虽然医学文献中有丰富的关于基因组测试在风险评估和医学肿瘤学决策中的应用的信息，但是在护理领域中缺乏理论的反思。为了理解分子生物学在护理实践中的含义，并强调护理理论在指导护士思维方面的作用，我们在Medline和Google Scholar中搜索了2000年至2022年间的文献。科学证据由不同领域的作者进行分析。根据文献的发现，人们对于对基因组风险分析结果进行适当护理的关注已经提出。特别是缺乏考虑分子生物学发展及其对护理的影响的理论思考和概念模型，加上在护理实践中普遍存在启发性思维和临床模式的应用，可能导致患者错误判断，导致预防、治疗、康复和教育护理干预的不当规划。从事肿瘤学工作的护士应该意识到，基因组测试确定的风险分析仅仅是癌症患者的一小部分，即冰山浮出部分。 本研究展示了基因组测试如何利用在肿瘤组织中发现的基因子集来建立风险分析。这个基因子集与社会基因组有所不同，社会基因组可以确定社会不良环境对痴呆症、癌症和心血管疾病风险的影响。护理理论将环境视为元范式，必须考虑一个能够将基因组测试的结果与关于人类社会基因组的研究建议相结合的概念模型，以便更容易构建能够更好地降低这些风险的护理治疗方法。基因组的护理理论话语是发展有效护理的重要要求。© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

Although, there is a wealth of information in the medical literature on the usefulness of genomic testing in assessing risk and its application in medical oncology decision making, there are no theoretical reflections in the nursing field.To understand the implications of molecular biology in nursing practice and highlight the role of Nursing Theory in guiding nurses' reasoning.Searching literature published between 2000 and 2022 in Medline and Google Scholar. Scientific evidence was analysed by the authors expert in different fields.Based on the findings of the literature, concerns have been raised about the proper care of cancer patients who have a genomic risk profile determination. In particular, the absence of theoretical thinking and conceptual models that consider developments in molecular biology and their impact on nursing, in addition to the prevalence of heuristic thinking and the application of clinical patterns in nursing practice, could induce patient misjudgement with inadequate planning of preventive, curative, rehabilitative and educational nursing interventions. Nurses working in the field of oncology should be aware that the risk profile determined by genomics tests is merely the visible and stated portion of the cancer patient: the tip of iceberg.This study demonstrates how genomic testing takes into account a fraction of genes discovered in tumour tissue to establish a risk profile. This subset differs, for example, from the social genome, which can determine the risk of dementia, cancer and cardiovascular disease, but in response to social adversity. Nursing theory, which views the environment as a metaparadigm, must consider a conceptual model that can integrate the findings of genomic testing with recommendations from studies on the social genome of humans to make it easier to build nursing treatments that can better reduce these risks.A nursing theoretical discourse on genomics is a paramount requirement for developing effective nursing care.© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.