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CINAHL Guided Exercise: 6. Add Third Concept

6.  Add Third Concept

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

In Steps 2 to 5, we completed the first and second piece of our PICO concept - Population and Intervention.

We will now repeat this process for our final PICO element: Outcome

Step by Step: Adding the Third PICO Concept - Outcome

Subject Heading Search - (Outcome)

  1. Start on the CINAHL Search Bar
    • Select Suggest Subject Terms in the checkbox above the search box.
  2. In the search bar, type diaper rash and click Search
  3. From the mapped list of Subject Headings
    • Click on the linked term Diaper Rash for the tree view.
      • Ensure there are no more specific Subject Headings in the tree.
      • Remember to click on the Scope note.
    • Select the checkbox for Diaper Rash.
      • A list of subheadings will be displayed. See Tip: Subheadings
    • Click Search Database.
Video Demo: Adding the Third PICO Concept: Subject Heading

Keyword Search - (Outcome)

  1. Start on the CINAHL Search Bar
    • Leave unchecked the Suggest Subject Terms box
    • For the PICO Concept Outcome, we will use some synonyms/used for terms from the scope note for Diaper Rash: Nappy Rash for the UK term. We will also use the suggestion from the search bar, diaper dermatitis. Combining the two, we'll also add Nappy Dermatitis.
  2. For the PICO element Outcome, our keyword search terms include
    • diaper rash
    • nappy rash
    • diaper dermatitis
    • nappy dermatitis
  3. In the firs field of the CINAHL Search bar enter
    • "diaper rash" OR "nappy rash" OR "diaper dermatitis" OR "nappy dermatitis" (each search term is combined with the operator OR). Remember to include the quotation marks.
  4. Click Search
  5. The keyword search is displayed in the Search History

Combine the Subject Heading and Keyword Search - (Outcome)

  1. Start in the Search History
  2. Select the checkbox for the Diaper Rash subject heading search (S7)
  3. Select the checkbox for the Diaper Rash or Nappy Rash keyword search (S8)
  4. Combine both searches with OR
  5. The combined Intervention search is saved in the Search History as S9, defined as S7 OR S8.
Video Demo: Third PICO concept - Outcome - Keyword Search

Proximity Operators

You can simplify this search string and avoid typing every combination of these two words-- "nappy" and "diaper" with "dermatitis" and "rash"-- by using proximity operators.
  • Near: Use N# (N1, N2, N3, etc) to find the two words near each other in either order, separated by up to the number of words.

We can combine this with operators we have already learned to make a simpler search string: (diaper* or nappy or nappies) N3 (dermatitis or rash*). This retrieves results with diaper dermatitis, diaper rash, diaper rashes, nappy dermatitis, or nappy rash; it will also retrieve "rashes from nappies", "diaper-caused dermatitis" and "dermatitis due to diapers."

Be careful when using these operators, and check your results to make sure you're getting what you want; you can adjust the number down to find results with a closer relationship. For example, if a paper never mentions "diaper rash" but includes the words near each other by coincidence, e.g. "There are many skin conditions other than rashes. Disregarding diapers, bedding is important".

Adding your outcome

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