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In this paper, we draw on the authors' collective experiences as qualitative researchers undergoing research ethics reviews. We highlight specific areas within our standard national guidelines that support qualitative research. Using case examples, we illustrate how diverse interpretations of these guidelines can be inconsistent and problematic for qualitative researchers. We outline recommendations for transparency, reciprocity, and streamlining of the review process. It is our hope that adoption of these recommendations will lead to a more collegial evaluative process, thereby contributing to the advancement of knowledge.

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The concept of self-care is multidimensional, with many defining elements. This paper describes the origin of this comprehensive concept. It examines the response of the nursing discipline to citizen self-care initiatives and the subsequent effects this response has had on the development of nursing knowledge. The evolution of self-care as a core concept within Canadian health policy is presented; the potential readiness for citizens to accept self-care as an aspect of healthcare delivery is explored, identifying potential benefits and obstacles. The paper concludes with a proposed self-care approach to healthcare reform in Canada and the subsequent influence this approach may have on the discipline of nursing. The congruency between a self-care healthcare delivery system and the theoretical foundations and perspective of healthcare delivery held by the nursing discipline is discussed. The role nurses might assume in shaping a self-care healthcare delivery system is delineated.Self-care is not a new idea. Since the beginning of humankind, people have taken action to ensure personal safety and have developed strategies to address illness and other health challenges (Haug et al. 1989;Levin 1976;Padula 1992;Saunders 1994;Woods 1989). Primitive societies developed healing rituals that sometimes involved the consumption of special foods to promote the health of particular individuals or entire communities (Hill and Smith 1985). Women assisted one another in childbirth and shared the acquired knowledge with the next generation. Implementing self-care strategies to address day-to-day concerns about health is normal and usual (Bohart and Tallman 1996;DeFriese et al. 1989;Levin 1981; Punamaki and Ascham 1994 Individuals select self-care behaviours in order to maintain an acceptable level of health or well-being, to prevent illness or injury and to promote health. These selfcare behaviours contribute to one's ability to perform a variety of tasks, ranging from ensuring survival to attaining self-actualization. Families accept responsibilities for facilitating the self-care of their members and take on self-care activities for other members who, owing to maturation, illness or other life events, are unable to complete the necessary task themselves. Community leaders support resources that enable individuals and families to carry out self-care tasks important to them. Clients at the individual, family and community levels have different self-care needs and expectations.Different beliefs (Keller et al. 1989) and individual characteristics or conditioning factors (Chang 1980;Connelly 1993;Edwardson and Dean 1999;Horsburgh 1999;McCaleb 1995) influence the self-care behaviours selected or processes used to achieve a particular level of health. As well, the type or level of client (individual, family or community) influences choice of self-care activities.Multiple descriptors of self-care result in varied definitions within and across disciplines (DeFriese et al. 1989;Health Canada 1997;Punamaki and Aschan 1994;Rew 1990)...

This grounded theory research study, explored health experiences of 11 homeless persons in shelters in three New Brunswick cities and the strategies that they used to attain, maintain, or regain health. Audiotaped interviews were conducted, transcribed verbatim, and analyzed. The model that emerged from analysis consists of three pathways to health. This model of health has two central components, person and health. Person is influenced directly by family values and beliefs, and directly and indirectly by societal values and beliefs. Health is the outcome and is reached through two mediating factors of lifestyle behaviors and sector services. The first pathway to health contains the mediating factor of lifestyle behaviors, the second contains the mediating factor of sector services, and the third contains both mediating factors. Pathway strategies of choosing, accessing, and appraising appropriateness of methods influence the active participation of the person that directs the action within the model. Implications of the study include that a fragmented system of help hinders access to services intended to promote health in this population.