then, instead of creating horses for a wide variety of

courses, universities in the UK will be forced down the

road of merely designing courses for horses.

Roger Watson

Media Review Editor

and

David R. Thompson

Professor of Nursing

University of York

York

England

References

Anonymous (2000) Degree could be new entreÂe to social. Work

Times Higher Educational Supplement 28 July, p. 2.

Calman K.C. & Downie R.S. (1988) Education and training in

medicine. Medical Education 22, 488±491.

Clark J. (2000) Should nursing become an all graduate-entry

profession? Nursing Times 96(12), 18.

Commission on Nursing (1998) Report of the Commission on

Nursing: A Blueprint for the Future. The Stationery Of®ce,

Dublin.

Department of Health (2000) Making a Difference. Department of

Health, London.

Grif®ths M. (2000) Dumbing down medicine will be the death of

us. Sunday Times 9 April, p. 17.

Smith D. (2000) The medicine that never works. Sunday Times

News Review 30 July, p. 6.

Tyrrel M.P. (1998) Developments in Pre-registration Nursing

Education ± An International Perspective: A report prepared

for the Commission on Nursing The Stationery Of®ce, Dublin.

United Kingdom Central Council on Nursing Midwifery and

Health Visiting (1987) Project 2000: the Final Proposals. UKCC,

London.

Watson R. (2000) Inaugural Lecture: Elitism, advanced practice

and the Charge of the Light Brigade. University of Hull, 20

March.

THIS MONTH IN JAN

This month in JAN in October identi®ed that from January

2001 the journal will have a new look. Published fort-

nightly with 15 papers in each issue, this new version will

replace the current monthly journal with up to 30 papers

in the contents. Looking forward once more to the New

Year, from January 2001 all manuscripts will have a

structured abstract normally incorporating the headings

shown below:

· Aim(s) of the study/paper

· Background/Rationale

· Design/Methods

· Results/Findings

· Conclusions

If, occasionally, authors ®nd these to be inappropriate

they will be advised to substitute those headings which

best summarize the content of their papers. Unstructured

abstracts will not be used in future. Authors of papers

already submitted for review, or accepted for publication

in January 2001 or later, are being requested to send

revised, structured abstracts immediately. These develop-

ments are all a part of the modernization process that the

editors are pursuing with Blackwell Science, and readers

of this column will be updated on further changes in

future issues.

Turning now to this month, the November 2000 issue

follows a long tradition in nursing scholarship with

several papers concerned centrally with the concepts that

nurses use daily in their clinical practice. The issue begins

with ®ve papers in the Philosophical and ethical issues

category, three of which are concerned with the ethical

aspects of the concept of care. Care and caring practices

continue to remain high on the nursing agenda, and these

three papers encourage nurses once again to re¯ect upon

their origins and ethical meanings, and the implications

for modern health care.

Fatigue is another concept widely used in nursing

practice, but less subjected to critical scrutiny than care

and caring. Two papers in this issue are concerned with

this concept. The ®rst, in the Nursing theory and concept

development or analysis category, subjects the term

`chronic fatigue' to a concept analysis using Walker and

Avant's (1995) framework. This is an essential preliminary

exercise before carrying out research into chronic obstruct-

ive pulmonary disease as, the author claims, the literature

contains no universal de®nition and fails to distinguish

between fatigue and chronic fatigue. The author of the ®rst

paper concludes that the concept remains complex, but

that a start has been made on clari®cation. The second

paper on fatigue appears in the Issues and innovations in

nursing practice category. This is because the authors'

exploration of the concept was carried out within the

context of an empirical study of the personal experiences

and biochemical analysis of patients with renal failure on

maintenance dialysis. This paper takes our understanding

of fatigue a step further, for no correlation was found in

the study between the biochemical and situational varia-

bles measured. There was however, a signi®cant associ-

ation between sleep problems, poor physical health and

depression. Further complex relationships are also noted.

Together, these two papers on fatigue illustrate that it is

impossible to develop research into caring practices

without ®rst exploring in great detail the contexts and

the concepts under investigation.

Two further papers in the Nursing theory and concept

development or analysis category explore, respectively,

Editorial

1042 Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 32(5), 1041±1043

the beliefs and meanings in the experience of cancer, and

the concept of hope in the Dominican Republic. These

concepts have been addressed previously in the Journal of

Advanced Nursing, but both papers take our under-

standing further. The Canadian authors of `Understanding

beliefs and meanings in the experience of cancer' argue

that there is often overlap in the use of the terms, and that

they are sometimes used synonymously. Yet, their

analysis leads them to argue that the `Clarity in the

conceptual de®nitions of beliefs and meanings can help

researchers select measures that accurately re¯ect the

phenomenon of interest' (my emphasis). Thus, once again,

the importance of the prior analysis of terms before

embarking on research is emphasized.

In exploring the concept of hope in the Dominican

Republic, the North American author asks `What are the

universals and diversities in the meaning of hope for this

cultural group and United States (of America, US) main-

stream culture?' In embarking on this study she points out

that little research has explored whether hope has

different attributes in various cultural groups. The author

arrives at a very complex de®nition of hope and its

attributes derived from the data gathered in a rural

Dominican village. She compares this locally derived

de®nition with those developed from research amongst

USA populations, to propose universals and diversities of

hope. In an international journal, such as JAN, this is

important work and perhaps the next step is to conduct a

global analysis of nursing work on hope. For example, JAN

Volume 28 contained papers on aspects of hope from

Sweden, United Kingdom and the USA (Benzein et al.

1998, Cutcliffe 1998, Herth 1998). The time is surely ripe

to use systematic review techniques in order to test the

universals already identi®ed, against the populations in

these very different studies? In this way, conceptual

generalization in nursing research can move further ahead

in this important area.

The November 2000 issue of JAN is not, of course,

con®ned to the discussion of conceptual issues, important

though these may be. There are many other papers on

signi®cant subjects for nurses in practice, research,

management and education. Three papers on aspects of

nursing home care are drawn from authors in Northern

Ireland, Sweden and Switzerland, demonstrating once

again the importance of this ubiquitous trend in the care of

older people. Aspects of the support needed for breast

feeding may be found in three papers originating from

Australia, Slovenia and Sweden. These, together with a

paper on `Personal control of pain relief in labour' jointly

from authors in Northern Ireland and Scotland, illustrate

midwives' and nurses' continuing concern with issues in

maternal and child health across an international spec-

trum of countries.

Aspects of cancer care and its research feature in three

papers; two more focus on the care of patients with

coronary heart disease, and one paper each on the quality

of life in a Swedish sample of HIV-infected persons, and

dementia mapping in service quality audit. Together,

these papers illustrate the breadth of clinical practice

content in this month's issue.

Papers concerning the role, function, education and

management of the nurse include health education and

promotion. Amongst these is a systematic review of the

health promotion role of the school nurse by authors in

Wales. A timely paper from Northern Ireland describes the

development and de®nition of the operating theatre nurse,

a topical subject given current international interest in the

ways that this role may develop in the future. Further

papers on clinical supervision, `observation levels'

nursing policy, and three on Methodological issues in

nursing research complete the 30 papers for November

2000. In this issue JAN demonstrates, once again, that its

content is analytic, eclectic, international, and above all,

highly relevant to practice.

Jane Robinson

Editor

References

Benzein E., Norberg A. & Saveman B.-I. (1998) Hope: future

imagined reality. The meaning of hope as described by a group

of healthy Pentecostalists. Journal of Advanced Nursing 28,

1063±1070.

Cutcliffe J.R. (1998) Hope, counselling and complicated bereave-

ment reactions. Journal of Advanced Nursing 28, 754±761.

Herth K. (1998) Hope as seen through the eyes of homeless

children. Journal of Advanced Nursing 28, 1053±1062.

Walker L.O. & Avant K.C. (1995) Strategies for Theory Construc-

tion in Nursing, 3rd edn. Appleton and Lange, Norwalk,

Connecticut.

Editorial

Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 32(5), 1041±1043 1043