As the focus of health promotion moves from individuals to organizations, communities and broader social policy, the models that guide public health program planning and development need reexamination. Public health nurses are gaining experience in strengthening and supporting the ability of communities to grow and change. This study aimed to illuminate the process. Data, gathered as part of an action research project to develop individual and community-based strategies to decrease isolation in frail older adults, provided a rich source of qualitative data. Analysis was directed toward identifying the factors and processes of capacity-building. The emerging model was clarified and partially validated with academics and practitioners from health promotion programs across the age span. Four stages of building collective capacity were identified: identifying common ground, working cooperatively, working in partnership, and working across the community. At each stage, processes of relationship building, project management and capacity-building resulted in stage specific products. A model of building collective capacity, grounded in community health practice and supported by the literature provides a base for developing practice indicators, and practice guidelines which will strengthen the ability to reach health goals.

Patients diagnosed with cancer are frequently prescribed radiation therapy. The treatment is a source of much anxiety and worry for patients and their families. Support, a highly valued intervention strategy in nursing, is believed to assist patients to adjust to stressful experiences. A qualitative study was conducted to determine patients' experiences of support while receiving radiotherapy. Data from 12 patients were analysed using the procedures and techniques of grounded theory. A substantive theory of support emerged which showed that support is an interpersonal process embedded in an array of social exchanges which involves encountering support, recognising support and feeling supported. Three main types of support are encountered: being there, giving help and giving information. It is a multifaceted concept and all types of support are seen as important. Actions are interpreted within the norms and expectations of a relationship and labelled as supportive by the recipient. Family and friends are the principal sources of all types of support. Professional support is mainly informational. The findings raise many questions, one of which is should there be a rethinking of the concept of support in nursing?

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One hundred and sixty parents of 10- to 18-year-old children with diabetes were interviewed using Hymovich's Chronicity Impact and Coping Instrument (CICI: PQ). Eighty-two parents had access to a specialist nurse service; 72 parents did not. Regardless of the age of the child or the duration of diabetes, parents expressed a need for advice and support with child care. Parents with a specialist nurse needed information on more topics tending to focus on activities of daily living and child development rather than physical care and illness. They were also more likely to seek and receive help from nurses. Their level of concern was greater and, it is argued, may be the price parents pay for greater awareness. The findings of this study suggest that a systematic assessment of parent coping is necessary if specialist nurses are to help parents in their role as primary health carers.

An ageing population has implications for community-based health promotion and disease prevention. There is concern about older people who do not fit into existing programmes and services yet need minimal support to maintain independence. A study was designed to develop approaches to gain access to this hard to reach population, assess needs and design and test interventions to integrate them into the community. The study, informed by theories of health promotion and social support, used action research methods. Participant observation documented in field notes, together with case notes and clinical assessments, provided a rich source of qualitative and quantitative data. This article discusses the needs assessment. Over a 3-year period, public health nurses linked with community groups in a predominantly francophone, urban community to identify the target group. Key characteristics of the target group included limitations with instrumental activities of daily living and low levels of social support combined with stressful life situations that challenged adaptation. Three patterns of inadequate support were identified.