Numerous nursing leadership organizations and nursing experts emphasize the need for nurses to develop health policy skills. However, most nurses continue to lack this skill. Few examples of successful ways to deal with health policy in the curriculum can be found in the literature. The authors present a discussion of how health policy skills may be developed at various curriculum levels and use a Master's core course in health policy as an example of a graduate course.
Rapid health care delivery system changes combined with the Institute of Medicine's (1988) call for refocusing public health practice into the Core Functions provide an opportunity to shape community/public health nursing (C/PHN) education and practice for the future. Critical examination is the key to clarifying C/PHN practice. What is the practice now? Is it population-focused, community-based, or both? And what do these terms mean today? The purpose of this paper is to share the authors' thinking about what it is that makes population-focused nursing "different" from community-based practice, as well as unique and useful to the health care delivery system, through the examination of old and new terms and concepts. The significance of this article lies in its ability to encourage dialogue among our colleagues. It is hoped that thoughts shared here will stimulate action to define C/PHN practice in broader arenas.
Substance abuse among young people is of critical concern to public health nurses. When substance abusers are young mothers without the skills, experience, guidance, or resources to become adequate parents, this problem is compounded This study examined a community-based intervention program for young mothers from the perspective of 42 participants. A qualitative, descriptive design was used within a process of participatory action research. Two major domains emerged from the data: risk perceptions and behaviors, and health promoting perceptions and behaviors. The study demonstrated the value of obtaining data from the participants and offers implications for practice and research.
The aim of this research was to explain some processes used by family caregivers and care recipients with acute conditions to develop and maintain satisfying care relationships in home settings. Grounded theory method was used to develop a beginning theory of individual and relationship growth and development. From a sample obtained through two home health agencies, 9 dyads (e.g., care recipient and family caregiver) were interviewed once, 4 dyads twice, and 1 dyad three times. The substantive theory that emerged--recreating life--suggests that caregivers and care recipients respond to disrupted realities caused by illness through redefining self and redefining the relationship. Four mitigating factors affecting the developmental process were identified: (a) prognosis, (b) progress, (c) social support, and (d) professional support.
The changing health care delivery system has affected nursing care delivery models. To meet the needs of these shifting sands, health-related professions must examine curricula preparing new graduates. An exploratory, descriptive survey design was employed to discover motivators for and types of curricular changes occurring in nursing programs and determine what supportive educational materials are needed. One hundred sixty-seven (26%) of the 651 surveys mailed to a sample of the whole of U.S. baccalaureate nursing programs were returned. Relationships between and among categories of nominal data culled from the participants' experiences were compared using nonparametric statistics. Findings demonstrated why and what changes were made and what educational materials are needed to support new curricula. Results also indicated that blurring of boundaries between community and general acute care nursing is necessary, and changes throughout curricula, including educational materials, must reflect the real-life community aspects of the health care needs of all individuals.
The health care delivery system in the United States is moving from an institutionally driven and controlled medical care model toward the Primary Health Care model described by the Alma-Alta Conference (World Health Organization [WHO], 1978) as community-driven comprehensive health care. However, nursing education still remains institutionally based, anchored in a medical model. Dynamic curricula must be developed that prepare nurses to practice in an ever-changing health care delivery system that is becoming more community based. The purpose of this article is twofold: to provide an overview of the revised curriculum of Brigham Young University's College of Nursing (BYU-CON) as one example of a faculty's attempt to develop a program that prepares graduates skilled in providing health care in the 21st century; and to examine closely the integration of community health nursing into the curriculum.
Critical thinking ability is one of the required outcomes of nursing education and content coverage is a focus of the past (National League for Nursing, 1996). As educators, we must attend to how we define critical thinking, what educational methods support its development, and how we can assure that students have achieved some acceptable level of critical thinking skill (Tanner, 1993). This article describes the emergent development of one critical thinking format in a Community Health Nursing course. Rather than approaching critical thinking from a theoretical perspective or focusing on one type of assignment or experience as a tool to foster critical thinking development in nursing courses, this article shares with the reader a complete package. Problems, pitfalls, new insights, and changes are shared as they developed through the teaching of a semester-long Community Health Nursing course. The authors hope their experiences give faculty ideas about how to infuse critical thinking into nursing curricula.
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