1. Bliss, Donna Zimmaro PhD, RN, FAAN, Guest Editor

Article Content

Managing adverse health symptoms is a core focus of nursing research and practice. Symptom management is essential for those with chronic health problems for which there is no cure, for patients who elect a conservative therapeutic approach, for those on wait lists for organ transplants, and for others whose risk of complications of more definitive treatments are deemed to outweigh possible benefit. More than one million Americans have a chronic health problem, and approximately 14% reported having a "bad physical health day" every day of the past 30 days (Wolff, Starfield, & Anderson, 2002;The Robert Wood Johnson Foundation & The Foundation for Accountability [FACCT], 2001). Symptom management addresses these experiences. Goals for symptom management are consistent with the patient-centeredness of nursing: to retard or prevent disability, palliate physical and emotional suffering, improve the quality of living and dying, involve patients in their care, and uphold the dignity of each individual.


Nurse researchers have surpassed all other disciplines in advancing the science supporting symptom management. Research on symptom management has invited a broad scope of scholarly inquiry from theory development to clinical trials of interventions to evaluating the quality of health service systems in which symptoms are managed. In their investigations of managing adverse symptoms, nurse researchers have been challenged to develop and refine more sophisticated and appropriate outcome measures to keep pace with their innovative ideas, outreach to multicultural groups, and technology-based strategies.


Studies in this special issue showcase some of the current investigations of adverse symptom management. Miles et al. and Lorig et al. tested interventions for managing adverse health symptoms in groups who have been traditionally underserved by healthcare systems, African American mothers with HIV and Spanish speakers with chronic heart or lung disease, respectively. Studies by Miles et al., Armer et al., and Gift et al., are examples of strategies that empower the patient to self-monitor adverse symptoms of a chronic illness (i.e., HIV, breast cancer, or lung cancer). The community education program of Lorig et al. used peer leaders to promote better management of heart or lung disease and improved healthful behaviors and reduced emergency room use. Garvin et al. investigated whether the styles of coping of men and women suggest ways to tailor interventions to decrease anxiety after a myocardial infarction.


Several articles focus on methodological issues in conducting symptom management research. Henly et al. provoke thoughtful consideration about handling temporal factors that influence the design and analysis of symptom management interventions conducted over time. Gift et al. examined a cluster of symptoms as a more robust indicator of health status over time in lung cancer patients than single symptoms. Smith et al. evaluated the acceptability and cost effectiveness of the therapeutic writing intervention for reactive depression that they had been developing in a series of earlier studies. Naylor's insights about the direction nursing research should take in order to improve the quality of healthcare are salient to symptom management research.


Nursing research on symptom management addresses health concerns that are increasing in prevalence in our aging, global, and multi-cultural society. This area of investigation should remain a priority for research funding, intensity of scholarly effort, and recruitment of new investigators.




1. The Robert Wood Johnson Foundation, & FACCT-The Foundation for Accountability. (2001). A portrait of the chronically ill in America, 2001 (p. 9). Princeton, NJ: Authors. [Context Link]


2. Wolff, J. L., Starfield, B., Anderson, G. (2002). Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Archives of Internal Medicine, 162( 20), 2269-2276. [Context Link]