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Searching the Literature: A Guide for Nurses : Step 1: Background & Foreground Questions

Determine the type of information you need.

The investigation process begins with determining the type of information needed in order to answer your research question or topic. The questions that arise are typically divided into Background or Foreground questions.

Background questions

Ask for general knowledge of disease processes or clinical contexts; they ask "who, what, when, why, where or how" about a single disease, drug, intervention or concept. Secondary sources such as textbooks, nursing reference sources and review articles can provide relevant and reliable answers quickly.


What are COX-2 inhibitors?
What causes depression?
When do complications of appendicitis usually occur?
What is temporal arteritis?
How is Type II Diabetes managed?

**The best resources to answer them are: Books & textbooks, clinical practice guidelines, clinical EBM resources

Foreground questions

Ask for specific knowledge one can apply to a specific patient or problem. They often compare two things: two drugs or treatments, the prognosis of two groups, two diagnostic tests, or the harms or benefits of two approaches. They require primary sources that synthesize a wide range of knowledge, and usually call for evidence-based answers.


What are the effects of prolonged bed rest on patients with severe scoliosis after lumbar surgery? Are mobile devices an effective tool to manage workflow in an emergency department? What are the determinants of transitions to palliative care in acute care patients under the age of 35?

**The best resources to answer them are: Databases

Foreground questions will require you to comprehensively search the literature. To do so, you will need to develop a search strategy using the PICOT model. See Step 2.

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