Faculty practice in joint appointments: implications for nursing staff development.

Faculty joint appointments can capitalize on the talents and unique knowledge of nurses in varied settings. Altered role expectations, recurring emphases on cost control, and demands for accountability in the transforming health care system urge academic nursing faculty and clinically-based nurses to work together to achieve requisite health care and educational outcomes. This article addresses the types of faculty practice models, discusses three major role types of joint appointments, and presents the benefits and challenges of faculty functioning in joint appointments. Implications for nursing staff development are examined.

Substruction: illustrating the connections from research question to analysis.

This article examines the process of theoretical substruction as a heuristic device to assist graduate students and beginning investigators identify the conceptualization and operationalization phases of research proposals. As a thinking process, substruction enables investigators to delineate the foundational elements of studies. Creating the figure during substruction helps researchers increase their knowledge of the theoretical, empirical, or descriptive links between the conceptual and operational components of a study. Consequently, the researcher ascertains the fundamental pattern of the study. A qualitative and a quantitative example of substructed studies are included.

A collaborative assessment of workload and patient care needs in four rehabilitation facilities.

This article describes the process used by nurse executives at four freestanding rehabilitation facilities to implement and validate an interactive patient classification system. The research process involved defining critical indicators, measuring workloads by level of staff, and validating the number of care hours for the levels of patient classification. The database enabled the four consortium members to share their knowledge, resources, and costs of implementing a patient classification system, and it provides a benchmark of rehabilitation services. The study data are being used in making staffing decisions, preparing and defending budgets, and identifying the cost of care by disability classification.

Health promotion during childhood chronic illness: a paradox facing society.

Childhood chronic illness presents challenges to families in the area of health promotion. Parents are diligent in handling the concerns associated with chronicity and compromised health status but may find themselves excessively directing their energies toward the illness-oriented needs of the child rather than health. The article identifies Healthy Children 2000 objectives and discusses their application to children with chronic illness. Health risks that confront families place extra burdens on them and require adjustments in life style, coping, support system, and finances. Specific risks focus on life style changes, nutrition and exercise concerns, developmental needs, and environmental hazards.

The challenge for education in a transformed health care system.

A focus on health promotion, disease prevention, and health education for all members of society has emerged from the federal guidelines of Healthy People 2000 and, more important, from the demonstrated needs of vulnerable populations. New and potent organisms and diseases have stressed the health care system. Nursing administrators face significant challenges in managing health care delivery and nursing within the multidisciplinary team in the transformed system. In all areas, education must be directed to meet the challenges and nursing must assume the leadership for ensuring the health care needs of individuals and communities, now and in the future.

Impact of childhood cancer on siblings and family: family strategies for primary health care.

The article reviews the impact of a chronic illness with a potentially life-threatening outcome on siblings and suggests strategies to enhance sibling support by an advanced practice nurse. The well siblings in the family system have the potential to perceive threatened or actual losses as a result of their brother's or sister's illness. The importance of considering total family structure, including the sibling's emotional needs, in an ongoing assessment to determine strengths, vulnerabilities, and coping abilities is presented. The advanced practice nurse in an ambulatory care setting, community setting, or hospital is in a unique position to provide comprehensive guidance and coordination of mechanisms of support in concert with the family in an effort to reduce vulnerability and to maintain the emotional well-being of the siblings.

Loss of a parent in childhood: attachment and coping in a model of adolescent resilience.

Adolescent resilience after parental death in childhood and its relationship to attachment and coping were examined in this cross-sectional correlational study. Resilience was operationalized as social competence, global self-worth, and health. Sixty-two adolescents were interviewed using self-report instruments. Pearson product moment correlations and multiple regression analyses were used to test five hypotheses. Three hypotheses were partially supported in that adaptive coping was a significant predictor of the measures of resilience. Correlations were significant between attachment and coping and between attachment and health. All adolescents shared observations about their experiences.