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
The 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.Validation of the knowledge of care options instrument to measure knowledge of curative, palliative, and hospice care
AbstractSchulman-Green, D., Ercolano, E., Jeon, S., & Dixon, J. (2012). Journal of Palliative Medicine, 15(10), 1091-1099. 10.1089/jpm.2011.0514AbstractObjective: Treatment decision-making may be hindered by a lack of knowledge about the care options of curative, palliative, and hospice care. Our purpose was to create and validate an instrument to measure knowledge of these care options, the Knowledge of Care Options (KOCO) instrument. Methods: We began by generating a pool of true-false items. Experts (n=32) evaluated items in two rounds of review. For each round, we calculated Content Validity Indexes for each item and for the total scale (S-CVI). Items were revised or dropped as indicated. The clarity and acceptability of KOCO were assessed through cognitive interviews with 10 men and women with cancer. We pilot-tested KOCO with a target population sample of 23 women with metastatic breast cancer as part of larger study testing self-management training materials that included a module on care options. Results: Following expert review, the S-CVI was 85.2%, and the KOCO consisted of 11 items. Cognitive interviews showed KOCO to be clear and acceptable. The KR-20 test revealed high internal consistency of 0.89. In the pilot test, the mean pre-test score was 9.3 items correct (SD 1.29). The mean post-test score was 10.21 items correct (SD 0.92). KOCO captured change in knowledge of care options (signed rank test=42.5, p<0.006). Conclusions: KOCO is a brief, acceptable instrument capable of assessing knowledge of curative, palliative, and hospice care. Additional testing is needed with larger samples to assess the utility of KOCO for use with various patient populations, family caregivers, and clinicians.Validity of the end-of-life professional caregiver survey to assess for multidisciplinary educational needs
AbstractLazenby, M., Ercolano, E., Schulman-Green, D., & McCorkle, R. (2012). Journal of Palliative Medicine, 15(4), 427-431. 10.1089/jpm.2011.0246AbstractThe National Consensus Project for Quality Palliative Care (NCP) has put forth eight domains of clinical practice guidelines that address the multidisciplinary nature of palliative and end-of-life (EOL) care. Extant surveys to assess education needs of palliative and EOL workers, however, have been constructed for individual professions. Thus we developed the End-of-life Professional Caregiver Survey (EPCS) as an instrument for assessing the palliative and EOL care-specific educational needs of multidisciplinary professionals.Developing and testing a web-based survey to assess educational needs of palliative and end-of-life health care professionals in connecticut
AbstractSchulman-Green, D., Ercolano, E., LaCoursiere, S., Ma, T., Lazenby, M., & McCorkle, R. (2011). American Journal of Hospice and Palliative Medicine, 28(4), 219-229. 10.1177/1049909110385219AbstractInstitute of Medicine reports have identified gaps in health care professionals' knowledge of palliative and end-of-life care, recommending improved education. Our purpose was to develop and administer a Web-based survey to identify the educational needs of multidisciplinary health care professionals who provide this care in Connecticut to inform educational initiatives. We developed an 80-item survey and recruited participants through the Internet and in person. Descriptive and correlational statistics were calculated on 602 surveys. Disciplines reported greater agreement on items related to their routine tasks. Reported needs included dealing with cultural and spiritual matters and having supportive resources at work. Focus groups confirmed results that are consistent with National Consensus Project guidelines for quality palliative care and indicate the End-of-Life Nursing Education Consortium modules for education.Experiences of participants in a Collaborative to develop Performance measures for Hospice Care
AbstractSchulman-Green, D., Cherlin, E., Pace, K. B., Hennessy, M., Crocker, P. A., & Bradley, E. H. (2011). Joint Commission Journal on Quality and Patient Safety, 37(1), 38-44. 10.1016/S1553-7250(11)37005-5AbstractBackground: There has been increasing attention paid to quality assessment in hospice as the industry has grown and diversified. In response, policymakers have called for standardized approaches to monitoring hospice quality. The experiences of a set of hospices involved with the National Association for Home Care & Hospice (NAHC) Quality Assessment and Performance Improvement Collaborative, which was designed to test the use of a standardized patient symptom assessment tool as an exemplar of efforts to standardize symptom assessment in hospice, were examined. Methods: Transcripts of semistructured telephone interviews with 24 individuals from eight of the nine participating hospices, which were conducted in July-August 2007, were analyzed using the constant comparative method. Interview questions centered on the collaborative's impact on the process of quality assessment at the hospices. Findings: The collaborative activities influenced several hospices' quality assessment processes, most beneficially by prompting greater attention to quality assessment processes, by promoting the adoption of quality assessment tools, and by creating a supportive community. Challenges included the limits of distance communication technology, participants' misconceptions about data to be received, and potential lack of support and resources for quality assessment. Conclusions: The experiences of the participating hospices in the NAHC collaborative are intended to inform the design of future interorganizational learning efforts to promote quality assessment initiatives within hospice settings. Future hospice collaboratives should use multiple methods of communication to build a close participant network and be clear about collaborative goals and participant expectations and about the reciprocal relationship of the collaborative and the participants.Self-management and transitions in women with advanced breast cancer
AbstractSchulman-Green, D., Bradley, E. H., Knobf, M. T., Prigerson, H., Digiovanna, M. P., & McCorkle, R. (2011). Journal of Pain and Symptom Management, 42(4), 517-525. 10.1016/j.jpainsymman.2010.12.007AbstractContext: Self-management involves behaviors that individuals perform to handle health conditions. Self-management may be particularly challenging during transitions - shifts from one life phase or status to another, for example, from cure- to noncure-oriented care - because they can be disruptive and stressful. Little is known about individuals' experiences with self-management, especially during transitions. Objectives: Our purpose was to describe experiences of self-management in the context of transitions among women with advanced breast cancer. Methods: We interviewed a purposive sample of 15 women with metastatic breast cancer about their self-management preferences, practices, and experiences, including how they managed transitions. Interviews were recorded and transcribed. The qualitative method of interpretive description was used to code and analyze the data. Results: Participants' mean age was 52 years (range 37-91 years); most were White (80%), married (80%), and college educated (60%). Self-management practices related to womens' health and to communication with loved ones and providers. Participants expressed a range of preferences for participation in self-management. Self-management included developing skills, becoming empowered, and creating supportive networks. Barriers to self-management included symptom distress, difficulty obtaining information, and lack of knowledge about the cancer trajectory. Women identified transitions as shifts in physical, emotional, and social well-being, as when their cancer progressed and there was a need to change therapy. Transitions often prompted changes in how actively women self-managed and were experienced as positive, negative, and neutral. Conclusion: Self-management preferences can vary. Providers should explore and revisit patients' preferences and ability to self-manage over time, particularly during transitions.