Velda Gonzalez

Faculty

Velda J. González Mercado, Ph.D, MSN, RN

Velda Gonzalez

MSN PhD RN

Assistant Professor

1 212 998 5392

Velda Gonzalez's additional information

Velda J. González-Mercado, Ph.D, MSN, RN, is an assistant professor at NYU Rory Meyers College of Nursing. Her research focuses on symptom science and symptom management, particularly in relation to addressing the needs of the GI/GU cancer population. Her research uses innovative patient-centered phenotyping and “omic” approaches (such as microbiomics, metabolomics, and genomics) to understand the bio-behavioral underpinnings of cancer-related symptoms experienced by GI/GU cancer patients. Her research also examines ethnic differences in cancer-related symptoms, with the goal of developing symptom management interventions to improve treatment outcomes of Latinx and other minority patients receiving cancer therapies.

In her post-doctoral fellowship, González-Mercado received funding for her research from the National Institute of Nursing Research (NINR) (F32NR016618; Dr. Wendy Henderson, PhD, MSN, CRNP, FAAN, consultant) and the American Nurses Foundation, to gather initial evidence of the relationship among chemo-radiation, dysbiosis, and fatigue in the rectal cancer population. Her dissertation,  “Gene Expression and Fatigue in Puerto Rican Men Receiving Radiation Therapy for Prostate Cancer,” was supported and conducted intramurally at the NINR, Division of Intramural Research, under the mentorship of Leorey Saligan, PhD, RN, CRNP, FAAN.

Prior to joining NYU, González-Mercado was a postdoctoral scholar at the University of South Florida College of Nursing. She also worked as a nursing instructor at the University of Puerto Rico-Medical Sciences Campus School of Nursing; a research coordinator at the University of Puerto Rico Cancer Center; and a heart transplant coordinator at the Cardiovascular Center of Puerto Rico and the Caribbean.

González-Mercado completed a PhD at the University of Kansas School of Nursing; an MS in nursing at the University of Florida College of Nursing; and a BS in nursing at the University of Puerto Rico Nursing School of the Medical Sciences Campus.

PhD, Nursing - University of Kansas
MS, Nursing - University of Florida
BS, Nursing - University of Puerto Rico

Chronic disease
Adult health

International Society of Nurses in Genetics
Midwest Nursing Research Society
College of Nursing Professionals of Puerto Rico
Oncology Nursing Society
Sigma Theta Tau International

Faculty Honors Awards

Sousa Award of Excellence, University of Kansas, School of Nursing (2015)
Crighton Award, University of Kansas, School of Nursing (2014)
Ruth O. McKibben Alumni Research Award, University of Kansas, School of Nursing (2014)
Manuel A. Pérez Award, Commonwealth Government of Puerto Rico (2002)
Paulina R. Dávila Award, College of Nursing Professionals of Puerto Rico (2001)
International inductee, Sigma Theta Tau (1992)

Publications

Effectiveness of a Home-Based Exercise Intervention in the Fitness Profile of Hispanic Survivors of Breast Cancer

Ortiz, A., Hughes, D. C., Mama, S. K., Tirado-Gomez, M., Liao, Y., Song, J., Gonzalez, V., & Basen-Engquist, K. (2021). Rehabilitation Oncology, 39(4), 175-183. 10.1097/01.REO.0000000000000253
Abstract
Abstract
Background: Home-based exercise interventions might be a desirable long-term option for breast cancer survivors to enhance compliance and long-term health benefits. Purpose: To assess the effectiveness of a home-based intervention aimed at helping survivors of breast cancer meet the physical activity guidelines of the American College of Sports Medicine. Methods: Eighty-nine women (age: 55.4 ± 10 years; body mass index: 31 ± 6.5 kg/m2) from 2 cancer centers serving Hispanic women participated in this study. Women underwent a baseline assessment of cardiorespiratory fitness, muscle endurance and strength, flexibility, range of motion, and extremity disability. After baseline measures, women were randomized into a control or exercise group. The exercise intervention consisted of a walking program, elastic band strengthening, and flexibility exercises performed at home. The outcome measures were reassessed 16 weeks after baseline measures. Results: The intervention showed a strong effect of time on muscle strength and shoulder range of motion, and time and group for self-reported disability. There were no differences in sedentary behavior, physical fitness, and disability measures across intervention groups, including both exercise groups combined and changes over time between intervention groups. Conclusion: It appears that a home-based intervention affects only upper-body strength and related disability, indicating that other components might need closer monitoring for significant changes to occur across time.

Consortium Building for Nurse Scientists Interested in Symptoms Research in the Era of Precision Health

Hsiao, C. P., Dickinson, K., Gonzalez-Mercado, V., Kelly, D. L., Lukkahatai, N., McCabe, M., Mayo, S., Musanti, R., & Saligan, L. N. (2020). Journal of Nursing Scholarship, 52(2), 183-191. 10.1111/jnu.12534
Abstract
Abstract
Purpose: This article aims to provide perspectives on the establishment of a consortium for nurse scientists with similar career trajectories interested in cancer-related symptoms (CRS) research. Hereby, we describe the development of and recent outcomes from the CRS consortium, the lessons learned in establishing the consortium, and future directions to advance the science of CRS. Model and Methods: New and innovative strategies are needed to address the complexity of CRS research. A CRS consortium was created to allow a mechanism for oncology nurse scientists with varying expertise to collaborate to advance CRS research. The National Institutes of Health (NIH) Symptom Science Model (SSM) guides the research of the CRS Consortium. Discussion and Conclusions: A need for improved CRS assessment and management has been identified. The CRS consortium was created as a collaborative think tank to begin to address this need. Guided by the NIH SSM, CRS consortium members have worked to define symptom phenotypes, enhance understanding of the biologic mechanisms that can contribute to symptom phenotypes, and develop tailored interventions to improve symptom management. Dissemination of the CRS consortium efforts involve publications and presentations. Clinical Implications: Nurse scientists interested in symptom science and biobehavorial research face many challenges on how to initiate and sustain independent programs of research. Through the formation of a CRS consortium, oncology nurse scientists can work together to address identified issues in symptom measurement and management.

Gut microbiota differences in Island Hispanic Puerto Ricans and mainland non-Hispanic whites during chemoradiation for rectal cancer: A pilot study

González-Mercado, V. J., Lim, J., Berk, L., Esele, M., Rodríguez, C. S., & Colón-Otero, G. (2020). Current Problems in Cancer, 44(4). 10.1016/j.currproblcancer.2020.100551
Abstract
Abstract
Purpose: To investigate whether there are differences in diversity, taxonomic composition, and predicted functional pathways of the gut microbiome between Island Hispanic Puerto Ricans (HPR) and mainland non-Hispanic whites (NHW) measured before and at the end of chemo-radiation (CRT) for Rectal Cancer. Methods: Fifty-six stool samples of newly diagnosed rectal cancer patients (25 HPR and 31 NHW) were amplicon-sequenced during chemo-radiotherapy. 16S rRNA gene data was analyzed using QIIME2, phyloseq, and LEfSe. Results: We observed similar within-sample alpha diversity for HPR and NHW participants during CRT. However, at the end of CRT, several taxa were present at significantly different abundances across both groups. Taxa enriched in the gut of HPR compared to NHW included Muribaculaceae, Prevotella 2 and 7, Gemella, Bacillales Family XI, Catenibacterium, Sutterella, Pasteurellales, and Pasteurellaceae genera, whereas over-represented taxa in NHW participants were Turicibacter and Eubacteriaceae. Significant differences in predicted HPR microbiota functions included pathways for synthesis of L-methionine and degradation of phenylethylamine and phenylacetate. Conclusion: In this pilot study, taxonomic analyses and functional predictions of the gut microbiomes suggest greater inflammatory potential in gut microbial functions among HPR rectal cancer patients undergoing CRT compared to that of NHW participants.

Gut microbiota perturbation is associated with acute sleep disturbance among rectal cancer patients

González-Mercado, V. J., Sarkar, A., Penedo, F. J., Pérez-Santiago, J., McMillan, S., Marrero, S. J., Marrero-Falcón, M. A., & Munro, C. L. (2020). Journal of Sleep Research, 29(3). 10.1111/jsr.12915
Abstract
Abstract
Cancer treatment-associated gut microbial perturbation/dysbiosis has been implicated in the pathobiology of sleep disturbance; however, evidence is scarce. Eighteen newly diagnosed rectal cancer patients (ages 52–81 years; 10 males) completed a sleep disturbance questionnaire and provided stool samples for 16s RNA gene sequencing during chemo-radiotherapy. Descriptive statistics, Wilcoxon test and regression analyses were computed. Regression analyses showed the Shannon's diversity index to be a significant factor associated with sleep disturbance. This preliminary work suggests that the biological “gut–brain axis” mechanism may be associated with symptoms of sleep disturbance.

Exploring the relationship between diarrhea and fatigue that can occur during cancer treatment: Using structural equation modeling

Gonzalez, V. J., Beckstead, J., Groer, M., McMillan, S., Ortiz, D., Marrero, S., & Saligan, L. N. (2019). Puerto Rico Health Sciences Journal, 38(2), 81-86.
Abstract
Abstract
Objective: To examine the relationship of the symptoms of diarrhea and fatigue by testing a model that included multiple dimensions of the cancer-related-symptom experience. Methods: A secondary data analysis was conducted on data from the self-reports of 102 cancer patients co-experiencing diarrhea and fatigue during treatment at a comprehensive cancer center in the Southeastern United States. Structural equational modeling was employed to examine the relationship between the 2variables. Fatigue and diarrhea were assessed using items from the Cancer Symptom Scale. Results: The structural model results showed that (a) the model fit was adequate (b) diarrhea explained 7% of the variance in fatigue, and (c) the structural or path coefficient between diarrhea and fatigue was significant (0.267; p<0.05). Diarrhea had the strongest effect on fatigue interference (0.251). Conclusion: Diarrhea is a potential contributing factor to the symptom of fatigue and a potential target for interventions to prevent and ameliorate fatigue.

Differences in fatigue severity in a sample of adult cancer patients

Gonzalez, V. J., Tofthagen, C. S., Chen, X., Pedro, E., & Saligan, L. N. (2018). Journal of Clinical Nursing, 27(17), 3345-3354. 10.1111/jocn.13840
Abstract
Abstract
Aims and objectives: To describe differences in fatigue severity in a sample of adult Puerto Rican patients during and postcancer treatments. Background: Hispanics, including Puerto Ricans, are an understudied population who are under-represented in clinical trials, especially in symptom research. Although symptom management is a clinical priority in oncology care, treatment-related differences in Puerto Rican cancer patients’ report of fatigue severity have not been well described. Design/Methods: A cross-sectional survey was conducted from data of self-report of 138 Puerto Rican patients during and postcancer treatments at two ambulatory facilities located in San Juan, Puerto Rico. Fatigue severity was assessed using the Fatigue subscale from the Functional Assessment of Cancer Therapy-Fatigue quality of life questionnaire Spanish version. Differences in fatigue severity across type of treatment (radiation therapy, chemotherapy, combined radiation chemotherapy and post-treatment) were evaluated using nonparametric (Kruskal–Wallis and Mann–Whitney test) statistical tests. Results: The majority of the participants had prostate (33%) and breast (32%) cancers and were receiving radiation therapy (43%) or chemotherapy (28%). The Kruskal–Wallis test showed that there was a statistically significant difference in fatigue scores between the different four treatment conditions, χ2(3) = 39.1, p =.001 with patients on combined radiation chemotherapy or chemotherapy alone experiencing more severe fatigue. Conclusions: Findings from the current study suggest that type of treatment is a key component of the symptom burden of fatigue among the Puerto Rican oncology population. Specially, patients receiving combined therapy or chemotherapy alone were at increased risk for experiencing severe fatigue, compared to radiation therapy and post-treatment patients. Relevance to clinical practice: With the worldwide increase in migration of Puerto Rican families, nurses need to recognise that type of treatment is a key component of the symptom burden of fatigue among the Puerto Rican population. The results of this study will improve understanding of treatment-related fatigue to identify therapeutic targets and improve quality of life of patients.

Differences in the Severity, Distress, Interference, and Frequency on Cancer-Related Symptoms Between Island Hispanic Puerto Ricans and Mainland Non-Hispanic Whites

González-Mercado, V. J., Saligan, L. N., Ji, M., Groer, M., Pedro, E., & McMillan, S. (2018). Journal of Immigrant and Minority Health, 20(4), 1029-1039. 10.1007/s10903-017-0651-z
Abstract
Abstract
The knowledge base of cancer-related symptoms is increasing; yet, limited attention has been given to provide evidence on differences in the perception of cancer symptoms between ethnic groups, especially in the Hispanic Puerto Rican (PR) population. To examine whether there are significant differences in the severity, distress, interference, and frequency of cancer symptoms between island Hispanic PR and mainland non-Hispanic whites. In this secondary data analysis, data from 109 Hispanic PR was matched by age, gender and cancer diagnosis with data from non-Hispanic whites. Cancer symptoms were assessed using the Cancer Symptom Scale (CSS). Mann–Whitney statistical test was used to evaluate pairwise differences between Hispanic PR and non-Hispanic whites on symptoms from the CSS. There were significant differences on some symptoms including PR reporting: (a) more intense itching, swelling, taste change, difficulty sleeping, bloating, depression, sadness, worry, and nervousness; (b) significantly greater distress about taste change, appetite, anxiety, depression, worry, and feeling nervous; (c) rash, anxiety, depression, sadness, and nervousness interfered the most with their daily lives; and, (d) that the frequency of occurrence of the symptoms of pain, itching, dizziness, taste change, anxiety, sadness, and nervousness was higher compared to non-Hispanic whites. PR cancer patients are at increased risk for experiencing greater severity of cancer symptoms compared to non-Hispanic whites. But because the Hispanic oncology population does not always report symptoms, risking under-assessment and under-management, this suggests there may be a greater need for symptoms surveillance for this population.

Expression of Sestrin Genes in Radiotherapy for Prostate Cancer and Its Association With Fatigue: A Proof-of-Concept Study

Gonzalez, V. J., Abbas-Aghababazadeh, F., Fridley, B. L., Ghansah, T., & Saligan, L. N. (2018). Biological Research for Nursing, 20(2), 218-226. 10.1177/1099800417749319
Abstract
Abstract
Genetic factors that influence inflammation and energy production/expenditure in cells may affect patient outcomes following treatment with external beam radiation therapy (EBRT). Sestrins, stress-inducible genes with antioxidant properties, have recently been implicated in several behaviors including fatigue. This proof-of-concept study explored whether the sestrin family of genes (SESN1, SESN2, and SESN3) were differentially expressed from baseline to the midpoint of EBRT in a sample of 26 Puerto Rican men with nonmetastatic prostate cancer. We also examined whether changes in expression of these genes were associated with changes in fatigue scores during EBRT. Method: Participants completed the 13-item Functional Assessment of Cancer Therapy—Fatigue subscale, Spanish version. Whole blood samples were collected at baseline and at the midpoint of EBRT. Gene expression data were analyzed using the limma package in the R (version R 2.14.0.) statistical software. Linear models and empirical Bayes moderation, adjusted for radiation fraction (total number of days of prescribed radiation treatment), were used to examine potential associations between changes in gene expression and change in fatigue scores. Results: Expression of SESN3 (adjusted p <.01, log fold change −0.649) was significantly downregulated during EBRT, whereas the expressions of SESN1 and SESN2 remained unchanged. After adjustment for radiation fraction, change in SESN3 expression was associated with change in fatigue during EBRT (false discovery rate <.01). Conclusions: Downregulation of SESN3, a novel pharmacoactive stress response gene, was associated with fatigue intensification during EBRT. SESN3 may serve as an interventional target and a biomarker for the cellular and molecular events associated with EBRT-related fatigue.

The health related quality of life of Puerto Ricans during cancer treatments; a pilot study

Gonzalez, V. J., McMillan, S., Pedro, E., Tirado-Gomez, M., & Saligan, L. N. (2018). Puerto Rico Health Sciences Journal, 37(1), 46-51.
Abstract
Abstract
Objective: To examine the health related quality of life (HRQOL) experienced by 79 Puerto Rican adults during cancer treatments. Methods: This study used a descriptive, cross-sectional design. Participants completed a demographics form and the Functional Assessment of Cancer Therapy-General QOL questionnaire (FACT-G). Descriptive statistics were generated. Results: Participants were ages 28-78; most of the participants had breast (38.0%), prostate (14.0%) and cervical and ovarian cancers (10.1%) treated with chemotherapy (45.6%). The participants had a mean total score on the FACT-G of 75.2 (SD = 18.9). As a group, the functional well-being was the most affected (mean 17.2, SD 6.8), and the Social/Familial was the least affected (mean 20.7, SD 6.0). Conclusion: Cancer is the leading cause of death in the island of Puerto Rico. Female Puerto Rican cancer patients in this study sample had increased risk for experiencing worse: overall HRQOL, physical well-being and emotional well-being compared to males. Given that the Hispanic oncology population does not always report symptoms, risking under-assessment and under-management, this suggests there may be a greater need for HRQOL surveillance for this population.

Relationship between physical activity, disability, and physical fitness profile in sedentary Latina breast cancer survivors

Ortiz, A., Tirado, M., Hughes, D. C., Gonzalez, V., Song, J. J., Mama, S. K., & Basen-Engquist, K. (2018). Physiotherapy Theory and Practice, 34(10), 783-794. 10.1080/09593985.2018.1424978
Abstract
Abstract
Objective: To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. Methods: Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m2; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. Results: Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). Conclusion: Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence.