Janet H Van Cleave

Faculty

Janet Helen Van Cleave headshot

Janet H Van Cleave

MBA PhD

Assistant Professor

1 212 992 7340

433 First Ave
Room 408
New York, NY 10010
United States

Accepting PhD students

Janet H Van Cleave's additional information

Janet Helen Van Cleave, PhD, is an assistant professor at NYU Rory Meyers College of Nursing. Her program of research is focused on symptom science and mHealth technology use in cancer. She is an oncology nurse and nurse scientist whose career goal is to improve the quality of care for patients with cancer.

Van Cleave developed the Electronic Patient Visit Assessment (ePVA)© for head and neck cancer for early detection and intervention for debilitating symptoms. Her program of research has received both federal and foundation funding. She has published in high-impact scientific journals and online magazines like WIRED.

Among her many awards, she received the Poster of Distinction by the International Federation of Head and Neck Oncologic Societies and the 2014 CANCER NURSING Research Award. She was a fellow of the American Psychosocial Oncology Society Conference in New Orleans, LA.

Van Cleave received her PhD from Yale University and completed post-doctoral training at the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. She earned her MS and BS in nursing from the University of Pennsylvania.

Post-Doctoral Research Fellow - University of Pennsylvania (2010)
PhD - Yale University (2008)
MSN - University of Pennsylvania (1995)
BSN - University of Pennsylvania (Summa Cum Laude, 1994)
Diploma of Nursing - St. Luke’s Hospital School of Nursing (1983)
MBA - University of Kansas (1978)
BA - Kansas State University (1976)

Gerontology

Academy Health
American Psychosocial Oncology Society
Gerontological Society of America
International Association for the Study of Pain
Oncology Nursing Society

Faculty Honors Awards

Mayday Pain & Society Fellowship, The Mayday Fund (2019)
ENRS/Nursing Research Authorship Award, Eastern Nursing Research Society (2017)
Poster of Distinction, International Federation of Head and Neck Oncologic Societies (2014)
Fellowship, American Psychosocial Oncology Society Conference, New Orleans, LA (2010)
Scholarship, 8th National Conference on Cancer Nursing Research, John A. Harford Foundation Policy Leadership Institute Oncology Nursing Society/American Cancer Society (2009)
Outstanding Colleague, Mount Sinai Medical Center (2004)
Best Article, Oncology Nursing Society Special Interest Group Newsletter Editor (2004)
Nominee, Clinical Excellence Award, Mount Sinai Medical Center (2002)
Unit Recognition Award for Special Clinics, Philadelphia Veterans Affairs Medical Center (2000)
Health Professional Scholarship, Department of Veterans Affairs (1994)
Sigma Theta Tau, University of Pennsylvania School of Nursing (1994)
Joan Ethel Huebner Award for High GPA, University of Pennsylvania School of Nursing (1994)

Publications

An integrative review on factors contributing to fear of cancer recurrence among young adult breast cancer survivors

Gormley, M., Ghazal, L., Fu, M. R., Van Cleave, J. H., Knobf, T., & Hammer, M. (2021). Cancer Nursing, 45(1), E10-E26. 10.1097/NCC.0000000000000858
Abstract
Abstract
Background: Fear of cancer recurrence (FCR) is the most prevalent need among breast cancer survivors. Age is the most consistent predictor of higher FCR, with prevalence rates as high as 70% among young adults. Although the association between age and higher FCR is well established, a more comprehensive understanding of the factors contributing to higher FCR among young adult breast cancer survivors is needed. Objective: The purpose of this integrative review was to explore the factors associated with higher FCR among young adult breast cancer survivors (≤ 45 years old). Methods: A literature search was conducted using PubMed, CINAHL, PsycINFO, and EMBASE databases with specific Medical Subject Headings terms delimited to FCR, diagnosis, sex, and age range. The initial search yielded 378 studies, 13 of which met the eligibility criteria. Results: Themes include motherhood status, health behaviors and decision making (eg, surveillance behaviors and surgical decision making), psychological morbidity, and social support. Cognitive behavioral factors include cognitive processing, metacognition, illness intrusiveness, and self-efficacy. Conclusion: Fear of cancer recurrence among young adult breast cancer survivors is a unique construct requiring further exploration and tailored interventions to improve the health-related quality of life for this population. Implications for Practice: Oncology nurses should screen all cancer survivors for FCR, with particular attention to the unique needs of young adults. Future research should address the role of age-appropriate support and increased levels of FCR during surveillance periods.

A Scoping Review of Nursing's Contribution to the Management of Patients with Pain and Opioid Misuse

Van Cleave, J. H., Booker, S. Q., Powell-Roach, K., Liang, E., & Kawi, J. (2021). Pain Management Nursing, 22(1), 58-68. 10.1016/j.pmn.2020.11.007
Abstract
Abstract
Background: Nursing brings a unique lens to care of patients with pain and opioid misuse. Aims: This scoping review describes nursing's contribution to the literature on the management of patients with pain and opioid misuse, generating evidence to guide clinical care. Design: The scoping review was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews guideline. Data Sources: Using combined key terms (“opioid misuse,” “pain,” “nursing”) in systematic searches in PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) electronic databases, snowball technique, and personal knowledge resulted in 108 relevant articles, reports, and websites. Analysis Method: Summative approach to content analysis was used to quantify and describe nursing's contribution to the literature. Results: Contributions of nurses emerged in the areas of research, clinical practice, policy, and education. The highest number of publications addressed research (50%, 54 of 108), whereas the fewest number of publications involved education (7%, 8 of 108). Conclusion: Results provide a picture of the breadth of expertise and crucial leadership that nurses contribute to influence management of patients with pain and opioid misuse. Implications for Nursing: This scoping review indicates the importance of continued support from key stakeholders, including training and interprofessional collaboration opportunities supported by the National Institutes of Health, to sustain nursing's contribution to quality care of patients with pain and opioid misuse. Ultimately, all health care professionals must collaborate to conduct rigorous research and construct evidence-based guidelines to inform policy initiatives and education strategies to solve the complex co-occurring epidemics of pain and opioid misuse.

The usefulness of the Electronic Patient Visit Assessment (ePVA)© as a clinical support tool for real-time interventions in head and neck cancer

Van Cleave, J. H., Fu, M. R., Bennett, A. V., Concert, C., Riccobene, A., Tran, A., Most, A., Kamberi, M., Mojica, J., Savitski, J., Kusche, E., Persky, M. S., Li, Z., Jacobson, A. S., Hu, K. S., Persky, M. J., Liang, E., Corby, P. M., & Egleston, B. L. (2021). MHealth, 7. 10.21037/mhealth-19-250
Abstract
Abstract
Background: Patients with head and neck cancer (HNC) experience painful, debilitating symptoms and functional limitations that can interrupt cancer treatment, and decrease their health-related quality of life (HRQoL). The Electronic Patient Visit Assessment (ePVA) for head and neck is a web-based mHealth patient-reported measure that asks questions about 21 categories of symptoms and functional limitations common to HNC. This article presents the development and usefulness of the ePVA as a clinical support tool for real-time interventions for patient-reported symptoms and functional limitations in HNC. Methods: Between January 2018 and August 2019, 75 participants were enrolled in a clinical usefulness study of the ePVA. Upon signing informed consent, participants completed the ePVA and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) general (C30) questionnaire v3.0 (scores range from 0 to 100 with 100 representing best HRQoL). Clinical usefulness of the ePVA was defined as demonstration of reliability, convergent validity with HRQoL, and acceptability of the ePVA (i.e., >70% of eligible participants complete the ePVA at two or more visits and >70% of ePVA reports are read by providers). Formal focus group discussions with the interdisciplinary team that cared for patients with HNC guided the development of the ePVA as a clinical support tool. Qualitative and quantitative methods were used throughout the study. Descriptive statistics consisting of means and frequencies, Pearson correlation coefficient, and Student’s t-tests were calculated using SAS 9.4 and STATA. Results: The participants were primarily male (71%), White (76%), diagnosed with oropharyngeal or oral cavity cancers (53%), and undergoing treatment for HNC (69%). Data analyses supported the reliability (alpha =0.85), convergent validity with HRQoL scores, and acceptability of the ePVA. Participants with the highest number of symptoms and functional limitations reported significantly worse HRQoL (sum of symptoms: r=–0.50, P<0.0001; sum of function limitations: r=–0.56, P<0.0001). Ninety-two percent of participants (59 of 64) who had follow-up visits within the 6-month study period completed the ePVA at two or more visits and providers read 89% (169 of 189) of automated ePVA reports. The use of the ePVA as a clinical support tool for real-time interventions for symptoms and functional limitations reported by patients is described in a clinical exemplar. Conclusions: This research indicates that the ePVA may be a useful mHealth tool as a clinical support tool for real-time interventions for patient-reported symptoms and functional limitations in HNC. The study findings support future translational research to enhance the usefulness of the ePVA in real world settings for early interventions that decrease symptom burden and improve the QoL of patients with HNC.

Multidimensional Pain Assessment Tools for Ambulatory and Inpatient Nursing Practice

Scher, C., Petti, E., Meador, L., Van Cleave, J. H., Liang, E., & Reid, M. C. (2020). Pain Management Nursing, 21(5), 416-422. 10.1016/j.pmn.2020.03.007
Abstract
Abstract
Background: One of the critical components in pain management is the assessment of pain. Multidimensional measurement tools capture multiple aspects of a patient's pain experience but can be cumbersome to administer in busy clinical settings. Aim: We conducted a systematic review to identify brief multidimensional pain assessment tools that nurses can use in both ambulatory and acute care settings. Methods: We searched PUBMED/MEDLINE, PsychInfo, and CINAHL databases from January 1977 through December 2019. Eligible English-language articles were systematically screened and data were extracted independently by two raters. Main outcomes included the number and types of domains captured by each instrument (e.g., sensory, impact on function, temporal components) and tool characteristics (e.g., administration time, validity) that may affect instrument uptake in practice. Results: Our search identified eight multidimensional assessment tools, all of which measured sensory or affective qualities of pain and its impact on functioning. Most tools measured impact of pain on affective functioning, mood, or enjoyment of life. One tool used ecological momentary assessment via a web-based app to assess pain symptoms. Time to administer the varying tools ranged from less than 2 minutes to 10 minutes, and evidence of validity was reported for seven of the eight tools. Conclusions: Our review identified eight multidimensional pain measurement tools that nurses can use in ambulatory or acute care settings to capture patients’ experience of pain. The most important element in selecting a multidimensional pain measure, though, is that one tool is selected that best fits the practice and is used consistently over time.

The development, usability, and reliability of the Electronic Patient Visit Assessment (ePVA) for head and neck cancer

Van Cleave, J. H., Fu, M. R., Bennett, A. V., Persky, M. S., Li, Z., Jacobson, A., Hu, K. S., Most, A., Concert, C., Kamberi, M., Mojica, J., Peyser, A., Riccobene, A., Tran, A., Persky, M. J., Savitski, J., Liang, E., & Egleston, B. L. (2019). MHealth, 5, 21. 10.21037/mhealth.2019.06.05
Abstract
Abstract
Background: Annually, over 65,000 persons are diagnosed with head and neck cancer in the United States. During treatment, up to 50% of patients become severely symptomatic with pain, fatigue, mouth sores, and inability to eat. Long term complications are lymphedema, fibrosis, dysphagia, and musculoskeletal impairment. Patients' ability to perform daily activities and to interact socially may be impaired, resulting in poor quality of life. A pragmatic, clinically useful assessment is needed to ensure early detection and intervention for patients to report symptoms and functional limitations over time. We developed the Electronic Patient Visit Assessment (ePVA) that enables patients to report 42 symptoms related to head and neck cancer and 17 limitations of functional status. This manuscript reports (I) the development of the ePVA, (II) the content validity of the ePVA, and (III) the usability and reliability of the ePVA.Methods: Usability was evaluated using the "Think Aloud" technique to guide the iterative process to refine the ePVA based on participants' evaluations. After signing the informed consent, 30 participants with head and neck cancer completed the ePVA using digital tablet devices while thinking aloud about ease of use. All patient conversations were recorded and professionally transcribed. Reliability of the ePVA symptom and functional limitation measures was estimated using the Kuder-Richardson test. Convergent validity of the ePVA was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 global QoL/health scale. Transcribed qualitative data were analyzed using directed content analysis approach. Quantitative analyses consisted of descriptive statistics and correlation analyses.Results: Among participants, 90% strongly agreed or agreed that the ePVA system was easy to use and 80% were very satisfied. Only minor usability problems were reported due to formatting and software "bugs". Reporting of usability problems decreased in frequency over the study period and no usability problems were reported by the last 3 participants who completed the ePVA. Based on participants' suggestions during the iterative process, refinement of the ePVA included increased touch sensitivity of the touch screen technology and customized error messages to improve ease of use. The ePVA also recorded patient reported symptoms (mouth symptoms: 93%, fibrosis: 60%, fatigue: 60%). The ePVA demonstrated acceptable reliability (alpha =0.82-0.85) and convergent validity (ePVA total number of reported symptoms and function limitations was negatively correlated with EORTC QLQ-C30 global QOL/health scale: r=-0.55038, P<0.01).Conclusions: The ePVA was rigorously developed, accepted by patients with satisfaction, and demonstrated acceptable reliability and convergent validity. Future research will use data generated by the ePVA to determine the impact of symptom trajectories on functional status, treatment interruptions and terminations, and health resource use in head and neck cancer.

The Effect of Glucose Levels Prior to Hematopoietic Cell Transplantation on Post-Transplant Complications and Health Resource Utilization

Steinberg, A., Van Cleave, J. H., Parikh, A. B., Moshier, E., Ru, M., Marks, D., Montelibano, A., Philpott, A., Garner, K., & Hammer, M. J. (2019). International Journal of Hematology-Oncology and Stem Cell Research, 13(3), 122-131. 10.18502/ijhoscr.v13i3.1270
Abstract
Abstract
Background: Abnormal blood glucose (BG) levels during hematopoietic cell transplantation (HCT) are associated with increased infections, delayed engraftment, and prolonged hospitalization, though little is known about these associations. Materials and Methods: We retrospectively evaluated mean BG levels in the week prior to HCT and subsequent outcomes for 852 HCTs at our hospital from 1/2009 � 12/2013 pertaining to 745 patients. Outcomes included infections (pneumonia, C. difficile, positive cultures, administration of antimicrobials, or neutropenic fever), time-to-engraftment (TTE), and quality indicators (30- and 90-day readmission rates [RR] and median length-of-stay [LOS]). Results: We retrospectively evaluated mean BG levels in the week prior to HCT and subsequent outcomes for 852 HCTs at our hospital from 1/2009 � 12/2013 pertaining to 745 patients. Outcomes included infections (pneumonia, C. difficile, positive cultures, administration of antimicrobials, or neutropenic fever), time-to-engraftment (TTE), and quality indicators (30- and 90-day readmission rates [RR] and median length-of-stay [LOS]). Conclusion: Pre-HCT BG trends may be a prognostic biomarker for adverse outcomes, and thus can help improve quality of care for HCT patients.

The Experience of Being Aware of Disease Status in Women with Recurrent Ovarian Cancer: A Phenomenological Study

Finlayson, C. S., Fu, M. R., Squires, A., Applebaum, A., Van Cleave, J., O’Cearbhaill, R., & Derosa, A. P. (2019). Journal of Palliative Medicine, 22(4), 377-384. 10.1089/jpm.2018.0127
Abstract
Abstract
Background: Awareness of disease status has been identified as a factor in the treatment decision-making process. Women with recurrent ovarian cancer are facing the challenge of making treatment decisions throughout the disease trajectory. It is not understood how women with ovarian cancer perceive their disease and subsequently make treatment decisions. Purpose: The purpose of this phenomenological study was to understand the lived experience of women with recurrent ovarian cancer, how they understood their disease and made their treatment decisions. Methods: A qualitative design with a descriptive phenomenological method was used to conduct 2 in-depth interviews with 12 women (n = 24 interviews). Each interview was ∼60 minutes and was digitally recorded and professionally transcribed. Data collection focused on patients' understanding of their disease and how patients participated in treatment decisions. A modified version of Colaizzi's method of phenomenological reduction guided data analysis. Results: Three themes emerged to describe the phenomenon of being aware of disease status: (1) perceiving recurrent ovarian cancer as a chronic illness, (2) perceived inability to make treatment decisions, and (3) enduring emotional distress. Conclusions and Implications: This study revealed how 12 women conceptualized recurrent ovarian cancer as a chronic disease and their perceived inability to make treatment decisions because of lack of information and professional qualifications, resulting in enduring emotional distress. Future research should replicate the study to confirm the persistence of the themes for racially, ethnically, and religiously diverse patient samples and to improve understanding of awareness of disease status and decision-making processes of patients.

Mental health and substance use disorders in patients diagnosed with cancer: An integrative review of healthcare utilization

Woersching, J., Van Cleave, J. H., Haber, J., & Chyun, D. (2019). Oncology Nursing Forum, 46(3), 365-383. 10.1188/19.ONF.365-383
Abstract
Abstract
PROBLEM IDENTIFICATION: The impact of mental health disorders (MHDs) and substance use disorders (SUDs) on healthcare utilization (HCU) in patients with cancer is an understudied phenomenon. LITERATURE SEARCH: A literature search of studies published prior to January 2018 that examined HCU in patients with preexisting MHDs or SUDs diagnosed with cancer was conducted. DATA EVALUATION: The research team evaluated 22 studies for scientific rigor and examined significant trends in HCU, as well as types of the MHD, SUD, and cancer studied. SYNTHESIS: The heterogeneity of HCU outcome measures, MHD, SUD, sample sizes, and study settings contributed to inconsistent study findings. However, study trends indicated higher rates of HCU by patients with depression and lower rates of HCU by patients with schizophrenia. In addition, the concept of HCU measures is evolving, addressing not only volume of health services, but also quality and efficacy. IMPLICATIONS FOR RESEARCH: Oncology nurses are essential to improving HCU in patients with MHDs and SUDs because of their close connections with patients throughout the stages of cancer care. Additional prospective studies are needed to examine specific MHDs and different types of SUDs beyond alcohol use, improving cancer care and the effectiveness of HCU in this vulnerable population.

Can Multidimensional Pain Assessment Tools Help Improve Pain Outcomes in the Perianesthesia Setting?

Petti, E., Scher, C., Meador, L., Van Cleave, J. H., & Reid, M. C. (2018). Journal of Perianesthesia Nursing, 33(5), 767-772. 10.1016/j.jopan.2018.07.010

Frailty in Older Adults: Assessment, Support, and Treatment Implications in Patients With Cancer

Overcash, J., Cope, D. G., & Van Cleave, J. H. (2018). Clinical Journal of Oncology Nursing, 22(6), 8-18. 10.1188/18.CJON.S2.8-18
Abstract
Abstract
BACKGROUND: Frailty is defined as a disability in those of advanced age, often with comorbidities, poor nutritional status, cognitive decline, and reduced functional status. OBJECTIVES: The purpose of this article is to discuss the concept of frailty, assess the use of a comprehensive geriatric assessment (CGA), and understand the implications for treatment to maintain or enhance physical, functional, and cognitive health of older adult patients with cancer. METHODS: Literature about frailty in older adult patients diagnosed with cancer was reviewed to determine evidence-based assessment and treatment options. FINDINGS: About half of all older adult patients with cancer experience some degree of frailty. CGA is a useful way to evaluate frailty and the extent of limitations. Many frailty-specific tools have been developed. Evidence-based strategies are available to address limitations associated with frailty in older adult patients with cancer.

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