Faculty

Prof. Wright headshot

Fay Wright

APRN-BC PhD RN

Assistant Professor
Director, Meyers Biological Laboratory

1 212 998 5394

433 First Avenue
Room 508
New York, NY 10010
United States

Accepting PhD students

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Professional overview

Fay Wright, RN, APRN-BC, PhD, is an assistant professor at NYU Rory Meyers College of Nursing. Her research focuses on improving symptom self-management in adults with chronic comorbid conditions, including cancer, metabolic syndrome, heart disease, and diabetes. She was the first to identify, demographic, clinical, and genotypic differences in morning and evening fatigue severity among oncology patients undergoing chemotherapy. Fatigue is a debilitating symptom that decreases an individual’s functional performance and quality of life. By identifying phenotypic and genomic risk factors for more severe fatigue, precision health symptom management interventions can be developed and tested.  

Wright has experience conducting clinical research within large urban and community hospital settings using quantitative and biobehavioral methodology. She provides consultation for clinical nursing research and evidence-based practice projects as a nurse scientist at the Magnet ® recognized Northern Westchester Hospital, in Mt Kisco, NY.

Wright received her PhD from NYU College of Nursing and BSN and MS from the University of Michigan School of Nursing. She completed a T-32 post-doctoral fellowship in self and symptom management at Yale University School of Nursing.

Education

PhD - New York University
Post-Master's Certificate - New York University
MS - University of Michigan School of Nursing
BSN - University of Michigan School of Nursing

Specialties

Acute care
Chronic disease

Professional membership

American Nurses Association
Association of New York State Nurses
Eastern Nursing Research Society (Chronic Comorbid Conditions Research Interest Group Co-Chair)
Oncology Nursing Society
Sigma Theta Tau

Honors and awards

Faculty Honors Awards

T32 Post-doctoral fellowship, National Institute of Nursing Research (2017)
Intramural Research Training Award, Precision Health Boot Camp, National Institute of Nursing (2016)
Valedictorian, PhD Program, NYU Rory Meyers College of Nursing (2015)
Intramural Research Training Award, Summer Genetics Institute, National Institute of Nursing Research (2015)
Best Dissertation Award, NYU Rory Meyers College of Nursing (2015)
Intramural Research Training Award, Summer Genetics Institute, National Institute of Nursing (2015)
Distinguished PhD Student, NYU Rory Meyers College of Nursing (2015)
Evidence-Based Practice Excellence Award, Maintaining Normothermia in Perioperative Patients, Foundation of New York State Nurses Association (2012)
Evidence-Based Practice Excellence Award, Developing an Evidence-based Protocol for Sedation in Mechanically Ventilated Critical Care Patients, Foundation of New York State Nurses Association (2011)

Publications

Publications

Alterations in Patterns of Gene Expression and Perturbed Pathways in the Gut-Brain Axis Are Associated With Chemotherapy-Induced Nausea

Singh, K. P., Dhruva, A., Flowers, E., Paul, S. M., Hammer, M. J., Wright, F., Cartwright, F., Conley, Y. P., Melisko, M., Levine, J. D., Miaskowski, C., & Kober, K. M. (2020). Journal of Pain and Symptom Management, 59(6), 1248-1259.e5. 10.1016/j.jpainsymman.2019.12.352
Abstract
Context: Despite current advances in antiemetic treatments, approximately 50% of oncology patients experience chemotherapy-induced nausea (CIN). Objectives: The purpose of this study was to evaluate for differentially expressed genes and perturbed pathways associated with the gut-brain axis (GBA) across two independent samples of oncology patients who did and did not experience CIN. Methods: Oncology patients (n = 735) completed study questionnaires in the week before their second or third cycle of chemotherapy. CIN occurrence was assessed using the Memorial Symptom Assessment Scale. Gene expression analyses were performed in two independent samples using ribonucleic acid sequencing (Sample 1, n = 357) and microarray (Sample 2, n = 352) methodologies. Fisher's combined probability method was used to determine genes that were differentially expressed and pathways that were perturbed between the two nausea groups across both samples. Results: CIN was reported by 63.6% of the patients in Sample 1 and 48.9% of the patients in Sample 2. Across the two samples, 703 genes were differentially expressed, and 37 pathways were found to be perturbed between the two CIN groups. We identified nine perturbed pathways that are involved in mechanisms associated with alterations in the GBA (i.e., mucosal inflammation, disruption of gut microbiome). Conclusion: Persistent CIN remains a significant clinical problem. Our study is the first to identify novel GBA-related pathways associated with the occurrence of CIN. Our findings warrant confirmation and suggest directions for future clinical studies to decrease CIN occurrence.

Association of personality profiles with coping and adjustment to cancer among patients undergoing chemotherapy

Langford, D. J., Morgan, S., Cooper, B., Paul, S., Kober, K., Wright, F., Hammer, M. J., Conley, Y. P., Levine, J. D., Miaskowski, C., & Dunn, L. B. (2020). Psycho-Oncology. 10.1002/pon.5377
Abstract
Objective: Specific personality traits are associated with differential use of various coping strategies. Few studies have examined the relationship between personality and coping in oncology patients undergoing chemotherapy. We, therefore, examined the relationship between previously identified personality profiles (ie, Distressed [14.3% of total sample], Normative [53.8%], Resilient [31.9%]) and measures of coping and adjustment. Methods: Patients (n = 1248) undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer completed measures of personality (NEO-Five Factor Inventory), coping (Brief COPE), and psychological adjustment to cancer (Mental Adjustment to Cancer [MAC] scale). Differences in coping and adjustment among the three personality profiles were evaluated using analysis of variance. Results: On the Brief COPE, the Distressed class endorsed lower use of Active Coping, Positive Reframing, Acceptance, Emotional Support (ie, “engagement” coping); and greater use of Denial, Venting, Behavioral Disengagement, Self-Blame (ie, “disengagement” coping) compared to the Normative and Resilient classes. On the MAC scale, the Distressed class scored higher on Anxious Preoccupation, Helplessness/Hopelessness, Fatalism, and Avoidance, and lower on Fighting Spirit, compared to the other two classes. Conclusions: In this sample of oncology patients receiving chemotherapy, patients in the Distressed personality class showed a reduced repertoire of adaptive coping strategies, while those in the Resilient class reported greater use of adaptive or engagement coping strategies. Further work should examine the potential mediating or moderating role of coping and adjustment in the relationships between personality and patient outcomes. Interventions to enhance beneficial and reduce harmful coping strategies in cancer patients should be evaluated.

Distinct Stress Profiles Among Oncology Patients Undergoing Chemotherapy

Langford, D. J., Cooper, B., Paul, S., Humphreys, J., Hammer, M. J., Levine, J., Conley, Y. P., Wright, F., Dunn, L. B., & Miaskowski, C. (2020). Journal of Pain and Symptom Management, 59(3), 646-657. 10.1016/j.jpainsymman.2019.10.025
Abstract
Context: Cancer and its treatment are inherently stressful and stress impacts important patient outcomes. Patients vary considerably in their response to stress. Understanding this variability requires a patient-centered multidimensional approach. Objectives: The objectives of this study were to identify and characterize patient subgroups with distinct multidimensional stress profiles (stress appraisal, exposure, and adaptation) during cancer treatment. Methods: Among 957 patients undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer, latent profile analysis was performed to identify patient subgroups using concurrent evaluations of global (Perceived Stress Scale) and cancer-specific (Impact of Events Scale–Revised) stress, lifetime stress exposure (Life Stressor Checklist–Revised), and resilience (Connor-Davidson Resilience Scale-10). Results: Three latent classes were identified: “Normative” (54.3%; intermediate global stress and resilience, lower cancer-related stress, lowest life stress); “Stressed” (39.9%; highest global and cancer-specific stress scores, lowest resilience, most life stress); and “Resilient” (5.7%; lowest global stress, cancer-specific stress comparable to Normative class, highest resilience, intermediate life stress). Characteristics that distinguished the Stressed from the Normative class included the following: younger age, female gender, lower socioeconomic status, unmarried/partnered, living alone, poorer functional status, and higher comorbidity burden. Compared to Stressed patients, Resilient patients were more likely to be partnered, to not live alone, and had a higher functional status. No demographic or clinical characteristics differentiated Normative from Resilient patients. Exposure to specific life stressors differed significantly among the classes. Conclusion: A subset of patients warrants intensive psychosocial intervention to reduce stress and improve adaptation to cancer. Intervention efforts may be informed by further study of Resilient patients.

Gastrointestinal symptoms are associated with trajectories of chemotherapy-induced nausea

Singh, K., Kober, K. M., Paul, S. M., Hammer, M., Wright, F., Conley, Y. P., Levine, J. D., & Miaskowski, C. (2020). Supportive Care in Cancer, 28(5), 2205-2215. 10.1007/s00520-019-05031-5
Abstract
Purpose: Between 19 and 58% of oncology patients experience chemotherapy-induced nausea (CIN). In a sample of outpatients with breast, gastrointestinal (GI), gynecological, and lung cancer, the study purposes were to evaluate for inter-individual differences in the severity of CIN over two cycles of chemotherapy (CTX) and to determine which demographic and clinical characteristics and GI symptoms were associated with higher initial levels as well as with the trajectories of CIN severity. Methods: Patients completed study questionnaires at six time points over two cycles of CTX. These questionnaires provided information on demographic and clinical characteristics, as well as the occurrence of twelve GI symptoms. Hierarchical linear modeling based on full maximum likelihood estimation was performed. Results: Of the 1251 patients, 47.2% reported CIN. Across two cycles of CTX, lower functional status scores and higher levels of comorbidity were associated with higher initial levels of CIN. Younger age and emetogenicity of the CTX regimen were associated with higher initial levels as well as worse trajectories of CIN. The occurrence of five GI symptoms (i.e., vomiting, lack of appetite, constipation, feeling bloated, and difficulty swallowing) was associated with higher initial levels of CIN. The occurrence of mouth sores was associated with higher initial levels as well as with worst trajectories of CIN. Conclusions: This study is the first to identify distinct demographic, clinical, and GI symptom characteristics associated with CIN severity. These findings suggest that the etiology of CIN is complex and may warrant interventions beyond standard antiemetics.

Higher levels of stress and different coping strategies are associated with greater morning and evening fatigue severity in oncology patients receiving chemotherapy

Wright, F., Kober, K. M., Cooper, B. A., Paul, S. M., Conley, Y. P., Hammer, M., Levine, J. D., & Miaskowski, C. (2020). Supportive Care in Cancer. 10.1007/s00520-020-05303-5
Abstract
Purpose: A cancer diagnosis and associated treatments are stressful experiences for most patients. Patients’ perceptions of stress and their use of coping strategies may influence fatigue severity. This study extends our previous work describing distinct profiles of morning (i.e., Very Low, Low, High, and Very High) and evening (i.e., Low, Moderate, High, and Very High) fatigue in oncology patients by evaluating for differences in stress and coping strategies among these fatigue classes. Methods: This longitudinal study evaluated for changes in morning and evening fatigue in oncology patients (n = 1332) over two cycles of chemotherapy (CTX). Patients completed measures of cumulative exposure to stressful life events (SLEs) (i.e., the Life Stressor Checklist-Revised), general stress (i.e., Perceived Stress Scale [PSS]), cancer-specific stress (i.e., Impact of Event Scale-Revised [IES-R]), and coping strategies (i.e., Brief Cope). Differences among the latent classes were evaluated using analyses of variance, Kruskal-Wallis, or chi-square tests. Results: Patients in both the Very High morning and evening fatigue classes reported higher numbers of and a higher impact from previous SLEs and higher PSS scores than the other fatigue classes. The IES-R scores for the Very High morning fatigue class met the criterion for subsyndromal PTSD. Patients in the Very High evening fatigue class used a higher number of engagement coping strategies compared with the Very High morning fatigue class. Conclusions: Our findings suggest that interventions to reduce stress and enhance coping warrant investigation to decrease fatigue in patients undergoing CTX.

Neuropsychological Symptoms and Intrusive Thoughts Are Associated With Worse Trajectories of Chemotherapy-Induced Nausea

Singh, K., Paul, S. M., Kober, K. M., Conley, Y. P., Wright, F., Levine, J. D., Joseph, P. V., & Miaskowski, C. (2020). Journal of Pain and Symptom Management, 59(3), 668-678. 10.1016/j.jpainsymman.2019.10.023
Abstract
Context: Although chemotherapy-induced vomiting is well controlled with evidence-based antiemetic regimens, chemotherapy-induced nausea (CIN) remains a significant clinical problem. Objectives: Study purposes, in a sample of outpatients with breast, gastrointestinal, gynecological, or lung cancer who received two cycles of chemotherapy (CTX, n = 1251), were to evaluate for interindividual differences in the severity of CIN and to determine which demographic, clinical, symptom, and stress characteristics are associated with higher initial levels as well as with the trajectories of CIN. Methods: Patients were recruited during their first or second cycle of CTX. Patients completed self-report questionnaires a total of six times over two cycles of CTX. Hierarchical linear modeling was used to evaluate for interindividual differences in and characteristics associated with the severity of CIN. Results: Across the two cycles of CTX, higher levels of sleep disturbance, depression, and morning fatigue, as well as higher levels of intrusive thoughts, were associated with higher initial levels of CIN. In addition, lower functional status scores and shorter cycle lengths were associated with higher initial levels of CIN, and younger age and higher emetogenicity of the CTX regimen were associated with both higher initial levels as well as worse trajectories of CIN severity. Conclusion: These findings suggest that common symptoms associated with cancer and its treatment are associated with increased severity of CIN. Targeted interventions for these symptoms may reduce the burden of unrelieved CIN.

Identification of subgroups of chemotherapy patients with distinct sleep disturbance profiles and associated co-occurring symptoms

Tejada, M., Viele, C., Kober, K. M., Cooper, B. A., Paul, S. M., Dunn, L. B., Hammer, M. J., Wright, F., Conley, Y. P., Levine, J. D., & Miaskowski, C. (2019). Sleep, 42(10). 10.1093/sleep/zsz151
Abstract
Study Objectives: Purposes of this study were to identify subgroups of patients with distinct sleep disturbance profiles and to evaluate for differences in demographic, clinical, and various sleep characteristics, as well for differences in the severity of co-occurring symptoms among these subgroups. Methods: Outpatients with breast, gynecological, gastrointestinal, or lung cancer (n = 1331) completed questionnaires six times over two chemotherapy cycles. Selfreported sleep disturbance was evaluated using the General Sleep Disturbance Scale (GSDS). Latent profile analysis was used to identify distinct subgroups. Results: Three latent classes with distinct sleep disturbance profiles were identified (Low [25.5%], High [50.8%], Very High [24.0%]) across the six assessments. Approximately 75% of the patients had a mean total GSDS score that was above the clinically meaningful cutoff score of at least 43 across all six assessments. Compared to the Low class, patients in High and Very High classes were significantly younger, had a lower functional status, had higher levels of comorbidity, and were more likely to be female, more likely to have childcare responsibilities, less likely to be employed, and less likely to have gastrointestinal cancer. For all of the GSDS subscale and total scores, significant differences among the latent classes followed the expected pattern (Low < High < Very High). For trait and state anxiety, depressive symptoms, morning and evening fatigue, decrements in attentional function, and decrements in morning and evening energy, significant differences among the latent classes followed the expected pattern (Low < High < Very High). Conclusions: Clinicians need to perform in-depth assessments of sleep disturbance and co-occurring symptoms to identify high-risk patients and recommend appropriate interventions.

Implementation of Enhanced Recovery After Surgery in a Community Hospital: An Evidence-Based Approach

Persico, M., Miller, D., Way, C., Williamson, M., O’Keefe, K., Strnatko, D., & Wright, F. (2019). Journal of Perianesthesia Nursing, 34(1), 188-197. 10.1016/j.jopan.2018.02.005
Abstract
Purpose: Enhanced recovery after surgery (ERAS) is an evidence-based practice protocol that has been shown to reduce cost, decrease length of stay (LOS), and improve surgical outcomes. Design: An evidence-based practice improvement project with a multidisciplinary team translated the ERAS protocol into practice at a community hospital. The evidence-based practice improvement design allows integration of evidence into projects to improve clinical outcomes for patients. Methods: Small tests of change using the Plan-Act-Study-Do methodology were used to evaluate the process of implementing one surgical service at a time to ensure effective outcomes. After the process was determined to be effective, patient outcomes (eg, LOS) were measured. Findings: On average, LOS was decreased from 3.2 to 1.7 days. Surgical readmission rate decreased from 3% to 1%. There has been positive feedback and nursing workload has decreased with consistent processes. Conclusions: The ERAS order set continues to be modified based on the evidence and feedback from anesthesia and registered nurses. Monthly reports ensure consistency.

Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement

Spano-Szekely, L., Winkler, A., Waters, C., Dealmeida, S., Brandt, K., Williamson, M., Blum, C., Gasper, L., & Wright, F. (2019). Journal of Nursing Care Quality, 34(2), 127-132. 10.1097/NCQ.0000000000000344
Abstract
Background: A 245-bed community hospital established patient fall prevention as its patient safety priority. Problem: The hospital's fall prevention program was not consistently effective. The baseline fall rate was 3.21, higher than the National Database of Nursing Quality Indicators' median of 2.91. Approach: An interprofessional fall prevention team evaluated the hospital's fall program using the evidence-based practice improvement model. A clinical practice guideline with 7 key practices guided the development of an individualized fall prevention program with interventions to address 4 fall risk categories and an algorithm to identify interventions. Interventions included nurse-driven mobility assessment, purposeful hourly rounding, and video monitoring for confused and impulsive fall-risk patients. Outcomes: The fall rate decreased to 1.14, with a 72% expense reduction based on decreased sitter usage. Conclusions: An interprofessional team successfully reduced falls with an evidence-based fall prevention program.

Morning Fatigue Severity Profiles in Oncology Outpatients Receiving Chemotherapy

Wright, F., Dunn, L. B., Paul, S. M., Conley, Y. P., Levine, J. D., Hammer, M. J., Cooper, B. A., Miaskowski, C., & Kober, K. M. (2019). Cancer Nursing, 42(5), 355-364. 10.1097/NCC.0000000000000626
Abstract
Background Morning fatigue is a distinct symptom experienced during chemotherapy that demonstrates significant interindividual variability. Objectives The aims of this study were to identify subgroups with distinct morning fatigue profiles and evaluate how these subgroups differed by demographic, clinical, and symptom characteristics. Methods Outpatients (N = 1332) with breast, gastrointestinal, gynecological, or lung cancer completed questionnaires 6 times over 2 cycles of chemotherapy. Morning fatigue was assessed with the Lee Fatigue Scale. Latent profile analysis was used to identify distinct morning fatigue profiles. Results Four morning fatigue profiles (ie, very low, low, high, and very high) were identified. In the high and very high classes, all 6 morning fatigue scores were higher than the clinical cutoff score. Compared with those in the very low and low classes, patients in the very high class were younger and not married/partnered; lived alone; had higher incomes, higher comorbidity, and higher body mass index; and did not exercise regularly. Across the 4 classes, functional status and attentional function scores decreased and anxiety, depression, sleep disturbance, morning fatigue, and evening fatigue scores increased across the 2 cycles. Conclusion Results provide insights into modifiable risk factors for morning fatigue. These risk factors can be used to develop more targeted interventions. Implications for Practice Patients in the high and very high morning fatigue classes experienced high symptom and comorbidity burdens and significant decrements in functional status. Using this information, clinicians can identify patients who are at an increased risk for higher levels of morning fatigue and prescribe interventions to improve this devastating symptom.