Substruction and The Outcomes Model for Health Care Research

　I am very pleased to have the opportunity to share with you an update on my thinking related to the processes of substruction. Our article (Dulock ＆ Holzemer, 1991) on substruction was reprinted in The Japanese Journal of Nursing Research in 1993. The article reviewed the history of the concept of substruction and its origins in descriptive research primarily utilizing path analyses as its analytical technique. Substruction is a strange word in English and is related to the concept of construction and deconstruction, or building up and tearing down.