Dena Schulman-Green
PhD
Associate Professor
Director of the Florence S. Downs PhD Program
dena.schulman-green@nyu.edu
1 212 998 5786
Associate Professor
Director of the Florence S. Downs PhD Program
433 First Ave
New York, NY 10010
United States
Accepting PhD students
Dena Schulman-Green's additional information
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Dena Schulman-Green, PhD, is an associate professor at NYU Rory Meyers College of Nursing. Her program of research focuses on the integration of palliative care into patient and family management of serious, 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 Middle Range Theory of Self- and Family Management of Chronic Illness to guide research on patient and family management of chronic illness. Schulman-Green’s work is rooted in her belief that healthcare goals should reflect personal goals and values.
Additional research interests include health-illness transitions, psychosocial issues in cancer survivorship, and tailoring research methods for vulnerable populations. Schulman-Green consults on qualitative and mixed methods 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. She is active in the American Academy of Hospice and Palliative Medicine and serves on the Editorial Board of the Journal of Pain and Symptom Management. Invested in mentorship and leadership development, Schulman-Green supervises PhD and postdoctoral research trainees.
Prior to joining NYU Meyers, Schulman-Green was faculty at the Yale School of Nursing for 18 years, initially as a Research Scientist and later as an Associate Professor. She also served as faculty for the 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 the Yale School of Nursing under the mentorship of Drs. Ruth McCorkle and Elizabeth Bradley.
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PhD, University of Massachusetts BostonMS, University of Massachusetts BostonEdM, Columbia University, Teachers CollegeMA, Columbia University, Teachers CollegeBA, Boston University
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Palliative careChronic diseaseGerontologyGlobal
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American Academy of Hospice and Palliative MedicinePalliative Care Research Cooperative GroupEastern Nursing Research SocietyGerontological Society of AmericaAmerican Psychosocial Oncology Society
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Faculty Honors Awards
Suzanne Feetham Nurse Scientist Family Research Award, Eastern Nursing Research Society (2019)American Academy of Hospice and Palliative Medicine Poster Award (2017)Annie W. Goodrich Award for Excellence in Teaching, Yale School of Nursing (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) -
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Publications
A metasynthesis of factors affecting self-management of chronic illness
AbstractSchulman-Green, D., Jaser, S. S., Park, C., & Whittemore, R. (2016). Journal of Advanced Nursing, 72(7), 1469-1489. 10.1111/jan.12902AbstractAim: To identify factors that may serve as facilitators and barriers to self-management described by adults living with chronic illness by conducting a qualitative metasynthesis. Background: Self-management is an individuals' active management of a chronic illness in collaboration with their family members and clinicians. Design: Qualitative metasynthesis. Data sources: We analysed studies (N = 53) published between January 2000–May 2013 that described factors affecting self-management in chronic illness as reported by adults aged over 18 years with chronic illness. Review methods: Sandelowsi and Barroso approach to qualitative metasynthesis: literature search; quality appraisal; analysis and synthesis of findings. Results: Collectively, article authors reported on sixteen chronic illnesses, most commonly diabetes (N = 28) and cardiovascular disease (N = 20). Participants included men and women (mean age = 57, range 18-94) from 20 countries representing diverse races and ethnicities. We identified five categories of factors affecting self-management: Personal/Lifestyle Characteristics; Health Status; Resources; Environmental Characteristics; and Health Care System. Factors may interact to affect self-management and may exist on a continuum of positive (facilitator) to negative (barrier). Conclusion: Understanding factors that influence self-management may improve assessment of self-management among adults with chronic illness and may inform interventions tailored to meet individuals' needs and improve health outcomes.Risk Stratification in Older Patients with Acute Myocardial Infarction: Physicians' Perspectives
AbstractFeder, S. L., Schulman-Green, D., Dodson, J. A., Geda, M., Williams, K., Nanna, M. G., Allore, H. G., Murphy, T. E., Tinetti, M. E., Gill, T. M., & Chaudhry, S. I. (2016). Journal of Aging and Health, 28(3), 387-402. 10.1177/0898264315591005AbstractObjective: Risk stratification models support clinical decision making in acute myocardial infarction (AMI) care. Existing models were developed using data from younger populations, potentially limiting accuracy and relevance in older adults. We describe physician-perceived risk factors, views of existing models, and preferences for future model development in older adults. Method: Qualitative study using semi-structured telephone interviews and the constant comparative method. Results: Twenty-two physicians from 14 institutions completed the interviews. Median age was 37, and median years of clinical experience was 11.5. Perceived predictors included cardiovascular, comorbid, functional, and social risk factors. Physicians viewed models as easy to use, yet neither inclusive of risk factors nor predictive of non-mortality outcomes germane to clinical decision making in older adults. Ideal models included multidimensional risk domains and operational requirements. Discussion: Physicians reported limitations of available risk models when applied to older adults with AMI. New models are needed to guide AMI treatment in this population.Physicians' perceptions of the Thrombolysis in Myocardial Infarction (TIMI) risk score in older adults with acute myocardial infarction
AbstractFeder, S. L., Schulman-Green, D., Geda, M., Williams, K., Dodson, J. A., Nanna, M. G., Allore, H. G., Murphy, T. E., Tinetti, M. E., Gill, T. M., & Chaudhry, S. I. (2015). Heart and Lung: Journal of Acute and Critical Care, 44(5), 376-381. 10.1016/j.hrtlng.2015.05.005AbstractObjectives: To evaluate physician-perceived strengths and limitations of the Thrombolysis in Myocardial Infarction (TIMI) risk scores for use in older adults with acute myocardial infarction (AMI). Background: The TIMI risk scores are risk stratification models developed to estimate mortality risk for patients hospitalized for AMI. However, these models were developed and validated in cohorts underrepresenting older adults (≥75 years). Methods: Qualitative study using semi-structured telephone interviews and the constant comparative method for analysis. Results: Twenty-two physicians completed interviews ranging 10-30 min (mean = 18 min). Median sample age was 37 years, with a median of 11.5 years of clinical experience. TIMI strengths included familiarity, ease of use, and validation. Limitations included a lack of risk factors relevant to older adults and model scope and influence. Conclusions: Physicians report that the TIMI models, while widely used in clinical practice, have limitations when applied to older adults. New risk models are needed to guide AMI treatment in this population.A revised Self- and Family Management Framework
AbstractGrey, M., Schulman-Green, D., Knafl, K., & Reynolds, N. R. (2015). Nursing Outlook, 63(2), 162-170. 10.1016/j.outlook.2014.10.003AbstractBackground: Research on self- and family management of chronic conditions has advanced over the past 6 years, but the use of simple frameworks has hampered the understanding of the complexities involved. Purpose: We sought to update our previously published model with new empirical, synthetic, and theoretical work. Methods: We used synthesis of previous studies to update the framework. Discussion: We propose a revised framework that clarifies facilitators and barriers, processes, proximal outcomes, and distal outcomes of self- and family management and their relationships. Conclusions: We offer the revised framework as a model that can be used in studies aimed at advancing self- and family management science. The use of the framework to guide studies would allow for the design of studies that can address more clearly how self-management interventions work and under what conditions.Printed guide improves knowledge of curative, palliative, and hospice care among women with metastatic breast cancer
Schulman-Green, D., & Jeon, S. (2013, October 1). In Supportive Care in Cancer (Vols. 21, Issues 10, pp. 2651-2653). 10.1007/s00520-013-1864-xThe importance of social networks on smoking: Perspectives of women who quit smoking during pregnancy
AbstractNguyen, S. N., Von Kohorn, I., Schulman-Green, D., & Colson, E. R. (2012). Maternal and Child Health Journal, 16(6), 1312-1318. 10.1007/s10995-011-0896-4AbstractWhile up to 45% of women quit smoking during pregnancy, nearly 80% return to smoking within a year after delivery. Interventions to prevent relapse have had limited success. The study objective was to understand what influences return to smoking after pregnancy among women who quit smoking during pregnancy, with a focus on the role of social networks. We conducted in-depth, semi-structured interviews during the postpartum hospital stay with women who quit smoking while pregnant. Over 300 pages of transcripts were analyzed using qualitative methods to identify common themes. Respondents [n = 24] were predominately white (63%), had at least some college education (54%) and a mean age of 26 years (range = 18-36). When reflecting on the experience of being a smoker who quit smoking during pregnancy, all participants emphasized the importance of their relationships with other smokers and the changes in these relationships that ensued once they quit smoking. Three common themes were: (1) being enmeshed in social networks with prominent smoking norms (2) being tempted to smoke by members of their social networks, and (3) changing relationships with the smokers in their social networks as a result of their non-smoking status. We found that women who quit smoking during pregnancy found themselves confronted by a change in their social network since most of those in their social network were smokers. For this reason, smoking cessation interventions may be most successful if they help women consider restructuring or reframing their social network.One step at a time: Self-management and transitions among women with ovarian cancer
AbstractSchulman-Green, D., Bradley, E. H., Nicholson, N. R., George, E., Indeck, A., & McCorkle, R. (2012). Oncology Nursing Forum, 39(4), 354-360. 10.1188/12.ONF.354-360AbstractPurpose/Objectives: To describe experiences of self-management and transitioning among women with ovarian cancer. Research Approach: Interpretive description. Setting: Participants' homes. Participants: Purposive sample of 10 women with ovarian cancer. Methodologic Approach: Individual interviews about women's self-management and transition experiences. Main Research Variables: Self-management, transitions, and ovarian cancer. Findings: Participants self-managed to increase their sense of control and to self-advocate. They managed their care one step at a time to prevent becoming overwhelmed. Common transitions were diagnosis, surgery and recovery, starting chemotherapy, managing symptoms, and recurrence. Transitions were challenging, even if previously experienced, and influenced the ability and willingness of women to self-manage. Barriers and facilitators to self-management were identified. Conclusions: The approach to self-management of one step at a time is somewhat illusory, as women face multiple transitions simultaneously. The short trajectory of ovarian cancer leaves little time between transitions and an awareness of mortality. Women are forced to confront goals of care quickly, which may affect their ability to self-manage. Interpretation: Women with ovarian cancer need clinical and social support to prioritize and manage transitions. Introducing palliative care shortly after diagnosis could facilitate women's anticipation of and adjustment to transitions.Processes of Self-Management in Chronic Illness
AbstractSchulman-Green, D., Jaser, S., Martin, F., Alonzo, A., Grey, M., Mccorkle, R., Redeker, N. S., Reynolds, N., & Whittemore, R. (2012). Journal of Nursing Scholarship, 44(2), 136-144. 10.1111/j.1547-5069.2012.01444.xAbstractPurpose: Self-management is a dynamic process in which individuals actively manage a chronic illness. Self-management models are limited in their specification of the processes of self-management. The purpose of this article is to delineate processes of self-management in order to help direct interventions and improve health outcomes for individuals with a chronic illness. Design: Qualitative metasynthesis techniques were used to analyze 101 studies published between January 2000 and April 2011 that described processes of self-management in chronic illness. Methods: Self-management processes were extracted from each article and were coded. Similar codes were clustered into categories. The analysis continued until a final categorization was reached. Findings: Three categories of self-management processes were identified: focusing on illness needs; activating resources; and living with a chronic illness. Tasks and skills were delineated for each category. Conclusions: This metasynthesis expands on current descriptions of self-management processes by specifying a more complete spectrum of self-management processes. Clinical Relevance: Healthcare providers can best facilitate self-management by coordinating self-management activities, by recognizing that different self-management processes vary in importance to patients over time, and by having ongoing communication with patients and providers to create appropriate self-management plans.A Qualitative Study of Postpartum Mothers' Intention to Smoke
AbstractVon Kohorn, I., Nguyen, S. N., Schulman-Green, D., & Colson, E. R. (2012). Birth, 39(1), 65-69. 10.1111/j.1523-536X.2011.00514.xAbstractBackground: Many women stop smoking during pregnancy. Factors associated with relapse are known, but no intervention prevents the return to smoking among pregnant women. The objective of this study was to determine why women return to smoking after prolonged abstinence during pregnancy by examining mothers' intention to smoke at the time of delivery and the perceptions that shape their intention. Methods: We conducted in-depth, semi-structured interviews during their postpartum hospital stay with 24 women who stopped smoking while pregnant. We asked participants whether they intended to resume smoking after pregnancy and why. Transcripts were analyzed using grounded theory-based qualitative methods to identify themes. Results: Participants ranged in age from 18 to 36years, and 63 percent were white. Three themes emerged from the interviews with the mothers: 1) they did not intend to return to smoking but doubted whether they would be able to maintain abstinence; 2) they believed that it would be possible to protect their newborns from the harms of cigarette smoke; and 3) they felt that they had control over their smoking and did not need help to maintain abstinence after pregnancy. Conclusions: Although most participants did not intend to resume smoking, their intentions may be stymied by their perceptions about second-hand smoke and by their overestimation of their control over smoking. Further study should quantify these barriers and determine their evolution over the first year after pregnancy with the goal of informing more successful, targeted interventions.Using online learning and interactive simulation to teach spiritual and cultural aspects of palliative care to interprofessional students
AbstractEllman, M. S., Schulman-Green, D., Blatt, L., Asher, S., Viveiros, D., Clark, J., & Bia, M. (2012). Journal of Palliative Medicine, 15(11), 1240-1247. 10.1089/jpm.2012.0038AbstractBackground: To meet the complex needs of patients with serious illness, health professional students require education in basics aspects of palliative care, including how to work collaboratively on an interprofessional team. Objectives: An educational program was created, implemented, and evaluated with students in medicine, nursing, chaplaincy, and social work. Five learning objectives emphasized spiritual, cultural, and interprofessional aspects of palliative care. Design: The program blended two sequential components: an online interactive, case-based learning module, and a live, dynamic simulation workshop. Measurements: Content analysis was used to analyze students' free-text responses to four reflections in the online case, as well as open-ended questions on students' postworkshop questionnaires, which were also analyzed quantitatively. Results: Analysis of 217 students' free-text responses indicated that students of all professions recognized important issues beyond their own discipline, the roles of other professionals, and the value of team collaboration. Quantitative analysis of 309 questionnaires indicated that students of all professions perceived that the program met its five learning objectives (mean response values>4 on a 5-point Likert scale), and highly rated the program and its two components for both educational quality and usefulness for future professional work (mean response values approximately>4). Conclusions: This innovative interprofessional educational program combines online learning with live interactive simulation to teach professionally diverse students spiritual, cultural, and interprofessional aspects of palliative care. Despite the challenge of balanced professional representation, this innovative interprofessional educational program met its learning objectives, and may be transferable for use in other educational settings.