Velda Gonzalez

Faculty

Velda J. González Mercado Headshot

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

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.

Validation of the Spanish version of the Cancer Symptom Scale in Hispanic cancer patients

Gonzalez-Mercado, V. J., Saligan, L. N., Rodriguez, C. S., Ortiz, D., Pedro, E., & McMillan, S. C. (2018). International Journal of Nursing Practice, 24(6). 10.1111/ijn.12700
Abstract
Abstract
Aim: To assess the validity of the translated Spanish Cancer Symptom Scale. Background: Instruments to facilitate comprehensive and objective assessments of the cancer symptom experience in underrepresented populations are essential. Methods: The Cancer Symptom Scale was translated into Spanish, and a back translation was conducted. During June 2016, a sample of 121 Hispanic Puerto Rican patients with any cancer diagnosis, all undergoing cancer treatments, completed four paper surveys. A subgroup of 15 patients agreed to complete the Spanish Cancer Symptom Scale a second time after a short delay of 1 to 2 hours. Construct validity and reliability (internal consistency via Cronbach alpha and test-retest reliability) was evaluated. Results: All the Intensity Items of the Spanish Cancer Symptom Scale correlated significantly with the matched items on the MD Anderson Symptom Inventory. In a subgroup of 77 participants, each Cancer Symptom Scale subscale total of scores correlated significantly with the total scores from the Functional Assessment of Cancer Therapy-General. Discriminant validity was demonstrated between those receiving chemotherapy and those from post treatment. The Spanish Cancer Symptom Scale internal consistency reliability was 0.98. Conclusion: The Spanish Cancer Symptom Scale has excellent evidence of validity and reliability for assessing cancer-therapy-related symptoms.

Communication about sex and HPV among Puerto Rican mothers and daughters

Colón-López, V., Fernández-Espada, N., Vélez, C., Gonzalez, V. J., Diaz-Toro, E. C., Calo, W. A., Savas, L. S., Pattatucci, A., & Fernández, M. E. (2017). Ethnicity and Health, 22(4), 348-360. 10.1080/13557858.2016.1246938
Abstract
Abstract
Objective: Although opportunities to vaccinate against human papillomavirus (HPV) are available, vaccination rates in Puerto Rico remain low. Communication between parents and adolescents about sexual topics may influence decisions about HPV vaccination uptake, particularly among young women; yet, few studies have addressed this issue. This qualitative study explored Puerto Rican mothers’ and daughters’ communication on sex-related topics, and HPV, including the HPV vaccine. Design: Thirty participants, including 9 mothers and 21 daughters, participated in seven focus groups. Participants were divided into groups of mothers and daughters, and further stratified by vaccination status. Transcripts were analyzed using a modified grounded theory approach to identify emergent themes. Results: Focus group data revealed four main themes: (1) limited parent–daughter communication about sex-related topics; (2) daughters’ discomfort discussing sex-related topics with their parents; (3) parental focus on abstinence; and, (4) limited parent–daughter communication about HPV and the HPV vaccine. Conclusion: Although daughters in this study struggled with feelings of embarrassment, invasion of privacy, encouragement of abstinence, and the fear of parents’ reaction to them being sexually active prior to marriage, they also recognized the need to increase the parent–daughter communication about sex-related topics including HPV and the HPV vaccine. Educational efforts should target both daughters and parents to increase communication skills and self-efficacy and to enable them to discuss sexual health in open and nonjudgmental conversations.

Dietary Patterns in Puerto Rican and Mexican-American Breast Cancer Survivors: A Pilot Study

Palacios, C., Daniel, C. R., Tirado-Gómez, M., Gonzalez-Mercado, V., Vallejo, L., Lozada, J., Ortiz, A., Hughes, D. C., & Basen-Engquist, K. (2017). Journal of Immigrant and Minority Health, 19(2), 341-348. 10.1007/s10903-016-0398-y
Abstract
Abstract
Breast cancer is the leading cause of cancer death among Hispanic women. Certain dietary factors have been associated with the risk of breast cancer recurrence, but data in Hispanic survivors is scarce. Objective: to examine dietary patterns and diet quality in two groups of Hispanic breast cancer survivors. Methods: 23 Mexican-American (MA) and 22 Puerto Rican (PR) female breast cancer survivors completed a culturally adapted validated food frequency questionnaire. Intake was standardized per 1000 kcal and compared to US Dietary Guidelines and the DASH-style diet adherence score was calculated. Results: Overweight/obese was 70 % in MA and 91 % in PR. PR consumed diets rich in fruit/100 % fruit juices and beans, while MA diets were high in vegetables, beans, and total grains. Both groups consumed high amounts of starchy vegetables, refined grains, animal protein and calories from solid fats and added sugars but low intakes of whole grains, dairy products and nuts and seeds. DASH scores were relatively low. Conclusion: MA and PR female breast cancer survivors have different dietary patterns but both groups had relatively low diet quality. These groups could benefit from culturally tailored interventions to improve diet quality, which could potentially reduce cancer recurrence. ClinicalTrials.gov Identifier NCT01504789.

Gene expression, and fatigue in puerto rican men during radiotherapy for prostate cancer: An exploratory study

González, V. J., Saligan, L. N., Fridley, B. L., Ortiz-Zuazaga, H., & Aaronson, L. S. (2017). Puerto Rico Health Sciences Journal, 36(4), 223-231.
Abstract
Abstract
Objective: To examine the trajectory of fatigue experienced by 26 Puerto Rican (PR) men over the course of External Beam Radiation Therapy (EBRT) and to assess gene expression changes from baseline to midpoint of EBRT using microarray technology. Design/Research Approach- Prospective exploratory and comparative design study. Setting- RT facility located in San Juan, PR. Sample/Participants-26 PR men with non-metastatic prostate cancer. Methods: Participants completed 2 paper forms: demographics and the Spanish version of the 13-item FACT–fatigue at baseline, midpoint, and end of EBRT. Wholeblood samples were collected at baseline and at midpoint of EBRT. Descriptive data was analyzed using t-test, Wilcoxon, and Friedman test for repeated measures. Gene expression data was analyzed using the LIMMA package in R; the functional network analysis was conducted using Ingenuity Pathway analysis. Main Research Variable- Fatigue scores, gene expression. Results: Subjects were of ages 52-81 with fatigue scores that remained unchanged during EBRT (baseline=42.38, SD=9.34; midpoint=42.11, SD=8.93, endpoint=43.04, SD=8.62). Three hundred seventy-three genes (130-up regulated and 243-down regulated) were differentially expressed from baseline to mid-point of EBRT (FDR<0.01). The top distinct canonical pathways of the differentially expressed probesets (p< 0.0001) were: “Phospholipase C Signaling,” “Role of NFAT in Regulation of the Immune Response,” and “Gαq Signaling.” Conclusion: While fatigue did not worsen over the course of EBRT for this sample as a group, there was variability in fatigue across the sample. It is possible that the over expression of the SESN3 gene, known to suppress oxidative damage, may have contributed to the attenuation of fatigue in this clinical population.