The Center for Research on Symptoms, Symptom Interactions and Health Outcomes (Symptoms Center) at Emory University's Nell Hodgson Woodruff School of Nursing received close to $1 million in renewed funding over the next three years from the National Institutes of Health, National Institute for Nursing Research (NINR). It is one of only nine NINR-funded exploratory research centers in the country. The Symptoms Center is led by the center's director Kathy P. Parker, PhD, RN, FAAN, Edith F. Honeycutt Endowed Chair in Nursing and Sandra B. Dunbar, DSN, RN, FAAN, Charles Howard Candler Professor of Cardiovascular Nursing, the center's co-director.
Research at the Symptoms Center is based on the Symptom Interactional Framework, which was recently published in the September issue of the "Journal of Nursing Scholarship."
Instead of studying the frequency and severity of a single symptom in a specific illness, center researchers examine how symptoms relate and interact in multiple types of illnesses and patients. The framework's goals are to help researchers better understand the mechanisms underlying symptoms and how they interact, and to translate those findings into more effective interventions that improve health outcomes.
According to the framework, patients' symptoms occur within the context of their environment and developmental status. Symptoms are caused by factors that lie in four primary categories (etiologic domains) -- physiological, psychological, behavioral, and sociocultural. Because of this, a major focus of the Center is facilitating interdisciplinary research.
The relationship between or among symptoms and the factors causing them is complex. "They are bi-directional," notes Dr. Parker. "Symptoms may be caused by and affect factors in these categories, which may cause new conditions or worsen existing ones. If we understand why that happens, we can develop nursing interventions that may yield clinical outcomes superior to those that result from interventions focused on isolated symptoms."
"We're looking at one of the most problematic dimensions of chronic illnesses," Dr. Parker continues. "By understanding how symptoms occur and interact, we can develop creative nursing interventions to improve and extend patients' lives."
"The center cuts across a number of chronic illnesses and patient populations with a variety of symptoms," adds Dr. Dunbar. "Pain, sleep disturbances, fatigue, psychosocial problems such as depression or anxiety, fluid overload, shortness of breath, or edema -- the list is endless. As nurses, our practice involves a lot of symptom assessment and symptom management. We are building the science and the evidence to support this area of nursing practice. Better understanding and management of symptoms should translate into improved quality of life and functioning, and reduced health resource use."