Health care research typically focuses on final outcomes such as cure or death overlooking the fact that health and illness are dynamic states that evolve and change over time. A special collection of articles on health trajectory research is now available in a supplement to Nursing Research, official journal of the Eastern Nursing Research Society and the Western Institute of Nursing. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The special supplement presents a series of original studies and commentaries on the development of nursing intervention science focused on the "promotion, maintenance, and restoration of health over time." It reflects a growing interest in studying the ways that health care interventions can affect health trajectories at different stages of life.

Health Trajectory Research Aims at New Strategies to Influence Health Over Time The papers in the supplement were supported by the efforts of the Minnesota Center for Health Trajectory Research, an exploratory research center funded by the National Institute of Nursing Research. In an introductory article, guest editors Jean F. Wyman, PhD, RN, FAAN, and Susan J. Henly PhD, RN, of University of Minnesota School of Nursing write: "The goal was to develop ways to better understand how interventions influence health trajectories experienced by individuals, families, groups, or communities with transitional, acute, or chronic health challenges across the life span."

Several types of health trajectories can be affected by nursing interventions. Developmental trajectories refer to normal physiologic changes such as puberty, menopause, or aging or even life transitions such as marriage or retirement. Acute illness trajectories have to do with illnesses that tend to resolve or improve over time, while chronic illness trajectories are associated with illnesses that aren't curable, but can still have positive health outcomes. Other categories include disability trajectories and end-of-life or dying trajectories. "Having a better understanding of these various health trajectories and how they can be shaped through interventions will help clinicians provide better care for individuals and families at all stages of their lives," Drs. Wyman and Henly write.

Articles in the special issue present the nursing science perspective on health trajectory research and important theoretical considerations in studying health and illness over time including advances in statistical modeling that support this area of research. The supplement also includes a series of original studies illustrating the health trajectory perspective in health and illness; in community, hospital, and laboratory settings; and across time scales ranging from seconds to years. Topics include:

-- Changes in functioning of the parasympathetic nervous system related to feeding in newborns after surgery for major congenital heart abnormalities.

-- Changes in patterns of condom use by sexually active teens participating in a pregnancy-prevention program.

-- Changes in anxiety related to mechanical ventilation in critically ill patients.

-- Changes in patterns of pain (claudication) during treadmill testing in patients with peripheral artery disease.

-- Changes in gastrointestinal symptoms in incontinent patients being treated with fiber supplements.

-- Changes in burden and depression in caregivers of spouses with dementia as they transition to nursing care.

The supplement concludes with a look at the top priorities for health trajectory research in nursing science, including preparation of nurse scientists to use the methods of health trajectory research. Along with the editors of Nursing Research, Drs. Wyman and Henly hope the special issue will provide nurse researchers with new ideas on how to incorporate a health trajectory perspective into studies of nursing interventions and especially how interventions affect the course of health for individuals.

Source: Lippincott Williams & Wilkins