Chronobiology in Health Care

Such situations hinder application of chronobiology theory to nursing practice. As guest editor for a planned issue (as opposed to the resulting section) on chronobiology, I was both surprised and disappointed with the modest response to the call for papers until I reflected on how few nurse scientists conduct translational research in chronobiology. To avoid the appearance of a conflict of interest, I refrained from submitting a paper for review. Several of my collaborators did, however, and those papers were processed by the journal editor. I would like to express my appreciation to Carolyn Yucha for serving as editor for those papers. The articles in this special section, “Chronobiology in Health Care,” represent a diverse offering of three research reports, a methods article, and an integrated review of the literature. However, all address, in one way or another, the potential for translating chronobiology to health care. McCarley and colleagues examined temporal variations of the symptoms of dyspnea and fatigue and pulmonary function in community-dwelling elderly men and women with chronic obstructive lung disease. The small-sample, intensive design permitted a beginning look at withinsubject variability in self-assessments of the study variables over time. The daily fluctuations in dyspnea, fatigue, and pulmonary function for the majority of participants should plant seeds of inquiry into the rationale for treatment regimens in patients with moderate to severe obstructive lung disease. Further research on within-subject variability in symptoms may spur development and testing of such promising methods as nanotechnology both to monitor symptoms and physiological functions and to deliver medications in a way that is aligned with timing of the patient’s distress. Such an approach would negate the problems associated with self-assessments and selfreports that have plagued many clinical studies such as this one and would jump-start translational chronobiological research. Chronobiology—a theory of biological time structures and their interaction with the environment—has been used by many disciplines to both predict and explain responses of diverse organisms. The theory, however, has received only nominal attention in nursing research and practice. The goal of this special section is to share “science in the making” that has potential for translating chronobiology theory, methods, and research findings into health care. This is the second section of an issue of Biological Research for Nursing to focus on chronobiology. The first section, published in 2001, was devoted to circadian temperature rhythm and complemented the issue theme of circadian and thermoregulatory responses (Holtzclaw & Hanneman, 2001). During the interceding years, there has been an explosion in chronobiological research. Abundant literature has been produced on the molecular basis of the biological clock, but translation of bench work to health care has occurred at a less impressive pace. The conduct of chronobiological research is arduous. Because mammalian biological rhythms are complicated by a multitude of endogenous and exogenous factors, study of the rhythms often requires access to a wide range of resources and expertise. Few nurse scientists have been trained in chronobiology, and although many elect to pose specific research questions within a chronobiology framework for a particular project, they then defer to more familiar frameworks in subsequent projects.