NURS 354/375

Background questions ask for general knowledge about a condition or thing.

Foreground questions ask for specific knowledge to inform clinical decisions or actions. 

Background Questions:

• Asks for general knowledge about a disease or disease process
• Has two essential components: A question root (who, what, when, etc.) with a verb A disorder, test, treatment, or other aspect of healthcare
  • Example: What causes migraines? or How often should women over the age of 40 have a mammogram?
• The background question is usually asked because of the need for basic information. It is not normally asked because of a need to make a clinical decision about a specific patient.

Foreground Questions:

• Ask for specific knowledge about managing patients with a disease
• Have 3 or 4 essential components (see PICO below)

Evidence-based practice uses the PICO(T) model for formulating a searchable question. 

PICO(T) is a mnemonic used to describe the four elements of a good clinical foreground question:

P = Population or Problem

How would I describe the problem or a group of patients similar to mine?

I = Intervention

What main intervention, prognostic factor or exposure am I considering?

C = Comparison

Is there an alternative to compare with the intervention?

O = Outcome

What do I hope to accomplish, measure, improve, or affect?

T = Timeframe

The timeframe for data collection or time to outcome. Timeframe is not always included in this model.

Fill in the blanks with information from your clinical scenario:

INTERVENTION / THERAPY

In__________________(P), how does  ________________(I) compared with _________________(C) ______________ affect_____________ within______________________________?

ETIOLOGY

Are ______________(P) who have _______________(I) compared to those without _______________ (C) at ______________ risk for/of ________________(O) over____________________(T) ?

DIAGNOSIS OR DIAGNOSTIC TEST

In _________________ (P), are/is ________________ (I) compared with _______________ more accurate at diagnosing __________ (O)?

PREVENTION

For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?

PROGNOSIS

Does ____________ influence ______________ in patients who have _____________?

MEANING

How do _______________(P) diagnosed with _______________(I) perceive (O) __________________ during_______________(T)?

* Adapted from Melnyk, & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare : a guide to best practice (Fifth edition.). Wolters Kluwer.

Intervention/Therapy

In patients with acute bronchitis, (P) do antibiotics (I) reduce sputum production or cough? (O)

Etiology

Are young people (P) with a low fiber diet (I) compared with those with recommended fiber intake (C) at a higher risk for hypertension (O)? 

Meaning

How do young patients (P) who have had mastectomies (I) perceive reconstructive surgery (O)?