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Searching Bibliographic Databases for Nursing Theory
by 
Margaret (Peg) Allen, MLS-AHIP 
The CINAHL® database is the best database to use when searching for information related to nursing theory. You may want to supplement your CINAHL search with a MEDLINE search in order to retrieve journal articles published before 1982 and additional articles from non-English language nursing journals. Why search the CINAHL database first?    
  1. Cinahl indexes more nursing journal titles than any other bibliographic database.
  2. It also indexes information in multiple formats, including books, book chapters, audiovisuals, and websites. MEDLINE is limited to journal articles.
  3. The CINAHL thesaurus offers subject headings for the major nursing theories and models.
  4. The CINAHL database offers publication types that let you limit your search to specific types of information, such as Research.
  5. CINAHL includes a "Cited References" field that includes the bibliographies of articles from many journals indexed in CINAHL. This is an excellent way to find older and classic literature.
For more information on bibliographic databases for nursing, see "Nursing Knowledge: Access via Bibliographic Databases."   

Database selection is the first step in a successful search. The second step is learning about the process you’ll use to search the database(s) you choose. If you’re not familiar with the database search software used by your library, you will want to take a class or review the help files. Pay particular attention to information on how to search using formal subject headings, and information on searching specific fields, particularly the "Publication Type" (Document Type in SilverPlatter searching) and "Cited Reference" fields. If your library or professional association doesn’t offer the CINAHL® database, you may want to investigate the CINAHLdirect® online service, available at http://www.cinahl.com or the CINAHL database on HealthGate at http://www.healthgate.com/HealthGate/nursing/ - both offer fee-based searching.   

CINAHL Search Strategies  

The next step is to construct a search strategy that will retrieve the most relevant literature. Your CINAHL search should begin with a Subject Heading search. There are three basic types of search questions related to nursing theory: information ABOUT a particular nursing theory; information on studies using a nursing theory; and information on which nursing theories have been used in studies similar to your research topic. Strategies for each type of question are outlined below. If you are not familiar with the concept of using Subject Headings for database searches, think of them as the codes used for indexing articles. Indexers need to standardize what concepts are called, just as nursing seeks standardization of the language used for nursing diagnoses, interventions, and outcomes. For more information on the indexing process, see Allen, M. Selecting Keywords: Helping Others Find Your Article.  

Search strategy 1: Information (citations to resources) ABOUT a particular nursing theory  

If an article, book, book chapter, or other resource focuses on describing a nursing model or theory, the indexer will assign the official subject heading for that theory as a MAJOR heading. Therefore, if you search on the heading in the Major Heading field (limit to focus in some systems), you will retrieve citations to resources that describe the theory. Official CINAHL subject headings come from the Nursing Theory Tree, under the broader heading Nursing Models, Theoretical:  

NURSING-THEORY
        NURSING-MODELS-THEORETICAL
                BENNERS-PROFESSIONAL-ADVANCEMENT-MODEL
                CORBIN-AND-STRAUSS-CHRONIC-ILLNESS-TRAJECTORY-FRAMEWORK
                COX-INTERACTION-MODEL-OF-CLIENT-HEALTH-BEHAVIOR
                FITZPATRICK-LIFE-PERSPECTIVE
                GORDONS-FUNCTIONAL-HEALTH-PATTERNS
                HENDERSON-NURSING-MODEL
                JOHNSON-BEHAVIORAL-SYSTEM-MODEL
                KING-OPEN-SYSTEMS-MODEL
                LEININGERS-THEORY-OF-CULTURE-CARE-DIVERSITY-AND-UNIVERSALITY
                LEVENTHAL-AND-JOHNSONS-THEORY-OF-SELF-REGULATION
                LEVINE-CONSERVATION-MODEL
                MARKER-NURSING-MODEL
                MISHEL-UNCERTAINTY-IN-ILLNESS-THEORY
                NEUMAN-SYSTEMS-MODEL
                NEWMAN-HEALTH-MODEL
                NIGHTINGALES-NURSING-THEORY
                OREM-SELF-CARE-MODEL
                ORLANDOS-NURSING-THEORY
                PARSES-THEORY-OF-HUMAN-BECOMING
                PATERSON-AND-ZDERADS-THEORY-OF-HUMANISTIC-NURSING
                PENDER-HEALTH-PROMOTION-MODEL
                PEPLAU-INTERPERSONAL-RELATIONS-MODEL
                ROGERS-SCIENCE-OF-UNITARY-HUMAN-BEINGS
                ROPERS-ACTIVITIES-OF-LIVING-MODEL
                ROY-ADAPTATION-MODEL
                RUBINS-THEORY-OF-MATERNAL-IDENTITY
                TRAVELBEE-INTERPERSONAL-THEORY
                WATSONS-THEORY-OF-CARING
                WIEDENBACHS-THEORY
(Copyright© Cinahl Information Systems, 1999. Reprinted with permission from the CINAHL Subject Heading List.)
Note that most of these headings include more than just the last name of the author.  All indicate a formal name for the theory or model, and must be searched as a phrase in the major subject-heading field.   

What if the theory you’re looking for isn’t listed?  Some models are broader than nursing.  They may still have a subject heading in the MODELS, THEORETICAL tree in the CINAHL Subject Heading List, either as a general theory (i.e. HEALTH BELIEF MODEL) or as a theory or model in another field, such as Physiological, Psychological, or Sociological Theory. First, try searching the thesaurus for the name of the theory that you’re researching.  If that doesn’t work, try searching the heading MODELS, THEORETICAL, “exploded” to include all narrower headings. Do this search in the Major Heading field, or do a subject search and limit to focus (Ovid and CINAHLdirect search software). Hint:  when you “explode” a subject heading, you will retrieve all database records using the term you explode, plus all the narrower terms included under that term in the database thesaurus. Combine that search with the last name of the theory’s author as a text word or keyword search, and you should have records relevant to the theory you're looking for.  

Search strategy 2: Citations to studies USING a nursing theory  

When a theory or model is used in a research study, the main focus of the article is usually the actual research question, so the indexer will usually assign the name of the theory or model as a MINOR heading.  However, if the research tests a theory, it could also be a major heading.  So, the best strategy is to search as in the first strategy, but DON’T limit to focus or search as a MAJOR heading.  You will retrieve citations to all resources discussing the theory or model.  

Next, limit your retrieval to Publication Type = Research (Document type if using SilverPlatter).  This will retrieve citations describing research studies, including journal articles, abstracts, and dissertations.  

For more citations, try searching the Cited Reference field for the classic books and articles describing the theory.  To do this, search on the author last name and a key phrase from the title for each classic citation.  Do not search on journal names, as they may not be cited in a consistent format – some journals use full titles and others use abbreviations.  

Search strategy 3: Citations on which nursing theories have been used in studies similar to your research topic  

First, do a CINAHL search on your research topic – you might want to broaden the search if you retrieve just a few citations.  Then do a subject search on MODELS, THEORETICAL, Exploded as explained in Search Strategy 1. Combine the two results to get citations to articles on your topic which also refer to a theory or model  
  
MEDLINE search hints  

You can search MEDLINE using a wide variety of search engines, including free MEDLINE from the National Libray of Medicine at http://www.nlm.nih.gov/. In MEDLINE you can only search on the broad MeSH (Medical Subject Heading) NURSING THEORY, which you will want to combine with a text word search on the last name of the theorist.  This does not provide for precision searching, but may help you find journal articles published prior to 1982 or in a journal not indexed by CINAHL. MEDLINE indexes more non-English titles than CINAHL, so this could be helpful if you read other languages.  

Notes

Exploding Subject Headings 

To understand "Exploding" subjects, it helps to understand how the CINAHL Subject Headings List and MeSH (Medical Subject Headings) used by the National Library of Medicine (NLM) are organized. Print versions of the thesauri lists each term three ways:  

*Alphabetical list  

*Permuted list  

*Tree Structures  

The "Permuted" list includes every term in every heading as a cross reference from the form listed to the form used, i.e. Theory, Nursing see Nursing Theory. The online thesaurus used for most search interfaces "maps" from what you type to the the appropriate form of the subject heading. If you click on the term, you may see the term in relation to its Tree (broader and narrower headings), as described in the next paragraph.  

In the Tree Structures, the terms are listed in a hierarchial arrangement, and some terms appear in more than one tree. For example, the "Nursing Models, Theoretical" tree in the CINAHL Subject Heading List includes all the nursing model terms. Most database search software allows you to "Explode" a subject heading to include all the more specific terms that are listed below it in the thesaurus. Some search engines will even give you this choice when there are no more specific terms! When you "Explode" a term, you will retrieve citations indexed with that term AND all the terms which appear below in it the thesaurus. An example from the Anatomy tree may help:  

Extremities
    Arm
         Elbow
         Forearm
         Hand
                Fingers
                Thumb
         Shoulder
         Wrist
   Leg
         Ankle
         Foot
                Heel
                Toes
         Hip
         Knee
         Thigh
Explode Arm, and you get all the parts of the Arm, plus anything listed (indented) under Arm - likewise for Leg.  
References
 
Allen, M. “Nursing Knowledge: Access via Bibliographic Databases” in Thede, Linda Q.  Computers in Nursing: Bridges to the Future, Philadelphia: Lippincott, c1999, pp. 149-170.   

Allen, M. Selecting Keywords: Helping Others Find Your Article.  Nurse Author & Editor (Winter 1998) 8:4,7-9.  

________________________________________________________________  
Questions?  Contact:  
Margaret (Peg) Allen, MLS-AHIP  
P.O. Box 2  
Stratford, WI 54484-0002  
715-687-4976 or 715-687-2287  
 Fax: 715-687-4976     E-mail:  pegallen@tznet.com  
________________________________________________________________ 

 

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