Overview

In this section, we will look at how genetics plays an important role in day-to-day nursing and midwifery. Read about Mrs Dade's current health concerns. As you read, see if you pick up some key information that would make you take further action.

Mrs Dade's story

“Well, when I was first diagnosed with high blood pressure I was really quite shocked. I was only 39 and I hadn’t had any real health problems. I’m not very overweight and I’m not like those folk on ‘fat vs skinny’ and I gave up smoking 11 years ago when my Johnnie was born. The doctor said that sometimes heart disease can show up early and he made lots of suggestions about healthy diet and exercise. I didn’t like to tell him I was a bit scared of exercise as my uncle dropped dead of a heart attack at 50 whilst out jogging! He was really fit but exercise didn’t do him much good in the end did it?

But, I’ve taken the doctors advice and my Jack and the children are all complaining about the new ‘healthy’ diet but I have told them it’s good for all of us. I’ve also asked Jack not to smoke in the house any more, although he never does in front of the children. We’ve started going walking together and I do feel much healthier. When I went for my follow up, my blood pressure was much better so the nurse said it was probably ‘white coat syndrome’. Apparently people's blood pressure can go up when you see a doctor. We had a real laugh over that!”

What did you notice?

Clearly there are environmental factors that are relevant to this case such as:

However, did you pick up on her comment, 'my uncle dropped dead of a heart attack at 50'? This is a clue that her condition could ‘run in the family’. These familial tendencies towards ill health or disease are every bit as important as environmental influences such as diet, exercise and lifestyle.

Six out of ten people are likely to develop a disease before the age of 60 that is at least partially determined by inherited factors.  That’s a lot of people you will see in your day-to-day work.

How do genes work?

You may hear terms such as 'inherited condition',  ‘genetically determined’, ‘genetic causes of disease’ or ‘genetically influenced’. This is because genes are the mechanism through which inheritance works.  When conditions 'run in the family' this could be due to a changed gene being passed on from a parent to their child. Remember, genes can have a positive or negative influence on an individual's risk of disease and ill health.

Watch the animation below to find out more about the influence of genes.

Watch the animation below to find out more about how genes and chromosomes work.

A common misconception is that a child will definitely develop a genetically determined condition if one or more of their parents have the condition or carry an altered gene.  Let's see why this may not be the case. Watch the animation below to find out more.

What's my role?

Obtaining a family history about an individual's immediate family members (siblings and parents) is an important tool in identifying the likelihood of them developing a condition. Genetic testing might then be used to confirm a diagnosis.  The importance of taking a family history is becoming increasingly recognised and can lead to a change in management. Try this short quiz to check what you already know about genetic factors.

In summary, some conditions are affected by changes in a single gene and some are influenced by combinations of genes. Genetics isn’t just about the specific single-gene conditions we have just covered. There are a number of common conditions in the general population, such as diabetes, obesity, cancer, and heart conditions that appear to be at least partially genetically determined. For example, our genes appear to play a role in how the body processes fatty food and therefore how likely you are to develop high cholesterol levels. The research looking at this interaction is called genomics. Genomics can be defined as, ‘the use of modern, and in particular molecular technologies to interrogate genetic make-up with a view to informing decision-making and to identify and develop new applications'. Health care genomics is the use of such an approach to improve health through better informed public health policies, disease management and drug discovery programmes.

So, you will be starting to have a sense that many common condition have a genetic component, which means genetics can no longer be considered a specialist or ‘niche’ area. This makes it important when caring for your patients that you consider the genetic as well as the possible environmental causes of disease relevant to your clinical area, i.e. be on the ‘look out’ for family tendencies towards disease so you can ensure the right care is provided to help people maximise their long-term health and wellbeing.