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Spotlight on Symptom Science and Nursing Research

Overview

woman rubbing templesSymptom science focuses on symptom experiences, rather than diseases and illnesses, with the understanding that many symptoms across ailments are shared. Symptom science is becoming increasingly important as people are living longer but with multiple chronic illnesses. Living with these illnesses includes managing all the symptoms that go with them.

The National Institute of Nursing Research (NINR) focuses on a range of symptoms including pain, fatigue, difficulty breathing, sleep disorders, mood disturbance, and depressive symptoms. NINR supports symptom science research in ethnically and racially diverse populations, rural and urban populations, and underserved communities across the lifespan.

NIH Symptom Science Center

symptom science photo collageThe mission of the Symptom Science Center (SSC) is to promote the understanding of the biologic and behavioral mechanisms of symptoms to ultimately improve the lives of patients. The Center is led by NINR, but is a collaboration across the National Institutes of Health. The Center follows NINR’s commitment to train scientists and clinicians interested in symptom science. Dr. Leorey Saligan currently leads the Center within NINR’s Division of Intramural Research (DIR).

Research Conducted at NINR

NINR’s Division of Intramural Research (DIR) was founded in the early days of research on HIV/AIDS with a focus on the symptoms of HIV/AIDS with a focus on the symptoms of HIV/AIDS. Current DIR research continues this symptom science tradition with research that focuses on the symptoms associated with cancer-treatment-related fatigue, the mechanisms of chemosensory symptoms such as alterations in taste and smell, and the neurological and behavioral symptoms of traumatic brain injury.

The overall aim of DIR science is to determine the genomic, metabolic, and biobehavioral pathways to symptoms with the goal of developing therapies to prevent or manage symptoms.

Research Funded by NINR

NINR supports research at universities, hospitals, and other institutions across the U.S. on a broad range of topics related to symptom science. NINR priorities also include wellness, self-management of chronic conditions, and end-of-life and palliative care. To learn more about current funding opportunities, please visit the Division of Extramural Science Programs page.

How Nursing Research Informs Symptom Science

NINR developed the NIH Symptom Science Model (SSM), which identifies a complex symptom, characterizes it into a phenotype with biological and clinical data, and applies genomic and other discovery methodologies to highlight targets for therapeutic and clinical interventions. NINR encourages the use of the SSM in planning new research projects in symptom science, and it provides the basis for research conducted by scientists in the NINR intramural program.

Research Highlights

NINR-supported investigators at universities and health centers across the U.S. are conducting innovative research in symptom science to improve quality of life:

  • Somatization and pain catastrophizing mediate the relationships between pain severity, anxiety, and depressive symptoms in children with irritable bowel syndrome

    Children with irritable bowel syndrome (IBS) often experience anxiety and depressive symptoms associated with pain severity. Researchers examined the relationship between these psychological symptoms and the processes of somatization (experiencing physical symptoms that can’t be explained medically) and pain catastrophizing (expecting the worst and feeling helpless in response to pain). They found that in children with IBS, somatization and pain catastrophizing influence the relationship between anxiety and depressive symptoms and pain severity. These findings suggest that treating somatization and pain catastrophizing could alleviate abdominal pain more effectively than treating anxiety and depressive symptoms in children with IBS. PMID:30549152

  • Higher symptom distress indicates diagnosis of suspected acute coronary syndrome among men and women

    In an analysis of emergency department patients who were evaluated for acute coronary syndrome (ACS), researchers found that higher symptom severity was significantly associated with an ACS diagnosis. Radiation of pain to the jaw, neck, and throat was more likely to be reported by women with ACS, and they were also more likely to experience chest pressure. This study is an important contribution to the understanding of the complexity of the clinical presentation of ACS and the differences between men and women’s symptoms. PMID: 30738603

  • Scientists find lower health status associated with dyspnea and high symptom burden in patients with heart failure

    In a recent study, scientists used a web-based mHealth application to measure symptoms of heart failure in a racially and ethnically diverse patient population. They found that better health status was associated with higher physical function and ability to participate in social roles and activities. Lower health status was associated with dyspnea (shortness of breath) and high symptom burden. These findings suggest that modifiable risk factors that reduce dyspnea, improve functional status, and enhance engagement in social roles could be targeted to improve health status of individuals living with heart failure. PMID:30681003

  • Intervention focused on positive emotion regulation for dementia caregivers significantly increases positive emotion and reduces depressive symptoms

    Researchers conducted a randomized controlled trial among dementia caregivers of the Life Enhancing Activities for Family Caregivers (LEAF) intervention. The 6-week, online LEAF intervention promotes capitalizing on positive events, gratitude, mindfulness, positive reappraisal, personal strengths, attainable goal setting, and acts of kindness. The study found that the intervention was effective at increasing positive emotion. The study also found that the intervention improved caregiving skills, decreased levels of depressive symptoms and anxiety and improved physical health as defined by the Patient-Reported Outcomes Measurement Information System (PROMIS®) self-report measures. This intervention could help improve the well-being of dementia caregivers who experience high levels of stress and depression. PMID: 31045422

  • People living with HIV/AIDS in the deep south report a number of symptoms that could be lessened by a mobile self-management intervention

    Researchers conducted a survey of people living with HIV/AIDS who sought services from a community-based organization in Alabama, in an area of the U.S. experiencing high rates of new HIV diagnoses. The survey identified frequently reported symptoms, including muscle aches or joint pain, fatigue, sleep difficulties, neuropathy, and depressive symptoms. The study also assessed the use of smartphones among respondents. It found that the large majority had access to this technology, providing a strong scientific premise to support the feasibility of a mobile-delivered symptom self-management tool. PMID: 30908348

  • Moderate blast exposure results in differences in gene expression in individuals with TBI

    A series of studies to determine the role of gene activity in injury, recovery, and symptoms following blast-induced traumatic brain injury (TBI) in active duty military personnel compared individuals with a record of blast-induced TBI (or moderate blast exposure) to individuals without TBI. From these studies, researchers identified genes that were regulated or expressed differently in those with TBI. These findings provide a roadmap for characterizing and measuring the symptoms and effects of blast-induced TBI immediately after a blast injury, as well as in the ensuing months and years. These findings also establish a critical pathway for accurate diagnosis of blast-induced TBI and prediction of recovery trajectory in military personnel. PMID: 25346719, 28975156

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