Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators.

Searching Databases- PICO(T) Question for Falls in Elderly Care

Falls among elderly adults are a social issue of concern (Zhang et al., 2019). They are the leading causes of unintentional injury, hospitalizations, and even death (Saftari & Kwon, 2018). The current population is fast aging, and the number of people living in long-term care facilities is increasing. Aging includes various physical, physiological, and cognitive changes that make the bones and muscles frail and cognitive decline (Brigola et al., 2020). This increases the risk of falls among the elderly. This requires adopting evidence-based strategies to reduce the risk of falls among elderly adults in long-term care and improve their quality of life.

PICO(T) Question

For elderly adults aged 65 years and older living in communities, how effective are therapeutic exercises compared to the use of assistive technologies in improving strength and stability in six months?

Database Searches

The databases utilized in the search included PubMed Central and The Cochrane Library. The key search terms included elderly falls, community-dwelling elderly, therapeutic exercises, and elderly falls. The database search also uses the ‘AND’ and ‘OR’ Boolean operators. The database search was limited to papers published in the last five years (2018-2022). Using the database in the search refined the search to return more relatable studies to my search terms. For example, when the search terms “elderly falls” and “controlled trials” were used in the Cochrane Library, 845 articles were returned. Searching elderly falls and therapeutic exercises returned 67 papers, while elderly falls and therapeutic exercises and community-dwelling returned 20 articles. A database search in PubMed Central using the same searches brought up 53,757, 11,484, and 6,772 articles, respectively.

Optimizing Database Search for My PICO(T) Question

I will optimize the database searches for my PICO(T) question by limiting the search by article publication date by specifying a date range. According to Jensen (2018), research can also be filtered and optimized to give better search results by limiting the results to evidence-based research articles or by further specifying between major publication types, including case studies, clinical trials, meta-analyses, randomized controlled trials, research, and systematic reviews. For my PICO(T) question, the rigor and effectiveness of a database search can be improved by limiting the searches to evidence-based research articles and specifying case studies and randomized controlled trials.

References

Brigola, A. G., Ottaviani, A. C., Alexandre, T. da S., Luchesi, B. M., & Pavarini, S. C. I. (2020). Cumulative effects of cognitive impairment and frailty on functional decline falls and hospitalization: A four-year follow-up study with older adults. Archives of Gerontology and Geriatrics, 87, 104005. https://doi.org/10.1016/J.ARCHGER.2019.104005

Jensen, K. (n.d.). EVIDENCE-BASED NURSING PRACTICE: 7 Steps to the Perfect PICO Search WHAT IS EVIDENCE-BASED NURSING PRACTICE AND WHY IS IT IMPORTANT? 2018. Retrieved June 14, 2022, from https://www.ebsco.com/sites/g/files/nabnos191/files/acquiadam-assets/7-Steps-to-the-Perfect-PICO-Search-White-Paper_0.pdf

Saftari, L. N., & Kwon, O. S. (2018). Aging vision and falls: a review. Journal of Physiological Anthropology 2018 37:1, 37(1), 1–14. https://doi.org/10.1186/S40101-018-0170-1

Zhang, L., Zeng, Y., Weng, C., Yan, J., & Fang, Y. (2019). Epidemiological characteristics and factors influencing falls among elderly adults in long-term care facilities in Xiamen, China. Medicine, 98(8). https://doi.org/10.1097/MD.0000000000014375