266 VOLUME 25, ISSUE 3, SUMMER 2015 � CANADIAN ONCOLOGY NURSING JOURNAL REVUE CANADIENNE DE SOINS INFIRMIERS EN ONCOLOGIE
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earching for research study articles may seem daunting given the vast array of articles. Furthermore, some articles have limited access making it more diffi cult to obtain the full arti- cle. The purpose of this paper is to: a) demonstrate a series of six steps to fi nd a research study in PubMed to answer questions patients ask; and b) explore ways to link to other relevant articles within PubMed.Scenario Part I:
Mrs. F. is a 45-year-old woman who com- pleted treatments for stage II breast cancer three months ago. Today at her follow-up visit, she tells you that she is still feeling a lot of fatigue. She asks you whether yoga will make her feel less tired.
You do not know the answer to her ques- tion and your initial desire is to say that it would not hurt. You ask other health pro- fessionals in the clinic: some think it could make the fatigue worse and others think it may help. However, no one referred to research to answer the question.
Rather than give Mrs. F. an unin- formed and vague response, you decide to fi nd an answer to the question by conduct- ing an online search for research studies.
The following six steps illustrate how to fi nd an answer to a research question.
Step 1: Identify the research question Does yoga decrease fatigue in breast cancer survivors?
Step 2: List Keywords and synonyms What are the keywords in the research question and synonyms? For example:
• yoga/exercise/stretching
• fatigue/feeling tired/tiredness/low energy
• breast cancer/breast malignancy
• survivor/survivorship Step 3: Go to PubMed
Open PubMed directly at http://ncbi.
nlm.nih.gov/pubmed or fi nd “PubMed Central” using your preferred search engine (e.g. Google). PubMed provides a link to more than 24 million articles that are focused on biomedical litera- ture (e.g. MEDLINE, life science, online books). It is free of charge for anyone to use. If available, PubMed will provide the abstract as a brief description of the article. Commonly PubMed will link to the full-text of articles with some arti- cles available free of charge and others having limited access.
Step 4: Conduct an advanced search Given there are usually several key- words, click on the “Advanced” search option, located under the search box at the top of the webpage. Start with the original set of keywords to see if you can fi nd relevant articles to help answer your question. On the fi rst line and each subsequent line, change “All Fields” to
“Title/Abstract”.
For example, add ‘yoga’; then, on the second line add ‘fatigue’; on the third line add ‘cancer’; on the fourth line add ‘breast’; and fi nally add “survi- vor” (Figure 1). The fi ndings reveal a list of articles that include all of these key- words in the title and/or the abstract.
Review the titles of the articles found to determine if any are relevant to your research question.
If there are not enough articles, a) remove one or two of the key words and re-run the search; or b) exchange one of the keywords for a synonym. When we removed “survivor” in the example, we identifi ed more than 1 article.
Step 5: Read article titles to see if one or more answer the question
In the centre of the screen, browse the results by reading the titles of the articles (Figure 2). If there is a relevant
reseArcH reFlections
Finding research to answer patients’ questions
by Dawn Stacey, Marie-Cecile Domecq, Freya Crawley and Joelle Doucet
ABout tHe AutHors
Dawn Stacey, RN, PhD, Professor, School of Nursing, University of Ottawa, Scientist, Ottawa Hospital Research Institute
Marie-Cecile Domecq, Librarian, Health Sciences Library, University of Ottawa
Freya Crawley, Fourth year nursing student, School of Nursing, University of Ottawa [email protected]
Joelle Doucet, Second year nursing student, School of Nursing, University of Ottawa
Figure 1: Conduct an Advanced Search (Step 4)
1. Select the “Title/ Abstract” search option to focus the results 2. Add keywords
3. Run your search
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Canadian OnCOlOgy nursing JOurnal • VOlume 25, issue 3, summer 2015 reVue Canadienne de sOins infirmiers en OnCOlOgie
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title, click on the title to access the abstract that briefly describes the article.
For example, there is one article on the second page titled:
• “Yoga for persistent fatigue in breast cancer survivors: A randomized con- trolled trial” written by J.E. Bower and colleagues in 2012
After reading the abstract, your research question may be answered and this particular article is labelled as a Free PMC (PubMed Central) Article.
Located in the upper right-hand side of the webpage you will find a link to get free access to the paper. According to Bower and colleagues, when women survivors of breast cancer used yoga for three months, they had less severe fatigue, improved vigour, felt less depressed, and were less stressed.
Step 6: Look at related citations
When the abstract is open in PubMed, there are links to many other potentially better resources (Figure 3).
The “Cited by Systematic Reviews” tab on the right-hand side of the webpage provides you with evidence from similar studies that have been combined into a single article. For example,
• “Yoga for breast cancer patients and survivors: A systematic review and meta-analysis” by H. Cramer and col- leagues in 2012 reported that several studies suggest that yoga can be rec- ommended to improve psychological health during breast cancer treatment.
• “Effects of yoga interventions on fatigue in cancer patients and survi- vors: A systematic review of random- ized controlled trials” by J. Sadja and
P.J. Mills in 2013 reported that sev- eral studies suggest that yoga may be beneficial for reducing cancer-related fatigue in women with breast cancer.
Scenario Part II:
You telephone Mrs. F. at home to tell her that you found out that several studies reported that yoga reduced cancer-related fatigue in women with breast cancer. For example, in one study the severity of fatigue decreased after three months of yoga, and women felt less depressed and less stressed.
conclusions
In this article, we demonstrated how a simple set of six steps can be used to find research studies to answer ques- tions patients may ask. For more details on using PubMed, go to the PubMed Quick Start Guide on the homepage.
Figure 3: Read the abstract and access the paper (Step 5) and Look at related citations (Step 6)
1. Access to full text. Choose the free one!
2. This article has been cited by more recent articles or sys- tematic reviews published in PubMed. Worth looking at!
3. PubMed suggested “related” articles. It may be an excellent way to discover new articles.
Figure 2: Read article titles to see if one or more answers the question (Step 5)
(Note: the number and order of results may change over time as PubMed is constantly adding new articles to the database) 1. Most recent articles first
2. Other relevant articles based on the title
3. Free full-text articles from the PubMed collection
