Dena Schulman-Green


Dr. Dena Schulman-Green

Dena Schulman-Green

Associate Professor

1 212 998 5786

433 1st Ave.
New York , NY 10010
United States

Accepting PhD students

Dena Schulman-Green's additional information

Dena Schulman-Green, PhD, is an associate professor at NYU Rory Meyers College of Nursing. Her program of research focuses on the timely integration of palliative care into patient and family management of chronic illness. She designed Managing Cancer Care as an intervention to help women with breast cancer and their family caregivers to manage cancer collaboratively with clinicians. Schulman-Green is well known for her role in developing the Self- and Family Management Framework to guide research on patient and family management of chronic illness. Other research interests include addressing health disparities in palliative care, use of telehealth in palliative care, and tailoring research methods for vulnerable populations. Schulman-Green consults on qualitative and mixed methods research studies nationally. Her work has been funded by the American Cancer Society, the National Institutes of Health, the National Palliative Care Research Center, and the Palliative Care Research Cooperative, among others. invested in mentorship and leadership development, Schulman-Green supervises PhD and postdoctoral research trainees. 

Prior to joining NYU Meyers, Schulman-Green conducted research and taught and advised in the PhD and DNP programs at Yale School of Nursing for 18 years. She was also faculty for Yale School of Medicine’s Palliative Medicine Fellowship and Interprofessional Palliative Care Education programs. She was instrumental in developing palliative care research and providing qualitative and mixed methods research support university wide.  

Schulman-Green received a PhD and an MS in gerontology from the University of Massachusetts Boston, an MA and EdM in counseling psychology from Columbia University, and a BA in psychology and religion from Boston University. She completed a post-doctoral fellowship in breast cancer and palliative care at Yale School of Nursing through a US Army Department of Defense Breast Cancer Research Program Training Grant under the mentorship of Drs. Ruth McCorkle and Elizabeth Bradley.

PhD, University of Massachusetts Boston
MS, University of Massachusetts Boston
EdM, Columbia University, Teachers College
MA, Columbia University, Teachers College
BA, Boston University

Palliative care
Chronic disease

American Academy of Hospice and Palliative Medicine
Palliative Care Research Cooperative Group
Eastern Nursing Research Society
Gerontological Society of America
American Psychosocial Oncology Society

Faculty Honors Awards

Suzanne Feetham Nurse Scientist Family Research Award, Eastern Nursing Research Society (2019)
Annie W. Goodrich Award for Excellence in Teaching, Yale School of Nursing (2017)
American Academy of Hospice and Palliative Medicine Poster Award (2017)
American Academy of Hospice and Palliative Medicine Poster Award (2016)
American Academy of Hospice and Palliative Medicine Poster Award (2010)
Center for Disease Control Success Story Award (2010)
Ellison Medical Foundation Aging New Scholar Award Nominee, University of Massachusetts Boston (2006)
National Hospice and Palliative Care Organization Research Award (2004)
Inducted into Sigma Phi Omega, Gerontology Honor Society (1999)
Association for Gerontology in Higher Education/AARP Andrus Foundation Graduate Scholarship in Gerontology (1998)
Columbia University General Scholarship Award (1993)
Inducted into Psi Chi, Psychology Honor Society (1992)


Exploring Cancer Pain Self-Management Needs and Preferences: A Meta-Ethnography

Anderson, A., Starkweather, A., Cong, X., Kyounghae, K., Judge, M., & Schulman-Green, D. (2021). Qualitative Health Research. 10.1177/1049732321998975
Self-management of chronic disease and related symptoms provides a framework for understanding the contextual factors that influence self-management knowledge and skills that patients and families require to manage their condition on a day-to-day basis. The management of cancer pain is a significant issue for patients and families, and their experience can provide insight on cancer pain self-management support needs and preferences. A meta-synthesis of 20 qualitative research articles on self-management of cancer pain was conducted to gain a deeper understanding of the self-management support needs of patients with cancer pain. Noblit and Hare’s meta-ethnographic model was used. The meta-synthesis resulted in increased understanding of the needs and preferences for self-management support of cancer pain and the role of the health care practitioner. Practical implications are presented.

Family Caregiver Support of Patient Self-Management During Chronic, Life-Limiting Illness: A Qualitative Metasynthesis

Schulman-Green, D., Feder, S. L., Dionne-Odom, J. N., Batten, J., En Long, V. J., Harris, Y., Wilpers, A., Wong, T., & Whittemore, R. (2021). Journal of Family Nursing, 27(1), 55-72. 10.1177/1074840720977180
Family caregivers play an integral role in supporting patient self-management, yet how they perform this role is unclear. We conducted a qualitative metasynthesis of family caregivers’ processes to support patient self-management of chronic, life-limiting illness and factors affecting their support. Methods included a systematic literature search, quality appraisal of articles, data abstraction, and data synthesis to produce novel themes. Thirty articles met inclusion criteria, representing 935 international family caregivers aged 18 to 89 years caring for patients with various health conditions. Three themes characterized family caregivers’ processes to support patient self-management: “Focusing on the Patient’s Illness Needs,” “Activating Resources to Support Oneself as the Family Caregiver,” and “Supporting a Patient Living with a Chronic, Life-Limiting Illness.” Factors affecting family caregivers’ support included Personal Characteristics, Health Status, Resources, Environmental Characteristics, and the Health Care System. The family caregiver role in supporting patient self-management is multidimensional, encompassing three processes of care and influenced by multiple factors.

Pediatric Patients' and Parents' Perspectives of Unsedated Transnasal Endoscopy in Eosinophilic Esophagitis: A Qualitative Descriptive Study

Scherer, C., Sosensky, P., Schulman-Green, D., Levy, M., Smith, C., Friedlander, J., & Koral, A. (2021). Journal of Pediatric Gastroenterology and Nutrition, 72(4), 558-562. 10.1097/MPG.0000000000003029
BACKGROUND: Eosinophilic esophagitis is an increasingly common inflammatory disease of the esophagus. Diagnosis and management are based on the histological presence of eosinophils in the esophageal mucosa, often requiring multiple endoscopies with sedation. Unsedated transnasal endoscopy (TNE), an alternative method of assessing the mucosa without the risks of sedation, is now being performed in the pediatric population. This is the first qualitative study on pediatric patients' and parents' experiences with TNE. OBJECTIVE: The objective of the study was to describe pediatric patients' and parents' experiences of TNE with the goal of refining TNE protocols to improve the clinical experience. METHODS: We used a qualitative descriptive approach that included in-depth, semistructured interviews with patients and parents following completion of TNE. Interviews continued until we reached thematic saturation. We analyzed data using qualitative content analysis. RESULTS: A total of 21 interviews were completed. We identified 4 themes: Appeal of TNE; Expectations and Preparation for TNE; Tolerance of TNE; and Evaluation of TNE. Perceived positive aspects of TNE were no exposure to intravenous anesthesia; helpful and clear preparation for the procedure with a demonstration video and physician phone call; distraction during TNE with virtual reality goggles and a stress ball; parent able to accompany the patient; and TNE requiring less time than an esophagogastroduodenoscopy. Negative aspects included patient stress before TNE, patient dislike of nasal spray taste and sensation, and discomfort during the TNE procedure. CONCLUSION: The overall perception of TNE among our participants was positive. Study data will allow pediatric gastroenterologists the opportunity to improve both preparation for and comfort during TNE.

Communication strategies to mitigate fear and suffering among COVID-19 patients isolated in the ICU and their families

Akgün, K. M., Shamas, T. L., Feder, S. L., & Schulman-Green, D. (2020). Heart and Lung, 49(4), 344-345. 10.1016/j.hrtlng.2020.04.016

New Delirium Severity Indicators: Generation and Internal Validation in the Better Assessment of Illness (BASIL) Study

Vasunilashorn, S. M., Schulman-Green, D., Tommet, D., Fong, T. G., Hshieh, T. T., Marcantonio, E. R., Metzger, E. D., Schmitt, E. M., Tabloski, P. A., Travison, T. G., Gou, Y., Helfand, B., Inouye, S. K., & Jones, R. N. (2020). Dementia and Geriatric Cognitive Disorders, 49(1), 77-90. 10.1159/000506700
Background: Delirium is a common and preventable geriatric syndrome. Moving beyond the binary classification of delirium present/absent, delirium severity represents a potentially important outcome for evaluating preventive and treatment interventions and tracking the course of patients. Although several delirium severity assessment tools currently exist, most have been developed in the absence of advanced measurement methodology and have not been evaluated with rigorous validation studies. Objective: We aimed to report our development of new delirium severity items and the results of item reduction and selection activities guided by psychometric analysis of data derived from a field study. Methods: Building on our literature review of delirium instruments and expert panel process to identify domains of delirium severity, we adapted items from existing delirium severity instruments and generated new items. We then fielded these items among a sample of 352 older hospitalized patients. Results: We used an expert panel process and psychometric data analysis techniques to narrow a set of 303 potential items to 17 items for use in a new delirium severity instrument. The 17-item set demonstrated good internal validity and favorable psychometric characteristics relative to comparator instruments, including the Confusion Assessment Method-Severity (CAM-S) score, the Delirium Rating Scale Revised 98, and the Memorial Delirium Assessment Scale. Conclusion: We more fully conceptualized delirium severity and identified characteristics of an ideal delirium severity instrument. These characteristics include an instrument that is relatively quick to administer, is easy to use by raters with minimal training, and provides a severity rating with good content validity, high internal consistency reliability, and broad domain coverage across delirium symptoms. We anticipate these characteristics to be represented in the subsequent development of our final delirium severity instrument.

Palliative care advanced practice nursing in Israel: bridging creation and implementation

Collett, D., Feder, S., Aaron, E., Haron, Y., & Schulman-Green, D. (2020). International Nursing Review, 67(1), 136-144. 10.1111/inr.12555
Aim: To describe Israel's development of the palliative care advanced practice registered nurse as a foundation for the development of the advanced practice registered nurse role in other specialties. Background: Palliative care centres on alleviating physical, emotional, social and spiritual distress associated with life-limiting illness. In 2009, Israel introduced the palliative care advanced practice nurse role, that is, registered nurses with specialized training in palliative care, to address increasing palliative care needs. Introduction: While there has been investment in its development, full implementation of the advanced practice nurse has not yet been achieved. Methods: In this qualitative descriptive study, we conducted a document analysis (n = 11) and key informant interviews (n = 11), extracted themes using qualitative content analysis and triangulated data sets. Results: Documents reflected growing palliative care needs and uniform requirements for advanced practice nurse training. Interviews uncovered a perceived lack of awareness of palliative care, the need for increased role definition and practice authority for advanced practice nurses, and barriers to entry and training for this role. Discussion: Findings highlight ongoing needs in palliative care and advanced practice nursing and a trajectory of growth. Conclusions: The challenges Israel faces in implementation of the palliative care advanced practice nurse role inform development of other advanced practice nursing roles in Israel and other countries. Implications for Nursing Practice: Streamlining training pathways and resolving scope of practice issues will assist in implementation of advanced practice nursing roles. Implications for Health Policy: Our data offer targets for policymakers advocating the advanced practice nurse role, including training requirements and scope of practice.

Palliative care strategies offer guidance to clinicians and comfort for COVID-19 patient and families

Feder, S. L., Akgün, K. M., & Schulman-Green, D. (2020). Heart and Lung, 49(3), 227-228. 10.1016/j.hrtlng.2020.04.001

Patient and Family Caregiver Considerations When Selecting Early Breast Cancer Treatment: Implications for Clinical Pathway Development

Schulman-Green, D., Cherlin, E., Capasso, R., Mougalian, S. S., Wang, S., Gross, C. P., Bajaj, P. S., Eakle, K., Patel, S., Douglas, K., & Adelson, K. (2020). Patient, 13(6), 683-697. 10.1007/s40271-020-00426-7
Background: While clinical pathways have been widely adopted to decrease variation in cancer treatment patterns, they do not always incorporate patient and family caregiver perspectives. We identified shared patient and family caregiver considerations influencing treatment preferences/decision making to inform development of a shared decision pathway. Methods: We conducted qualitative interviews with women who completed initial definitive treatment for stage I–III breast cancer and their family caregivers. As part of a broader interview, we asked participants what they considered when choosing a treatment option for themselves/their loved one. We coded transcribed interviews, analyzed patient and family caregiver datasets separately, and compared findings. Findings Patients’ (n = 22) mean age was 55.7 years, whereas family caregivers’ (n = 20) mean age was 59.5 years, with most (65%) being patients’ spouses/partners. Considerations reported by both groups included cancer status, treatment issues, physical/psychosocial/family consequences, and provider/health care system issues. Data revealed three key tensions that arise during treatment decision making: (1) having enough information to set expectations but not so much as to be overwhelming; (2) balancing the highest likelihood of cure with potential physical/emotional/social/financial consequences of the chosen treatment; and (3) wanting to make data-driven decisions while having a personalized treatment plan. Discussion: Patients and family caregivers identified several considerations of shared relevance reflecting different perspectives. Efforts to balance considerations can produce tensions that may contribute to decision regret if unaddressed. Conclusion: Clinical pathways can increase exposure to decision regret if treatment options are selected without consideration of patients’ priorities. A shared decision pathway that incorporates patient-centeredness could facilitate satisfactory decision making.

Sustaining frontline ICU healthcare workers during the COVID-19 pandemic and beyond

Akgün, K. M., Collett, D., Feder, S. L., Shamas, T., & Schulman-Green, D. (2020). Heart and Lung, 49(4), 346-347. 10.1016/j.hrtlng.2020.05.012

The Better Assessment of Illness Study for Delirium Severity: Study Design, Procedures, and Cohort Description

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Background/Objectives: To describe the design, procedures, and cohort for the Better ASsessment of ILlness -(BASIL) study, which is conducted to develop and test new delirium severity measures, compare them with existing measures, and examine related clinical outcomes. Methods: Prospective cohort study with 1 year follow-up of study participants at a large teaching hospital in Boston, Massachusetts. After brief cognitive testing and the Delirium Symptom Interview, delirium and delirium severity were rated daily in the hospital using the Confusion Assessment Method (CAM) and CAM-Severity score, the Delirium Rating Scale-Revised-98 (DRS-R-98), and the Memorial Delirium Assessment Scale (MDAS). Other key study variables included comorbidity, physical function (basic and instrumental activities of daily living [ADL]), ratings of subjective health and well-being, and clinical outcomes (length of stay, 30 day rehospitalization, nursing home admission, healthcare utilization). Follow-up interviews occurred at 1- and 12-month with patients and families. In 42 patient interviews, inter-rater reliability for key variables was assessed. Results: Of 768 eligible patients approached, 469 were screened and 352 enrolled, yielding an overall study response rate of 67% for potentially eligible participants. The mean participant was 80.3 years old (SD 6.8) and 203 (58%) were female. The majority of patients were medically complex with Charlson Comorbidity Scores ≥2 (192 patients, 55%), and 102 (29%) met criteria for dementia. Inter-rater reliability assessments (n = 42 pairs) were high for overall ratings of presence or absence of delirium by CAM (κ = 1.0), delirium severity by DRS-R-98 and MDAS (weighted kappa, κ = 1.0 for each) and for ADL impairment (κ = 1.0). For eligible participants at each time point, 278 out of 308 (90%) completed the 1-month follow-up and 132 out of 256 (53%) have completed the 12-month follow-up to date, which is still in progress. Among those who completed interviews, there was only 1-3% missing data on most major outcomes (delirium, basic ADL, and readmission). Conclusion: The BASIL study presents an innovative effort to advance the conceptualization and measurement of delirium severity. Unique strengths include the diverse cohort with complete high quality data and longitudinal follow-up, along with detailed collection of multiple delirium measures daily during hospitalization.