My program of research focuses on determining which demographic, clinical, and genotypic characteristics predict patients with the most severe symptoms, evaluating the deleterious effects of unrelieved symptoms on patient outcomes, and developing and testing interventions to decrease symptoms in patients with cancer and other chronic medical conditions.
My program of research focuses on preventing rehospitalization for patients hospitalized with heart failure with an emphasis on symptoms, physical function, and health disparities. My studies have included hospitalized heart failure patients, yoga interventions, and vulnerable populations.
My research focuses on the effects of chronic progressive neurological diseases. I am interested in circadian and rest-activity rhythm function in older adults and symptom management of disturbances in people with dementia and Parkinson’s disease. I am also interested in gait and balance and recently received NIH funding to partner with Red Hill Studios to create a therapeutic interactive video game based on a classroom training program that has proven efficacy in improving gait and balance in people with Parkinson's disease. Methodologies are primarily quantitative and include measurement of physiological and psychosocial variables.
For the past six years, my program of research has focused on common symptoms (e.g. fatigue, pain, sleep disturbance) in the setting of chronic disease. Studies have included cancer patients, people living with HIV/AIDS, and individuals with chronic obstructive pulmonary disease. I am currently active in the Symptom Management Faculty Group at UCSF School of Nursing and the American Pain Society.
As a research nurse with a specialty in gero-oncology, I have spent over 10 years understanding the factors involved in older adult smoking. My research and clinical foci include: the impact of tobacco industry activities on older smokers; stigma, symptom burden, and quality of life among lung cancer patients; and clinical trials for smoking cessation interventions for cancer patients and cancer survivors. I am also piloting an Avatar intervention for enhancing coping ability with lung cancer stigma. With a team in Australia, I am comparing symptom occurrence and severity in both young and older cancer patients during active treatment.
My program of research is focused on an evaluation of the symptom experience of children receiving treatment for cancer. Aspects of this program of research include the assessment of changes in symptom occurrence, severity, and distress across the child’s treatment trajectory, the impact of symptoms on patient outcomes (e.g., functional status, quality of life), and parents’ perceptions of children’s symptoms. An additional focus of my research is the use of technology to develop and evaluate tools on mobile platforms to assess and manage cancer-related symptoms (mHealth).
My research and practice focus on the psycho-physiological adaptation to aging. Specifically, diabetes, sensory/hearing loss, caregivers, healthy aging, and sense of control. I completed a longitudinal study of the experience of hearing loss and am starting a study to develop and embed a hearing screening and educational program in primary care. Having recently been an Atlantic Philanthropies Health and Aging Policy Fellow, I am incorporating my interest in the policy-practice interface into my research and teaching, and as Director of our HCGNE, I am involved in its mission to build a cadre of nurses with expertise in gerontology.
Current goals of my research are to: 1) use the heart’s electrical activity, measured at home and transmitted via the internet, to detect acute allograft rejection following heart transplantation and 2) improve ECG monitoring practice in hospital and pre-hospital settings for better diagnosis of cardiac arrhythmias, myocardial ischemia, and prolonged QT syndrome. I founded the ECG Monitoring Research Lab in the School of Nursing and have mentored numerous graduate students pursuing studies in the field of electrocardiology. My research has shaped the development of commercial cardiac monitors, including the introduction of multi-lead ECG monitoring, ST-segment ischemia monitoring, QT interval monitoring, and pre-hospital mobile phone-transmitted ECGs for patients who call 911 for chest pain