Barriers and Facilitators Influencing Nurses in Genetic Services Provision: A Systematic Review
Main Article Content
Keywords
Barriers, Facilitators, Genetic Services, Nurses, Systematic Review
Abstract
Background: Nurses play a crucial role in the provision of genetic services, yet their capacity to deliver these services is often constrained by various barriers. Understanding these barriers and identifying facilitators is essential for optimizing genetic services delivery in nursing practice. This systematic review aimed to explore the barriers and facilitators influencing nurses' roles in providing genetic services, including genetic counseling, testing, and patient management.
Methodology: A comprehensive search across multiple databases yielded 1,275 articles. After de-duplication and screening, 12 studies published between 2001 and 2024 were included. These studies, conducted in nine countries, utilized qualitative and quantitative approaches. Data was synthesized narratively, focusing on key themes related to barriers and facilitators.
Results: Barriers were identified across six domains: gaps in educational preparedness, insufficient knowledge, administrative hurdles, negative attitudes, logistical difficulties, and environmental limitations. Common challenges included knowledge deficits, role ambiguity, time constraints, and cultural variations. Facilitators were grouped into five domains: educational support, role expansion, integration across specialties, positive attitudes, and policy/institutional support. Key enablers included genomic education programs, multidisciplinary teamwork, and structured institutional policies.
Conclusion: Barriers and facilitators to nurses' provision of genetic services are multifaceted, spanning individual, institutional, and systemic factors. Addressing these challenges through targeted interventions, such as enhancing genomic education and fostering interdisciplinary collaboration, can significantly improve genetic services delivery in nursing practice.
References
2. Kirk M, Tonkin E, Skirton H. An iterative consensus‐building approach to revising a genetics/genomics competency framework for nurse education in the UK. Journal of advanced nursing. 2014 Feb;70(2):405-20.
3. Limoges J, Pike A, Dewell S, Meyer A, Carlsson L et al. Leading Canadian nurses into the genomic era of healthcare. Nurs Leadersh. 2022; 35(2):79–95.
4. Adejumo PO, Kolawole IO, Ojo IO, Ilesanmi RE, Olorunfemi O, Tijani WA. University students’ knowledge and readiness to practice genomic nursing in Nigeria. International Journal of Africa Nursing Sciences. 2021;15:100371.
5. Patch C, Middleton A. Genetic counselling in the era of genomic medicine. Br Med Bull. 2018 1;126(1):27-36.
6. White S, Jacobs C, Phillips J. Mainstreaming genetics and genomics: a systematic review of the barriers and facilitators for nurses and physicians in secondary and tertiary care. Genet Med. 2020;22(7):1149-1155.
7. Boothe E, Greenberg S, Delaney CL, Cohen SA. Genetic counseling service delivery models: A study of genetic counselors’ interests, needs, and barriers to implementation. Journal of genetic counseling. 2021 ;30(1):283-92.
8. Seibel E, Gunn G, Ali N, Jordan E, Kenneson A. Primary care providers’ use of Genetic Services in the Southeast United States: barriers, facilitators, and strategies. Journal of primary care & community health. 2022;13:21501319221134752.
9. Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers. EFI 2018;34:285–91.
10. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.) 2021;29(372):n71.
11.Zhao X, Li X, Liu Y, Calzone K, Xu J, Xiao X, et al. Genetic and genomic nursing competency among nurses in tertiary general hospitals and cancer hospitals in mainland China: a nationwide survey. BMJ Open. 2022 ;12(12):e066296.
12. Bottorff JL, McCullum M, Balneaves LG, Esplen MJ, Carroll J, Kelly M, et al. Establishing roles in genetic nursing: interviews with Canadian nurses. Can J Nurs Res. 2005;37(4):96-115.
13. Kocatepe V, Yıldırım D, Yılmaz M. Determining the Genetic Knowledge Levels of Oncology and Chemotherapy Nurses. Cyprus J Med Sci. 2022 ;7(4):507-512.
14. Shevach JW, Aiello LB, Lynch JA, Petersen J, Hoffman-Hogg L, Hartzfeld D, et al. On-Site Nurse-Led Cancer Genetics Program Increases Cancer Genetic Testing Completion in Black Veterans. JCO Oncol Pract. 2023 Aug;19(8):637-644.
15. Alloubani A, Othman N, Nimer R, Almomani F. Genomic literacy among nurses in Jordan: A population-based study. J Nurs Educ Pract. 2023;13(2):45–53.
16.Wright J, Fitch M, McKeever P. Genomics in oncology nursing practice in Australia. Aust J Cancer Nurs. 2020;21(3):14–20.
17. Keels JN, Thomas J, Calzone KA, Badzek L, Dewell S, Murthy V, et al. Consumer-oriented (patient and family) outcomes from nursing in genomics: a scoping review of the literature (2012-2022). Front Genet. 2024;15:1481948.
18. Mudgal SK. Assess learning needs of nursing students and effectiveness of workshop on knowledge regarding extended and expanded role of nurses. Intl J Nurs Edu. July 2018; 10 (3): 109-113.