Search

Editor's Note Deciding when to assist and when to stand back so that individuals may follow their own desires has been a source of much public debate in the last few years with respect to health behaviors, social structures, and also political beliefs. The following short essay, published in the July 1948 issue of the first Public Health Nursing, illustrates, first, that from flawed logic we derive flawed conclusions, but also maybe a modicum of truth. Secondly, it aptly highlights the conundrum of "incentives" and the disillusionment of well-meaning "givers" when the recipients do not view our "gifts" through the same lens. We do not subscribe to the views of Ms. King, but rather raise the following questions for your consideration, "When we give, how much are we meeting our own needs rather than the needs of others?""Can a society be empathic without losing its own sense of identity?" Things to ponder in this holiday season ...

This historical analysis draws attention to differing assumptions, which promote or limit user involvement in nursing practice. The meaning of the term 'user involvement' is analyzed with reference to varying models. A continuum is offered to illustrate the relationship between assumptions about people with mental health problems and their involvement in care. It is argued that the range of views concerning recipients of mental health services, from being dangerous and irrational to being considered equal partners with health professionals, creates an unresolved tension that has existed through the ages. The key to resolving this tension is for all parties openly to acknowledge conflicts between their views and those of others and engage in meaningful dialogue about them. In this way the lessons from history may be learned.

The effectiveness of disease control by mobile teams decreased when countries became independent. Early case-finding and continuity of care require permanently accessible health care facilities where rationalization by professionals and participation of the users are well balanced. The Primary Health Care concept, a plea for this equilibrium, has been discredited by different types of misapplication. Correctly functioning and accessible first line health services, completed by a referral level, are a precondition for effective participation of the users. Where 'ideal health districts' cannot be realized, a form of steady exchanges between generalists and the specialists of the referral level has lead to diverse 'functional districts'.