Dianne McCormack

Research with homeless people uncovers a model of health.

This grounded theory research study explored health experiences of 11 homeless persons in shelters in three New Brunswick cities and the strategies that they used to attain, maintain, or regain health. Audiotaped interviews were conducted, transcribed verbatim, and analyzed. The model that emerged from analysis consists of three pathways to health. This model of health has two central components, person and health. Person is influenced directly by family values and beliefs, and directly and indirectly by societal values and beliefs. Health is the outcome and is reached through two mediating factors of lifestyle behaviors and sector services. The first pathway to health contains the mediating factor of lifestyle behaviors, the second contains the mediating factor of sector services, and the third contains both mediating factors. Pathway strategies of choosing, accessing, and appraising appropriateness of methods influence the active participation of the person that directs the action within the model. Implications of the study include that a fragmented system of help hinders access to services intended to promote health in this population.

Nursing Theory-Directed Healthcare Modifying Kolcaba's Comfort Theory as an Institution-Wide Approach

The tradition of the nursing discipline borrowing theory from other disciplines is examined, and the idea of other healthcare disciplines borrowing nursing theory is proposed. A brief literature review of borrowed theory sets the stage to examine how a modification in the theoretical framework of Kolcabas theory of comfort can guide the thinking and work of other healthcare disciplines. This change positions Kolcabas theory as an acceptable blueprint to guide the activities of all health disciplines within an institution, transposing this theory from a theory for nursing to a theory for healthcare. In a healthcare climate that embraces interprofessional collaboration, a single theoretical framework has the potential to facilitate greater understanding between disciplines and greater continuity of care for healthcare recipients and their families. To clearly demonstrate this assertion, a hypothetical case example is presented.

An Integrative Review Illuminates Curricular Applications of Primary Health Care.

The International Council of Nurses supported primary health care and advocated its acceptance by other intersectorial stakeholders. Nurse educators involved in curriculum development have respected this direction. To pursue the primary health care vision and influence the adoption of primary health care delivery systems, all principles of primary health care must be implemented simultaneously. An integrative review was conducted to ascertain the interpretation of primary health care held by nurse authors. A content analysis of the nursing literature revealed that 184 of the 254 articles retrieved (72%), applied primary health care in a manner that is consistent with the World Health Organization (WHO) definition. Through curricular applications of different interpretations of the primary health care principles, differences in the created learning environment are discussed. The Declaration of Alma Ata, evolving from beliefs and values shared by 134 member nations present at the Assembly, delineated that primary health care was the accepted infrastructure to guide policies that direct health care delivery systems regardless of the context in the country (WHO, 1978). Even with this overwhelming endorsement, very few countries have made changes in policies and infrastructure for implementing the underlying values and beliefs ascribed in primary health care. Changes that have occurred have not been organized around the vision or the principles of primary health care. This delay has had, and will continue to have, a huge impact on nursing education, practice, and research. Nurses are interested in helping people attain, maintain, or regain health; primary health care has the potential to achieve health for all citizens of the world.

Primary health care: a framework for policy development.

Primary health care has utility for policy development at all levels of organization in any nation, including policies influencing the health of persons living with severe and persistent mental illnesses. Using the primary health care framework, policies to improve health and housing for this population evolve from intersectoral collaboration. Active participation by those persons whose essential health is compromised by housing that is not acceptable, adequate, suitable, and affordable is required. Appropriate and affordable methods that address health challenges are identified. Access to services meeting essential health care needs of citizens has potential for healthy outcomes.