“One of the biggest lies is that time could help,” she said. “Time does not help. It only deepens the feeling that something is missing. One simply learns to live with such trauma. And if you don’t get to the point where you can forgive them, then I think you can’t go on living.”
Constructing your clinical question
- Take time out to construct your clinical question thoroughly – spending 5 minutes with a pen and paper brainstorming your question will be more effective than spending 50 minutes searching aimlessly on a computer.
- When constructing your PICO question, provide as much detail on all of the domains (e.g. middle aged men with a history of colorectal cancer (P); 400mg tablet dose ibuprofen (I)).
- Think about potential synonyms as they will be useful when constructing your search string (e.g. panadol, paracetamol, acetaminophen).
- Reflect on why your clinical question is of importance, or what the significance of it is. For example you might be interested in whether drinkers of ‘coke’ are at more risk of developing liver damage than drinkers of ‘pepsi’. Why is this important? What’s the connection between cola and liver damage? Is there really a difference between ‘coke’ and ‘pepsi’? Are you really interested in caffeine and its potential harmful effects? Is there any real physiological connection between the exposure and event?
- Use databases such as Best Practice to provide you with some background information on the topic – i.e. basics, prevention, diagnosis, treatment etc…
2. Conducting your literature search
• Source summaries and synopses to determine if an overview of the literature is present.
• Use a variety of databases to conduct your search i.e. don’t just limit yourself to MEDLINE. If it is a question relating to mental health use PsychINFO for instance.
• Do not apply limits such as ‘only available if full-text’ immediately – many articles may not be indexed as full-text but are freely available by performing an online search on Google.
• Take time to stop and ponder! If your search reveals too many, or too little, results take a moment to think why this may be so. Have you missed a key term, have you misspelt something, or could it be that the evidence on your topic really is limited.
Evidence based clinical practice has been described as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”.