The focus of nursing as a discipline has not been clearly defined but is emergent in the centrality of the concepts of caring and health. The authors propose a focus for nursing as a professional discipline in the form of a statement that identifies a domain of inquiry that reflects the social relevance and nature of its service. Several perspectives from which the focus can be studied are described. The authors assert that a unitary-transformative perspective is essential for the full explication of nursing knowledge.

A framework for organizing the study of nursing informatics is presented. The management and processing of nursing dnta, information science and nursing science is proposed as an area for study. The premises for such s t d y and the key concepts and relationships are discussed. Nursing informatics would support the practice of nursing and delivery of nursing care.

This study explored the scope of decisions encountered by elderly cancer patients and/or their family caregivers, and the types of decision-making assistance requested and required within one practice setting. Semistructured interviews were conducted with five cancer center nurse coordinators (CCNCs). The CCNCs were interviewed weekly for 16 weeks to identify decision-making topics addressed, assistance requested, and perceptions of assistance required during telephone conversations. The CCNCs' reports of 41 telephone conversations revealed 44 specific decision-making topics. Content analysis uncovered 11 categories: symptom management, use of chemotherapy, ancillary choices selection of a medical provider, planning for end-of-life care, alternative therapy, vacation planning, weekend-pass planning, discharge planning, family survivor issues, and involvement of adult children in the elder's care. Elderly patients and/or their family caregivers requested information and assistance with making decisions. CCNCs perceived that callers also needed information clarification, reassurance about their decisions, a listener, permission to change the treatment regimen, and help with communication among health professionals, the elderly patient, and the family.

Family members, typically spouses, serve as the primary caregivers for individuals with dementia. While it is recognized that caregivers experience both positive and negative subjective responses to caregiving, relatively little research has been done on the relationship between these types of responses. The objectives of the study were to examine the relationships between and among spouse caregivers' positive and negative subjective responses to caregiving, and increase understanding of the experience of being a spouse caregiver for a person with dementia. Fifty spouse caregivers completed quantitative measures of positive subjective responses (Positive Aspects of Caregiving and Caregiver Competence) and negative subjective responses (Relational Deprivation, Role Captivity, and Loss of Self). Additionally, participants were interviewed concerning their caregiving experiences. Positive Aspects of Caregiving and Caregiving Competence were significantly related to each other (p < .01), as were the three measures of negative subjective responses (p < .01). No significant correlations were found between any measures of a positive and a negative subjective response, suggesting the two types of responses are independent. Duration of caregiving was significantly related to Positive Aspects of Caregiving (p < .05), Caregiver Competence (p < .05), and Relational Deprivation (p < .01). Qualitative interview data revealed that participants simultaneously experienced caregiving as self-affirming, while also enduring losses and difficulties resulting from their caregiving role. Integrating the positive and negative aspects of the whole of caregiving is important to understand the caregiving experience and to design interventions to support caregivers.

The Krikelas model was used as a framework for investigating supplemental-information-seeking behavior of cardiovascular nurses. (Supplemental information is that which is not available from memory and could be made available by computer). One hundred seventy-five instances of supplemental-information-seeking behavior were collected from 46 cardiovascular nurses in three metropolitan hospitals. Self-report and observation-interview methods were used. Findings indicated that the nurses sought patient-specific data most frequently, followed by institution-specific data and domain knowledge. They needed a surprisingly large portion of the information to track people, equipment, medications, and reports. The findings have implications for nursing information system design.