Nursing Science Interventions in Aging

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.

Knowledge development related to caring is examined from the epistemological perspective of nursing as a practical science. Four stages of knowledge development for a practical science of caring are proposed and then used as a basis for evaluating efforts to develop a body of knowledge related to caring. Issues that need to be addressed to facilitate the advancement of nursing as a practical science of caring are identified.

Background and Objectives Nursing home (NH) staff mealtime care approaches are associated with behaviors of residents with dementia, but their impact on food intake remains unexplored. This study examined the role of staff person-centered and task-centered approaches and resident positive, neutral, and challenging behaviors on food intake. Research Design and Methods Videotaped mealtime observations ( N = 160) involving 36 staff and 27 residents (53 unique staff–resident dyads) in 9 NHs were coded using the refined Cue Utilization and Engagement in Dementia mealtime video-coding scheme. The dependent variable was resident food intake. The independent variables were staff person-centered approaches that support resident abilities, staff–resident (dyadic) interactions, and dining environments, staff task-centered approaches, and resident positive, neutral, and challenging behaviors. Resident challenging behaviors included mealtime functional impairments and resistive behaviors. Linear mixed modeling was used. Moderating effects of staff approaches, food type, and length of dyadic mealtime interactions (ie, video duration) were examined. Results The relationship between food intake and resident mealtime functional impairments was moderated by food type ( p < .001). The relationship between food intake and resident resistive behaviors was moderated by food type ( p = .002) and staff person-centered verbal approaches ( p = .001). The relationships between food intake and staff person-centered nonverbal approaches ( p = .003) and resident positive/neutral nonverbal behaviors ( p = .004) were moderated by the length of dyadic mealtime interactions. Discussion and Implications Food intake was associated with staff person-centered approaches and resident positive/neutral and challenging behaviors. Findings emphasize the importance of facilitating positive dyadic interactions using individualized, context-based, multifaceted, person-centered care. Future research on temporal and causal relationships is warranted in larger diverse samples.