1
|
Hsiao CP, Goto T, Von Ah D, Saligan LN. Cancer-Related Cognitive Impairment Associated with APOE rs7412 and BDNF rs6265 in Breast Cancer Survivors. Semin Oncol Nurs 2024:151721. [PMID: 39198096 DOI: 10.1016/j.soncn.2024.151721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVES Cancer-related cognitive impairment (CRCI) is a highly prevalent and debilitating symptom reported by breast cancer survivors (BCS). The etiology of CRCI remains unclear, leading to poor symptom management. Building from prior studies, BCS with the C/C genotype of apolipoprotein E (APOE) rs7412 and the T/T genotype of brain-derived neurotrophic factor (BDNF) rs6265 were hypothesized to experience more severe CRCI. Therefore, we investigated the relationships between the severity of CRCI and polymorphisms of APOE and BDNF among BCS. METHODS This was a subanalysis of data from a larger descriptive, correlational, and cross-sectional study. Subjective and objective CRCI were measured using the Patient-Reported Outcomes Measurement Information System and CANTAB Cambridge Cognitive assessment, respectively. Buccal swab samples were collected to evaluate the single nucleotide polymorphisms. Multivariable generalized linear regression models were used to analyze data. RESULTS APOE rs7412 and BDNF rs6265 were significantly associated with lower self-reported cognitive abilities in a total of 353 BCS. Age was positively associated with self-reported cognitive scores, indicating that younger BCS perceived lower cognitive abilities. Individuals carrying genotype of C/T for APOE with the C/C or C/T for BDNF showed positive associations with cognitive abilities. CONCLUSIONS Younger BCS with the C/C genotype for APOE rs7412 and the T/T genotype for BDNF rs6265 may be at risk for CRCI. Knowledge regarding predictive markers for CRCI symptoms is essential for precision symptom management. Further investigation with a longitudinal and translational design is necessary to explore the etiologies for CRCI. IMPLICATIONS FOR NURSING PRACTICE Integrating genetic phenotyping into routine clinical practice will provide nurses with unique opportunities to understand individual susceptibilities, and how symptoms may trigger other symptoms. Further, findings from these innovative investigations will provide symptom interventionists and implementation scientists with critical data to optimize individualized strategies for symptom prevention, detection, and management.
Collapse
Affiliation(s)
- Chao-Pin Hsiao
- Case Western Reserve University School of Nursing, Cleveland, Ohio
| | - Taichi Goto
- Symptoms Biology Unit, Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland
| | - Diane Von Ah
- The Ohio State University College of Nursing, Columbus, Ohio
| | - Leorey N Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland.
| |
Collapse
|
2
|
Hetland LH, Maguire J, Debono D, Wright H. Scholarly literature on nurses and pharmacogenomics: A scoping review. NURSE EDUCATION TODAY 2024; 137:106153. [PMID: 38484442 DOI: 10.1016/j.nedt.2024.106153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/18/2024] [Accepted: 03/05/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Pharmacogenomics is the bioscience investigating how genes affect medication responses. Nurses are instrumental in medication safety. Pharmacogenomics is slowly being integrated into healthcare, and knowledge and understanding of it is now pertinent to nursing practice. PURPOSE This paper aims to map the scholarly literature on pharmacogenomics in relation to nurses. METHODS A scoping review was conducted in four databases: CINAHL, Embase (Ovid), ProQuest Health and Medicine and PubMed using the search terms pharmacogenomic*, pharmacogenetic*, PGx*, and nurs*, resulting in 263 articles of which 77 articles met the inclusion criteria. FINDINGS Most articles (85 %, n = 65) were non-empirical and 12 presented empirical data (15 %, n = 12). The articles were USA-centric (81 %, n = 62) and represented a broad range of nursing specialties. CONCLUSION The majority of scholarly literature on nurses and pharmacogenomics is narrative reviews. Further empirical research is warranted to investigate nurses' current knowledge levels and potential involvement with pharmacogenomics in clinical practice.
Collapse
Affiliation(s)
- Linn Helen Hetland
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia.
| | - Jane Maguire
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Deborah Debono
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Helen Wright
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia
| |
Collapse
|
3
|
Hines-Dowell S, McNamara E, Mostafavi R, Taylor L, Harrison L, McGee RB, Blake AK, Lewis S, Perrino M, Mandrell B, Nichols KE. Genomes for Nurses: Understanding and Overcoming Barriers to Nurses Utilizing Genomics. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:140-147. [PMID: 38347731 DOI: 10.1177/27527530231214540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Background: Genomic testing is an increasingly important technology within pediatric oncology that aids in cancer diagnosis, provides prognostic information, identifies therapeutic targets, and reveals underlying cancer predisposition. However, nurses lack basic knowledge of genomics and have limited self-assurance in using genomic information in their daily practice. This single-institution project was carried out at an academic pediatric cancer hospital in the United States with the aim to explore the barriers to achieving genomics literacy for pediatric oncology nurses. Method: This project assessed barriers to genomic education and preferences for receiving genomics education among pediatric oncology nurses, nurse practitioners, and physician assistants. An electronic survey with demographic questions and 15 genetics-focused questions was developed. The final survey instrument consisted of nine sections and was pilot-tested prior to administration. Data were analyzed using a ranking strategy, and five focus groups were conducted to capture more-nuanced information. The focus group sessions lasted 40 min to 1 hour and were recorded and transcribed. Results: Over 50% of respondents were uncomfortable with or felt unprepared to answer questions from patients and/or family members about genomics. This unease ranked as the top barrier to using genomic information in clinical practice. Discussion: These results reveal that most nurses require additional education to facilitate an understanding of genomics. This project lays the foundation to guide the development of a pediatric cancer genomics curriculum, which will enable the incorporation of genomics into nursing practice.
Collapse
Affiliation(s)
| | | | | | - Leslie Taylor
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lynn Harrison
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Rose B McGee
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Alise K Blake
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sara Lewis
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | | | - Kim E Nichols
- St. Jude Children's Research Hospital, Memphis, TN, USA
| |
Collapse
|
4
|
Bayrak Aykan E, Eren Fidancı B. Developing the scale of genetic/genomic awareness in pediatric nurses. Arch Pediatr 2024; 31:59-65. [PMID: 37993316 DOI: 10.1016/j.arcped.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/07/2023] [Accepted: 09/10/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE In recent years, genomic information and technology have been increasingly integrated into healthcare services for the prevention of genetic diseases, screening, diagnosis, treatment selection, and follow-up of treatment efficacy. The aim of the study was to develop the Scale of Genetic/Genomic Awareness in Pediatric Nurses (SGAPN) and to evaluate its psychometric properties. MATERIAL AND METHODS This was a methodological study covering the development of the SGAPN and testing its psychometric properties. SGAPN items were developed based on a literature review and were evaluated by content validity. The SGAPN was then tested for internal consistency coefficients, face validity, criterion validity, and construct validity in a convenience sample of 280 pediatric nurses. RESULTS The SGAPN is a scale consisting of 32 items. Its Cronbach alpha value was calculated as 0.893. It has a structure with three factors including "genetic/genomic information" (13 items), "genetic transmission information" (7 items), and "genetic education and practices" (12 items). The Cronbach alpha values of the factors were 0.845, 0.600, and 0.893, respectively. CONCLUSION It is suggested that the SGAPN can be used as a valid and reliable scale in the evaluation of the genetic/genomic information, education, and practices of pediatric nurses.
Collapse
Affiliation(s)
- Emine Bayrak Aykan
- Ankara Medipol University, Nursing Department - Anafartalar Blok, Talatpaşa Boulevard, Biga 2 Street, Nu:2, 06050 Al Ankara, Turkey.
| | - Berna Eren Fidancı
- Department of Pediatric Nursing, University of Health Sciences, Gülhane School of Nursing, Ankara, Turkey.
| |
Collapse
|
5
|
Thomas J, Keels J, Calzone KA, Badzek L, Dewell S, Patch C, Tonkin ET, Dwyer AA. Current State of Genomics in Nursing: A Scoping Review of Healthcare Provider Oriented (Clinical and Educational) Outcomes (2012-2022). Genes (Basel) 2023; 14:2013. [PMID: 38002957 PMCID: PMC10671121 DOI: 10.3390/genes14112013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
In the 20 years since the initial sequencing of the human genome, genomics has become increasingly relevant to nursing. We sought to chart the current state of genomics in nursing by conducting a systematic scoping review of the literature in four databases (2012-2022). The included articles were categorized according to the Cochrane Collaboration outcome domains/sub-domains, and thematic analysis was employed to identify key topical areas to summarize the state of the science. Of 8532 retrieved articles, we identified 232 eligible articles. The articles primarily reported descriptive studies from the United States and other high-income countries (191/232, 82%). More than half (126/232, 54.3%) aligned with the "healthcare provider oriented outcomes" outcome domain. Three times as many articles related to the "knowledge and understanding" sub-domain compared to the "consultation process" subdomain (96 vs. 30). Five key areas of focus were identified, including "nursing practice" (50/126, 40%), "genetic counseling and screening" (29/126, 23%), "specialist nursing" (21/126, 17%), "nurse preparatory education" (17/126, 13%), and "pharmacogenomics" (9/126, 7%). Only 42/126 (33%) articles reported interventional studies. To further integrate genomics into nursing, study findings indicate there is a need to move beyond descriptive work on knowledge and understanding to focus on interventional studies and implementation of genomics into nursing practice.
Collapse
Affiliation(s)
- Joanne Thomas
- Genomics Policy Unit, Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK;
| | - Jordan Keels
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02476, USA;
| | - Kathleen A. Calzone
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- National Institutes of Health, National Cancer Institute, Center for Cancer Research, Genetics Branch, Bethesda, MD 20892, USA
| | - Laurie Badzek
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- Ross and Carol Nese College of Nursing, Penn State University, University Park, PA 16802, USA
| | - Sarah Dewell
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- School of Nursing, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - Christine Patch
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- Engagement and Society, Wellcome Connecting Science, Hinxton CB10 1RQ, UK
| | - Emma T. Tonkin
- Genomics Policy Unit, Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK;
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
| | - Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02476, USA;
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
| |
Collapse
|
6
|
Liu Q, Wang F, Wang G, Liu L, Hu X. Recent evidence and progress for developing precision nursing in symptomatology: A scoping review. Int Nurs Rev 2023; 70:415-424. [PMID: 36597558 DOI: 10.1111/inr.12816] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/24/2022] [Indexed: 01/05/2023]
Abstract
AIM To summarize the omics results of symptomatic research that can help nurses identify intervention targets and design precision interventions for pain, mental health, cognitive impairment, sleep disorder, fatigue, lymphedema, and quality of life, so as to provide a comprehensive summary of help and inspire to precision nursing. METHODS CINAHL, PubMed, Web of Science, and ScienceDirect databases were searched. Retrieval time was from January 2012 to December 2021. Symptomatology research applying omics that can be used to guide nurses in designing targeted interventions was included. RESULTS Forty-six studies were included in the final review. Symptomatology research that can be integrated with nursing science to develop precision nursing focused on pain, mental health, cognitive impairment, sleep disorder, fatigue, lymphedema, and quality of life. Most studies were related to cognitive impairment (n = 10; 21.74%), pain (n = 9; 19.57%), and mental health (n = 8; 17.39%). Moreover, the included studies involved various omics technologies, such as whole genome, epigenome, transcriptome, proteome, and metabolome. CONCLUSION The rapid development of various omic technologies promotes symptomatology research, which can help nurses fully understand the information of patients. Phenotypic characteristics and biomarkers shown in symptomatology research help nurses identify intervention targets and develop individualization interventions, so as to prevent and reduce symptoms and improve the quality of life. IMPLICATION FOR NURSING AND HEALTH POLICY This scoping review is the first synthesis of all peer-reviewed literature to summarize and provide important information and references from the omic results of symptomatology studies to develop precision nursing, highlighting the status and development of precision nursing. Nursing education policies should introduce the development and importance of precision nursing. Further research could consider investing more attention in precision nursing. Nursing researchers can carry out some studies applying omics technology to explore more biomarkers, helping guide the formulation of clinical intervention for symptoms.
Collapse
Affiliation(s)
- Qian Liu
- West China School of Nursing, Sichuan University/ Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Sichuan, China
| | - Fang Wang
- West China School of Nursing, Sichuan University/ Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Sichuan, China
| | - Guan Wang
- West China School of Nursing, Sichuan University/ Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Sichuan, China
| | - Li Liu
- West China School of Nursing, Sichuan University/ Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Sichuan, China
| | - Xiuying Hu
- West China School of Nursing, Sichuan University/ Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Sichuan, China
| |
Collapse
|
7
|
Dreisbach C, Wright ML, Walker RK, Byon HD, Keim-Malpass J. Nursing science as a federally-recognized STEM degree: A call to action for the United States with global implications. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100084. [PMID: 38745631 PMCID: PMC11080356 DOI: 10.1016/j.ijnsa.2022.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 11/22/2022] Open
Abstract
Nursing science contributes to advancements in patient care, public health, and innovation within numerous scientific domains. Despite commonality with United States Department of Education definitions of a science, technology, engineering, and mathematics (STEM) educational programs, nursing continues to be excluded from Department of Homeland Security STEM classification. This exclusion prevents societal recognition of nursing as a science and limits attraction of clinicians and nurse scientists born outside of the United States due to omission from various federal visa provisions the Department of Homeland Security classification provides. We evaluated existing Department of Homeland Security STEM-classified educational programs and identified methodological and content congruency among STEM-classified programs and nursing. We provide clear evidence that nursing contributes impactful STEM research; and argue that inclusion is critical for advancement of the profession and the potential to mitigate the faculty shortage. Beyond evaluation of nursing as a STEM field, we offer a policy-focused solution for development and diversification of the nursing workforce.
Collapse
Affiliation(s)
- Caitlin Dreisbach
- Columbia University, Data Science Institute, New York, NY, USA
- Center for Advanced Medical Analytics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Michelle L. Wright
- University of Texas at Austin, School of Nursing, Austin, TX, USA
- Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, TX, USA
- Center for Advanced Medical Analytics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Rae K. Walker
- University of Massachusetts-Amherst, College of Nursing, Amherst, MA, USA
- IALS Center for Health and Human Performance, University of Massachusetts-Amherst, Amherst, MA, USA
- Center for Advanced Medical Analytics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Ha Do Byon
- University of Virginia, School of Nursing, P.O. Box 800782, Charlottesville, VA 22901, USA
- Center for Advanced Medical Analytics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jessica Keim-Malpass
- University of Virginia, School of Nursing, P.O. Box 800782, Charlottesville, VA 22901, USA
- School of Medicine, Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
- Center for Advanced Medical Analytics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
8
|
Yeşilçinar İ, Seven M, Şahin E, Calzone K. Test/Retest Reliability of a Turkish Version of the Genetics and Genomics in Nursing Practice Survey. J Nurs Meas 2022; 30:464-481. [PMID: 36127149 PMCID: PMC10433692 DOI: 10.1891/jnm-d-21-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: The Genetics and Genomics in Nursing Practice Survey (GGNPS) was developed to evaluate the use of genetics in clinical practice. This study aimed to translate the GGNPS into Turkish and perform the test/retest reliability. Methods: A descriptive, cross-sectional research design was used to collect data. Data were collected two times with ~3-7 weeks apart by using RedCap software. Results: At Time 1, a total of 385 nurses completed the survey; at Time 2, 88 nurses completed the retest survey. Findings show that one item has a slight agreement, 9 items fair agreements and 18 items moderate agreements, and 19 items substantial agreements between Times 1 and 2. Conclusions: The Turkish version of GGNPS appears to be a reliable instrument.
Collapse
Affiliation(s)
| | - Memnun Seven
- University of Massachusetts Amherst, Amherst, Massachusetts
| | | | | |
Collapse
|
9
|
Educational Programme for Cancer Nurses in Genetics, Health Behaviors and Cancer Prevention: A Multidisciplinary Consensus Study. J Pers Med 2022; 12:jpm12071104. [PMID: 35887601 PMCID: PMC9318790 DOI: 10.3390/jpm12071104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022] Open
Abstract
(1) Background: Most common hereditary cancers in Europe have been associated with lifestyle behaviors, and people affected are lacking follow up care. However, access to education programmes to increase knowledge on cancer and genetics and promote healthy lifestyle behaviors in people at high risk of cancer is scarce. This affects the quality of care of people with a hereditary risk of cancer. This study aimed to reach a multidisciplinary consensus on topics and competencies and competencies that cancer nurses need in relation to cancer, genetics, and health promotion. (2) Methods: A two-round online Delphi study was undertaken. Experts in cancer and genetics were asked to assess the relevance of eighteen items and to suggest additional terms. Consensus was defined as an overall agreement of at least 75%. (3) Results: A total of 74 multiprofessional experts from all around the world participated in this study including healthcare professionals working in genetics (39%), researchers in cancer and genetics (31%) and healthcare professionals with cancer patients (30%). Thirteen additional items were proposed. A total of thirty-one items reached consensus. (4) Conclusions: This multidisciplinary consensus study provide the essential elements to build an educational programme to increase cancer nurses’ skills to support the complex care of people living with a higher risk of cancer including addressing lifestyle behaviors. All professionals highlighted the importance of cancer nurses increasing their skills in cancer and genetics.
Collapse
|
10
|
Yeşilçinar İ, Seven M, Şahin E, Calzone K. Genetics and genomic competency of Turkish nurses: A descriptive cross-sectional study. NURSE EDUCATION TODAY 2022; 109:105239. [PMID: 34915239 PMCID: PMC9389323 DOI: 10.1016/j.nedt.2021.105239] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/03/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Nurses have essential roles in genetic related healthcare, including risk assessment, referring individuals to genetics services, advocating for and educating individual, families, and communities who might benefit from genetic services. OBJECTIVE To determine the genetics and genomic competency of Turkish nurses. DESIGN A descriptive cross sectional research design was used to collect data. SETTING Totally 385 nurses working in clinical or academic settings in Turkey were recruited between 20 January and 20 April 2020. METHODS Data were collected using socio-demographic characteristics form and Genetics and Genomics in Nursing Practice Survey on 20 January-20 April 2020. Descriptive statistics, Kruskal Wallis, and Mann-Whitney U tests were used for data analyses. RESULTS A total of 385 nurses participated in this study. Most, 44.9% had a BSN degree, 42.1% were clinical nurses. Of the nurses, 34.5% reported that they had genetics included in their nursing curriculum, and 74.0% intended to learn more about genetics. The mean knowledge score was 9.36/12. Gender, primary role of nurses, and whether to see patients actively in practice were the factors effecting knowledge score of nurses in genetic and genomics. CONCLUSIONS Turkish nurses' genomics skills need additional development and integration of genomics to the nursing curriculum can be effective to decrease their knowledge gaps. Clinical nurses' genomic competency should improve to increase the nursing care quality.
Collapse
Affiliation(s)
- İlknur Yeşilçinar
- Izmir Katip Celebi University, Health Science Faculty, Obstetrics and Gynecology Nursing, Izmir, Turkey.
| | - Memnun Seven
- University of Massachusetts Amherst, College of Nursing, Amherst, MA, USA.
| | - Eda Şahin
- Giresun University, Health Science Faculty, Obstetrics and Gynecology Nursing, Giresun, Turkey.
| | - Kathleen Calzone
- Center for Cancer Research, Genetics Branch, National Cancer Institute, Bethesda, MD 20892, USA.
| |
Collapse
|
11
|
Building Environmental Health and Genomics Literacy among Healthcare Providers Serving Vulnerable Communities: An Innovative Educational Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020929. [PMID: 35055751 PMCID: PMC8776035 DOI: 10.3390/ijerph19020929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 12/10/2022]
Abstract
This study addresses healthcare providers’ knowledge deficits in environmental health and genetics, and primarily focuses on student nurses and nurses serving marginalized, low-income communities frequently exposed to environmental toxicants. Our approach to improve public health is unique, combining hands-on modeling exercises with case-based lessons in addition to three targeted 40 min lectures on toxicology. These lectures included the team’s community-based environmental health research among Indigenous peoples of the U.S. The hands-on approach employed DNA and protein molecular models designed to demonstrate normal and dysfunctional molecules, as well as genetic variants in world populations. The models provided learners with visuals and an experience of “learning by doing.” Increased awareness of the effects of environmental toxicants is the first step toward improving health care for exposed communities. We measured knowledge gains by pre- and post-tests among student nurses and nurses serving Native Americans living both in urban and rural areas of the U.S. (n = 116). The modeling lessons illustrated genetic variants in liver proteins common in Native peoples and their resulting health vulnerabilities. Participants were engaged and enthusiastic; and pre- and post-test results reported substantial knowledge gains and a greater understanding of genetic susceptibility (p < 0.0001). Our study demonstrates the utility of this framework across diverse populations and remote communities.
Collapse
|
12
|
Dagan E, Amit Y, Sokolov L, Litvak P, Barnoy S. Integrating Genomic Professional Skills Into Nursing Practice: Results From a Large Cohort of Israeli Nurses. J Nurs Scholarsh 2021; 53:753-761. [PMID: 34151506 DOI: 10.1111/jnu.12686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE To explore the association of genomic knowledge, self-epistemic authority (SEA; i.e., subjective perception of knowledge expertise), perceived importance of genomics in nursing, and the integration of genomic skills into nursing practice. DESIGN A cross-sectional study of nurses working in pediatric, obstetric, and internal wards of two medical centers in Israel between February and October 2018. METHODS Participants completed anonymous questionnaires about genomic knowledge, SEA, perceived importance of genomics, and the performance of genomic skills in nursing practice. Associations between variables were analyzed using Pearson correlations, and a hierarchical regression model was used to determine which variables explained the performance of genomic practices among participants. FINDINGS Altogether 423 nurses participated in the study. The mean genomic knowledge was low (55.05 ± 14.82%). Nurses reported a low integration of genomic skills in their practice (M = 1.90, SD = 0.71), although their overall perceived importance of genomics was positive (M = 2.88, SD = 0.68). Positive correlations were found between SEA and the integration of genomic skills in nursing practice. Obstetric nurses had more genomic knowledge, more positive perceptions about genomics, and performed more genomic skills in their nursing practice. CONCLUSIONS Although nurses realized the importance of genomics to their practice, and genomics is part of the Israeli nursing core curriculum, we found disappointingly low levels of knowledge and performance of genomic skills in nursing practice. CLINICAL RELEVANCE The results call for action to establish ongoing education programs in genomics for nurses, which would lead to the inclusion of genomic skills into routine nursing practice, and prepare nurses for providing personalized medicine.
Collapse
Affiliation(s)
- Efrat Dagan
- Associate Professor. The Cheryl Spencer, Department of Nursing, University of Haifa, Haifa, Israel
| | - Yulia Amit
- Department of Nursing, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Sheba Medical Center, Ramat-Gan, Israel
| | - Libi Sokolov
- The Cheryl Spencer Department of Nursing, Haifa, Israel and the Internal Department, Carmel Medical Center, Haifa, Israel
| | - Patricia Litvak
- Department of Nursing, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Sheba Medical Center, Ramat-Gan, Israel
| | - Sivia Barnoy
- Delta Lambda at-Large Associate professor, Department of Nursing, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
13
|
Kurnat-Thoma E, Fu MR, Henderson WA, Voss JG, Hammer MJ, Williams JK, Calzone K, Conley YP, Starkweather A, Weaver MT, Shiao SPK, Coleman B. Current status and future directions of U.S. genomic nursing health care policy. Nurs Outlook 2021; 69:471-488. [PMID: 33487404 PMCID: PMC8282091 DOI: 10.1016/j.outlook.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/26/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND As genomic science moves beyond government-academic collaborations into routine healthcare operations, nursing's holistic philosophy and evidence-based practice approach positions nurses as leaders to advance genomics and precision health care in routine patient care. PURPOSE To examine the status of and identify gaps for U.S. genomic nursing health care policy and precision health clinical practice implementation. METHODS We conducted a scoping review and policy priorities analysis to clarify key genomic policy concepts and definitions, and to examine trends and utilization of health care quality benchmarking used in precision health. FINDINGS Genomic nursing health care policy is an emerging area. Educating and training the nursing workforce to achieve full dissemination and integration of precision health into clinical practice remains an ongoing challenge. Use of health care quality measurement principles and federal benchmarking performance evaluation criteria for precision health implementation are not developed. DISCUSSION Nine recommendations were formed with calls to action across nursing practice workforce and education, nursing research, and health care policy arenas. CONCLUSIONS To advance genomic nursing health care policy, it is imperative to develop genomic performance measurement tools for clinicians, purchasers, regulators and policymakers and to adequately prepare the nursing workforce.
Collapse
Affiliation(s)
- Emma Kurnat-Thoma
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD; School of Nursing and Health Studies, Georgetown University, Washington, DC
| | - Mei R Fu
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA.
| | | | - Joachim G Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | | | | | - Kathleen Calzone
- National Cancer Institute, Center for Cancer Research, Genetics Branch, Bethesda, MD
| | | | | | | | - S Pamela K Shiao
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Bernice Coleman
- Nursing Research and Performance Improvement, Cedars-Sinai Medical Center, Los Angeles, CA
| |
Collapse
|
14
|
Rahma AT, Ahmed LA, Elsheik M, Elbarazi I, Ali BR, Patrinos GP, Al-Maskari F. Mapping the Educational Environment of Genomics and Pharmacogenomics in the United Arab Emirates: A Mixed-Methods Triangulated Design. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2021; 25:285-293. [PMID: 33904793 DOI: 10.1089/omi.2021.0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pharmacogenomics (PGx) education is crucial to support the effective delivery of PGx services in any health care system. We mapped the current educational environment of genomics and PGx in the United Arab Emirates (UAE) and assessed the readiness of the accredited higher education system to move forward with the implementation of PGx in the country. We employed a mixed-methods triangulated approach to map the PGx educational environment in UAE. We used two qualitative methods and one quantitative method. University curricula inspection, interviews, and questionnaires were the main resources of data. PGx was taught in 6 out of 21 accredited universities, but only for pharmacy majors. Only three out of six PGx courses were stand-alone. Majority of academia exhibited positive attitudes toward the availability and accessibility of genetic testing, with 89% agreeing that the government should invest more money into its development. Interviews with academics and, importantly, the commissioners who oversee the accreditation process of universities in UAE revealed recurrent themes that included recognizing the importance of genomic medicine and PGx and called for translational and implementational research, including recruitment of experts in the field. We recommend, as supported by our findings in this study, the creation of standardized curriculum of genomics and PGx for each health science field, using the blended teaching approach, and benchmarking internationally accredited universities to foster international collaboration and improve the education and practice of genomics in the clinic and public health systems. An 11-item genomics and PGx strategy is presented herein. Finally, the mixed-methods study design employed in this research may also serve as a model conceptual frame for other science education mapping efforts at country or multi-institutional scales in the future.
Collapse
Affiliation(s)
- Azhar T Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mahanna Elsheik
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Bassam R Ali
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - George P Patrinos
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| |
Collapse
|
15
|
Dumo AM, Laing B, Lim AG, Palaganas E, Abad PJ, Valdehueza O, Palovaara M, Saunders H, Estola M, Mandysova P, Maguire J, Ward LD, Carlberg C, Vehviläinen‐Julkunen K. Randomized controlled trial on the effectiveness of web‐based Genomics Nursing Education Intervention for undergraduate nursing students: a study protocol. J Adv Nurs 2020; 76:3136-3146. [DOI: 10.1111/jan.14477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/05/2020] [Accepted: 06/26/2020] [Indexed: 01/01/2023]
Affiliation(s)
| | - Bobbi Laing
- School of Nursing University of Auckland Auckland New Zealand
| | | | | | - Peter James Abad
- College of Nursing University of the Philippines Manila Philippines
| | | | | | - Hannele Saunders
- South‐Eastern Finland University of Applied Sciences Kouvola Finland
| | | | - Petra Mandysova
- Department of Nursing Faculty of Health Studies University of Pardubice Pardubice Czech Republic
| | - Jane Maguire
- Faculty of Health University of Technology Sydney Australia
| | | | | | | |
Collapse
|
16
|
|
17
|
Kurnat-Thoma E. Educational and Ethical Considerations for Genetic Test Implementation Within Health Care Systems. NETWORK AND SYSTEMS MEDICINE 2020; 3:58-66. [PMID: 32676590 PMCID: PMC7357722 DOI: 10.1089/nsm.2019.0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2020] [Indexed: 01/17/2023] Open
Abstract
Introduction: The precision medicine (PM) era presents unprecedented proliferation of genetic/genomic initiatives, information, and bioinformatic tools to enhance targeted molecular diagnosis and therapeutic treatments. As of February 29, 2020, the National Institutes of Health (NIH) National Center for Biotechnology Information (NCBI) Genetic Testing Registry contained 64,860 genetic tests for 12,268 conditions and 18,686 genes from 560 laboratories, and the Food and Drug Administration had 404 entries for pharmacogeneomic biomarkers used in drug labeling. Population-based research initiatives including NIH's All of Us and Veterans Affairs' Million Veteran Program, and the UK Biobank, combine use of genomic biorepositories with electronic medical records (i.e., National Human Genome Research Institute's [NHGRI's] electronic Medical Records and Genomics [eMERGE] Network). Learning health care systems are implementing clinical genomics screening programs and precision oncology programs. However, there are insufficient medical geneticists, nurse geneticists, and genetics counselors to implement expanding number of clinical genetic tests that are required for PM implementation. Methods: A scoping review of current (2014-2019) trends in U.S. genomic medicine translation, PM health care provider workforce education and training resources, and genomic clinical decision support (CDS) implementation tools was conducted. Results: Health care delivery institutions and systems are beginning to implement genetic tests that are driving PM, particularly in the areas of oncology, pharmacogenetics, obstetrics, and prenatal diagnostics. To ensure safe adoption and clinical translation of PM, health care systems have an ethical responsibility to ensure their providers and front-line staff are adequately prepared to order, use, and interpret genetic test information. Conclusion: There are a number of high-quality evidenced-based educational resources and CDS tools available. Strong partnerships between health care system leaders, front-line providers and staff coupled with reasonable goal setting can help drive PM translation interests.
Collapse
Affiliation(s)
- Emma Kurnat-Thoma
- Department of Intramural Research, DHHS/NIH/NINR, Bethesda, Maryland, USA
- School of Nursing and Health Studies, Georgetown University, Washington, District of Columbia, USA
| |
Collapse
|
18
|
Genetic and Genomic Advances in Breast Cancer Diagnosis and Treatment. Nurs Womens Health 2019; 23:518-525. [PMID: 31669147 DOI: 10.1016/j.nwh.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/18/2019] [Accepted: 09/01/2019] [Indexed: 02/06/2023]
Abstract
Advances in genetic testing for people at high risk for cancer and in targeted gene therapy for breast cancer are rapidly emerging, including newly developed key hormone receptor-targeted therapies and individualized molecular fusion identification and treatment options. These advances are contributing to a new era in cancer treatment modalities and care delivery. As more innovative and advanced treatment options emerge, women's health outcomes and survival rates may improve. Nursing professionals in primary care and women's health specialties must be aware of the latest options for testing, referrals, and treatment modalities.
Collapse
|
19
|
The changing face of clinical genetics service delivery in the era of genomics: a framework for monitoring service delivery and data from a comprehensive metropolitan general genetics service. Genet Med 2019; 22:210-218. [DOI: 10.1038/s41436-019-0602-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/19/2019] [Indexed: 11/08/2022] Open
|