Fay Wright

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

Fay Wright's additional information

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.

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

Acute care
Chronic disease

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

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)
Distinguished PhD Student, NYU Rory Meyers College of Nursing (2015)
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)
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

Distinct profiles of multiple co-occurring symptoms in patients with gastrointestinal cancers receiving chemotherapy

Lin, Y., Bailey, D. E., Docherty, S. L., Porter, L. S., Cooper, B. A., Paul, S. M., Kober, K. M., Hammer, M. J., Wright, F., Dunn, L. B., Conley, Y. P., Levine, J. D., & Miaskowski, C. (2021). Supportive Care in Cancer. 10.1007/s00520-020-05946-4
Abstract
Abstract
Purpose: Identify subgroups of gastrointestinal (GI) cancer patients with distinct multiple co-occurring symptom profiles and evaluate for differences among these subgroups in demographic and clinical characteristics and quality of life (QOL) outcomes. Methods: Patients with GI cancers (n = 399) completed the Memorial Symptom Assessment Scale (MSAS) that was used to assess for multiple co-occurring symptoms. Latent class analysis (LCA) was used to identify subgroups of patients with distinct symptom profiles using symptom occurrence ratings. Differences in demographic and clinical characteristics and QOL outcomes among the subgroups were evaluated using parametric and nonparametric tests. Results: All Low (36.6%), Moderate (49.4%), and All High (14.0%) classes were identified. Compared to the All Low class, patients in the other two classes were significantly younger and were more likely to report depression and back pain. Compared to the other two classes, patients in the All High class had fewer years of education and a higher number of comorbidities. Significant differences were found among the three classes for comorbidity burden and total number of MSAS symptoms (i.e., All Low < Moderate < All High), as well as for performance status (i.e., All Low > Moderate > All High). A higher symptom burden was associated with poorer QOL outcomes. Conclusions: The first study to identify subgroups of patients with GI cancers based on distinct symptom profiles. LCA allowed for the identification of risk factors associated with a higher symptom burden. Clinicians can use this information to identify high-risk patients and develop personalized symptom management interventions.

Higher Levels of Stress Are Associated With a Significant Symptom Burden in Oncology Outpatients Receiving Chemotherapy

Jakovljevic, K., Kober, K. M., Block, A., Cooper, B. A., Paul, S. M., Hammer, M. J., Cartwright, F., Conley, Y. P., Wright, F., Dunn, L. B., Levine, J. D., & Miaskowski, C. (2021). Journal of Pain and Symptom Management, 61(1), 24-31.e4. 10.1016/j.jpainsymman.2020.07.019
Abstract
Abstract
Context: A cancer diagnosis and associated treatments, as well as the uncertainty of the disease course, are stressful experiences for most patients. However, little information is available on the relationship between stress and symptom burden. Objectives: The study purpose was to evaluate for differences in the severity of fatigue, lack of energy, sleep disturbance, and cognitive function, among three groups of patients with distinct stress profiles. Methods: Patients receiving chemotherapy (n = 957) completed measures of general, cancer-specific, and cumulative life stress and symptom inventories. Latent profile analysis was used to identify subgroups of patients with distinct stress profiles. Results: Three distinct subgroups of patients were identified (i.e., stressed [39.3%], normative [54.3%], resilient [5.7%]). For cognitive function, significant differences were found among the latent classes (stressed < normative < resilient). For both sleep disturbance and morning and evening fatigue, compared to the normative and resilient classes, the stressed class reported higher severity scores. Compared to the normative and resilient classes, the stressed class reported low levels of morning energy. Compared to the normative class, the stressed class reported lower levels of evening energy. Conclusions: Consistent with our a priori hypothesis, patients in the stressed class had the highest symptom severity scores for all four symptoms and all these scores were above the clinically meaningful cutoffs for the various instruments.

A Microbial Relationship Between Irritable Bowel Syndrome and Depressive Symptoms

Perez, N. B., Wright, F., & Vorderstrasse, A. (2021). Biological Research for Nursing, 23(1), 50-64. 10.1177/1099800420940787
Abstract
Abstract
Irritable bowel syndrome (IBS) is associated with depressive symptoms, but this relationship is poorly understood. Emerging research suggests that gut microbes are associated with symptoms in persons with IBS. The purpose of this integrative review is to describe the state of the science of the microbial relationship between IBS and depressive symptoms. PubMed, CINAHL, PsychINFO, and Web of Science were searched using “irritable bowel syndrome,” “microbiome,” “depression,” and related terms. Included articles were published in peer reviewed journals in English from 2009 to 2018. Studies on inflammatory bowel conditions, extra-intestinal microbiomes, or animal models were excluded. Fourteen quantitative studies met inclusion criteria, were critically appraised, and were analyzed using the Whittemore and Knafl method. Analysis revealed a consistently lower microbial biodiversity and lower proportions of Bifidobacterium and Lactobacillus in persons with IBS and co-occurring depressive symptoms. Inclusion of participants with moderate or greater depressive symptoms scores distinguished the studies which reported microbe differences in depressive symptoms. The results of this integrative review underscore the need for studies with larger samples and inclusion of a larger range of depressive symptoms guided by an overarching conceptual framework, such as the biopsychosocial ecology framework. This effort needs to be combined with longitudinal designs in order to identify related microbial markers.

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
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, 29(6), 1060-1067. 10.1002/pon.5377
Abstract
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 diarrhea profiles during outpatient chemotherapy

Diaz, R., Kober, K. M., Viele, C., Cooper, B. A., Paul, S. M., Hammer, M., Wright, F., Conley, Y. P., Levine, J. D., & Miaskowski, C. (2021). Supportive Care in Cancer, 29(5), 2363-2373. 10.1007/s00520-020-05753-x
Abstract
Abstract
Purpose: Chemotherapy-induced diarrhea (CID) is a common symptom that occurs in 50 to 80% of patients. Given that the majority of the data on the occurrence and severity of CID is based on physician-rated toxicity criteria, this study’s purposes were to identify subgroups of patients with distinct CID profiles and determine how these subgroups differ in terms of demographic and clinical characteristics; severity, frequency, and distress of CID; the co-occurrence of common GI symptoms; and QOL. Methods: Patients (n = 1133) completed the Memorial Symptom Assessment Scale six times over two cycles of chemotherapy. Latent profile analysis was used to identify subgroups of patients with distinct diarrhea profiles. Differences among these subgroups were evaluated using parametric and nonparametric statistics. Results: Four distinct diarrhea profiles were identified: none (58.3%), decreasing (22.0%), increasing (5.2%), and high (14.5%). Compared with the none class, patients in the high class had a lower functional status, a worse comorbidity profile, were more likely to have gastrointestinal cancer, and were more likely to receive chemotherapy on a 14-day cycle. No differences were found among the classes in the percentages of patients who received chemotherapy with a targeted therapy. Conclusion: Given that CID occurred in over 40% of the patients, clinicians should assess for this symptom and other common GI symptoms and initiate appropriate pharmacologic and dietary interventions.

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
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.

Fatigue, Stress, and Functional Status are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy

Joseph, P. V., Nolden, A., Kober, K. M., Paul, S. M., Cooper, B. A., Conley, Y. P., Hammer, M. J., Wright, F., Levine, J. D., & Miaskowski, C. (2020). Journal of Pain and Symptom Management. 10.1016/j.jpainsymman.2020.11.029
Abstract
Abstract
Context: A common complaint among oncology patients receiving chemotherapy is altered taste perception. Objective: The purpose of this study was to evaluate for differences in common symptoms and stress levels in patients who reported taste changes. Methods: Patients were receiving chemotherapy for breast, gastrointestinal, gynecological, or lung cancer. Change in the way food tastes (CFT) was assessed using the Memorial Symptom Assessment Scale before the patients’ second or third cycle of chemotherapy. Valid and reliable instruments were used to assess for depressive symptoms, state and trait of anxiety, cognitive impairment, diurnal variations in fatigue and energy, sleep disturbance, and pain. Stress was assessed using the Perceived Stress Scale and the Impact of Events Scale-Revised. Multiple logistic regression was used to evaluate for risk factors associated with CFT. Results: Of the 1329 patients, 49.4% reported CFT. Patients in the CFT group reported higher levels of depression, anxiety, fatigue, and sleep disturbance as well as higher levels of general and disease specific stress. Factors associated with CFT group included being non-White; receiving an antiemetic regimen that contained a neurokinin-1 receptor antagonist with two other antiemetics; having a lower functional status; higher levels of morning fatigue; and reporting higher scores on the hyperarousal subscale of the Impact of Event Scale-Revised. Conclusions: This study provides new evidence on associations between taste changes and common co-occurring symptoms and stress in oncology patients receiving chemotherapy. Clinicians need to evaluate for taste changes in these patients because this symptom can effect patients’ nutritional intake and quality of life.

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
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, 28(10), 4697-4706. 10.1007/s00520-020-05303-5
Abstract
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.