title: The clinical nurse specialist in chronic diseases.
abstract: BACKGROUND
  The number of individuals with chronic illness is growing at an astonishing rate because of the rapid aging of the population and the increased longevity of persons with chronic conditions. Nurses in clinical nurse specialist (CNS) roles are well positioned and ideally suited to meet the needs of a growing population with chronic diseases; yet, to date, there has been no critical review of the CNS in chronic diseases.
  
  
  OBJECTIVE
  This article provides a critical review of the literature in order to better define and understand the CNS related to patients living with chronic illnesses (cardiovascular and oncology).
  
  
  METHODS
  Using the guidelines of DiCenso et al (2005) for evaluating health services interventions, the literature was appraised in order to identify the characteristics of CNS roles, and the strengths and limitations of research about the effectiveness of CNS in chronic disease management.
  
  
  CONCLUSIONS
  Clinical nurse specialists with master's-level preparation provided high-quality and cost-effective care to patients with chronic diseases. The CNSs had a positive impact on patient, family, and healthcare team outcomes. Further evaluation of the CNS role in the research domain of practice is recommended.
authors.affiliation: Department of Nursing, Faculty of Applied Health Sciences, Brock University, St Catharines, Ontario, Canada. jmoore4@brocku.ca
authors.forename: Jane
authors.initials: J
authors.lastname: Moore
authors.forename: Maurene
authors.initials: M
authors.lastname: McQuestion
mesh_terms: D002170:Canada; D002908:Chronic Disease / Q000451:nursing*; D006801:Humans; D017060:Patient Satisfaction; D011788:Quality of Life; D013041:Specialties, Nursing; D014481:United States