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On the road to nowhere

November 20, 2012
tags: ,

When nothing might be the right answer – generating new information

It’s rather annoying ( 🙂 ) when some people come up with good ideas, there is that little hint of why didn’t I think of doing that!  Of course that is actually the joy of engaging in open dialogue, being open to suggestions and willing to accept that you might not be the only one with good ideas. When Craig White tweeted and asked if I’d blogged about my PhD as it “may generate new info” a wee light bulb flickered into life – why didn’t I think of that?


This blog is prompted by nothing, or to be more accurate ‘zero’ – zero hits when I did my initial literature search, which I need to write my 12 week report, which outlines what my enquiry is going to be about and what I consider might be my unique contribution to knowledge.  I’m aware that I seem to be starting this story at the end ie the outcome of my search, rather than beginning at the beginning – some may recognise this as an SBAR approach (Situation, Background, Assessment, Recommendation), an approach prevalent in patient safety communications.  However I digress.


I started a PhD in October, my topic is dementia and healthcare associate infection.  Being a mental health nurse I’m interested in this from the mental wellbeing, stress, distress aspect of care rather than the infection pathogens.  In general my enquiry will consider the impact of isolation and/or infection control restrictions on someone who has dementia.

First stage in the process is to complete a literature review to see what information is already out there, what has already been discovered, what might yet still be fertile ground worthy of further exploration.  Using CINAHL and OVID databases which include Medline and PsycInfo along with Web of Knowledge I searched using the term dementia – this lead to in excess of 100,000 hits, clearly a little too much info for me to sift through (its a PhD not my life’s work!).  Adding in qualifications to the search is how I got to zero.

I’ve laid out the search string below –

Searching in ‘Abstract’ or ‘Title’ then extending it to ‘Title’ and  ‘Abstract’ and ‘Article’ – no date limiters

Dementia AND (healthcare OR health care OR hospital) AND (associated OR acquired) AND infection

Result 100,00 to zero in a few easy steps – this is either a very good thing, or a very bad thing


  • It’s a very good thing – no-one has done this before; no-one has linked dementia and healthcare associate infection – outstanding!, my contribution is going to be unique!, a world first.
  • It’s a very bad thing – I’ve miss searched (NB this is just another way of saying I did it wrong!).  Perhaps I haven’t used the right terms, perhaps my initial enquiry is too narrow. Of course it may be that I’ve simply not used the search engines properly, that I haven’t clicked the right buttons in the right order.
  • I need to spend some time with our wonderful librarians in NHS Ayrshire and Arran and be re-instructed in how to carry out an effective literature search
  • I blog about it and invite those that read the blog to comment on my ‘thinking errors’, my ‘process errors’ or agree with what I’ve done and agree the outcomes I got are a true reflection of the literature.

Which brings us back to Craig’s suggestion about writing this blog.


1: Ask readers of the blog for their input, your comments, your thoughts and/or suggestions about how best to proceed

2: Make an appointment to get refresher training with the librarians

3: Discuss with my academic support team

And finally

I’d like to invite you to leave a comment and/or helpful suggestion re the way ahead.  In the mean time I’m off to look up the number for the library.

15 Comments leave one →
  1. Dave Barton permalink
    November 20, 2012 8:01 pm

    Hmmm – are you searching the right terms? From what I can see you are trying to evaluate the impact of the restrictions of the acute hospital environment on those with dementia. Perhaps its more about institutional environments, physical ill health and dementia? I my be on the wrong track – but a quick search on Google for ‘Dementia and physical health’ gives some interesting results.

    • November 20, 2012 8:12 pm

      Thanks Dave – I will have a look. The PhD is to be linked to other PhDs that are going on locally with them looking at the pathogen perspective i.e its not just the environment per se, it’s actually the infection control processes, however, as you’ve suggested perhaps the wider investigation is a better starting point with a more focussed enquiry at a later point. Thanks for looking at this for me. Derek

      • Dave Barton permalink
        November 20, 2012 9:07 pm

        Sounds really interesting. I have a team of ANPS working in acute elderly rehab – lots of dementia care. I will run it past them when I next see them – whether they have any thoughts.

  2. Kim Barron permalink
    November 20, 2012 11:54 pm

    Loved the blog. Without that key foundation laid anything you build is shaky! Great reminder of that.
    PS use ebsco 🙂

  3. November 21, 2012 9:43 am

    Hi Derek.
    Good luck with this. Coincidentally, I am aiming to host the next #NURSESHIFT debate on Dementia, and how we, as nurses, can use SoMe platforms (such as twitter) to help raise awareness. Whether this will be of any use to you I do not know, but if you were interested in attending I am sure you would find a array of professionals able to help you a lot more. Henceforth the beauty of #NURSESHIFT!
    In the meantime, I agree with Dave. Perhaps Google Scholar may help (although this will lead you to a world of adademic papers that would probably discuss infection [pathogens and physiology of dementia, but worth a try) I’ve usually found what I’m after there.

    Let me know your thoughts


    • November 21, 2012 6:09 pm

      Thanks for your comments Mikey- I’ve set aside study time on Friday afternoon, so hopefully will create a plan of attack based on suggestions – its always helpful getting a fresh perspective. Thanks Derek

  4. Wael Agur permalink
    November 23, 2012 8:14 pm

    Liked the blog.
    Have you tried Medical SubHeadings (MeSH) as well as free text?
    Expanding the tree of terms may help here e.g. to generate another name used to describe dementia?

    • November 23, 2012 10:31 pm

      Thank you for you suggestion – I did use MeSH in the original search. The consistent comments are that,at stage 1, I’m narrowing m search too much as this is only the discover stage. I’ve gone back and used #dementia and #infection = 363 papers. My next plan is to search #dementia and #hospital, then scan the abstracts for relevance. At least it’s a start – I appreciate you taking the time to comment. Thanks Derek

  5. Neil Shashoua permalink
    November 28, 2012 6:17 am

    Helo Derek. I liked your post. I can’t offer any help around the specifics but observe your post has been a good way to bring in people who suggest sources of information and people who you’re not able to reach alone. And also a good way to clarify what it is you;re searching for. I wish you well on your continued search.

    • December 2, 2012 10:47 pm

      Thanks for your comments Neil, I appreciate you taking the time to read the blog and comment. Derek

  6. Craig White permalink
    December 14, 2012 9:20 pm

    It would be good to hear how your searching and research journey has developed since the blog.


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