A Conceptual Model of Psychoneurological Symptom Cluster Variation in Women with Breast Cancer: Bringing Nursing Research to Personalized Medicine.
A Conceptual Model of Psychoneurological Symptom Cluster Variation in Women with Breast Cancer: Bringing Nursing Research to Personalized Medicine.
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DOI：
10.2174/18756921113119990004
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发表时间：
2013-09
影响因子：
--
通讯作者：
McCain NL
中科院分区：
文献类型：
--
作者：
Starkweather AR;Lyon DE;Elswick RK Jr;Montpetit AJ;Conley Y;McCain NL
个性化医疗应用有关患者与健康和干预结果相关的个体特征的知识，包括治疗反应和不良副作用，以制定量身定制的治疗计划。对于患有乳腺癌的女性，个性化医疗大大提高了生存率，然而，这些女性中有很高比例的人报告了治疗过程中多种并发的心理神经症状，这些症状对他们的生活质量产生了不利影响。在这些女性的一个子集中，被称为症状群的共同出现的症状可以在治疗结束后持续很长时间。在过去的十年中，来自护理和其他健康科学领域的研究专门研究了乳腺癌女性心理神经症状群的潜在潜在机制。最近的研究结果表明，表观遗传和基因组因素有助于个体间的差异，在乳腺癌治疗期间和之后的心理神经症状的经验。虽然护理研究在个性化医疗领域的代表性不足，但这些研究代表了一个共同的目标，即通过考虑个人短期和长期不良症状的风险来改善患者的预后。本文的目的是介绍一个概念模型的个体差异，影响乳腺癌妇女的心理神经症状，包括感知压力，下丘脑-垂体肾上腺皮质轴功能障碍，炎症，以及表观遗传和基因组因素。所提出的概念将有助于把护理研究和个性化医疗结合在一起，希望这一迄今被忽视和研究不足的生物医学研究领域的融合可能最终导致更有针对性的临床护理策略的发展，在乳腺癌患者的心理神经症状。
Personalized medicine applies knowledge about the patient’s individual characteristics in relation to health and intervention outcomes, including treatment response and adverse side-effects, to develop a tailored treatment plan. For women with breast cancer, personalized medicine has substantially improved the rate of survival, however, a high proportion of these women report multiple, co-occurring psychoneurological symptoms over the treatment trajectory that adversely affect their quality of life. In a subset of these women, co-occurring symptoms referred to as symptoms clusters, can persist long after treatment has ended. Over the past decade, research from the field of nursing and other health sciences has specifically examined the potential underlying mechanisms of the psychoneurological symptom cluster in women with breast cancer. Recent findings suggest that epigenetic and genomic factors contribute to inter-individual variability in the experience of psychoneurological symptoms during and after breast cancer treatment. While nursing research has been underrepresented in the field of personalized medicine, these studies represent a shared goal; that is, to improve patient outcomes by considering the individual’s risk of short- and long-term adverse symptoms. The aim of this paper is to introduce a conceptual model of the individual variations that influence psychoneurological symptoms in women with breast cancer, including perceived stress, hypothalamic-pituitary adrenocortical axis dysfunction, inflammation, as well as epigenetic and genomic factors. The proposed concepts will help bring nursing research and personalized medicine together, in hopes that this hitherto neglected and understudied area of biomedical research convergence may ultimately lead to the development of more targeted clinical nursing strategies in breast cancer patients with psychoneurological symptoms.