The following assignment from NURS 301 reflects learning meeting VCU Nursing School’s program outcome 4: knowledge of skills in information literacy, management, and patient care technology. It also maps to the objectives of program outcome 3: professional nursing practice grounded in the translation of current evidence. This paper compared and contrasted the search results when utilizing an online journal such as PubMed with a search engine such as Google. The quantity and quality of the evidence obtained by these methods was analyzed, showcasing skills with information literacy and evidence-based practice.
Evidence Based Search Assignment
School of Nursing, Virginia Commonwealth University
NURS 301: Nursing Informatics
Dr. Nancy Husson
February 22, 2021
I am interested in studying the treatment of anxiety in patients with burns. I work in a burn center, and many patients experience anxiety, especially during dressing changes. To find information pertaining to this topic, I first performed a Google search using the following keywords: anxiety burn patient treatment. This search retrieved 93,100,000 results. I then applied a filter to show results published within the past 5 years (more specifically, from January 1, 2016 through December 31, 2021). This narrowed the search to 159 results. Considering the first 30 results, 15 were published in a peer reviewed journal. Out of the 15 sources published in a peer reviewed journal, I was only able to access 11 without a paid subscription to the publishing journal. There were 2 cross-sectional studies (Bhatti et al, 2020; Jain et al, 2017). Six of the sources were literature reviews (Deniz & Arslan, 2017; Fagin & Palmieri, 2017; Griggs et al, 2017). However, one of the literature reviews was in its unedited manuscript edition (Griggs et al., 2017). Only 1 of the sources was a systematic review and meta-analysis (Kim et al., 2019). There were two duplicate sources. Most sources were published in English, but one of the articles was in Spanish. Most of the sources were educational in nature, but one of the websites was published by a medical device company with the intent of selling one of its products (Medline). The majority of these sources were not relevant to the treatment of anxiety in burn patients—only 8 out of 30 included information about treating anxiety in burn patients. 10 out of 30 of the sources were about the general treatment of burn injuries, and made no mention of anxiety. Other types of sources included an interview with physicians, a blog post, a graduate thesis by a candidate for a master’s degree in physician assistant studies, and fact sheets by various clinical groups for patients being treated for burns (Mayo Clinic, 2020; Model Systems Knowledge Translation Center, 2016; Shupp, 2017).
Next, I searched the PubMed Database. Initially, I went to the MeSH terms database to identify whether my original keywords were in fact MeSH headings. I used the MeSH heading “burns,” as well as the MeSH heading “anxiety.” Under the “anxiety,” heading, I specified the “therapy” subheading. The overall keyword search then became: (“Burns”[Mesh]) AND “Anxiety/therapy”[Mesh]. This generated 75 results. Then I applied filters, specifying that I only wanted to view sources published in the English language, within the last 5 years, that studied humans, and were focused on therapy. This resulted in 21 sources. For the first 10 results, 5 were systematic reviews and meta-analysis (Choi et al., 2018; Fardin et al., 2020; Provencal et al., 2018; Scapin et al., 2018; Sheffler et al., 2018). Four were randomized controlled studies (Chester et al., 2018; Daneshpajooh et al., 2019; Ghezeljeh & Ardebili, 2018; Li et al, 2019). One source was slightly different because in its study design, patients received both the standard treatment and the experimental treatment on an alternating basis (Rohilla et al., 2018). Each of the results were relevant, and focused on treating anxiety in burn patients. Interestingly, only 1 source involved a pharmacological intervention (Li et al., 2019). The other 9 sources studied non-pharmacological interventions, including aromatherapy, relaxation techniques, music, massage, hypnosis, and virtual reality.
When comparing the results of the Google search with the PubMed database search, the Google search generated many more sources, even after filters were applied. The Google search resulted in 159 sources, whereas the PubMed search resulted in 21 sources. The quality of the PubMed results was significantly higher than the Google search. The highest quality of evidence available “is derived from meta-analysis of randomized controlled studies (RCTs) and… systematic reviews of RCTs” (Sewell, 2019). 50% (5 out of 10) of the PubMed sources were systematic reviews and meta-analyses, while only 1 out of 30 of the Google sources were systematic reviews. Following systematic reviews, the next highest level of evidence is evidenced derived from a randomized controlled study (Sewell, 2019). 40% (4 out of 10) of the PubMed sources were randomized controlled studies, while the Google search did not produce any randomized controlled studies. Thus, 90% of the PubMed sources were in the top 2 tiers on the hierarchy of evidence, compared to 3.3% in the Google search. All of the PubMed sources were relevant to my interest in treating anxiety in burn patients, compared to only 27% of the Google search. Additionally, all of the PubMed sources came from a peer-reviewed journal, while 50% of the Google sources were peer-reviewed. The Google search also resulted in various problems that I did not encounter during the PubMed search, including duplicate sources, non-English publications, and sources one could not access without paying a subscription fee.
The results of the comparison were striking and irrefutable. The PubMed database search generated higher quality, more relevant evidence than the Google search. The PubMed search was more focused as well, with 21 sources after applying filters. The Google search required sifting through more sources (159), most of which irrelevant or were not authoritative sources. When searching for relevant, quality evidence to address a clinical issue, nurses should rely on library databases like PubMed rather than performing a Google search.
Bhatti, D., Ain, N., Zulkiffal, R., Al-Nabulsi, Z., Faraz, A., & Ahmad R. (2020). Anxiety and
depression among non-facial burns at a tertiary care center in Pakistan. Cureus, 12(11). https://doi:10.7759/cureus.11347
Chester, S., Tyack, Z., Young, A., Kipping, B., Griffin, B., Stockton, K., Ware, R., Zhang, X., &
Kimble, R. (2018). Efficacy of hypnosis on pain, wound-healing, anxiety, and stress in children with acute burn injuries: a randomized controlled trial. Pain, 159(9), 1790-1801. https://doi:10.1097/j.pain.0000000000001276.
Choi, J., Lee, J., Alimoradi, Z., & Lee, M. (2018). Aromatherapy for the relief of symptoms in
burn patients: a systematic review of randomized controlled trials. Burns, 44(6), 1395-1402. https://doi:10.1016/j.burns.2017.10.009.
Daneshpajooh, L., Ghezeljeh, T., & Haghani, H. (2019). Comparison of the effects of inhalation
aromatherapy using damask rose aroma and the Benson relaxation technique in burn patients: a randomized clinical trial. Burns, 45(5), 1205-1214. https://doi:10.1016/j.burns.2019.03.001
Deniz, S. & Arslan, S. (2017). Pain and anxiety in burn patients. International Journal of Caring
Sciences, 10(3), 1723-1727. Retrieved February 20, 2021 from http://www.internationaljournalofcaringsciences.org/docs/69_deniz_special_10_3.pdf
Fagin, A. & Palmieri, T. (2017). Considerations for pediatric burn sedation and analgesia. Burns
& Trauma, 5(28). https://doi.org/10.1186/s41038-017-0094-8
Fardin, A., Rezaei, S., & Maslakpak, M. (2020). Non-pharmacological interventions for anxiety
in burn patients: A systematic review and meta-analysis of randomized controlled trials. Complimentary Therapies in Medicine, 49, 102341. https://doi:10.1016/j.ctim.2020.102341
Ghezeljeh, T. & Ardebili, F. (2018). Comparing the effect of patients preferred music and
Swedish massage on anticipatory anxiety in patients with burn injury: randomized controlled clinical trial. Compliment Ther Clin Pract., 32, 55-60. https://doi:10.1016/j.ctcp.2018.05.002
Griggs, C., Governman, J., Bittner, E., & Levi, B. (2017). Sedation and pain management in burn
patients. Clin Plast Surg, 44(3), 535-540. Retrieved February 20, 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642992/
Jain, M., Khadilkar, N., & De Sousa, A. (2017). Burn related factors affecting anxiety,
depression and self-esteem in burn patients: an exploratory study. Annals of Burns and Fire Disasters, 30(1), 30-34. Retrieved February 20, 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446905/
Kim, D., Pruskowski, K., Ainsworth, C., Linsenbardt, H., Rizzo, J., & Cancio, L. (2019). A
review of adjunctive therapies for burn injury pain during the opioid crisis. Journal of Burn Care & Research, 40(6), 983-995. https://doi.org/10.1093/jbcr/irz111
Li, L., Pan, Q., Xu, L., Lin, R., Dai, J., Chen, X., Jiang, M., & Chen, Z., (2019). Comparison of
analgesic and anxiolytic effects of nitrous oxide in burn wound treatment: a single-blind prospective randomized controlled trial. Medicine, 98(51), 18188. https://doi:10.1097/MD.0000000000018188
Mayo Clinic. (2020, July 28). Burns. Retrieved February 20, 2021 from
Medline. (n.d.). Expert Q&A on burn care: a dressing innovation that helps you manage patient-
reported pain. Retrieved February 20, 2021 from https://www.medline.com/skin-health/expert-qa-burn-care-can-help-manage-patient-reported-pain-anxiety/
Model Systems Knowledge Translation Center. (2016). Psychological Distress after Burn Injury.
Retrieved February 20, 2021 from https://msktc.org/burn/factsheets/Psychological-Distress
Provencal, S., Bond, S., Rizkallah, E., & El-Baalbaki, G. (2018). Hypnosis for burn wound care
pain and anxiety: a systematic review and meta-analysis. Burns, 44(8), 1870-1881. https://doi:10.1016/j.burns.2018.04.017.
Rohilla, L., Agnihotri, M., Trehan, S., Sharma, R., & Ghai, S. (2018). Effect of music therapy on
pain perception, anxiety, and opioid use during dressing change among patients with burns in India: a quasi-experimental, cross-over pilot study. Ostomy Wound Manage., 64(10), 40-46. PMID: 30312157
Scapin, S., Echevarria-Guanilo, M., Junior, P., Goncalves, N., Rocha, P. & Coimbra, R. (2018).
Virtual reality in the treatment of burn patients: a systematic review. Burns, 44(6), 1403-1416. https://doi:10.1016/j.burns.2017.11.002.
Sewell, J. (2019). Informatics and nursing: Opportunities and challenges. Wolters Kluwer.
Sheffler, M., Koranyi, S., Meissner, W., Straub, B., & Rosendahl, J. (2018). Efficacy of non-
pharmacological interventions for procedural pain relief in adults undergoing burn wound care: a systematic review and meta-analysis of randomized controlled trials. Burns, 44(7), 1709-1720. https://doi:10.1016/j.burns.2017.11.019.
Shupp, J. (2017, January 20). Why we must address the psychological impact of burns. MedStar
Washington Hospital Center. Retrieved February 20, 2021 from https://blog.medstarwashington.org/2017/01/20/burn-treatment-psychological-toll/