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CINAHL Guided Exercise: 5. Add Second Concept

5.  Add Second Concept 


Remember our research question: "In infants, does using disposable diapers vs. cloth diapers affect the likelihood of diaper rash?"

In Steps 2 and 3, we completed the first piece of our PICO element - Population/Problem by performing both a Subject Heading and Keyword Search for the Infant concept.

We will now repeat this process for our second PICO element: Intervention.

Step by Step: Adding the Second PICO Concept - Intervention

Intervention: Subject Heading Search

  1. Start in the CINAHL Search Box.
    • Select the checkbox for “Suggest Subject Terms”.
  2. In the search bar, type diaper.
    • Note: We are using the concept diaper include both cloth and disposable diapers.
  3. Click Search.
  4. From the displayed list of Subject Headings, select the most appropriate subject heading, in this case Diapers.
  5. View the scope note for Diapers.
    • The Scope note clarifies that adult diapers would be filed under a different CINAHL Subject Heading, Incontinence Aids. Close the window.
  6. Click on the Diapers hyperlink to expand the tree.
    • Check if there are more specific Subject Headings in the tree. Diapers is the narrowest term.
    • Diapers appear in two different trees, Infant Equipment and Clothing. [Note: Being in different trees does not affect the search but can be informative for additional search terms]
  7. Select the checkbox to the left of Diapers. This opens the blue column. Scroll to the bottom of the blue column for additional information.
    • The history note advises that Diapers has been a subject heading since 1991. If doing a historical search, it advises what to use before 1991. In this instance, papers since 1991 will be sufficient.
    • Used for reminds us of different forms of the word to use as keywords, as well as synonyms, like the international Nappy and Nappies. Take note of these for later. (Note that variant spellings and terminology are essential for creating a comprehensive keyword search)
  8. The subject heading and tool selections appear on the top, on the right. Click Search Database.

Video Demo: Adding the second PICO concept and Subject Headings


Subheadings allow you to choose a specific aspect of your topic. For example, adding Trends will find papers about the changes over time that diapers have had or may have.
  • Leave Include All Subheadings selected in the blue column. See "Subheadings" Tip for more detail on how these can be effective.
  • They are useful when searching for an aspect of a particular topic. E.g. diapers/adverse effects finds papers about the negative impact of diapers.

Keyword Search - Intervention

  1. Start on the CINAHL Search Bar
    • Leave unchecked the Suggest Subject Terms box
    • For the PICO Concept Intervention, we will use some synonyms/used for terms from the scope note for Diapers: Diaper or Diapers as Diaper*; Nappies OR Nappy for the UK terms.
  2. In the first CINAHL Search bar enter
    • diaper* OR nappy OR nappies
    • each search term is combined with the operator OR
  3. Click Search
  4. The keyword search is displayed in the Search History

Video Demo: Second PICO concept - Adding the Keyword search and combining searches

Combine the Subject Heading and Keyword Search

  1. Select the Subject Heading (S4) and Keyword Search (S5)
  2. Combine with the operator OR
  3. The combined search for the second PICO element, Intervention, is complete and displayed in the Search History as S6, defined as S4 OR S5.

Video Demo: Combining searches

Continue building your search

  1. Using the Subject Heading steps 1-5 above, find and search for subject headings for your Intervention, or second, concept.
  2. Using the Keyword steps 1-4 above, find and search for keywords for your Intervention or second concept.
  3. Combine these 2 searches with OR