Nursing Research

The OSUCCC – James nursing philosophy emphasizes our belief that discovery supports evidence-based practice, fosters innovative patient care through research and promotes professional development.

The oncology nurses partner with teams of physicians and scientists from across disciplines who take ideas from bench to bedside. The OSUCCC – James nurses maintain advanced knowledge and skill to safely administer novel treatments for patients enrolled on clinical trials. In addition, they routinely explore new ways to improve quality, enhance service, reduce cost and streamline operations.

Nursing Research Studies

Oncology Nurses' Attitudes and Engagement in Nursing Research
Researchers: Elizabeth Arthur, PhD, APRN-CNP; Robin Rosselet, APRN-CNP

Understanding oncology nurses' attitudes toward research and the research environment is vital for the future of patient outcomes research. Results from this study inform strategic goals for increasing nursing research capacity, including the use of research teams and access to research mentors and resources, as well as nursing research fellowship programs.

MindBody Strong: Adapting a CBT-Based Coping and Healthy Lifestyle Intervention for Women With Breast Cancer
Researcher: Elizabeth Arthur, PhD, APRN-CNP

Cognitive behavioral therapy (CBT) is an effective intervention to reduce anxiety and depression among those with chronic illnesses, including breast cancer. Further, survivors of obesity-related cancers like breast cancer do not consistently engage in behaviors that can reduce their risk of cancer reoccurrence and improve anxiety and depressive symptoms. The addition of health promotion strategies with CBT may further improve global health and well-being outcomes among breast cancer survivors. COPE Healthy Lifestyles is a 15-session educational and CBT skills-building intervention that includes 20 minutes of physical activity in each session. We will conduct three focus groups as cognitive interviews of the existing COPE Healthy Lifestyles for adolescents in order to adapt and manualized COPE Healthy Lifestyles for adult breast cancer survivors. We will examine feasibility and acceptability of COPE Healthy Lifestyles and a wait-list control among breast cancer survivors and then explore the degree to which COPE Healthy Lifestyles versus wait-list control affects preliminary health-related outcomes among breast cancer survivors. Findings will inform an efficacy RCT and further work in other cancer populations.

Older Cancer Survivors’ Assessment of the MyChart App to Optimize Behaviors and Outcomes
Researcher: Elizabeth Arthur, PhD, APRN-CNP

Despite being the majority of cancer survivors, older adults (≥65 years) and their survivorship needs are greatly understudied. Older cancer survivors often have a myriad of health issues, and recent policy requires survivorship care plans (SCPs) to be administered to cancer survivors post-treatment. The MyChart application, a digital health portal for all The Ohio State University Wexner Medical Center (OSUWMC) patients, houses uploaded SCPs and facilitates telehealth visits. However, little is known regarding older cancer survivors’ opinions of the MyChart app for their survivorship care. Thus, this study will utilize three focus groups to gather information on older cancer survivors’ perspectives of the MyChart app, as well as their survivorship and SCP experiences. The proposed project will inform optimal user-centered methods for integrating the older adult population into telehealth and survivorship research. Specifically, we aim to investigate older cancer survivors’ opinions about the OSUWMC MyChart app for their survivorship care and SCPs through three focus groups. We also aim to gain insight into unmet needs of cancer survivors regarding their post-treatment symptoms and current behaviors as outlined by their SCP. Specifically, focus group participants will be asked to share their survivorship experiences, care needs and perspectives of SCPs.

Cellular Aging and Self: The Molecular Clock and Health Outcomes of Young Adult Cancer Survivors
Researcher: Elizabeth Arthur, PhD, APRN-CNP

The overall objective of this proposed work is to identify and characterize the relationships between cellular aging, health (HRQoL, physical and psychosocial measures) and CT-derived body composition measures, the latter of which is a strong predictor of physical function and outcome. Clarity surrounding these relationships will allow future pre-rehabilitations to be developed, including diet and exercise coaching, oncofertility and sexual health care, and psychosocial counseling. We will leverage a biopsychosocial approach to better understand the health of YAs with cancer. This approach systematically considers biological, psychological and social factors and their relationships. We first aim to establish a cohort of young adult (18-39) colon cancer (n=75) and breast cancer patients (n=75) in which we will assess HRQoL, anxiety, depression, stress, social support, sexual functioning and financial toxicity at diagnosis and one year following diagnosis. We also plan to estimate DNAm age using both Horvath’s and Hannum’s clock and measure the age acceleration, defined as the difference between calendar age and DNAm age in the young adult cohort at time of diagnosis and one year after diagnosis. Finally, we aim to measure the association of age acceleration in the young adult cohort with HRQoL, physical and psychosocial measures and body composition.

Pilot mHealth Optimizing Healthy Behaviors Intervention in Older Adult Cancer Survivors (mOHIO Study)
Researcher: Elizabeth Arthur, PhD, APRN-CNP

Despite being the majority of cancer survivors, older adults (≥65 years) and their survivorship needs are greatly understudied. Older cancer survivors often have a myriad of health issues, and living in Appalachia can bring accompanying challenges with access to timely survivorship care. Socioeconomic or demographic factors may contribute to the systematic underrepresentation of special populations like older adults in research and clinical applications. Older adults are more likely to have a fixed income, challenges with mobility or be reliant on family members for clinic visits. Add to this the challenges of driving distance, spotty cellular coverage and slow internet that are common with living in Appalachian areas. Designing an intervention that takes into account Appalachian living needs and preferences, as well as addresses barriers to access (i.e., telehealth), is important for integrating older adults into research and clinical innovation. In the current study, Appalachian older adult preferences regarding the use of a digital health portal will inform a user-centered methodology for creating a cancer survivorship intervention.

Health Coaches Facilitating Transitions of Care Among Older Cancer Survivors
Researcher: Elizabeth Arthur, PhD, APRN-CNP

There is a need for personalized pathways for cancer follow-up care including the use of survivorship care plans (SCPs) among older (≥65 years) cancer survivors, an underserved and understudied population. No studies have examined how other health professionals, such as health coaches, can leverage the existing resources of SCPs and electronic medical records (EMRs) to improve patient health behaviors and outcomes, as well as the PCPs follow-up care and communication. Thus, we propose to address the multi-level problem in survivorship care through a randomized controlled trial using health coaches to improve older cancer survivor-determined health behavior(s) listed in SCPs and communicate their progress and patient status via geriatric assessments to PCPs through EMRs. We anticipate that a health coaching intervention, through interactions with patients and PCPs, will improve patient health outcomes as well as PCP behaviors in their survivorship care. Our strategy is threefold: 1) Determine the effects of a two-year health coaching intervention on SCP-specific health behaviors (e.g., physical activity, diet) and health outcomes (e.g., health-related quality of life) among older breast and colorectal cancer survivors; 2) Examine the effect of EMR-based health coach communication on the PCPs’ behaviors (e.g., cancer screening and surveillance, communication) concerning their older cancer survivor patients; and 3) Evaluate, using mixed methods, the impact of the health coaching intervention on the transition of care from patient, primary care physician and health coach perspectives.

Professional Caregiver Stress With Leukemia Patients: Does Early Palliative Care Referral Make a Difference?
Researcher: Lisa Blackburn, APRN-CNP

This study is a sister study to a clinical trial in leukemia patients with early palliative care referral verses standard of care. This particular study focuses on the quality of life of the professional caregivers for these patients, including physicians, nurses, nurse practitioners, social workers and case managers. Within two weeks of discharge of each patient, the primary professionals listed above will be surveyed with the Professional Quality of Life Survey (ProQUOL) and the Secondary Trauma Stress Scale (STSS). The goal of the study will be to prove the hypothesis that the addition of early palliative care for leukemia patients will improve professional quality of life (QOL) and stress of professional oncology caregivers.

The Effect of Aromatherapy and Foot Reflexology on Pain and Anxiety in Cervical Cancer Patients Receiving Brachytherapy
Researcher: Lisa Blackburn, APRN-CNP

The sample for this study is cervical cancer patients who undergo a series of five separate radiation therapy treatments that have been shown to be particularly pain and stressful to patients because of their invasive nature. This randomized clinical trial assigns these patients randomly to one of two groups: a group receiving the addition of aromatherapy and 30 minutes of foot reflexology added to the standard treatment OR a standard of care only group. Both groups are then assessed at five distinct times during treatment for pain (on a 0-10 numeric pain scale) and anxiety (on a 0-10 numeric scale similar to pain). Trait anxiety is also measured at baseline with the State-Trait Anxiety Inventory (STAI). All procedural analgesia for each patient is tracked and converted to oral morphine equivalents (OMEs) for comparison. The goal of the study is to determine if the addition of aromatherapy and foot reflexology to standard care decrease pain and anxiety in patients receiving brachytherapy for cervical cancer.

Intection Potential of Nurses Wearing Fingernail Polish
Researcher: Lisa Blackburn, APRN-CNP

The purpose of this randomized controlled trial (RCT) was to determine if nurses wearing nail polish pose a greater infection risk to patients than nurses that are not wearing nail polish. The investigators assigned the three middle fingers of the dominant hand of 89 direct-care oncology nurses to groups including: no nail polish, one-day-old polish and four-day-old polish.  Participants were required to work a shift immediately prior to nail cultures, and practice routine hospital hand hygiene. Bacterial cultures were obtained from the non-polished nail and from the polished nails when polish was one day old and then again at four days old. Colony forming units (CFUs) of G+ and G- bacteria were compared for each of the nails in order to determine infection risk to oncology patients.

Satisfaction and Resilience in New Grads
Researcher: Diana McMahon, MSN, RN, OCN

Satisfaction and resiliency of new nurses is necessary to ensure staff nurse retention in light of significant nursing shortages. The purpose of this study is to explore resilience and job satisfaction in nurse residents (NR) engaged in facilitated conversations during a formal nurse residency program. Aim 1: Evaluate resilience of participants engaged in Claiming Resilience during a nurse residency program. Aim 2: Evaluate job satisfaction of participants engaged in Claiming Resilience during a nurse residency program. Consented participants will complete the Connor-Davidson Resilience scale (CD-RISC-10) at baseline, six months and 12 months from start of the Nurse Residency. The Casey Fink survey will be offered as part of the Nurse Residency at baseline, month six and month 12.  This research study is a collaboration between The James Department of Research, Professional Practice and Nursing Education.

Sarcoma Treatment Guide
Researcher: NJ Speece, BSN, RN, OCN

This project focuses on the impact that self-monitoring of side effects related to  chemotherapy among chemo naive patients has on overall quality of life, treatment compliance, communication and side effect management. The Sarcoma Treatment Guide is a small pocket journal that contains pages to track treatments, medications and symptoms while providing education on common oncology emergencies and symptom management.  

Researcher: Amber Williams, MSN, RN, OCN

Quality of life of a patient with cancer is impacted by the diagnosis itself and the treatments for the cancer. While cancer treatments have evolved over the years, becoming more personalized for improved length of life, the side effects of treatments have continued to contribute to decreased quality of life, increased nausea, decreased appetite, increased fatigue and increased anxiety. We will study the effects of certain inhaled essential oils on anxiety and nausea and the secondary impact those may have on fatigue and appetite via patient self-report. Our goal is to learn whether or not aromatherapy in the form of inhaled essential oils can benefit patients experiencing these side effects. 

Evidence-Based Practice Projects

Evidence-based practice (EBP) is central to our goals of providing world-class patient care, achieving the highest quality patient outcomes and providing a workplace environment for nursing practice to thrive. It has been demonstrated in a variety of clinical studies that patients who receive healthcare based on the best available evidence experience more positive outcomes and less adverse events.

OSUCCC – James nurses are encouraged and supported to consistently evaluate and integrate evidence-based findings into their practice. EBP mentors are available to work with individuals or teams of nurses as they evaluate and incorporate evidence into daily clinical practice.

Cancer Survivorship Education for Thoracic Advanced Practice Professionals: A Program Evaluation
Researcher: Taletha Askew, MS, RN, CNS

Incorporating an Interprofessional Educational Experience Into a Advance Practice Registered Nurse Critical Care Fellowship Program
Researcher: Cindy Byrd, DNP, APRN-CNP

Improving Adherence to a Hyperglycemia Clinical Practice Guideline in an Inpatient Blood and Marrow Transplant Population
Researcher: Lee Cordell, DNP, APRN-CNP

Health Literacy: Approach to Colon Cancer in African Americans
Researcher: Judy Jefferson-Gordon, APRN-CNP

Surgical Optimization
Researcher: Brenda Kendall, APRN-CNP

A Standardized Communication Tool to Reduce Hospital-Acquired Pressure Injuries (HAPIs) in Surgical Patients
Researcher: Claire McIntyre, APRN-CNP

Evaluation of Implementation of a Smoking Cessation e-Learning Education Program for Oncology Clinic Healthcare Providers
Researcher: Chase Weihong, APRN-CNP

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