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The future of nursing science has never been brighter. Because of nursing science, individuals and caregivers have a higher quality of life in spite of chronic conditions; we have a better fundamental understanding of symptoms such as fatigue, disordered sleep, and pain; people are learning better ways to keep themselves healthy and better manage their own health; and more of those with advanced illness are receiving the palliative care they need. At the same time, we recognize the many challenges that persist; we cannot rest on our laurels. Nursing science must be vigilant in looking toward the future to identify areas of science where we can continue to make major contributions to health and the research enterprise. The National Institute of Nursing Research (NINR) recently commemorated its 30th anniversary at the National Institutes of Health. This anniversary was an opportunity to recognize past achievements in NINR-supported science, to examine the current state of NINR-supported research, and to carefully consider the next frontiers in nursing science. In September 2016, NINR released its new Strategic Plan: Advancing Science, Improving Lives: A Vision for Nursing Science (2016). Developed with input from interdisciplinary scientists, clinicians, other experts across the nation, and the general public, the Strategic Plan details a blueprint for NINR-supported research that we believe will lead to new, significant advancements in nursing science. The Plan also incorporates feedback from the NINR Innovative Questions Initiative, in which members of the scientific community and the public were asked to contribute their ideas for new research questions that could lead to rapid improvements in health and quality of life over the next ten years (Grady, 2014, 2015). The new Strategic Plan describes four areas of scientific focus: As people live longer, they are also more likely to develop chronic conditions, many of which are accompanied by symptoms that lead to poor quality of life. Research is needed to better understand the underlying biological and genetic factors that contribute to adverse symptoms, as well as develop and test new interventions to reduce the disabling effects of symptoms and improve health outcomes. The most effective way to overcome an illness is to prevent illness from occurring in the first place. NINR supports research to promote long-term health, including healthy behaviors, and to prevent illness and comorbidities across health conditions, settings, and the lifespan. Research supported in this area focuses on the physical, social, behavioral, and environmental causes of illness, determinants of health, and assessment of behaviors that lead to healthy lifestyle choices. Effective self-management programs engage individuals and families as active participants in maintaining and improving quality of life while living with a chronic condition or multiple chronic conditions. Self-management research encompasses health strategies that allow individuals and their healthcare provider to adapt treatments to distinct circumstances by accounting for social, cultural, economic, and emotional factors that can influence their health and quality of life. There is a critical need to assist individuals, families, and healthcare professionals in managing the symptoms of advanced, serious illness, and planning for end-of-life decisions. In addition, high-quality, evidence-based palliative care is an important component of maintaining quality of life at any stage of illness, not just at the end of life. Research is needed in this area to address issues such as relieving symptoms and suffering; enhancing communication between patients, families, and clinicians; and understanding decision making surrounding care of advanced illness at the end of life. In addition, two areas are presented that were deemed of high priority across all of NINR's scientific programs: Innovative technologies play a critical role in advancing health and health care. Research is needed to develop novel interventions that deliver tailored care and real-time health information to patients, families, clinicians, and communities. In addition, new efforts are needed to develop and refine technologies for improving symptom risk assessment, and to identify potential interventions. The continued advancement of nursing science requires a scientific workforce that is innovative, multidisciplinary, and diverse. NINR will continue to support a variety of training opportunities for scientists and trainees at all career levels, particularly those at early career stages who are so critical to sustaining the future of leading-edge research and high-quality health care. Within each of these focus areas, the Plan describes potential future research directions. These topics represent promising targeted areas of exploration that we believe will advance NINR-supported science and develop the next generation of nurse scientists. These future directions also serve to demonstrate the breadth and depth of nursing science, and the potential impact the field can have on health, quality of life, and the research enterprise. Indeed, today is a time of extraordinary opportunity in research. Precision health offers the promise of tailoring treatment to individuals based on their genetics, lifestyle, and environment. Advances in data science are changing the way we collect, store, and analyze large datasets. These advances have the potential to transform the way we conduct clinical research and clinical trials and the way we explore the genetics of illnesses and their symptoms. Nursing science can lead in these areas, and NINR-supported scientists are already leading and contributing to the multidisciplinary teams at the forefront of these exciting frontiers in the health sciences. We fully recognize that science is not static, that new advances or urgent new challenges can sometimes require us to change course. Therefore, we view the Strategic Plan as a dynamic document. On an ongoing basis, NINR will revisit its research priorities and adapt them to meet current needs or take advantage of new opportunities. The field of nursing science must continue to move forward to meet the important health challenges of our society. The foundation is in place for nursing science to make remarkable strides in areas such as symptom science, caregiving research, and the science of palliative and end-of-life care. The future directions presented in the new NINR Strategic Plan represent only a sampling of what we could accomplish in the coming years. We must continue to recognize that nurses and nurse scientists are at the forefront of the patient experience, and we are in the best position to study, understand, and improve the lives of patients and caregivers. We must also be vigilant in communicating the results and impact of nursing science to ensure that the results of our studies reach the broader community and inform practice. At NINR, we are proud of what nursing science has achieved, and optimistic about what we can accomplish over the next 30 years, leading to better health and quality of life across the United States and around the world.
Patricia A. Grady (Wed,) studied this question.