School of Nursing, European Institute of Oncology IRCCS, Milan, Italy.
Italian Society of Psychoneuroendocrineimmunology, Rome, Italy.
J Adv Nurs. 2023 Dec;79(12):4560-4567. doi: 10.1111/jan.15858. Epub 2023 Sep 14.
Although, there is a wealth of information in the medical literature on the usefulness of genomic testing in assessing risk and its application in medical oncology decision making, there are no theoretical reflections in the nursing field.
To understand the implications of molecular biology in nursing practice and highlight the role of Nursing Theory in guiding nurses' reasoning.
Searching literature published between 2000 and 2022 in Medline and Google Scholar. Scientific evidence was analysed by the authors expert in different fields.
Based on the findings of the literature, concerns have been raised about the proper care of cancer patients who have a genomic risk profile determination. In particular, the absence of theoretical thinking and conceptual models that consider developments in molecular biology and their impact on nursing, in addition to the prevalence of heuristic thinking and the application of clinical patterns in nursing practice, could induce patient misjudgement with inadequate planning of preventive, curative, rehabilitative and educational nursing interventions. Nurses working in the field of oncology should be aware that the risk profile determined by genomics tests is merely the visible and stated portion of the cancer patient: the tip of iceberg.
This study demonstrates how genomic testing takes into account a fraction of genes discovered in tumour tissue to establish a risk profile. This subset differs, for example, from the social genome, which can determine the risk of dementia, cancer and cardiovascular disease, but in response to social adversity. Nursing theory, which views the environment as a metaparadigm, must consider a conceptual model that can integrate the findings of genomic testing with recommendations from studies on the social genome of humans to make it easier to build nursing treatments that can better reduce these risks.
A nursing theoretical discourse on genomics is a paramount requirement for developing effective nursing care.
尽管医学文献中有大量关于基因组测试在评估风险及其在肿瘤医学决策中的应用的有用信息，但护理领域没有理论反思。
了解分子生物学在护理实践中的意义，并强调护理理论在指导护士推理中的作用。
在 Medline 和 Google Scholar 上搜索 2000 年至 2022 年期间发表的文献。作者对不同领域的科学证据进行了分析。
基于文献的发现，人们对那些有基因组风险特征确定的癌症患者的适当护理提出了担忧。特别是，缺乏理论思维和概念模型，这些模型考虑了分子生物学的发展及其对护理的影响，除了启发式思维的流行和临床模式在护理实践中的应用外，可能会导致患者判断错误，对预防、治疗、康复和教育护理干预措施的规划不足。在肿瘤领域工作的护士应该意识到，基因组测试确定的风险特征仅仅是癌症患者可见和陈述的部分：冰山一角。
本研究表明，基因组测试如何考虑到在肿瘤组织中发现的部分基因来建立风险特征。例如，这个子集与社会基因组不同，社会基因组可以确定痴呆症、癌症和心血管疾病的风险，但这是对社会逆境的反应。将环境视为元范式的护理理论，必须考虑一个概念模型，该模型可以将基因组测试的结果与人类社会基因组研究的建议相结合，以便更容易构建可以更好地降低这些风险的护理治疗方法。
关于基因组学的护理理论论述是制定有效护理的首要要求。
