The experience of symptoms, minor to severe, prompts millions of patients to visit their healthcare providers each year. Symptoms not only create distress, but also disrupt social functioning. The management of symptoms and their resulting outcomes often become the responsibility of the patient and his or her family members. Healthcare providers have difficulty developing symptom management strategies that can be applied across acute and home-care settings because few models of symptom management have been tested empirically. To date, the majority of research on symptoms was directed toward studying a single symptom, such as pain or fatigue, or toward evaluating associated symptoms, such as depression and sleep disturbance. While this approach has advanced our understanding of some symptoms, we offer a generic symptom management model to provide direction for selecting clinical interventions, informing research, and bridging an array of symptoms associated with a variety of diseases and conditions. Finally, a broadly-based symptom management model allows the integration of science from other fields.

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Assessing critical thinking skills and disposition is crucial in nursing education and research. The California Critical Thinking Disposition Inventory (CCTDI) uses the Delphi Report's consensúe definition of critical thinking as the theoretical basis to measure critical thinking disposition. Item analysis and factor analysis techniques were used to create seven disposition scales, which grouped the Delphi dispositional descriptions into larger, more unified constructs: open-mindedness, analyticity, cognitive maturity, truth-seeking, systematicity, inquisitiveness, and self-confidence. Cronbach's alpha for the overall instrument, the disposition toward critical thinking, is .92. The 75-item instrument was administered to an additional sample of college students OV= 1019). The alpha levels in the second sample remained relatively stable, ranging from .60 to .78 on the subscales and .90 overall. The instrument has subsequently been used to assess critical thinking disposition in high school through the graduate level but is targeted primarily for the college undergraduates. Administration time is 20 minutes. Correlation with its companion instrument, the California Critical Thinking Skills Test, also based on the Delphi critical thinking construct, was measured at .66 and .67 in two pilot sample groups.

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