Health policy and NIH: implications for nursing research.

Since their beginnings in the 1930s, categorical institutes funded for medical research have been controversial. Some individuals in administrative positions, such as the surgeon general, director of National Institutes of Health (NIH), and members of the Department of Health and Human Services, argue that separate institutes add administrative costs and are unnecessary because research can be done better in a less fragmented fashion. Some scientists express concern about intellectual freedom when research directions are legislatively dictated. Proponents of institutes, usually lay people, legislators, or scientists with specific research interests, contend that the problem warrants a national research effort since it is not handled within current structures. Two major foci of nursing research are on disease prevention and on improvement of the quality of care for the acutely and chronically ill, whereas the traditional priorities of NIH for basic research have been disease diagnosis and cure. Therefore, NIH support for nursing research has been negligible. To bring nursing into "the mainstream of scientific investigation," as recommended by a 1983 study conducted by the Institute of Medicine, an Institute of Nursing or an acceptable alternative within NIH seems advisable.