the citation style required by the course or program. Catalyst will give a sample of a citation for the chosen resource in the chosen style. Remember! These citations may have formatting errors. This is because of the way publishers add information. For example, if they publish an article with a title all in capital letters, Catalyst’s citation generator will not correct this to lowercase. Always check citations using another source to make sure everything is accurate.

Need more information?
Use the handout and video below.

What’s the difference between a basic search and an advanced search?
A basic search uses a small number of carefully selected words typed into one search box to look for information. You can learn more about basic searching in the tab labelled Basic Searching. The phrase “advanced search” can mean one of two things: 

1. Advanced Search Screens
An advanced search screen has multiple search boxes, and it includes filters like format and date. Often, the advanced search screen also allows you to specify where you want a search term to be located - in the title of the resource, the subject headings, and so on. This combination of multiple search boxes and filters allow you to create a more focused search.

This is an image of the advanced search screen in Catalyst. Individual databases, like PubMed and CINHAL, also have the option to use an advanced search screen.

2. Advanced Search Techniques
There are three advanced searching techniques that can be used to create a more focused search:

• Boolean searching
• Truncation
• Quotation marks

What is Boolean searching?
Boolean searching uses three different words to give the search software a specific instruction. These three words - also called Boolean operators - are AND, OR and NOT.

Hint! Boolean operators are always typed in capital letters.

How do I use AND in a search?
Using AND between words tells the search software to find results that include both or all of the words; you can use AND to connect more than two words. AND focuses and narrows down the search by combining words. AND is often a default in many library databases, and it is often added behind the scenes in internet search engines like Google.

In the example below, the search software is being told to find results that include the words prenatal AND folic acid AND neural tube defects. Results must include all of the search words.

How do I use OR in a search?
Using OR between words tells the search software to find results that include either the first word OR the second - or the third; you can connect more than two words with OR. OR broadens the search, and can be very helpful when you are searching for a topic that has several synonyms, like those brainstormed when you create a search strategy. (See the tab labelled Creating a Search Strategy for more.) 
In the example below, the search software is being told to find results that include folic acid OR folate OR vitamin B9 OR folacin. Results must include one or several of the search words.
 

How do I use NOT in a search?
If there is a term you want to omit from the search results, include that word in the search, preceded by the word NOT. NOT narrows the search by removing or ignoring elements of a topic. NOT can be challenging to use, and it is important to remember that including it in a search may mean that useful information.

In the example below, the search software is being told to find results that include the word dementia, but NOT the word Alzheimer's.

What is truncation?
When truncation is used, a word ending is replaced by a symbol. Different databases use different truncation symbols so it is important to know which symbol to use. This information can often be found on the database’s “Help” screen - but if you are unsure, ask the Library. One of the most common symbols used is the asterisk. Using truncation tells the search software to search for different forms simultaneously. It increases the number of search results found, and can be very useful when you’re looking for different variations on a word.

In the example below, the use of the asterisk means that the search software will find variations on words beginning with “nurs”, like “nurse”, “nurses”, and “nursing”.
 

Truncation can be challenging to use! It can bring unexpected or irrelevant results, especially if the truncation symbol is placed too soon. Using the example above, if “nur*” was typed in, the search software will find results that include any words starting with the letters, “nur” - like “nursery” or “nurture”. 

How do I use quotation marks in a search?
Unlike using AND, which means that the search terms could be anywhere in the results in any order, using quotation marks tells the search software to find results with exactly those words in exactly that order. This is sometimes called an Exact Phrase search. 
 

What’s next?
These advanced search techniques can be combined into one search to build a more specific search. 

Hint! Put the synonyms for each search term on a line and separate them with OR. The drop-downs on the left supply the AND that connects each group of synonyms.




Need more information?
Use the handout and video below.

What is a PRISMA Flow Diagram?

PRISMA stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The PRISMA flow diagram is a tool that researchers can use to summarize their research, and the process they use for deciding what information resources to include in that research. The diagram starts by recording the number of articles found in a search. Next, it outlines the decisions that are made at each stage of reviewing those articles, including the reasons for excluding particular resources. (Reasons for exclusions are explained later in this section.) The number of articles is recorded at each of these different stages. This process is one way to ensure that you are finding resources that meet the needs of an assignment. You can learn more about the PRISMA flow diagram on the PRISMA website at prisma-statement.org.

There are two columns in a PRISMA flow diagram:

• On the left side of the page, there is a column labelled Identification of studies via databases and registers.

• On the right side of the page, there is a column labelled Identification of studies via other methods.

Each of these columns has three sections:

• Included

• Screening

• Identification

Please Note! This image is rotated. These section names appear vertically on the left side of the PRISMA flow diagram.


Which PRISMA Flow Diagram should I use?

There are different versions of the 2020 PRISMA flow diagram. The version you use depends on the kind of research being done and the types of sources you are asked to use.

How do I use a PRISMA Flow Diagram?

Step 1: Preparation and Planning

• Decide what search terms to use; the resources in the tab titled “Creating a Search Strategy” are a useful guide for this step. Create a list of search terms to work from, and build on this list while searching.

• Decide which databases to search, based on the research question and the requirements of the assignment. Databases in the Loyalist College Library have descriptions that can help you to decide which ones will be the most useful.

• Decide what filters to use, such as date of publication or peer-review.
  
   

Step 2: Database Searching

Search each database individually using the search terms you decided on in step 1. Apply any filters you chose. Try basic searches - adding terms into one search box - and advanced searches - using multiple search boxes, Boolean operators, and truncation. You can learn more about these in the tabs titled "Basic Searching" and "Advanced Searching".

Once all of the searches are complete, add up the number of results from each search, including any duplicates. This is your total number of articles or records. Put this number into the first box in the Identification section of the PRISMA flow chart. This box is labelled Records Identified from*: Databases (n=). 


 

What about registers?

On the PRISMA flow chart, the word "registers" refers to trial registries. These are online databases where researchers conducting clinical trials can register their trial. According to the World Health Organization, trial registration is " a scientific, ethical and moral responsibility" for several reasons. These include:

• ensuring that decisions about health care are informed by all of the available evidence

• reducing publication bias and selective reporting of data

• improving awareness of similar or identical trials to avoid unnecessary duplication

• identifying gaps in clinical research

• enabling collaboration between researchers around the world

More information about the benefits of registering a clinical trial can be found on the WHO website at who.int/clinical-trials-registry-platform/network/trial-registration. Try searching of of the registers linked below:

Do I need to use registers?

Whether or not you search trial registers as a part of your research depends on the assignment or the requirements of the research. If your instructor has not asked you to use trial registers as a part of your assignment, leave this section blank.


Step 3: Remove Duplicates

Remove any articles that appear more than once in your results. 

Hint! Duplicate records are more challenging to identify if you are only using Catalyst. Catalyst groups duplicates together under one search result; this is why you will sometimes see multiple links to the same article when you click on a title in your list of results. 

Identifying duplicates is most important when you are searching individual databases; the same article may appear in more than one database. Use the features in the database to export the articles you want into RefWorks or into an Excel file. Then, use the tools built into RefWorks or Excel to identify and remove duplicate articles.

If you are search individual databases, the feature to export may not be available, or it may look different depending on the database. If you need help, contact the Library at library@loyalistcollege.com.
 

How do I find and remove duplicates in RefWorks?

1. You must have a RefWorks account set up. Use your Loyalist College email to create an account; this makes connecting your library account and your RefWorks account easier.

2. Once you have uploaded the records from Catalyst into your RefWorks account, click Last Imported on the left side of the screen. This opens a list of the records you imported.

3. Click Duplicates on the left side of the screen. This allows you to tell RefWorks how to identify duplicates, and you can customize this criteria by title, author, year, etc. 

4. RefWorks will remove duplicate records. This process can take time.
   
    

How do I find and remove duplicates in Excel?

1. Click the Data tab at the top of the screen.

2. Find the group labelled Data Tools.

3. Click Remove Duplicates.

Count how many duplicate articles or records were found and/ or removed. Enter this number in the second box in the Identification section. This box is labelled Records removed before screening: Duplicate records removed  (n = )

What about the other two numbers in this box?

There are two other sections in this box - Records marked as ineligible by automation tools and Records removed for other reasons. If you are using automation tools to help you evaluate the relevance of citations in your results, you enter that number here. If you are not using these tools, leave this section blank. For research done in the nursing programs at Loyalist College, you will probably leave these two sections blank, unless you are told to do otherwise by your instructor.


I don't see any duplicates! What happened?

If you are searching in Catalyst only, it is very unlikely that you will see duplicates. Catalyst searches all of the databases at once, and it sorts duplicates for you; this is why you will sometimes see multiple links to the same article:

In this example, the highlighted titles - Academic Search Premier and Wiley Online Library - are the names of databases. They are both searched by Catalyst, and Catalyst has grouped these results together are one result. If this case, they are not considered duplicates. However, if you searched each of these databases on their own and found the same article in both searched, then they would be considered duplicates.


Step 4: Records Screened- Title/Abstract Screening

Add the number of articles that you will screen in the next box. Here, "screen" means to evaluate or analyze for appropriateness - i.e.: is the article likely to be useful for the assignment or project? Subtract the number from the Duplicate records removed box pictured in step 3 from the number of records identified. Enter this number into the first box in the Screening section. This box is labelled Records screened (n =).

Step 5: Records Excluded- Title/Abstract Screening

Evaluate - or "screen" - the article titles and abstracts and identify articles that are relevant to your research question. Any articles you think will be useful for answering the research question should be included. Count how many articles you have identified and enter this number into the second box of the Screening section. This box is labelled Records excluded (n =). You can add the reasons for exclusion at this level, but this is not required until full text screening in step 9.

Step 6: Reports Sought for Retrieval

This is the number of articles you identify for full text screening. Subtract the number of excluded records (step 5) from the total number screened (step 4). Enter this number into the third box in the Screening section. This box is labelled Reports sought for retrieval (n =). 


Why does it say "reports" instead of "articles"?

In this step, PRISMA uses "reports" instead of "articles", but they mean the same thing. In the PRISMA 2020 Explanation and Elaboration, a report is defined as, "a document (paper or electronic) supplying information about a particular study. It could be a journal article, preprint, conference abstract, study register entry, clinical study report, dissertation, unpublished manuscript, government report, or any other document providing relevant information". A link to the full article can be found here: https://www.bmj.com/content/372/bmj.n160


Step 7: Reports Not Retrieved

Count the number of articles for which you are unable to find the full text, and enter this number into the fourth box in the Screening section. This box is labelled Reports not retrieved (n = ).

Remember! If you do want full text for any of these articles later, ask the Library about interlibrary loan.


Step 8: Reports Assessed for Eligibility- Full Text Screening

This is the number of reports sought for retrieval step 6) minus the number of reports not retrieved (step 7). Review these articles to assess their appropriateness. Do they meet the needs of the research question? Enter this number into the fifth box in the Screening section. This box is labelled Reports assessed for eligibility (n = ).


Step 9: Reports Excluded

After reviewing the full text of all the articles identified in step 8, enter the total number of articles that you will exclude into the sixth box of the Screening section. This box is labelled Reports excluded.

 

In this box, you will also list the reasons for excluding the articles, and the number of records excluded for each reason. Only count an excluded article once in the list even if it meets multiple exclusion criteria. Examples of reasons for excluding articles can include - but are not limited to:

• duplicate articles

• insufficient qualitative analysis or data

• insufficient participant data

• a small sample size

• failure of the study to report patient outcomes

• lack of peer review

You can decide on your own exclusion criteria, and this criteria can be as simple or complex as you want.


Step 10: Included Studies 

The final step is to subtract the number of records excluded in step 9 from the total number of articles in step 8. Enter this number into the box in the Included section. This box is labeled Studies included in review (n =) and Reports of included studies (n = ). 

What's the difference between "studies" and "reports"?

Remember that PRISMA uses "reports" instead of "articles". This means that the number of scholarly articles found using databases will be entered where it says Studies included in review (n =). If you have been asked to include grey literature, include the number of resources where it says Reports of included studies (n = ).

Remember! Always confirm with your instructor that grey literature is permitted in your essay or assignment.


How do I search for and screen grey literature?

There are two columns in a PRISMA flow diagram:

• On the left side of the page, there is a column labelled Identification of studies via databases and registers.

• On the right side of the page, there is a column labelled Identification of studies via other methods.

To screen grey literature, use the boxes under the second column - Identification of studies via other methods. This column works exactly as described in steps 1 to 10, but the sources of information are different. Instead of library databases and clinical trial registers, you will search websites, professional associations, and indexes like Google Scholar. Use the same methods to fill in each box:

I need help with this step!

No problem! Go to the tab labelled Documenting a Grey Literature Search with PRISMA for more information.


What's next?

Nothing! You have completed your PRISMA flow diagram!

What is grey literature?

Grey literature is published informally or non-commercially, and some remains unpublished. It can include government reports, statistics, patents, conference papers and even non-written resources such as posters and infographics. It is produced by a variety of sources, and it is usually not indexed or organized, which makes it difficult to locate with a library’s search. It is more easily found through a search engine like Google Scholar, or on the website of an organization or government department. Some examples of sources for grey literature include:

Grey literature is not usually peer reviewed and is not considered “scholarly”. However, it is still good quality, reliable information, and it can be an excellent way to supplement. It can sometimes be more current than literature published in scholarly journals and it can offer a fuller picture of the information available on a particular topic.

How do I search for and screen grey literature to include it in a PRISMA flow diagram?

There are two columns in a PRISMA flow diagram:

• On the left side of the page, there is a column labelled Identification of studies via databases and registers.
• On the right side of the page, there is a column labelled Identification of studies via other methods.

To screen grey literature, use the boxes under the second column - Identification of studies via other methods. This column works exactly as described in the steps described in the PRISMA Flow Diagrams tab, but the sources of information are different. Instead of library databases and clinical trial registers, you will search websites and professional associations, like the ones listed above, and indexes like Google Scholar.


Step 1: Records Identified

Enter the total number of records from each source type in the first box on the right side of the PRISMA flow diagram.

If you are unsure about where your source should be counted, ask your instructor or the Library for help.


Step 2: Reports Sought for Retrieval

This is the total number of reports you find from each grey literature source. To find this number, add up each of the numbers in the box in step 1.

Step 3: Reports Not Retrieved

Count the number of articles for which you are unable to find the full text, and enter this number in the box labelled Reports not retrieved (n = ).

Remember! If you do want full text for any of these articles later, ask the Library about interlibrary loan.


Step 4: Reports Assessed for Eligibility

Take the number of reports sought for retrieval in step 2 and subtract the number of reports not retrieved in step 3. Enter this number into the box labelled Reports assessed for eligibility (n = ). Then, review these reports to assess their appropriateness. Do they meet the needs of the research question?

Step 5: Reports Excluded

After reviewing all of the reports for appropriateness, enter the total number of articles you will exclude in the box labelled Reports excluded. In this box, you will also list the reasons for excluding the articles, and the number of records excluded for each reason. Only count an excluded article once in the list even if if meets multiple exclusion criteria. Examples of reasons for excluding articles can include - but are not limited to:

• duplicate articles
• insufficient qualitative analysis or data
• insufficient participant data
• a small sample size
• failure of the study to report patient outcomes
• lack of peer review

You can decide on your own exclusion criteria, and this criteria can be as simple or complex as you want.

Step 6: Included Studies 

Subtract the number of Reports excluded from the number of Reports assessed for eligibility. Enter this number in the box at the very bottom of the PRISMA flow chart in the section labelled Reports of included studies.

Remember that PRISMA uses "reports" instead of "articles". This means that the number of scholarly articles found using databases will be entered where it says Studies included in review (n =) and grey literature resources will be entered where it says Reports of included studies (n = ).