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實證護理之應用 Literature Search 文獻搜尋. 郭美珠. 大 綱. 前言 文獻搜尋方向 實證研究機構 實證資料庫 醫護資料庫 實際操作. 實證護理五步驟. 步驟一: 形成出一個可回答的臨床問題 步驟二: 搜尋最佳證據 步驟三: 嚴格評讀證據 步驟四:應用證據於病患身上 步驟五: 評估執行效果及效用. PBL-EBM 整合教學 - 傳統的 PBL 著重於小組討論 -EBM 則著重於線上搜尋及嚴格評讀 -PBL 的小組討論與 EBM 的文獻搜尋可相互融合. - PowerPoint PPT Presentation
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Literature Search
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PBL-EBM -PBL -EBM -PBLEBM
EBM~~~
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266,000,000 Evidence based6
Combing terms (Boolean operator)
ANDORNOT A AND B --- AB A OR B --- AB A NOT B --- AB A AND (B OR C) ---A (BC) A OR (B NOT C) ---A (BC ) A NOT (B AND C)---A(B C)
Boolean - OR
DOULAS OR LABOUR SUPPORTDOULASLABOUR SUPPORTUse to combine like terms or terms within the same conceptBoolean - AND
CHILDBIRTHCONTINUOUS SUPPORTCHILDBIRTH AND CONTINUOUS SUPPORTUse to combine together different conceptsBoolean - NOTDOULA NOT MIDWIFEDOULA
MIDWIFEUse to exclude terms from your search
Hand searchingreference lists direct contact with pharmaceutical companies/researchers/
LevelTherapy1a Systematic review (, )1b, 1cAll or none2a (, )2b Cohort study; 2c Ecological studies, outcome research3a (-, )3b - Case-control study4; - 5, , , , Oxford Center for EBM:Levels of Evidence (Therapy)Where to Start?
Ask yourself: How much time do you have? What type of publication am I looking for? Is my query about a specific topic?
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15-2
16 17Cochrane library Up To DateMD Consult EBSCO JAMA & ArchivesMosbys Index Mosbys Nusing ConsultMosbys Nusing Skills
18Best Evidence
ACP Journal ClubAmerican College of Physicians Evidence-Based MedicineACP British Medical JournalGroup 50
20CEPS-()MedlineCINAHLPubMedGoogel Scholar
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23CEPS
25Google
Medline
Micromedex
The Cochrane Library
MDConsult
UpToDate
(11)
CINHAL332009NCKUFM-YCY
http://medlineplus.gov~~2006-12-30~~34
Database: -PubMed -medline -Cochrane library Key wards: -dialysis -statin -mortality
3699/06/09PubMedMy NCBIMeSHMeSHnatural language ANDORNOTAlertEndNotePubmed
2009NCKUFM-YCYPubMed40
Select MeSHMeSH DatabaseSearch KeywordSend toSearch Box with AND/OR/NOTSearch other MeSH and repeat Search PubMed
LinkPubMed Major Topic~~2006-12-30~~402009NCKUFM-YCYPubMed41
Limits~~2006-12-30~~41
43(PICO)Patient or ProblemIntervention or Indicator~~Comparison~~Outcome~~4444Patient or Problem45Intervention or Indicator or Exposure()~~eg: ~~eg: 46Comparison~~eg: CapsaicinLidocaine47Outcome~~eg: 4848Exercise
What types of evidence are relevant to your question
771228/min108/min39X515152Question: ?????????????KeywordsP? ? ? ?? ? ? ? ?I? ? ? ?? ? ? ? ?C? ? ? ?? ? ? ? ?O? ? ? ?? ? ? ? ?52XP77IXCgold standard: Osensitivity and specificityPICO5353Example60 y/o309.010Panadol54Question 1QPICO55Glucosamine(osteoarthitis)GlucosaminePlacebo OR NSAID OR Thank you.