- Professional overview
Dr. Dickson is an Associate Professor in the Rory Meyers College of Nursing with extensive clinical and research experience in cardiovascular and occupational health nursing. Her research program focuses on investigating the bio-behavioral influences on self-care in patients with cardiovascular disease including heart failure and multiple comorbidity; and evaluating the effectiveness of self-care interventions on health outcomes. Her work has led to an improved understanding of the sociocultural influences of self-care among vulnerable populations including older workers, women, and ethnic minority groups; and the development of innovative theory-based interventions. Dr. Dickson is recognized as an international expert in qualitative research techniques and mixed methods research and has conducted training to interdisciplinary teams locally, nationally and internationally. Dr. Dickson holds a clinical appointment as an advanced practice nurse in the division of cardiology at the NYU Langone Medical Center and the Bellevue Hospital. Currently, Dr. Dickson is the Program Director of the NIOSH-funded doctoral training program in Occupational and Environmental Health Nursing.
PhD, University of PennsylvaniaMSN, University of PennsylvaniaBSN, Temple University
- Professional membership
American Academy of NursingAmerican Heart AssociationHeart Failure Society of AmericaEastern Nursing Research SocietyGerontological Society of AmericaCouncil on the Advancement of NursingEuropean Society of CardiologyAmerican Academy of Nurse PractitionersAmerican Association of Occupational Health NursesSigma Theta Tau, XI ChapterSigma Theta Tua International Honor SocietyThe New York Nurse Practitioners AssociationAmerican Nurses Association
A qualitative meta-analysis of heart failure self-care practices among individuals with multiple comorbid conditions.Dickson, V. V., Buck, H., & Riegel, B. (2011). Journal of cardiac failure, 17, 413-9, 10.1016/j.cardfail.2010.11.011
Most heart failure (HF) patients have other comorbid conditions. HF self-care requires medication and diet adherence, daily weight monitoring, and a thoughtful response to symptoms when they occur. Self-care is complicated when other chronic conditions have additional self-care requirements. The purpose of this study is to explore how comorbidity influences HF self-care.
A situation-specific theory of heart failure self-care.Riegel, B., & Dickson, V. V. The Journal of cardiovascular nursing, 23, 190-6, 10.1097/01.JCN.0000305091.35259.85
Heart failure, a common syndrome in developed countries worldwide, is associated with poor quality of life, frequent rehospitalizations, and early death. Self-care is essential to improving outcomes in this patient population. The purpose of this article is to describe a situation-specific theory of heart failure self-care in which self-care is defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiologic stability (maintenance) and the response to symptoms when they occur (management). Self-care maintenance is further defined to encompass routine symptom monitoring and treatment adherence. Self-care management is characterized as a process initiated by symptom recognition and evaluation, which stimulates the use of self-care treatments and treatment evaluation. Confidence in self-care is thought to moderate and/or mediate the effect of self-care on various outcomes. Four propositions were derived from the self-care of heart failure conceptual model: (1) symptom recognition is the key to successful self-care management; (2) self-care is better in patients with more knowledge, skill, experience, and compatible values; (3) confidence moderates the relationship between self-care and outcomes; and (4) confidence mediates the relationship between self-care and outcomes. These propositions were tested and supported using data obtained in previous research. Support of these propositions provides early evidence for this situation-specific theory of heart failure self-care.
A typology of heart failure self-care management in non-elders.Dickson, V. V., Deatrick, J. A., & Riegel, B. (2008). European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 7, 171-81, 10.1016/j.ejcnurse.2007.11.005
Heart failure (HF) self-care is extremely challenging and few people master it. Self-care was defined as an active, cognitive process in which persons engage for the purpose of maintaining their health (maintenance) and managing symptoms (management).
An update on the self-care of heart failure index.Riegel, B., Lee, C. S., Dickson, V. V., & Carlson, B. The Journal of cardiovascular nursing, 24, 485-97, 10.1097/JCN.0b013e3181b4baa0
The Self-care of Heart Failure Index (SCHFI) is a measure of self-care defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiological stability (maintenance) and the response to symptoms when they occur (management). In the 5 years since the SCHFI was published, we have added items, refined the response format of the maintenance scale and the SCHFI scoring procedure, and modified our advice about how to use the scores.
Are we teaching what patients need to know? Building skills in heart failure self-care.Dickson, V. V., & Riegel, B. Heart & lung : the journal of critical care, 38, 253-61, 10.1016/j.hrtlng.2008.12.001
Heart failure (HF) self-care requires both knowledge and skill, but little attention has been given to identify how to improve skill in HF self-care. The objective was to assess what self-care skills patients with HF perceive that they need and how they developed the skills needed to perform self-care.
Cognitive influences on self-care decision making in persons with heart failure.Dickson, V. V., Tkacs, N., & Riegel, B. (2007). American heart journal, 154, 424-31, 10.1016/j.ahj.2007.04.058
Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation.
How Do Cognitive Function and Knowledge Affect Heart Failure Self-Care?Vaughan Dickson, V., Lee, C.S., & Riegel, B. (2011). Journal of Mixed Methods Research, 5, 167-189, 10.1177/1558689811402355
How do depressive symptoms influence self-care among an ethnic minority population with heart failure?Dickson, V. V., McCarthy, M. M., & Katz, S. M. (2013). Ethnicity & disease, 23, 22-8,
Depression is very common in patients with heart failure (HF). However, little is known about how depression influences self-care (ie, adherence to diet, medication and symptom management behaviors) in ethnic minority patients with HF. The purpose of this study was to explore the meaning of depression and how depressive symptoms affect self-care in an ethnic minority Black population with HF.
Qualitative analysis of naturalistic decision making in adults with chronic heart failure.Riegel, B., Dickson, V. V., & Topaz, M. Nursing research, 62, 91-8, 10.1097/NNR.0b013e318276250c
Self-care of heart failure has been described as a naturalistic decision-making process, but the data available to defend this description are anecdotal.
Role of self-care in the patient with heart failure.Moser, D. K., Dickson, V., Jaarsma, T., Lee, C., Stromberg, A., & Riegel, B. (2012). Current cardiology reports, 14, 265-75, 10.1007/s11886-012-0267-9
Optimal outcomes and quality of life for patients with heart failure depend on engagement in effective self-care activities. Self-care is a complex set of activities and most clinicians are not adequately prepared to assist their patients to engage in effective self-care. In this paper, we provide an overview of self-care that includes definitions, the importance of self-care to outcomes, the physiologic basis for better outcomes with good self-care, cultural perspectives of self-care, and recommendations for the improvement of self-care. Promotion of effective self-care by all clinicians could substantially reduce the economic and personal burden of repeated rehospitalizations among patients with heart failure.
Self care in patients with chronic heart failure.Riegel, B., Lee, C. S., Dickson, V. V., & (2011). Nature reviews. Cardiology, 8, 644-54, 10.1038/nrcardio.2011.95
'Heart failure self care' refers to the practices in which patients engage to maintain their own health, and to the decisions that they make about managing signs or symptoms. In this article, we base our discussion of self care in chronic heart failure on the classification of patients as being 'expert', inconsistent', or 'novice' in heart failure self-care behaviors. The available literature on factors predicting heart failure self care and its outcomes are reviewed within this context. Factors known to influence heart failure self care include experience with the illness, physical functioning, depression and anxiety, social support, daytime sleepiness, and attitudes such as confidence. Further research is needed to understand the contributions of comorbidities, patient sex, and health disparities on heart failure self care. The evidence to support a link between heart failure self care and health outcomes is limited, but early evidence suggests that adequate self care is associated with an improvement in health status, a decrease in the number and duration of hospitalizations, and a decline in levels of biomarkers of stress and inflammation, and in intrathoracic impedance. Implications of heart failure self care for clinical practice, policy, and public health are also described.
Sociocultural influences on heart failure self-care among an ethnic minority black population.Dickson, V. V., McCarthy, M. M., Howe, A., Schipper, J., & Katz, S. M. The Journal of cardiovascular nursing, 28, 111-8, 10.1097/JCN.0b013e31823db328
Heart failure (HF) places a disproportionate burden on ethnic minority populations, including blacks, who have the highest risk of developing HF and experience poorer outcomes. Self-care, which encompasses adherence to diet, medication, and symptom management, can significantly improve outcomes. However, HF self-care is notoriously poor in ethnic minority black populations.
The relationship of work, self-care, and quality of life in a sample of older working adults with cardiovascular disease.Dickson, V. V., Howe, A., Deal, J., & McCarthy, M. M. Heart & lung : the journal of critical care, 41, 5-14, 10.1016/j.hrtlng.2011.09.012
The study objective was to describe the self-care behaviors of adherence to medication, diet, exercise, and symptom monitoring of older workers with cardiovascular disease (CVD) and explore the relationship among job characteristics (job demands, job control, and workplace support), self-care, and quality of life. More than 3.5 million workers have CVD with significant work limitations and increased disability. Workers must meet the challenges of today's work processes that include increased stress and intense production demands while managing the complexities of their CVD.
Whose job is it? Gender differences in perceived role in heart failure self-careDickson, V.V., Worrall-Carter, L., Kuhn, L., & Riegel, B. (2011). Journal of Nursing and Healthcare of Chronic Illness, 3, 99-108, 10.1111/j.1752-9824.2011.01084.x