Advancing the symptom science model with environmental health

Abstract

Objective: Globally, indoor and outdoor pollutants are leading risk factors for death and reduced quality of life. Few theories explicitly address environmental health within the nursing discipline with a focus on harmful environmental exposures. The objective here is to expand the National Institutes of Health Symptom Science Model to include the environmental health concepts of environmental endotype (causative pathway) and environmental exposure. Design: Meleis' research to theory strategy for theory refinement was used. Research workshop proceedings, environmental health nursing research expert consensus, panelist research trajectories, and review of the literature were utilized as data sources. Results: Ongoing emphasis on the physical environment as a key determinant of health and theoretical perspectives for including environmental exposures and endotypes in symptom science are presented. Definitions of these concepts, further developed, are provided. Recommendations to strengthen environmental health nursing research and practice through capacity building/infrastructure, methods/outcomes, translational/clinical research, and basic/mechanistic research are included. Conclusion: The revised model deepens theoretical support for clinical actions that include environmental modification, environmental health education, and exposure reduction. This modification will enable a middle-range theory and shared mental model to inspire the prioritization of environmental health in nursing leadership, research, practice, and education. K E Y W O R D S endotype, Environmental Health Science, environmental justice, exposure, nursing theory, Symptom Science Model | 717 CASTNER ET Al.

Effect of Pro-Environmental Prenatal Education Program on Pregnant Women’s Environmental Health Awareness and Behaviors based on the Protection Motivation Theory

“…Environmental health educational interventions should be customized to suit pregnant women’s needs and to enhance environmental health awareness with concomitant behavioral solutions. 37 Although the threat of environmental toxins owing to global development is increasing to an unprecedented extent, 38 prenatal education does not suffice for the specific needs of pregnant women. 37 Therefore, this study verified the effects of a pro-environmental prenatal education intervention on pregnant women’s environmental health awareness and behaviors, filling a knowledge gap in the literature.…”

Perceptions and knowledge of air pollution and its health effects among caregivers of childhood cancer survivors: a qualitative study

“…The incorporation of environmental exposures in clinical care is uncommon. However, emerging literature in the field of symptom science in nursing [ 35 ], advocates for the integration of the impacts of environmental exposure on symptom management into the National Institutes of Health Symptom Science Model [ 35 ].…”

Nursing strategies for environmental justice: A scoping review

“…Nurse authors promoted the idea of nursing EJ strategies that engage local, state, and federal government officials to advocate for policy-level solutions (Amiri & Zhao, 2019b;Hackley et al, 2007;Huntington-Moskos et al, 2016;Nicholas & Breakey, 2017;Travers et al, 2019), and suggest partnership with other health and policy professionals (Amiri & Zhao, 2019b;Castner et al, 2019). Valentine-Maher et al (2018) specifically suggest advocacy for the reduction in income inequality and policy to address the disproportionate risk of chemical exposures in poor and underserved communities.…”

“…Although critical theories were often used in the sample articles, another finding of this scoping review was related to the importance of developing theoretical frameworks that describe how nurses implement EJ strategies. While some articles in the sample utilized the EPA's EJ definition to introduce the concept, most articles did not discuss the theoretical underpinnings of EJ, and this was suggested as a future direction for nursing knowledge development (Amiri & Zhao, 2019;Postma, 2006). For example, some nurse researchers discovered that communities viewed EJ more broadly than the standard EPA definition, including factors such as oppressive sociopolitical systems (Evans-Agnew, 2016;Postma et al, 2014).…”