This issue of Nursing Research focuses on articles that address issues related to precision health. Among these are reports of laboratory research that will lead to more precise diagnosis and care, analytic strategies to make the most precise use of symptom and other person-centered data, application of theoretical frameworks to guide precision research and practice, and challenges to the conduct of precision health science. Tying it all together is a commentary written by leading nursing scientists who address the challenges and opportunities for nursing science in the precision health era. To illustrate both, the group describes the beginning of a collaboration to advance understanding of the relationships among biological factors and clinical conditions associated with chronic pain. The goal of the commentary is to provide a model for scientists with research foci other than chronic pain as they develop collaborations.
As we planned this special issue, the editors considered the breadth of articles we desired. We started with our call for papers related to precision health, including approaches to individualizing prevention and healthcare management using multi-omics (e.g., genetics, transcriptomics, metabolomics, epigenetics, microbiome, etc.), technologies, and other physiological, psychological, imaging, environmental, and ethical factors for persons, families, and communities. We expressed a particular interest in articles where implications for nursing and healthcare research and practice were addressed. And of course, we preferred to have articles inclusive of all aspects of science in order to provide as complete a picture as possible. We were looking for the integration of omics, environment, and person; in some cases, this was achieved.
One difficulty that nurse scientists have with leading the integration of the multiple aspects necessary to move to precision health forward is, in some cases, a lack of in-depth training across each of the areas of science; this training is necessary to conduct rigorous precision health research. Many nurse scientists have strong backgrounds in aspects of personal characteristics. Others have strong backgrounds in assessing the environment and, in particular, the social and psychological environment, as well as the built environment, all of which may affect our understanding of precision health. A few nurse scientists are particularly well trained in the use of omics. However, it is not clear that all nurse scientists using omics in their research have this training, or if they do, it is not clear that they have sufficient training to conduct the assays or analyze and interpret the results from these very precise measures.
What we do see is that most nurse scientists engaged in efforts to move the profession toward a more comprehensive position on precision health have strong interdisciplinary teams. Nurses are generally well positioned to lead these teams and should take ownership of their holistic perspective and their leadership skills (Cashion & Pickler, 2018). However, nurse scientists without a strong background in specific methods associated with an integrated view of precision health may need their own research translator, a trusted team member who can help them understand the nature of key aspects of the scientific work, particularly omics. And to this end, we encourage the early establishment of these relationships.
As you read the collection of precision health articles, we hope you will consider how you might incorporate a precision health approach in your own work. We do not yet know whether precision health initiatives will fulfill their promise (Pickler, 2018). But we do know that nursing scientists need to be at the forefront of these efforts to understand health and illness and to address pressing healthcare initiatives using the most precise information possible.
Cashion A., & Pickler R. H. (2018). What will I bring: Nurse scientists' contributions to interdisciplinary collaboration. Nursing Research
, 67, 347–348. doi: 10.1097/NNR.0000000000000299. PMID: 30157137.
Pickler R. H. (2018). Precision's promise. Nursing Research
, 67, 271–272. doi: 10.1097/NNR.0000000000000295. PMID: 29953041.