Letters to the Editor.

This article contains Letters from the Readears.

Dementia care in the context of primary care reform: an integrative review.

Objectives: The purpose of this review was to determine the influence of the growing body of evidence about the attributes of high-performing primary care systems on the literature related to the primary care of people living with dementia.

Methods: In this integrative review, we examined a broad range of published and grey literature (2000-2013) about the primary care of dementia, using a systematic approach set up in advance of the literature search. The review was guided by two questions: What are the evident models of primary care for dementia? How do the models line up with the other attributes of high-performing primary care?

Results: Three models were noted: carved-out, co-managed, and integrative-hub, all informed by different assumptions about the role of primary care in dementia.

Sources of information used by nurses to inform practice: An integrative review.

Background: We present an integrative review of the literature about sources of information nurses use to inform practice. The demand for access to more and better information has been fueled by the evidence-based healthcare movement. Although the expectations for evidence-based practice have never been higher, the demands on care environments have never been greater.

The road less traveled: nursing advocacy at the policy level.

A frequent observation made about nursing advocacy at the policy level is its absence-or at least its invisibility. Yet there is a persistent belief that nurses will participate in advocacy at the societal level in matters of health. Although gaps exist in our knowledge about how to advocate at the policy level, the authors suggest that a number of other factors contribute to the disconnect between what nurses are expected to do in terms of policy advocacy and what they actually do.

Self-care from the perspective of people living with diabetes.

This review presents findings from a critical integrative review of research into barriers to and facilitators of self-care from the perspective of people with diabetes. The review was motivated by a perceived need to understand self-care from the perspective of those living with this chronic disease and to explore the implications of this understanding for health-care policy in Canada. Journal manuscripts and dissertations exploring self-care from the perspective of adults with type I or type II diabetes and published in English between 1993 and 2003 were reviewed.

Access to health services by Canadians who are chronically ill.

Access to health care services in Canada has been identified as an urgent priority, and chronic disease has been suggested as the most pressing health concern facing Canadians. Access to services for Canadians living with chronic disease, however, has received little emphasis in the research literature or in health policy reform documents. A systematic review of research into factors impeding or facilitating access to formal health services for people in Canada living with chronic illness is presented.

Out of fertile muck: the evolving narrative of nursing.

The ongoing debate over the appropriateness of embracing multiple research traditions in nursing is discussed, and the impacts of that debate on the development of nursing knowledge and the nature and structure of the discipline are explored. It is asserted that this previously healthy debate has become stalled between extreme positions of unbounded pluralism and critical exclusivism. The author suggests that one possible solution may lie in connecting the elements of human living, human healing, and human wholeness in an evolving narrative that crosses paradigmatic and theoretic boundaries, and reflects the unique meanings revealed in nursing practice and scholarship.