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NURS 4610: Translating Evidence for Nursing Practice: Formulating a PICO(T) Question

What is a PICO(T) Question?

Evidence-based practice (EBP) is a systematic approach to patient care decision-making based on current, best available research evidence. 

The first step in EBP involves re-phrasing a clinical patient care issue in the form of a focused, searchable, and answerable question

PICO(T) is a template for creating a well-built clinical question for evidence-based inquiry.

P - Patient/Population/Problem

I - Intervention/Variable of Interest

C - Comparison (can be "standard care" or "usual care", or the opposite of I - "no meditation," "no exposure to smoke", etc.)

O - Outcome(s)

T - Time

In _____ (P), what is the effect of _____ (I), compared with _____ (C), on _____ (O) within _____ (T)?

Ideas for Your PICO(T) Question

Your required textbook provides a wealth of material for generating and brainstorming ideas for PICO(T) Questions. 

Be sure to review Chapter 8 in your Introduction to Evidence-Based Practice text for ideas and examples of clinical questions for EBP research.

Two copies of this book are on reserve in the Mulford Library. To use a copy in the library, please ask a staff member at the library front desk to retrieve it for you. 

Helpful web resources for PICOT question ideas can be accessed below: 

Example: PICO(T) Question and Search Strategy

PICO(T) Question Example: 

"In adult cancer patients experiencing fatigue (P), what is the effect of meditation (I), compared with standard care (C), on quality of life (O) within 6 months (T)?" 

Building a Database Search Strategy for the PICO(T) Question: 

  • A well-built PICO(T) question forms the basis of a database search strategy for finding research literature.
  • Concepts from the PICO(T) question are used to construct a comprehensive database search strategy with search terms describing each relevant component of the PICO(T). 
  • Relevant elements of your PICO(T) question can be used to develop a "starter" list of keywords (including synonyms) to use in a database search. Most commonly, the most important parts of a PICO(T) question for searching are the P, I, and O. 
  • After developing a "starter" list of search terms, you can then begin brainstorming your search strategy for combining terms with OR or AND, and using other techniques such as a truncation (i.e. a keyword search for letharg* will also find articles with the term lethargic or lethargy):
PICO(T) Elements Example Starter List of Synonyms and Search Terms Initial Keyword Search Strategy
P - Patient/Population/Problem Adult cancer patients experiencing fatigue

Cancer

Neoplasms

Oncology

Tumor

Tumour

Malignancy

Fatigue

Tiredness

Lethargy

Exhaustion

cancer* OR neoplasm* OR oncolog* OR tumor* OR tumour* OR malignan*

AND

fatigue* OR tired* OR letharg* OR exhaust*

I - Intervention/Variable of Interest Meditation

Meditation

Mindfulness

Breathing

Relaxation

Yoga

Guided imagery

meditat* OR mindful* OR breath* OR relax* OR yoga OR "guided imagery"
C - Comparison (may be "standard care" or "usual care") Standard care Not needed as a search term  
O - Outcome(s) Improving quality of life

Quality of life

Quality of living

Life quality

Well-being

"quality of life" OR "quality of living" OR "life quality" OR well-being OR wellbeing OR "well being"
T - Time 6 months Not needed as a search term