Cancer Genetics and Genomics: Essentials for Oncology Nurses
Cancer Genetics and Genomics: Essentials for Oncology Nurses
Many organizations advocate for genetics-related information and technology as a component of best practices in oncology care. Some of those organizations include the American Society of Clinical Oncology (Robson et al., 2010), Centers for Disease Control and Prevention (2011), U.S. Preventive Task Force (2005), and the World Health Organization (2014). Oncology nurses have a role in patient and family education, communication, decision support, and psychosocial support (Calzone, Jenkins, Nicol, et al., 2013; White, Bonham, Jenkins, Stevens, & McBride, 2008). Oncology nurses are part of a multidisciplinary team that includes physicians, genetic counselors, and social workers. As part of that team, nurses are responsible for educating and communicating cancer risk, follow-up for genetic testing and counseling, and facilitating preventive services in collaboration with primary care providers in community settings (Calzone, Jenkins, Nicol, et al., 2013).
In addition, management of patients' genetic information involves knowledge of informed consent, use of bioinformatics to analyze data, and health information technology to advance early detection of risk and individualized care (Institute of Medicine, 2008; Khoury et al., 2007; U.S. Department of Health and Human Services, 2008). Nurses are involved with ethical, legal, and social implications related to bioethical issues of testing, patient fear of discrimination, and protection of patient information, including privacy and security concerns, as well as the effect on insurance coverage. To maintain privacy of genetic testing and mutation risk information, health policies include the Genetic Information Nondiscrimination Act, Affordable Care Act, and Americans With Disabilities Act (ADA) (National Human Genome Research Institute, 2012; Steck & Eggert, 2011).
In well-developed and insured populations, access to genetic testing, personalized medicine, and preventive treatment services is common. However, patients who lack access to as many resources also need genetic testing. Barriers to resources include inadequate financial coverage for genetic testing, the psychological impact on patients and families, and limits to preventive care for underprivileged populations within many U.S. and global communities (Brandt, Ali, Sabel, McHugh, & Gilman, 2008; Habin et al., 2010; World Health Organization, 2014).
Cultural considerations include stigma, fear, and mistrust surrounding genetic testing and care (Brandt et al., 2008; Schlich-Bakker, ten Kroode, Wárlám-Rodenhuis, van den Bout, & Ausems, 2007). Domestic and international efforts focus on ethical implications of genetic testing that involve racial discrimination, preservation of human rights, informed consent, and cultural self-determination (MacIntosh, 2005). Healthcare providers, including nurses, will need ongoing education about genetics-based clinical care to combat cultural considerations (Institute of Medicine, 2008; World Health Organization, 2014).
Implications for Nursing
Many organizations advocate for genetics-related information and technology as a component of best practices in oncology care. Some of those organizations include the American Society of Clinical Oncology (Robson et al., 2010), Centers for Disease Control and Prevention (2011), U.S. Preventive Task Force (2005), and the World Health Organization (2014). Oncology nurses have a role in patient and family education, communication, decision support, and psychosocial support (Calzone, Jenkins, Nicol, et al., 2013; White, Bonham, Jenkins, Stevens, & McBride, 2008). Oncology nurses are part of a multidisciplinary team that includes physicians, genetic counselors, and social workers. As part of that team, nurses are responsible for educating and communicating cancer risk, follow-up for genetic testing and counseling, and facilitating preventive services in collaboration with primary care providers in community settings (Calzone, Jenkins, Nicol, et al., 2013).
In addition, management of patients' genetic information involves knowledge of informed consent, use of bioinformatics to analyze data, and health information technology to advance early detection of risk and individualized care (Institute of Medicine, 2008; Khoury et al., 2007; U.S. Department of Health and Human Services, 2008). Nurses are involved with ethical, legal, and social implications related to bioethical issues of testing, patient fear of discrimination, and protection of patient information, including privacy and security concerns, as well as the effect on insurance coverage. To maintain privacy of genetic testing and mutation risk information, health policies include the Genetic Information Nondiscrimination Act, Affordable Care Act, and Americans With Disabilities Act (ADA) (National Human Genome Research Institute, 2012; Steck & Eggert, 2011).
In well-developed and insured populations, access to genetic testing, personalized medicine, and preventive treatment services is common. However, patients who lack access to as many resources also need genetic testing. Barriers to resources include inadequate financial coverage for genetic testing, the psychological impact on patients and families, and limits to preventive care for underprivileged populations within many U.S. and global communities (Brandt, Ali, Sabel, McHugh, & Gilman, 2008; Habin et al., 2010; World Health Organization, 2014).
Cultural considerations include stigma, fear, and mistrust surrounding genetic testing and care (Brandt et al., 2008; Schlich-Bakker, ten Kroode, Wárlám-Rodenhuis, van den Bout, & Ausems, 2007). Domestic and international efforts focus on ethical implications of genetic testing that involve racial discrimination, preservation of human rights, informed consent, and cultural self-determination (MacIntosh, 2005). Healthcare providers, including nurses, will need ongoing education about genetics-based clinical care to combat cultural considerations (Institute of Medicine, 2008; World Health Organization, 2014).
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