From theory to practice: community health nursing in a public health neighborhood team.

An interdisciplinary team in a local public health district tested its ability to implement the core public health functions of assessment, policy development, and assurance by changing its practice to a community-driven model of building partnerships for health with groups and communities in a designated locale. Evaluation of this innovation revealed that the public health nurse members of the team enacted their community health nursing knowledge to strengthen agency to cocreate health. Interdisciplinary collaboration was essential to the team's community mobilization efforts. Additional findings suggested that this organizational innovation was associated with developing a more participatory organizational climate, increasing system effectiveness, and building community capacity.

Focus on community: directions for nursing knowledge development.

Nurses are challenged to advance the theoretical foundations of community practice. This paper offers ideas on what has been done and what needs to be done to meet this challenge. Within a community health nursing perspective, the paper defines community, proposes an integrated knowledge development framework that focuses on community, analyses contemporary theoretical and philosophical foundations of community in nursing, considers three world-views in which nursing can be framed, and examines parameters for knowledge development for the future.

Community analysis in community health nursing practice: the GENESIS model.

A community-analysis strategy, GENESIS (general ethnographic and nursing evaluation studies in the state), is a comprehensive, holistic portrait of communities obtained through secondary analysis of existing data and qualitative methods. The GENESIS method is delineated and examples of studies are presented. To explicate the method and illustrate the findings, an aggregate-focused GENESIS study and two studies in which entire communities were the targets are compared and contrasted. Other defining concepts of nursing, such as caring and health, are redefined or explicated to make them congruent with the recognition that for community health nurses, the community is the client.

Outcomes of power development in work relationships.

Nurse executives who routinely feel overpowered in their work relationships are highly stressed. When high levels of stress are experienced regularly, ill health may be the outcome, resulting in negative consequences for both the nurse executive and the organization. Strategies are proposed for nurse executives to use in coping with consistent patterns of work-related overpowerment.

Foundations of nursing's perspectives on health education.

Nursing is one of the many diverse disciplines on which health education draws for theoretical perspectives, research, and practice tools. It brings more than a 130 year heritage of practice with individuals, groups, institutions, and communities toward the goals of restoring, promoting, and maintaining health. Nursing's more recent history of theory development and research, in which relationships are examined between persons, their environment and health, is especially germane to the art and science of health education. In nursing, health education is one of a large repertoire of intervention actions nurses take to support healing, caring, and health with individuals, families, groups, organizations, and communities. The theoretical foundations of these actions characterize the nursing domain and guide research and practice. In this paper, several theoretical frameworks from nursing and health education are examined to bring their perspectives more clearly into focus for the mutual advance of both fields.

Assessing community health needs of elderly populations: comparison of three strategies.

Three research strategies for assessing the community health needs of the elderly population of an urban neighbourhood are described. Two primary research strategies, survey and ethnography, are contrasted with the types of health-related information available from the Census of Population and Housing. Different types of data emerged from each research strategy with census and survey data providing a global portrait of the community, and ethnographic data yielding more detail about the place of health in the lived experience of older residents.

When client means more than one: extending the foundational concept of person.

A second generation of nursing theory is emerging that clarifies and extends the original defining concepts. Definitions of person/client in specialties where practice focuses on more than single persons often include the term "aggregate." Analysis of this term reveals it to mean statistical summing of entities. Because this meaning does not incorporate interaction, the term is incompatible with domain assumptions. To retain the interaction condition, "client" for these specialties is extended to refer to both pluralities of persons and interactional units, such as families, groups, organizations, and communities.

OR nursing in the future. Impact of projected demographics.

Implications of these population factors for operating room nursing are summarized as follows. Continued need for obstetric-related surgery throughout this decade and into the 21st century. Continued need for multilingual skills to care for non-English speaking individuals and continued need for sensitivity by health care professionals to other cultural norms with regard to illness and treatment. Increasing number of older adults needing perioperative care. Increasing use of surgery common to older adults. Continued pressure to reduce costs of care. Operating room nurses can ask several questions to discover demographic trends affecting their hospitals and areas. What is the age profile of patients in the health care facility? What are the patients' geographical origins? What percent of that population is served by the health care facility? What are the population trends in the geographical area from which they draw their patients? age proportions over time, fertility rate, migration trends, mortality rates over time, life expectancy What proportion of the hospital days are used by elderly? What is the rate per 1,000 for surgery among the elderly? Answers to these questions will give OR nurses the basis for anticipating change and planning to meet that change in their perioperative areas.