John Merriman

Faculty

John Merriman Headshot

John Merriman

PhD RN

Assistant Professor

1 212 998 5375
Accepting PhD students

John Merriman's additional information

John Merriman, PhD, RN, AOCNS is an assistant professor at NYU Meyers College of Nursing. He is interested in changes to cognitive function after a diagnosis of cancer and in biobehavioral correlates, particularly genomic markers and co-occurring symptoms. His program of research incorporates several phenotyping approaches to assess changes in cognitive function, including functional and structural neuroimaging, neuropsychological testing, and patient-reported outcomes.

Prof. Merriman’s study, funded by a K99/R00 award from the National Institute of Nursing Research (NR015473), uses these methods to examine the preliminary efficacy of Mindfulness-Based Stress Reduction versus a health enhancement program to improve cognitive function in postmenopausal women receiving aromatase inhibitor therapy for breast cancer. 

Prior to joining the faculty at NYU, he completed postdoctoral training at the University of Pittsburgh School of Nursing. He completed his PhD and MS in nursing at the University of California, San Francisco School of Nursing.

PhD, Nursing - University of California San Francisco
MS, Nursing - University of California San Francisco
BS, Communication - Mississippi College

Chronic disease
Complementary/integrative health

American Nurses Association
Eastern Nursing Research Society
International Society of Nurses in Genetics
Oncology Nursing Society
Sigma Theta Tau International

Faculty Honors Awards

Postdoctoral Alumni Award, University of Pittsburgh Postdoctoral Association (2016)
International inductee, Sigma Theta Tau (2006)

Publications

Exploration of Relationships Between Symptoms, Work Characteristics, and Quality of Life in Young Adult Hematologic Cancer Survivors

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"now Everybody Is Thinking about Things Like That." Young Adult Cancer Survivors Reimagining Work during the COVID-19 Pandemic

Ghazal, L. V., Santacroce, S. J., Merriman, J. D., & Dickson, V. V. (2022). Nursing Research, 71(2), 153-157. 10.1097/NNR.0000000000000567
Abstract
Abstract
Background Diagnosed between ages 20 and 39 years, young adult (YA) cancer survivors have faced disruption to their lives well before the COVID-19 pandemic. Often seen as an at-risk population within cancer survivors, YAs experience the demands of a serious illness, such as cancer, alongside meeting the typical milestones of young adulthood and often have worse quality of life than their noncancer peers. There is a need to further study the effect of the COVID-19 pandemic on specific populations, including YA cancer survivors (YACS), as it relates to work. Objectives The aim of this study was to explore working YACS' experiences during the COVID-19 pandemic and identify facets of cancer survivorship that researchers can use to explore COVID-19 survivorship further. Methods Secondary thematic analysis of 40 semistructured, qualitative interviews conducted through Zoom audio during the COVID-19 pandemic. YA hematologic cancer survivors were recruited through social media; they were eligible if they had completed active therapy, were within 5 years of their diagnosis, and working at the time of diagnosis. Interviews were transcribed verbatim and subjected to thematic content analysis. Results Themes surrounded COVID-19's influence on working YACS' experiences, with the overarching theme: "From solo to shared experience: A change in awareness and understanding."A subtheme was "Lesson reaffirmed: Reimagining the work environment."Discussion The consequences of COVID-19 on the overall quality of life for YACS are multilevel. Establishing the evidence for effective interventions to support YACS in the workplace, whether physical or virtual, is critically needed. Research is needed on YACS' risk and resilience factors that could ultimately impact future health and quality of life.

Financial Toxicity in Adolescents and Young Adults With Cancer: A Concept Analysis

Ghazal, L. V., Gormley, M., Merriman, J. D., & Santacroce, S. J. (2021). Cancer Nursing, 44(6), E636-E651. 10.1097/NCC.0000000000000972
Abstract
Abstract
BACKGROUND: A cancer diagnosis as an adolescent and young adult (AYA) poses exceptional challenges, including potential greater financial toxicity than older survivors experience who have had more time for career establishment and to build financial assets. Costs to patients have increased more than the past decade; prospects for AYA long-term survival have also increased. A better understanding of what financial toxicity is, how it presents, and the immediate and longer-term implications for AYAs is needed. OBJECTIVE: The aim of this study was to analyze the concept financial toxicity in AYAs diagnosed with cancer. METHODS: We used Rodgers' evolutionary method and articles published between January 2013 and December 2020. RESULTS: We identified key antecedents, attributes, and consequences of financial toxicity in AYAs and review its related terms that have often been used as surrogate terms. Attributes were financial burden, financial distress, and competing financial pressures. Consequences were mostly adverse and persistent and included engaging in various financial problem-solving behaviors, material hardship and poor financial well-being, and deteriorated quality of life. CONCLUSIONS: Results of this analysis clarify financial toxicity and provide guidance for a conceptual framework in the context of AYA cancer survivorship. Its consequences in AYAs with cancer are profound and will continue to evolve over time with changes in health systems and the economy. IMPLICATIONS FOR PRACTICE: Oncology nurses should understand the attributes and consequences of financial toxicity for AYAs throughout the cancer trajectory. Future research on financial toxicity should extend across AYAs living with other chronic illnesses and cancer survivors in other age groups.

An integrative review: Women’s psychosocial vulnerability in relation to paid work after a breast cancer diagnosis

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Latent Class Analysis of Symptom Burden Among Seriously Ill Adults at the End of Life

Murali, K. P., Yu, G., Merriman, J. D., Vorderstrasse, A., Kelley, A. S., & Brody, A. A. (2021). Nursing Research, 70(6), 443-454. 10.1097/NNR.0000000000000549
Abstract
Abstract
BACKGROUND: Serious illness is characterized by high symptom burden that negatively affects quality of life (QOL). Although palliative care research has highlighted symptom burden in seriously ill adults with cancer, symptom burden among those with noncancer serious illness and multiple chronic conditions has been understudied. Latent class analysis is a statistical method that can be used to better understand the relationship between severity of symptom burden and covariates, such as the presence of multiple chronic conditions. Although latent class analysis has been used to highlight subgroups of seriously ill adults with cancer based on symptom clusters, none have incorporated multiple chronic conditions. OBJECTIVES: The objectives of this study were to (a) describe the demographic and baseline characteristics of seriously ill adults at the end of life in a palliative care cohort, (b) identify latent subgroups of seriously ill individuals based on severity of symptom burden, and (c) examine variables associated with latent subgroup membership, such as QOL, functional status, and the presence of multiple chronic conditions. METHODS: A secondary data analysis of a palliative care clinical trial was conducted. The latent class analysis was based on the Edmonton Symptom Assessment System, which measures nine symptoms on a scale of 0-10 (e.g., pain, fatigue, nausea, depression, anxiousness, drowsiness, appetite, well-being, and shortness of breath). Clinically significant cut-points for symptom severity were used to categorize each symptom item in addition to a categorized total score. RESULTS: Three latent subgroups were identified (e.g., low, moderate, and high symptom burden). Lower overall QOL was associated with membership in the moderate and high symptom burden subgroups. Multiple chronic conditions were associated with statistically significant membership in the high symptom burden latent subgroup. Older adults between 65 and 74 years had a lower likelihood of moderate or high symptom burden subgroup membership compared to the low symptom burden class. DISCUSSION: Lower QOL was associated with high symptom burden. Multiple chronic conditions were associated with high symptom burden, which underlines the clinical complexity of serious illness. Palliative care at the end of life for seriously ill adults with high symptom burden must account for the presence of multiple chronic conditions.

Limb Volume Changes and Activities of Daily Living: A Prospective Study

Park, J. H., Merriman, J., Brody, A., Fletcher, J., Yu, G., Ko, E., Yancey, A., & Fu, M. R. (2021). Lymphatic Research and Biology, 19(3), 261-268. 10.1089/lrb.2020.0077
Abstract
Abstract
Background: Breast cancer-related lymphedema (BCRL) limits the movements of patients' limbs, which leads to a diminished ability to achieve essential activities of daily living (ADLs). The purpose of this study was to examine the associations between limb volume changes from the baseline before breast cancer surgery and self-reported difficulty in performing ADLs at 12 months following cancer surgery. We hypothesized that a positive association existed between limb volume changes from the baseline and self-reported difficulty in performing ADLs at 12 months following breast cancer surgery. Methods and Results: The data of the present study were part of a larger study with 140 breast cancer patients recruited before breast cancer surgery and followed up during their first year of treatment. Patients with more than 10% limb volume increase reported more frequent distress in performing 13 ADL items, compared with patients whose limb volume increased by 5%-10%. Regression analysis showed a significant increase in the odds ratio of reporting difficulty in ADLs compared with the group with less than 5% limb volume increase. Conclusion: Overall, patients with a greater limb volume increase underwent more difficulty performing ADLs. Patients reported more difficulty in performing ADLs even with 5%-10% limb volume increase. Currently, there is no standardized guideline to diagnose BCRL, although previous evidence suggests a limb volume increase greater than 10% as a criterion for BCRL. The findings from the present study suggest a more precise and clinically meaningful criteria for diagnosing BCRL to accommodate those with 5%-10% increase in limb volume.

Multiple Chronic Conditions among Seriously Ill Adults Receiving Palliative Care

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Survivors’ Dilemma: Young Adult Cancer Survivors’ Perspectives of Work-Related Goals

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An Adapted Conceptual Model Integrating Palliative Care in Serious Illness and Multiple Chronic Conditions

Murali, K. P., Merriman, J. D., Yu, G., Vorderstrasse, A., Kelley, A., & Brody, A. A. (2020). American Journal of Hospice and Palliative Medicine, 37(12), 1086-1095. 10.1177/1049909120928353
Abstract
Abstract
Objective: Seriously ill adults with multiple chronic conditions (MCC) who receive palliative care may benefit from improved symptom burden, health care utilization and cost, caregiver stress, and quality of life. To guide research involving serious illness and MCC, palliative care can be integrated into a conceptual model to develop future research studies to improve care strategies and outcomes in this population. Methods: The adapted conceptual model was developed based on a thorough review of the literature, in which current evidence and conceptual models related to serious illness, MCC, and palliative care were appraised. Factors contributing to patients’ needs, services received, and service-related variables were identified. Relevant patient outcomes and evidence gaps are also highlighted. Results: Fifty-eight articles were synthesized to inform the development of an adapted conceptual model including serious illness, MCC, and palliative care. Concepts were organized into 4 main conceptual groups, including Factors Affecting Needs (sociodemographic and social determinants of health), Factors Affecting Services Received (health system; research, evidence base, dissemination, and health policy; community resources), Service-Related Variables (patient visits, service mix, quality of care, patient information, experience), and Outcomes (symptom burden, quality of life, function, advance care planning, goal-concordant care, utilization, cost, death, site of death, satisfaction). Discussion: The adapted conceptual model integrates palliative care with serious illness and multiple chronic conditions. The model is intended to guide the development of research studies involving seriously ill adults with MCC and aid researchers in addressing relevant evidence gaps.

Exploratory Study of Associations Between DNA Repair and Oxidative Stress Gene Polymorphisms and Cognitive Problems Reported by Postmenopausal Women With and Without Breast Cancer

Merriman, J. D., Sereika, S. M., Conley, Y. P., Koleck, T. A., Zhu, Y., Phillips, M. L., Bertocci, M. A., Brufsky, A. M., & Bender, C. M. (2019). Biological Research for Nursing, 21(1), 50-60. 10.1177/1099800418799964
Abstract
Abstract
Purpose: Women with breast cancer report varying frequencies of cognitive problems during adjuvant systemic therapy. This variability suggests latent subgroups. Therefore, we identified latent subgroups of self-reported cognitive problems among postmenopausal women with and without breast cancer. We explored associations between membership in these subgroups and (a) demographic, clinical, and symptom characteristics and (b) variations in candidate gene polymorphisms. Methods: We evaluated frequency of cognitive problems using the Patient Assessment of Own Functioning Inventory. Growth mixture modeling identified latent subgroups over 18 months of adjuvant systemic therapy and at matched time points for women without cancer (N = 331). We evaluated for differences among subgroups in demographic, clinical, and symptom characteristics and in 41 single nucleotide polymorphisms in 10 candidate genes involved in DNA repair and oxidative stress pathways (n = 199). We modeled associations between genotypes and subgroup membership using multinomial logistic regression. Results: We identified three latent subgroups: more frequent, persistent, and almost never. Receipt of chemotherapy plus anastrozole, depressive symptoms, and baseline neuropathic symptoms increased the odds of belonging to the more frequent subgroup. Anxiety and depressive symptoms increased the odds of belonging to the persistent subgroup. With covariates controlled for, carrying the ERCC5 rs873601 G minor allele increased the odds of reporting more frequent cognitive problems. Conclusions: Chemotherapy plus anastrozole, depressive symptoms, and presence of neuropathic symptoms may predict more frequent cognitive problems during systemic therapy that later resolve. Mood dysregulation before therapy may predict persistent cognitive problems during therapy. ERCC5 genotype may influence frequency of cognitive problems after controlling for these risk factors.