The American Nurses Foundation (ANF) has funded the research of more than 950 scholars in its 50-plus years. Many ANF scholars have had distinguished nursing research careers, conducting trailblazing studies that have advanced the practice of nursing. Some of our most recent scholars are breaking ground in new areas of nursing research. This is illustrated by the work of Bashira Charles, MSN, RN, NP, who was funded in 2006 as the ANF/Eastern Nursing Research Society Scholar.
Charles became interested in genetics research after taking an introductory course in genetics. This interest was enhanced when she attended the National Institute of Nursing Research (NINR) Summer Genetics Institute. While completing the nurse practitioner program and working as a graduate student researcher, she began to wonder why some individuals with type 1 diabetes (T1D) who had good diabetes control had delayed development of diabetic retinopathy during follow-up, while other individuals with T1D and poor control did not develop diabetic retinopathy during follow-up. This observation came as a result of her reading a report from the Diabetes Control and Complications Trial. This report, coupled with her experiences as a pediatric nurse practitioner, led Charles to question whether there was a genetic component to the development of diabetic retinopathy or its stages.
While much of the focus of nurses’ care for patients with diabetes is on behavioral changes, research involving genetics can help explain the relationship between the genetic components of the disease and its complications. Understanding the genetic components of disease will perhaps lead to different strategies for management. Knowledge of whether there is a genetic component to diabetic retinopathy or its stages may serve to decrease the frustration experienced by people with diabetes who have good control, yet still experience the consequences of this serious complication.
Charles is a doctoral student at the University of Pittsburgh. She received a National Research Service Award (F31) for her education. However, it did not cover the cost of conducting genotyping experiments. Because the University of Pittsburgh School of Nursing has a genetics laboratory, Charles had access to an academic environment that supported the conduct of genetic research. The ANF grant funded the experiments necessary to answer her research questions.
Charles’ ANF research study, entitled Genes Implicated to Time of Onset and Severity in Diabetic Retinopathy is enabling her to examine seven of the 37 genes thought to be related to diabetic retinopathy. Charles is examining genes in diabetic retinopathy in individuals with T1D. The source of her banked genetic material is the Pittsburgh Epidemiology of Diabetes Complications (PEDC) Study. In addition, she had access through the PEDC to extensive longitudinal clinical data, including HBA1C, blood pressure, body mass index (BMI) and presence/stage of diabetic retinopathy. The original participants in the PEDC study were representative of the population of Allegheny County, PA. Charles’ work will enable her to determine whether specific alleles/genotypes and/or haplotypes generated for each gene are associated with the severity of diabetic retinopathy or length of diabetic retinopathy free T1D.
When asked what the ANF grant meant to her, Charles replied, “I learned about conducting genetic research, and I found that I truly enjoy doing this type of research. Basic research is clearly within the realm of nursing research. Nurses are in a prime position to conduct genetic research. Their nursing education and clinical expertise enable them to understand the larger picture and thus, ask the critical questions that will help our understanding of complex/multifactorial chronic illnesses. Analyzing the interaction between control of diabetes and genotype will help patients to have greater understanding of their illness and will enable clinicians to provide customized care.”
Charles’ research is adding to a growing body of knowledge involving the genetic components of diabetes complications. Her work is also challenging the limits of research traditionally conducted by nurses and may encourage other nurses to conduct genetic research involving chronic illnesses. At this point, Charles’ study is almost complete as she is analyzing her data and writing up the results.
Research in genetics is a relatively new and growing area of research for nurse scholars. Charles is only one of four ANF scholars who have conducted studies related to genetics. The very first ANF genetic study was conducted by Theresa Overfield, MPH, RN, in 1974 when she examined the pseudocholinesterase silent allele in Alaskan Eskimos. This allele is related to prolonged recovery from paralysis after the use of succinylcholine (eight hours versus five minutes). However, Charles is the very first ANF scholar to use modern genetic research techniques. Charles’ work illustrates how her experiences, training and support intersect to answer this important question regarding diabetic retinopathy, which has implications for future research in genetics.
The NINR Summer Genetics Institute with its intensive two-month summer research training program in molecular genetics, coupled with access to a genetics laboratory at the University of Pittsburgh and funding from the ANF/Eastern Nursing Research Society, clearly illustrates how the advancement of the scientific basis for nursing practice needs to be supported in multiple arenas.
Charles’ story is only one of many stories of ANF’s scholars over the years. Because of the scientific rigor demanded of the ANF grant recipients, obtaining an ANF grant not only facilitates important work, but also enables researchers to demonstrate a track record. This record has become increasingly valuable in an environment where access to research dollars is limited and highly competitive. This is why ANF’s ability to continue its work in supporting nursing research is so critically important to the profession. Please consider supporting the work of the ANF in advancing the scientific basis for nursing practice with a gift to ensure nursing’s future – a gift that keeps on giving to the profession.