MSN Insight: What Every Nurse Should Know About Family Health Histories
In many ways, genes are our destiny. They can determine everything from how we look to how we age to how likely we are to develop cancer. For nurses and others in healthcare, understanding a patient’s genes can mean understanding risk factors and getting a head start on preventing and/or treating illness. But genetic mapping isn’t the only way to collect information on a patient’s potential health future. You can also use family health histories.
A longtime part of medicine, family health histories remain a vital resource for nurses and other healthcare providers. How vital? Vital enough that former U.S. Surgeon General Boris Lushniak wrote a Surgeon General’s Perspective on the matter for the publication Public Health Reports.1 It’s an important look at family health histories and is routinely studied in the Advanced Health Assessment and Diagnostic Reasoning course offered as part of Walden University’s Master of Science in Nursing (MSN) program with a nurse practitioner specialization.
Below are a few of the most important excerpts from Lushniak’s Surgeon General’s Perspective.
More than a decade after completion of the Human Genome Project, science has made substantial progress in the development of genomic tests for disease diagnosis, prognosis, risk prediction, prevention, and treatment. Yet, the simplest, most readily available, and most affordable genomic tool for disease prevention—the family health history—remains underused. For almost all diseases of public health significance, people with a family history of the disease have a higher risk of developing the disease than people without a family history. Even so, many people do not collect family health history information and share it with relatives or even with their healthcare providers.
The collection of family health history information is part of routine healthcare interactions and can inform clinical decision-making and preventive services. Family health history is a part of many screening and treatment guidelines and, in some cases, can make a big difference in the recommended age for screening. For example, the U.S. Preventive Services Task Force (USPSTF) strongly recommends cholesterol screening beginning at age 35 years for men, but recommends early cholesterol screening beginning at age 20 years for men and women who are at increased risk of cardiovascular disease. A family history of cardiovascular disease before 50 years of age in male relatives, or before 60 years of age in female relatives, is one of several factors that are used to define increased risk. Using these recommendations, about 16% of young adults should be screened earlier based solely on the estimated prevalence of family history of early cardiovascular disease among this age group. Likewise, the USPSTF recommends screening for osteoporosis for women aged 65 years or older, but earlier screening for women aged 50–64 years with certain risk factors that include parental history of fracture. Thus, a 55-year-old white woman whose parent has had a hip fracture should consider getting screened early because her 10-year risk for major osteoporotic fracture is at least as great as a 65-year-old white woman who has no additional risk factors.
Most people have a family health history of at least one common disease (e.g., cancer, coronary heart disease, and diabetes) or health condition (e.g., high blood pressure and hypercholesterolemia). Preventive services recommendations that incorporate family health history can improve health outcomes for those at increased risk. A recent study demonstrated that systematic collection of family health history increases the proportion of people identified as having high cardiovascular risk for the purposes of targeted prevention. Similarly, family health history of diabetes has been shown to have added value for detecting undiagnosed diabetes in the U.S. population when combined with other known risk factors. But even in cases where family history does not alter specific preventive service recommendations (e.g., the USPSTF recommendations for high-blood-pressure screening of adults aged 18 years or older, regardless of risk factors such as family history), providers who know the patient's family health history can take this knowledge into consideration during clinical care.
With the growing availability of next-generation genome sequencing, current efforts to develop predictive tests for common chronic diseases have moved toward increasing numbers of common and rare genetic variants. But early studies suggest that these tests will likely complement rather than replace family health history. Family health history gives information not only about genes, but also about environmental and behavioral risk factors shared among family members. It therefore can provide a more accurate prediction of disease risk than many genetic tests can alone. During the next decade, research will continue to refine the interconnected roles of family health history and genomic information in screening, treatment, and prevention. In the meantime, enhanced training and education of the public health and clinical workforce is needed to realize the health benefits of these discoveries, and everybody needs to become more aware and savvy about the potential value of family health history.
How Else Can You Improve Patient Care?
As a nurse, one of the best ways to improve your abilities—and advance your nursing career—is to earn an MSN degree. In an MSN program, like the one offered at Walden University, family histories and resources like Lushniak’s Surgeon General’s Perspective are just one of the many topics you can study, depending on which Master of Science in Nursing specialization you choose.
At Walden, you can specialize as a nurse practitioner, choose a specialization that can help you go into nursing education or nursing management, or study to become a nurse leader in a field such as healthcare informatics. And thanks to Walden’s online learning format, completing a master’s in nursing program is more achievable than you might think.
Walden’s online nursing school is designed to meet the needs of working nurses like you. Much of the coursework for the school’s online MSN program can be completed from home or anywhere else you have internet access. Plus, you can take your master’s degree in nursing classes at whatever time of day works best for your schedule, allowing you to fit school around your job.
With Walden’s RN to MSN option, you can even qualify for enrollment in an MSN program without holding a Bachelor of Science in Nursing. As long as you’re a registered nurse, you can go from an RN to MSN online through Walden.
No other school graduates more MSN students than Walden.2 With its online education conveniences and its range of MSN nursing specializations, Walden is a great way to elevate your knowledge, enhance your skills, and improve your career in nursing.
Walden University is an accredited institution offering a Master of Science in Nursing (MSN) degree program online. Expand your career options and earn your degree using a convenient, flexible learning platform that fits your busy life.
2Source: National Center for Education Statistics (NCES) IPEDS database. Retrieved July 2017, using CIP code 51.3801 (Registered Nursing/Registered Nurse). Includes 2016 preliminary data.
Walden University is accredited by The Higher Learning Commission, www.hlcommission.org.
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