The Global Landscape of Nursing and Genomics

Scholarly literature on nurses and pharmacogenomics: A scoping review

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.

Integrating genomics into Canadian oncology nursing policy: Insights from a comparative policy analysis

AIM

To learn from two jurisdictions with mature genomics-informed nursing policy infrastructure-the United States (US) and the United Kingdom (UK)-to inform policy development for genomics-informed oncology nursing practice and education in Canada.

DESIGN

Comparative document and policy analysis drawing on the 3i + E framework.

METHODS

We drew on the principles of a rapid review and identified academic literature, grey literature and nursing policy documents through a systematic search of two databases, a website search of national genomics nursing and oncology nursing organizations in the US and UK, and recommendations from subject matter experts on an international advisory committee. A total of 94 documents informed our analysis.

RESULTS

We found several types of policy documents guiding genomics-informed nursing practice and education in the US and UK. These included position statements, policy advocacy briefs, competencies, scope and standards of practice and education and curriculum frameworks. Examples of drivers that influenced policy development included nurses' values in aligning with evidence and meeting public expectations, strong nurse leaders, policy networks and shifting healthcare and policy landscapes.

CONCLUSION

Our analysis of nursing policy infrastructure in the US and UK provides a framework to guide policy recommendations to accelerate the integration of genomics into Canadian oncology nursing practice and education.

IMPLICATIONS FOR THE PROFESSION

Findings can assist Canadian oncology nurses in developing nursing policy infrastructure that supports full participation in safe and equitable genomics-informed oncology nursing practice and education within an interprofessional context.

IMPACT

This study informs Canadian policy development for genomics-informed oncology nursing education and practice. The experiences of other countries demonstrate that change is incremental, and investment from strong advocates and collaborators can accelerate the integration of genomics into nursing. Though this research focuses on oncology nursing, it may also inform other nursing practice contexts influenced by genomics.

Genomes for Nurses: Understanding and Overcoming Barriers to Nurses Utilizing Genomics

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.

Developing the scale of genetic/genomic awareness in pediatric nurses

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.

Genomics-informed nursing strategies and health equity: A scoping review protocol

OBJECTIVE

The objective of this scoping review is to map the available evidence on strategies that nurses can use to facilitate genomics-informed healthcare to address health disparities.

INTRODUCTION

Advancements in genomics over the last two decades have led to an increase in the delivery of genomics-informed health care. Although the integration of genomics into health care services continues to enhance patient outcomes, access to genomic technologies is not equitable, exacerbating existing health disparities amongst certain populations. As the largest portion of the health workforce, nurses play a critical role in the delivery of equitable genomics-informed care. However, little is known about how nurses can help address health disparities within the context of genomics-informed health care. A review of the literature will provide the necessary foundation to identify promising practices, policy, and knowledge gaps for further areas of inquiry.

INCLUSION CRITERIA

We will include papers that explore strategies that nurses can undertake to facilitate genomics-informed care to address health disparities.

METHODS

This review will be conducted using JBI methodology for scoping reviews. We will search electronic databases including MEDLINE (OVID), EMBASE, Cochrane Library, PsychInfo, and CINAHL for quantitative and qualitative studies, systematic reviews and grey literature. Theses, books, and unavailable full-text papers will be excluded. The search will be limited to papers from 2013 and beyond. Two reviewers will screen titles and abstracts followed by full-text and disagreements will be resolved by a third reviewer. We will use a data extraction tool using Microsoft Excel and analyse data using descriptive statistics and conventional content analysis. Findings will be presented in the form of evidence tables and a narrative summary. We will report findings using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

DISCUSSION

Genomics will continue to transform all aspects of health care across the wellness continuum from prevention, assessment, diagnosis, management, treatment, and palliative care. The identification of nursing strategies to address health disparities will build the foundation for policy and practice to ensure that the integration of genomic technologies benefits everyone.

Recent evidence and progress for developing precision nursing in symptomatology: A scoping review

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.

Genetics and genomics knowledge and competency of Chinese nurses based on the theory of diffusion of innovation: A descriptive cross-sectional study

Background

Nurses are responsible for providing genetics and genomics health care services, including disease risk assessment, medical referrals, and advocating for communities and individuals who probably benefit from genomics and genetics services.

Objective

This study aimed to investigate Chinese nurses' understanding and previous training in genomics and genetics. Additionally, we aimed to understand the degree to which Chinese nurses use genomics and genetics knowledge in their daily practice and to assess the learning needs regarding genomics and genetics.

Method

This study utilized the design of a descriptive cross-sectional study. From January 18 to March 15, 2022, 406 registered nurses from the Shandong province of China working in clinical institutions and with good English proficiency were recruited as study subjects. Nurses' demographic data and data related to genetic knowledge and competency were collected using the Genetics and Genomics Nursing Practice Survey (GGNPS) questionnaire. Kruskal Wallis and Mann-Whitney-U tests were utilized to investigate the descriptive statistics and non-normally distributed data.

Results

There are 406 nurses from Shandong Province, China participated in the study. Among them, BSN degrees accounted for 83.7%. Female nurses accounted for 96.8%, and 40% are clinical nurses. Among such nurses, 65.5% reported that genetics was involved in their nursing courses, and 56.2% planned to study more knowledge associated with genetics. The mean knowledge score was 7.35 (out of 12). Nurses' gender, primary role, genomics education, and experience caring for patients with common diseases influenced nurses' scores on genetic and genomics knowledge.

Conclusion

The genomics knowledge and competency of Chinese nurses need to be further improved. Incorporating genomics into the standard nursing curriculum can effectively reduce the knowledge gap. Simultaneously, it is also necessary to improve the attention of senior nurses and nursing managers to genomics nursing and improve the clinical practice environment.

The State of Genetics and Genomics Education in US Physician Assistant Programs

PURPOSE

This study aimed to assess the current landscape of genetics-genomics education in physician assistant (PA) student training.

METHODS

A 25-question electronic survey was emailed to program directors of the 273 accredited PA programs. Questions represented PA program demographics and 4 domains: curricular characteristics and perceived adequacy; content; curricular approaches and instructional methods; and intent, barriers, and perceived needs for an optimal curriculum.

RESULTS

A total of 115 PA program representatives (42%) returned the survey. More than two-thirds of responding programs do not require a prerequisite genetics course for matriculation. Most programs (48%) include 1 to 10 contact hours of genetics-genomics content and use various content delivery methods and approaches. Most programs (67%) use PA program faculty to teach genetics-genomics as part of one course or many courses throughout the curriculum (85%) using didactic lectures (97%). The most significant barrier to developing an optimal curriculum is an already overloaded curriculum (71%). Physician assistant educators welcome supportive resources, such as genetic case studies (96%).

CONCLUSIONS

The study findings elucidate the current state of genetics-genomics education in PA programs. Every responding program reports that genetics-genomics is integrated into their curriculum; however, no standardization exists between programs. Although medical genetics-genomics has changed and advanced rapidly since a similar survey was conducted 14 years ago, the number of contact hours is unchanged, and genetics-genomics content is less dispersed throughout PA curricula. To create genetic-competent and genomic-competent PAs, education must evolve to stay current with ongoing advancements in genomic science.

Competencies of the UK nursing and midwifery workforce to mainstream genomics in the National Health Service: the ongoing gap between perceived importance and confidence in genomics

The United Kingdom is recognised worldwide as a leader in genomics. The use of genomic technologies in the National Health Service (NHS) is expected to deliver faster and more accurate diagnoses, supporting personalized treatments to improve patient outcomes. The ambition of embedding genomic medicine in the diagnostic pathway requires involvement of the front-line clinical workforce, known as 'mainstreaming'. Nurses and midwives are the largest professionally qualified workforce in the National Health Service thus, it is anticipated that they will play key roles in mainstreaming. This study investigated the level of competence/confidence of practicing nurses and midwives to support mainstreaming and their perception of the importance of genomics in delivery of patient care. A literature review of genetics/genomics competency frameworks, semi structured interviews of lead nurses and stakeholders were conducted to identify relevant competencies needed for mainstreaming. These were then used to survey four cohorts of nurses (n = 153) across England in four consecutive years (2019-22). The confidence level of these professionals in all aspects of genomics was 2.07 ± 0.47 measured on a 5-point Likert scale (1"Low confidence"; 5 "High confidence"). Intriguingly, these professionals all appreciated the importance of genomics for their patient care (4.01 ± 0.06). Whilst the importance scores increased, the confidence scores declined at the time when major genomic transformation took place in the NHS (e.g.: launch of the Genomic Medicine Service, the National Genomic Test Directory). To bridge this gap, relevant genomic education can play key roles. However, nurses and midwives were found to be grossly underrepresented in formal genomic education courses offered by Health Education England Genomics Education Programme since 2014. This may result from the lack of direct applicability of the currently offered courses for their practice and role. Thematic analysis revealed that nurses and midwives wish to support their patients by providing more information on their condition, inheritance, and treatment options in combination with the use of relevant genetic counselling skills. This study identified easy to follow competencies for embedding genomics into routine clinical care. We propose a training programme that addresses the gap that nurses and midwives currently have, to enable them to harness genomic opportunities for patients and services.

Nursing science as a federally-recognized STEM degree: A call to action for the United States with global implications

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.

Faculty education to improve integration of genomics education in nursing curriculum

Nurses play a crucial role in providing healthcare and need to possess essential knowledge and skill to integrate genomics into practice. Nursing faculty is charged with the education of nurses however, studies show the majority of faculty in the United States is ill-prepared to teach genetics/genomics concepts. Our aim was to increase genetics/genomics content in our college's nursing curriculum by bolstering our faculty knowledge and confidence through the implementation of a face-to-face educational program. Therefore, we launched an intentional, strategic plan in fall 2017. First a comprehensive review of the college's undergraduate nursing curriculum for genetics/genomics content was conducted. Five development workshops on genetics/genomics were delivered over an academic year with knowledge and confidence in genetics/genomics was measured pre- and post-workshops. After the workshops, faculty revised curriculum and added genetics/genomics content to align with the competencies. Participants in the end-of-program survey reported higher confidence levels in all genomics-related tasks and answered more knowledge-based items, as compared to participants in the pre-workshop survey. Changes to the curriculum were made to integrate genetics/genomics in BSN courses and an online genetics course was developed. Genetics/genomics workshops can improve faculty knowledge and confidence and facilitate the integration of genetic/genomic content in undergraduate nursing curricula.

Test/Retest Reliability of a Turkish Version of the Genetics and Genomics in Nursing Practice Survey

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.

Difficulties in providing genetic consultations by public health nurses in Japan

OBJECTIVE

The objectives of this study were to identify the topics that Japanese public health nurses (PHNs) find difficult during genetic consultations and to identify the relationships between these difficulties and PHNs' genetic education.

METHODS

We conducted a mail survey delivered to PHNs employed by local Japanese governmental agencies in the Tokyo metropolitan area, between July and October 2015. The self-administered questionnaire queried the (1) experience with genetic consultation, (2) perceived difficulties in genetic consultation, (3) genetics education background, and (4) demographics. The association between the perceived difficulties in genetic consultations and the genetics education opportunities was examined using logistic regression.

RESULTS

Of the 907 mailed surveys, 536 PHNs responded (59.1% response rate). Most of the respondents (89.7%) had previously conducted genetic consultations. The majority of respondents (72.7%) had partaken in consultations regarding a possible hereditary disorder in the client or their families, and of those, 76.6% perceived difficulties during the genetic consultation. Respondents who had previously studied decision-making support for genetic testing were significantly less likely to perceive difficulties in genetic consultations on prenatal diagnosis (OR = 0.04, 95% CI [0.00-0.73]).

CONCLUSIONS

Our results suggest that PHNs receive training in genetic consultation, which can be integrated into everyday practice.

Essential genomic knowledge in graduate nursing practice

BACKGROUND

Genetics-informed nursing is essential to personalized health care. Advanced practice nurses will increasingly encounter genomic information in clinical care and are expected to have competency.

PURPOSE

To examine genomic competency of advanced practice nursing students and faculty in a graduate nursing school.

METHODS

A convenience sample of graduate nursing faculty and students were electronically sent a survey assessing genomic knowledge. In total, 13.98% of faculty (33/236) and 9.87% of students (82/831) completed a demographic questionnaire, perceived genomic competency items, and Genomic Nursing Concept Inventory (GNCI). The GNCI is a 31-question multiple choice questionnaire assessing 18 genomic concepts in four categories (Human Genome Basics, Mutations, Inheritance Patterns, and Genomic Health care). Percentage of correct items was calculated for faculty and students, as were correlations between demographics, perceived genomic competency, and GNCI scores.

RESULTS

Students' GNCI overall scores were higher than faculty, 54.8% (interquartile range [IQR] 38-72%) vs 48.4% (IQR 32-68%). Both groups demonstrated the lowest scores in Genomic Basics (students 41.7% [IQR 25-67%] and faculty 33.3% [IQR 16-50%]). Students' and faculty's perceived genomic competency correlated with GNCI scores ( r = 0.49, p < .001 and r = 0.70, p < .001, respectively). Age ( r = -0.40, p < .001), entering nursing school after 2010 ( r = 0.47, p < .001), and previous genomics course ( r = 0.52, p < .001) were significantly correlated with GNCI total score for students, but not faculty.

CONCLUSIONS

This study indicates that faculty and students in a graduate nursing school perceive and demonstrate low genomic knowledge, particularly in basic genomics. Further exploration into innovative methods to provide basic genomic education is needed.

IMPLICATIONS

To provide access and equity for personalized genomic-based health care, we must prepare genomics-informed nurses.

Nurses’ Knowledge, Attitudes, Confidence, and Practices with Genetics and Genomics: A Theory-Informed Integrative Review Protocol

Introduction: As key healthcare providers, nurses require genomic competency to fulfil their professional obligations in the genomic era. Prior research suggests that nurses have limited competency with genomics-informed practice. Concepts in the Rogers’ Diffusion of Innovation (DOI) theory (i.e., knowledge, attitudes, and attributes of innovation adopters) provide a framework to understand the process of adoption of innovations, such as genomics, across organizations. We aim to synthesize what is known about the adoption of genomics across nursing within the DOI framework to identify gaps and opportunities to enact sustained adoption of genomics in nursing. Methods and analysis: An integrative literature review, following Whittemore and Knafl’s five steps, will be conducted to evaluate qualitative, quantitative, and mixed-method primary studies that meet inclusion and exclusion criteria. The MEDLINE, PsychINFO, CINAHL, Cochrane, and Sociological Abstracts electronic databases will be searched in addition to the ancestry search method. Two researchers will perform independent screening of studies, quality appraisal using the Mixed-Methods Appraisal Tool, and data analysis using the narrative synthesis method. Disagreements will be resolved by a third reviewer. Findings in this review could be used to develop theory- and evidence-informed strategies to support the sustained adoption of genomics in nursing.

Genetics and Genomics Teaching in Nursing Programs in a Latin American Country

Although the importance of genetics and genomics in nursing education has been widely recognized, surveys carried out in several countries show that these subjects are still limited in nursing undergraduate programs. In Latin America, the teaching of genetics and genomics in nursing programs has never been previously documented. Considering this scenario, we aimed to investigate how genetics and genomics have been taught in undergraduate nursing programs in Brazil. A total of 138 undergraduate nursing program coordinators and 49 faculty members were recruited to participate in this cross-sectional study. After IRB approval, data were collected using an online survey, covering curriculum design, faculty credentials, genetics and/or genomics teaching, as well as their impressions regarding the document “Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics”. Genetics is taught in most of the investigated courses (67.3%), mainly by biologists (77.6%), with master’s degree (83.7%), and with the syllabus mainly focused on molecular biology. More instructors agreed with Competency 2 (C2) which refers to advocating for clients’ access to desired genetic/genomic services and/or resources including support groups as well as C23 which refer to using health promotion/disease prevention practices that incorporate knowledge of genetic and genomic risk factors, than coordinators. That is, the participants’ type of appointment (instructors vs. coordinators) had a significant effect on their agreement level with competencies C2 (χ² = 6.23, p = 0.041) and C23 (χ² = 9.36, p = 0.007). Overall, a higher number of participants with both master’s and Ph.D. degrees significantly agreed with competencies C2, C4, which refer to incorporating genetic and genomic technologies and information into registered nurse practice, and C5—demonstrating in practice the importance of tailoring genetic and genomic information and services to clients based on their culture, religion, knowledge level, literacy, and preferred language, when compared to those with Ph.D. only, and those with a master’s degree only (χ² = 8.73, p = 0.033; χ² = 8.61, p = 0.033; χ² = 8.61, p = 0.033, respectively). Our results support reflections on ways to prepare the nursing workforce to deliver personalized nursing care. Additionally, they can be an aid in establishing guidelines for the undergraduate nursing curricula in Brazil and in other Portuguese-speaking countries, as well as in Latin America.

A Web Screening on Training Initiatives in Cancer Genomics for Healthcare Professionals

The disruptive advances in genomics contributed to achieve higher levels of precision in the diagnosis and treatment of cancer. This scientific advance entails the need for greater literacy for all healthcare professionals. Our study summarizes the training initiatives conducted worldwide in cancer genomics field for healthcare professionals. We conducted a web search of the training initiatives aimed at improving healthcare professionals’ literacy in cancer genomics undertaken worldwide by using two search engines (Google and Bing) in English language and conducted from 2003 to 2021. A total of 85,649 initiatives were identified. After the screening process, 36 items were included. The majority of training programs were organized in the United States (47%) and in the United Kingdom (28%). Most of the initiatives were conducted in the last five years (83%) by universities (30%) and as web-based modalities (80%). In front of the technological advances in genomics, education in cancer genomics remains fundamental. Our results may contribute to provide an update on the development of educational programs to build a skilled and appropriately trained genomics health workforce in the future.

Informed consent, genomic research and mental health: A integrative review

BACKGROUND

Research on genomics has increased while the biobank activities are becoming more common in different countries. In the mental health field, the questions concerning the potential participants' vulnerability as well as capacity to give the informed consent can cause reluctancy in recruiting persons with mental health problems, although the knowledge and understanding of mental health problems has remarkable changed, and practice is guided with inclusive approaches, such as recovery approach.

AIM

The aim of this study was to describe the current knowledge of informed consent practices in the context of genomic research on mental health from the nurses' viewpoint.

METHODS

An integrative review was conducted with search from seven international databases. Data consist 14 publications which were analyzed with thematic analysis.

ETHICAL CONSIDERATIONS

Ethical requirements were respected in every phase of the research process.

FINDINGS

Most of the papers were published in USA and between 2000-2010. Eight reports were categorized as discussion papers, four qualitative studies and one quantitative study. The thematic analysis provided information on five themes: complexity with the capacity to consent, mixed emotions towards participation, factors influencing the decision to participate, nurses' informed consent process competence and variations between consent procedures.

DISCUSSION

In the informed consent practices, there are various aspects which may affect both the willingness to participate in the study and the informed consent process itself. Implications for practice, education, research, and policies are discussed.

CONCLUSION

There is a need for more updated international research on the topic in the context of different international and national guidelines, legislation, and directives. This study provided a viewpoint to the more collaborative research activities with people with lived experiences also in this field of research following the ideas of recovery approach.

Genetics and genomic competency of Turkish nurses: A descriptive cross-sectional study

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.

Building Environmental Health and Genomics Literacy among Healthcare Providers Serving Vulnerable Communities: An Innovative Educational Framework

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.

Australian human research ethics committee members' confidence in reviewing genomic research applications

Human research ethics committees (HRECs) are evaluating increasing quantities of genomic research applications with complex ethical considerations. Genomic confidence is reportedly low amongst many non-genetics-experts; however, no studies have evaluated genomic confidence levels in HREC members specifically. This study used online surveys to explore genomic confidence levels, predictors of confidence, and genomics resource needs of members from 185 HRECs across Australia. Surveys were fully or partially completed by 145 members. All reported having postgraduate 94 (86%) and/or bachelor 15 (14%) degrees. Participants consisted mainly of researchers (n = 45, 33%) and lay members (n = 41, 30%), affiliated with either public health services (n = 73, 51%) or public universities (n = 31, 22%). Over half had served their HREC [Formula: see text]3 years. Fifty (44%) reviewed genomic studies [Formula: see text]3 times annually. Seventy (60%) had undertaken some form of genomic education. While most (94/103, 91%) had high genomic literacy based on familiarity with genomic terms, average genomic confidence scores (GCS) were moderate (5.7/10, n = 119). Simple linear regression showed that GCS was positively associated with years of HREC service, frequency of reviewing genomic applications, undertaking self-reported genomic education, and familiarity with genomic terms (p < 0.05 for all). Conversely, lay members and/or those relying on others when reviewing genomic studies had lower GCSs (p < 0.05 for both). Most members (n = 83, 76%) agreed further resources would be valuable when reviewing genomic research applications, and online courses and printed materials were preferred. In conclusion, even well-educated HREC members familiar with genomic terms lack genomic confidence, which could be enhanced with additional genomic education and/or resources.

Current Trends in Genetics and Neonatal Care

BACKGROUND

Genetic and genomic health applications are rapidly changing. A clear and updated description of these applications for the neonatal population is needed to guide current nursing practice.

PURPOSE

To provide scientific evidence and guidance on the current genetic and genomic applications pertinent to neonatal care.

METHODS

A search of CINAHL and PubMed was conducted using the search terms "newborn/neonatal" and "genetics," "genomics," "newborn screening," "pharmacogenomics," "ethical," and "legal." Google searches were also conducted to synthesize professional guidelines, position statements, and current genetic practices.

FINDINGS/RESULTS

Components of the newborn genetic assessment, including details on the newborn physical examination, family history, and laboratory tests pertinent to the newborn, are reported. The history and process of newborn screening are described, in addition to the impact of advancements, such as whole exome and genome sequencing, on newborn screening. Pharmacogenomics, a genomic application that is currently utilized primarily in the research context for neonates, is described and future implications stated. Finally, the specific ethical and legal implications for these genetic and genomic applications are detailed, along with genetic/genomic resources for nurses.

IMPLICATIONS FOR PRACTICE

Providing nurses with the most up-to-date evidence on genetic and genomic applications ensures their involvement and contributions to quality neonatal care.

IMPLICATIONS FOR RESEARCH

Ongoing genetic/genomic research is needed to understand the implications of genetic/genomic applications on the neonatal population and how these new applications will change neonatal care.

Increasing Genomic Literacy Through National Genomic Projects

Genomics is an advancing field of medicine, science, ethics, and legislation. Keeping up to date with this challenging discipline requires continuous education and exchange of knowledge between many target groups. Specific challenges in genomic education include tailoring complex topics to diverse audiences ranging from the general public and patients to highly educated professionals. National genomic projects face many of the same challenges and thus offer many opportunities to highlight common educational strategies for improving genomic literacy. We have reviewed 41 current national genomic projects and have identified 16 projects specifically describing their approach to genomic education. The following target groups were included in the educational efforts: the general public (nine projects), patients (six projects), and genomic professionals (16 projects), reflecting the general overall aims of the projects such as determining normal and pathological genomic variation, improving infrastructure, and facilitating personalized medicine. The national genomic projects aim to increase genomic literacy through supplementing existing national education in genomics as well as independent measures specifically tailored to each target group, such as training events, research collaboration, and online resources for healthcare professionals, patients, and patient organizations. This review provides the current state of educational activities within national genomic projects for different target groups and identifies good practices that could contribute to patient empowerment, public engagement, proficient healthcare professionals, and lend support to personalized medicine.

Nursing student and faculty attitudes about a potential genomics-informed undergraduate curriculum

OBJECTIVES

To explore attitudes about adding genomic content to an undergraduate nursing curriculum. Genomic knowledge is essential to nursing education, but challenges exist for curriculum innovation. Few countries have guiding documents from national nursing organizations on genomic competencies for practice or education. Information on attitudes about genomics may provide guidance for curriculum development.

METHODS

Nineteen undergraduate nursing students and two faculty from a school of nursing with two sites in western Canada participated. Five focus groups and four interviews were conducted using a semi-structured focus group guide. Data were analysed using thematic analysis. Coding was inductive.

RESULTS

Characteristics of participants, eight key themes, and four future focal areas were identified to guide future research and curriculum development.

CONCLUSIONS

Global development of genomics-informed curricula will require a focus on increasing knowledge, defining scope and role, increasing visibility of role models, and preparing to implement precision health.

Integrating Genomic Professional Skills Into Nursing Practice: Results From a Large Cohort of Israeli Nurses

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.

Thinking about the idea of consent in data science genomics: How 'informed' is it?

In this paper we argue that 'informed' consent in Big Data genomic biobanking is frequently less than optimally informative. This is due to the particular features of genomic biobanking research which render it ethically problematic. We discuss these features together with details of consent models aimed to address them. Using insights from consent theory, we provide a detailed analysis of the essential components of informed consent which includes recommendations to improve consent performance. In addition, and using insights from philosophy of mind and language and psycholinguistics we support our analyses by identifying the nature and function of concepts (ideas) operational in human cognition and language together with an implicit coding/decoding model of human communication. We identify this model as the source of patients/participants poor understanding. We suggest an alternative, explicit model of human communication, namely, that of relevance-theoretic inference which obviates the limitations of the code model. We suggest practical strategies to assist health service professionals to ensure that the specific information they provide concerning the proposed treatment or research is used to inform participants' decision to consent. We do not prescribe a standard, formal approach to decision-making where boxes are ticked; rather, we aim to focus attention towards the sorts of considerations and questions that might usefully be borne in mind in any consent situation. We hope that our theorising will be of real practical benefit to nurses and midwives working on the clinical and research front-line of genomic science.

Current status and future directions of U.S. genomic nursing health care policy

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.

Enhancing inclusion of diverse populations in genomics: A competence framework

Genomic knowledge and technology have developed rapidly over the last decade and increased our capabilities to diagnose and manage rare diseases. However, current genomic datasets lack ethnic diversity as many genomic studies have focused on participants of white European ancestry. Studies, such as the Deciphering Developmental Disorders study, have been available to participants of any ancestry but have been unsuccessful in recruiting diverse populations. The inclusion of diverse populations in exome and genome sequencing is important to ensure that clinical benefits of genomics advances are equally shared among all populations and to advance scientific knowledge. Our clinical and research experience with the British Pakistani population (the largest ethnic minority in Yorkshire and Humber, accounting for 4.3% of the population) has fostered the development of an innovative cultural competence framework to enhance the inclusion of diverse populations in clinical genomic research and service provision. The application of this framework has the potential to guide healthcare professionals to develop a wide range of competences, so they are ready to embrace genomic advances in order to improve health outcomes for all patients. This practice model will inform precision medicine and improve access of diverse populations to genomic studies. Although based upon work with the Pakistani population in the UK, it is anticipated that the model would be broadly applicable to all underrepresented populations across the world.

Key competencies for Korean nurses in prenatal genetic nursing: experiential genetic nursing knowledge, and ethics and law

PURPOSE

This study aims at determining the competencies of Korean nurses in prenatal genetic nursing.

METHODS

First, a 3-round Delphi survey was conducted to establish prenatal genetic nursing competencies. Second, a prenatal genetic nursing education program (PGNEP), incorporating the findings from the Delphi survey, was designed. Third, a single group pre- and post-quasi-experimental study at a PGNEP workshop was conducted to assess the effectiveness of the integration of the competencies into the PGNEP with the measurements of knowledge about prenatal genetic testing and nursing (K-PGTN) and information needs about prenatal genetic testing and nursing (I-PGTN). Finally, the identified competencies were reexamined for their clarity

RESULTS

Based on the Delphi survey 78 competency components were identified. The components were then classified under 10 categories, which were organized under 4 domains. The domain of “experiential genetic nursing knowledge” and the domain of “ethics and law” were ranked as the first and the second in significance. The quasi experimental study showed that the mean scores in K-PGTN were significantly increased from 8.19±2.67 to 11.25±2.51 (P<0.001). The mean scores of “ethics and law” in I-PGTN decreased significantly (P=0.023). The headings of 4 categories and 2 domains were revised.

CONCLUSION

This study identified competencies for prenatal genetic nursing and nursing education in Korea. There is a need for nursing instructors and researchers to improve the competencies of nurses in the identified areas. Particular emphasis should be placed on experiential nursing knowledge and on ethics and law related to prenatal genetic nursing.

Assessing knowledge of genomic concepts among Canadian nursing students and faculty

Objectives

Contemporary nurses require genomic literacy to engage in genomics-informed health care. Little is known about the genomic literacy of undergraduate nursing students and faculty in many countries. Concept inventories can be used to assess levels of knowledge and inform curriculum development.

Methods

The 31-item Genomic Nursing Concept Inventory (GNCI) was administered to undergraduate nursing students (n=207) and faculty (n=13) in a school of nursing with two sites in western Canada.

Results

Scores on the GNCI were low and comparable to those of US students and faculty. Six student characteristics were associated with total score on the GNCI.

Conclusions

Both students and faculty need to increase their knowledge of genomics. Mandates from national nursing organizations and international collaboration are needed to develop and implement foundational genomics content for undergraduate curricula to enable graduates to engage in genomics-informed health care.

Precision Health and Nursing: Seeing the Familiar in the Foreign

Precision health is the integration of personal genomic data with biological, environmental, behavioral, and other information relevant to the care of a patient. Genetics and genomics are essential components of precision health. Genetics is the study of the effects of individual genes, and genomics is the study of all the components of the genome and interactions between genes, environmental factors, and other psychosocial and cultural factors. Knowledge about the role of genetics and genomics on health outcomes has increased substantially since the completion of the human genome project in 2003. Insights about genetics and genomics obtained from bench science are now having positive clinical implications on patient health outcomes. Nurses have the potential to make distinct contributions to precision health due to their unique role in the health care system. In this article, we discuss gaps in the development of precision health in nursing and how nursing can expand the definition of precision health to actualize its potential. Precision health plays a role in nursing practice. Understanding this connection positions nurses to incorporate genetic and genomic knowledge into their nursing practice.

Understanding Taiwanese Women's Decisional Experiences Regarding Prenatal Screening Procedures And Diagnostics: A Phenomenological Study

PURPOSE

This study sought to understand Taiwanese women's decisional experiences regarding prenatal screening procedures and diagnostics.

METHODS

A hermeneutic phenomenological design guided semistructured interviews with 33 women who were 36 weeks pregnant. Data were collected between February and October 2016. Verbatim transcripts were analyzed following hermeneutic circle to cocreate an understanding of Taiwanese women's decision-making in prenatal screening and diagnostics.

RESULTS

Women's existential experiences were derived from their decision-making process on prenatal screening procedures and diagnostics for chromosomal aneuploidy. These decisional experiences were captured by four theme clusters and eight themes, which were inductively derived from 16 meaning units: (1) accessing health information; (2) considering what was best for my baby; (3) considering family finance; and (4) feeling anxiety posttest.

CONCLUSION

Participants made informed choices on several prenatal screening procedures, ostensibly, based on their personal values and considerations. During the decision-making process, often-cited benefits of genetic screenings were emphasized, but test limitations were often unheeded. A fundamental need for supportive information in decision making was further identified with recommended strategies. Hence, a revision of traditional genetic counseling approaches is recommended. As genomics technologies are increasingly available during antenatal services, women should be sufficiently educated about them to support decision making.

A Maturity Matrix for Nurse Leaders to Facilitate and Benchmark Progress in Genomic Healthcare Policy, Infrastructure, Education, and Delivery

Purpose:

Nurse leaders driving strategic integration of genomics across nursing need tools and resources to evaluate their environment, guide strategies to address deficits, and benchmark progress. We describe the development and pilot testing of a self-assessment maturity matrix (MM) that enables users to benchmark the current state of nursing genomic competency and integration for their country or nursing group; guides the development of a strategic course for improvement and implementation; and assesses change over time.

Design:

Mixed-methods participatory research and self-assessment.

Methods:

During a 3-day workshop involving nursing experts in health care and genomics, a genomic integration MM grid was built by consensus using iterative participatory methods. Data were analyzed using descriptive techniques. This work built on an online survey involving the same participants to identify the critical elements needed for “effective nursing which promotes health outcomes globally through genomics.”

Findings:

Experts from 19 countries across six continents and seven organizations participated in item development. The Assessment of Strategic Integration of Genomics across Nursing (ASIGN) MM incorporates 55 outcome-focused items serving as subscales for six critical success factors (CSFs): education and workforce; effective nursing practice; infrastructure and resources; collaboration and communication; public/patient involvement; policy and leadership. Users select their current circumstances for each item against a 5-point ordinal scale (precontemplation to leading). Nurses representing 17 countries undertook matrix pilot testing. Results demonstrate variation across CSFs, with many countries at the earliest stages of implementation.

Conclusions:

The MM has the potential to guide the strategic integration of genomics across nursing and enables additional assessments within and between countries to be made.

Clinical Relevance:

Nurse leadership and direction are essential to accelerate integration of genomics across nursing practice and education. The MM helps nurse leaders to benchmark progress and guide strategic planning to build global genomic nursing capacity.

A Roadmap for Global Acceleration of Genomics Integration Across Nursing

PURPOSE

The changes needed to accelerate integration of genomics across nursing are complex, with significant challenges faced globally. Common themes lend themselves to a coordinated and collaborative strategic approach to sustained change. We aim to synthesize the outputs of a research program to present a roadmap for nursing leadership to guide integration of genomics across practice.

DESIGN

Mixed methods involving a purposive sample of global nursing leaders and nursing organizations in a sustained, highly interactive program.

METHODS

Experts in nursing, health care and healthcare services, policy, and leadership were recruited. Online surveys preceded a 3-day residential meeting utilizing participatory methods and techniques to gain consensus on the essential elements of a roadmap to promote genomics integration.

FINDINGS

Twenty-three leaders representing 19 countries and seven organizations participated overall. Data on the scope and status of nursing, genomics health care, and resources have been synthesized. Participants identified 117 facilitators to genomics integration across diverse sources. Barriers and priorities identified were mapped to the constructs of the Consolidated Framework for Implementation Research. The roadmap is underpinned by a maturity matrix created by participants to guide and benchmark progress in genomics integration.

CONCLUSIONS

Nurse leaders seeking to accelerate change can access practical guidance with the roadmap, underpinned by support through the Global Genomics Nursing Alliance and its strategic priorities.

CLINICAL RELEVANCE

Genomics is shaping the future of healthcare, but change is needed for integration across nursing. This practical roadmap, adaptable to local health systems and clinical and educational contexts, is relevant to nurse leaders aiming to accelerate change.

Establishing the Omics Nursing Science & Education Network

PURPOSE

To establish a website to advance nursing research and education involving omics technologies and methodologies through facilitating collaborations, use of existing data and samples, mentoring, and access to training opportunities.

METHODS

The Omics Nursing Science & Education Network (ONSEN) website was established following identification of gaps in omics nursing infrastructure and resources that could be addressed via a concerted, collaborative effort. ONSEN content was created using input from a workgroup of experts in genomics and other omics, education, practice, and nursing research. Alpha testing was conducted with workgroup members, followed by website refinements and enhancements, and subsequent beta testing by potential end users. ONSEN was launched in August 2018.

FINDINGS

ONSEN has three main sections. The Education and Training section provides information on mentoring and pre- or postdoctoral opportunities in addition to a knowledge matrix to advance education and skills in genomic nursing science. The Research Collaborations section promotes awareness of ongoing omics nursing research in order to foster collaborations and sharing of samples or data among investigators with programs in omics nursing research or an interest in developing such programs. The Common Data Elements (CDE) section provides information on the benefits of incorporating CDEs into nursing science as well as links to National Institutes of Health resources to facilitate use of CDEs.

CONCLUSIONS

ONSEN provides opportunities for nurse scientists and trainees to leverage samples and datasets, locate mentors and pre- or postdoctoral positions, further the use of CDEs, and enhance education and skills for integrating omics into nursing science.

CLINICAL RELEVANCE

Advancing omics nursing science via ONSEN resources will accelerate the elucidation of the molecular underpinnings of disease and associated symptoms as well as inform the development of rapidly translatable, personalized intervention strategies, grounded in biological mechanisms, for improved health outcomes across populations and the lifespan.

Genomics Education in the Era of Personal Genomics: Academic, Professional, and Public Considerations

Since the completion of the Human Genome Project in 2003, genomic sequencing has become a prominent tool used by diverse disciplines in modern science. In the past 20 years, the cost of genomic sequencing has decreased exponentially, making it affordable and accessible. Bioinformatic and biological studies have produced significant scientific breakthroughs using the wealth of genomic information now available. Alongside the scientific benefit of genomics, companies offer direct-to-consumer genetic testing which provide health, trait, and ancestry information to the public. A key area that must be addressed is education about what conclusions can be made from this genomic information and integrating genomic education with foundational genetic principles already taught in academic settings. The promise of personal genomics providing disease treatment is exciting, but many challenges remain to validate genomic predictions and diagnostic correlations. Ethical and societal concerns must also be addressed regarding how personal genomic information is used. This genomics revolution provides a powerful opportunity to educate students, clinicians, and the public on scientific and ethical issues in a personal way to increase learning. In this review, we discuss the influence of personal genomics in society and focus on the importance and benefits of genomics education in the classroom, clinics, and the public and explore the potential consequences of personal genomic education.

Precision health: A nursing perspective

Precision health refers to personalized healthcare based on a person's unique genetic, genomic, or omic composition within the context of lifestyle, social, economic, cultural and environmental influences to help individuals achieve well-being and optimal health. Precision health utilizes big data sets that combine omics (i.e. genomic sequence, protein, metabolite, and microbiome information) with clinical information and health outcomes to optimize disease diagnosis, treatment and prevention specific to each patient. Successful implementation of precision health requires interprofessional collaboration, community outreach efforts, and coordination of care, a mission that nurses are well-positioned to lead. Despite the surge of interest and attention to precision health, most nurses are not well-versed in precision health or its implications for the nursing profession. Based on a critical analysis of literature and expert opinions, this paper provides an overview of precision health and the importance of engaging the nursing profession for its implementation. Other topics reviewed in this paper include big data and omics, information science, integration of family health history in precision health, and nursing omics research in symptom science. The paper concludes with recommendations for nurse leaders in research, education, clinical practice, nursing administration and policy settings for which to develop strategic plans to implement precision health.

Exploring professional issues: the psychosocial component of genetic counseling in genomic healthcare

Aim: To determine UK genetic counselors’ (UKGCs) opinion regarding ‘the psychosocial component of the UKGC remit in the new genomics era’. Methods: Facilitated discussions at a national conference (2016) using interactive methodologies (58 participants). Results: UKGCs recognized the rapid rate of change emerging with advances in genomic science. Change will be required to the UKGC remit and the roles, rules, relationships and responsibilities that underpin it (29 topics identified). UKGCs supported their ‘unique selling point’; integrating knowledge and the explicit focus on psychosocial aspects of genomic healthcare. By 2019, some of the aspirations have been achieved. Conclusion: UKGCs should proactively position themselves to capitalize on the challenges and opportunities of genomic healthcare to maximize patient benefit.

Patient and Health Care Provider Needs and Preferences in Understanding Pharmacogenomic and Genomic Testing: A Meta-Data Analysis

Tests that feature genomic indicators can now be used to guide the pharmacological treatment of patients. To better identify the needs and preferences of patients and health care providers in facilitating their understanding of information related to such pharmacogenomic tests (PGx), a review of literature on knowledge translation and health literacy in the context of testing was conducted. Using a grounded theory-based approach, a comparative analysis of data from 36 studies meeting the criteria for the meta-data analysis has revealed the recurrence of three principal themes: (a) knowledge and understanding of genetics and pharmacogenomics; (b) experiences with genetic, genomic, or PGx testing (decision about the test, information delivery, and understanding of test results); and (c) educational/informational resources. This synthesis sheds light on each theme from the standpoint of both patients and health care providers and suggests avenues in which to direct efforts to support the introduction of pharmacogenomic tests in current practice.

Validity evaluation of the genetics and genomics in nursing practice survey

Aim

To psychometrically test the Genetics and Genomics Nursing Practice Survey (GGNPS) for evidence of content, face and construct validity.

Design

This study was a secondary data analysis.

Method

Data collected from the Method for Introducing a New Competency into Nursing Practice (MINC) study were used to evaluate the GGNPS for evidence of construct validity via structural equation modelling and confirmatory factor analysis. Face validity was evaluated via feedback from practicing RNs without specific experience with or knowledge of genetics/genomics. Content validity was evaluated via content expert feedback and assessment of a content validity index.

Results

The thresholds for evidence of content and face validity were met. However, we found less evidence for construct validity of the GGNPS; an exploratory factor analysis, conducted to gain additional insight into the theorized latent constructs, determined that the variables were more interrelated that previously predicted.

Increasing nursing capacity in genomics: Overview of existing global genomics resources

BACKGROUND

Global genomic literacy of all health professions, including nurses, remains low despite an inundation of genomic information with established clinical and analytic validity and clinical utility. Genomic literacy and competency deficits contribute to lost opportunities to take advantage of the benefits that genomic information provides to improve health outcomes, reduce healthcare costs, and increase patient quality and safety. Nurses are essential to the integration of genomics into healthcare. The greatest challenges to realizing their potential in successful integration include education and awareness. Identification of resources, their focus, whether they targeted at nursing, and how to access them, form the foundation for a global genomic resource initiative led by the Global Genomics Nursing Alliance.

OBJECTIVES

The aim was to identify existing global genomic resources and competencies, identifying the source, type and accessibility.

DESIGN

Cross sectional online descriptive survey to ascertain existing genomic resources.

SETTINGS

Limited to eighteen countries and seven organizations represented by delegates attending the inaugural meeting in 2017 of the Global Genomics Nursing Alliance.

PARTICIPANTS

A purposive sample of global nursing leaders and representatives of national and international nursing organizations.

METHODS

The primary method was by online survey administered following an orientation webinar. Given the small numbers of nurse leaders in genomics within our sample (and indeed within the world), results were analyzed and presented descriptively. Those identifying resources provided further detailed resource information. Additional data were collected during a face-to-face meeting using an electronic audience-response system.

RESULTS

Of the twenty-three global delegates responding, 9 identified existing genomic resources that could be used for academic or continuing genomics education. Three countries have competence frameworks to guide learning and 5 countries have national organizations for genetics nurses.

CONCLUSIONS

The genomic resources that already exist are not readily accessible or discoverable to the international nursing community and as such are underutilized.