精準護理－－以人為本的知識轉譯

Precision Nursing: Individual-Based Knowledge Translation

美國總統歐巴馬宣告精準醫學的新時代，精準醫學倡議（precision medicine initiative）旨在發展考量個體差異的預防和治療，以加速個人化醫學的進步。最近快速發展的大規模生物數據庫（如人類基因組序列）用於區別病人特質（如：基因組學、微生物、多樣的生物標記物，甚至藥物基因組學），以及大數據分析的計算工具，可以提供精準醫藥的無限潛力。護理科學的未來發展，應遵循和緊跟上時代潮流，更清楚地闡明發展實徵性（empirical）的護理知識和專長，以及個人化護理的立場領域。護理科學家需要的是一個更廣泛的研究主題，以鼓勵創新的方法學來發展個人化精準護理，嚴格檢驗它們，最終並利用大數據來建立實證引導臨床實踐的需要。個人化精準護理包括解釋個人化的訊息、基因檢測、病人倡導和支持，並在整個疾病的軌跡共同參與決策支持，還必須注意家庭和個人化照護方式之倫理考量。護理人員面臨擁護精準護理的典範轉移，盡力推動跨領域學科合作，為病人提供最佳適配的個人化護理。最終能夠實現精準護理的潛力，以提供促進人們達到最好的身體健康機會。

U.S. President Obama announced a new era of precision medicine in the Precision Medicine Initiative (PMI). This initiative aims to accelerate the progress of personalized medicine in light of individual requirements for prevention and treatment in order to improve the state of individual and public health. The recent and dramatic development of large-scale biologic databases (such as the human genome sequence), powerful methods for characterizing patients (such as genomics, microbiome, diverse biomarkers, and even pharmacogenomics), and computational tools for analyzing big data are maximizing the potential benefits of precision medicine. Nursing science should follow and keep pace with this trend in order to develop empirical knowledge and expertise in the area of personalized nursing care. Nursing scientists must encourage, examine, and put into practice innovative research on precision nursing in order to provide evidence-based guidance to clinical practice. The applications in personalized precision nursing care include: explanations of personalized information such as the results of genetic testing; patient advocacy and support; anticipation of results and treatment; ongoing chronic monitoring; and support for shared decision-making throughout the disease trajectory. Further, attention must focus on the family and the ethical implications of taking a personalized approach to care. Nurses will need to embrace the paradigm shift to precision nursing and work collaboratively across disciplines to provide the optimal personalized care to patients. If realized, the full potential of precision nursing will provide the best chance for good health for all.