Victoria Vaughan Dickson

Faculty

Victoria Vaughan Dickson

Victoria Vaughan Dickson

FAAN FAHA FHFSA PhD RN

Dr. John W. Rowe Professor in Successful Aging
Assistant Dean, Research Innovation
Director, Pless Center for Research

1 215 704 7223

433 FIRST AVENUE
NEW YORK, NY 10010
United States

Victoria Vaughan Dickson, PhD, RN, FAHA, FHFSA, FAAN, is the John W. Rowe Professor in Successful Aging, Assistant Dean, Research Innovation, and Director of the Pless Center for Nursing Research at 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 risk, coronary heart disease, heart failure, and multiple comorbidities. Her work has led to an improved understanding of the sociocultural influences of self-care among vulnerable populations, including ethnic minority groups, women, and older workers; and the development of innovative theory-based interventions. Dickson is recognized as an international expert in qualitative research techniques, mixed methods research, and has conducted training for interdisciplinary teams locally, nationally, and internationally. 

Prof. Dickson is dedicated to building research capacity across disciplines and advancing nursing science that impacts policy and clinical care. Currently, Dickson serves as PI and program director of the NIOSH-funded doctoral training program in occupational and environmental health nursing, PI of the NHLBI- funded Research Education in Cardiovascular Conditions program, co-PI of the NINR-funded NYU Meyers P20 Exploratory Center for Precision Health in Diverse Populations and KL2 co-director and co-investigator of the NCATS-funded NYU CTSI. In addition, she is a co-investigator on numerous team science initiatives focused on multiple chronic conditions.  

Prof. Dickson has been recognized with numerous awards for her research and leadership including the STTI Nurse Researcher Hall of Fame (2019), HFSA Nursing Research Leadership award (2021), and ENRS Leadership Award (2020). She is a fellow in the American Academy of Nursing (2014), American Heart Association (2011), Heart Failure Society of America (2016), and New York Academy of Medicine (2018). Dickson is the editor of the Journal of Cardiovascular Nursing.  

Prof. Dickson holds a clinical appointment as an advanced practice nurse in the division of cardiology at NYU Langone Health and Bellevue Hospital. She earned her PhD and MSN from the University of Pennsylvania and BSN from Temple University.

PhD - University of Pennsylvania
MSN - University of Pennsylvania
BSN - Temple University

Non-communicable disease
Cardiology
Gerontology

American Academy of Nurse Practitioners
American Academy of Nursing
American Association of Occupational Health Nurses
American Heart Association
American Nurses Association
Council on the Advancement of Nursing
Eastern Nursing Research Society
European Society of Cardiology
Gerontological Society of America
Heart Failure Society of America
New York Academy of Medicine
New York Nurse Practitioners Association
Sigma Theta Tau, XI Chapter
Sigma Theta Tua International Honor Society

Nursing Research Leadership Award, HFSA (2021)
Leadership Award, ENRS (2021)
Nurse Researcher Hall of Fame, STTI (2019)
Associate Editor, Cardiovascular Nursing (2018)
Fellow, New York Academy of Medicine (2018)
President-Elect, Eastern Nursing Research Society (2018)
Spirit of Nursing Award, University of Massachusetts (2017)
President-Elect, Eastern Nursing Research Society (2017)
President-Elect, Eastern Nursing Research Society (2016)
Associate Editor to Circulation, Cardiovascular Quality & Outcomes (2016)
Fellow, Heart Failure Society of America (2016)
PhD Faculty Excellence Award, NYU (2014)
Fellow, American Academy of Nursing (2014)
Springer Publishing Company Award (2014)
Research Award, ENRS Rising Star (2012)
Fellow, American Heart Association Fuchs-Schoeck Research (2012)
Fellow, American Heart Association (2011)
Minority Aging Research and Community Health Scholar, University of Pennsylvania (2011)
Nursing and Allied Health Professional Award, European Society of Cardiology (2011)
Fellow, Brookdale Foundation Leadership in Aging (2010)
Reviewer of the Year, Journal of Cardiovascular Nursing (2009)
Nursing Research Award, Heart Failure Society of America (2007)
Martha Hill New Investigator Award, American Heart Association (2007)
Student Award, University of Pennsylvania (2007)
Research Award, American Association of Occupational Health Nurses (2006)

Position statement : Harmful effects of environmental noise exposures

Vaughan Dickson, V., Lusk, S. L., McCullagh, M., Dickson, V. V., & Xu, J. (2016). (Vols. 64, Issues 4, pp. 395-396). 10.1016/j.outlook.2016.06.001
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A qualitative secondary data analysis of intentional and unintentional medication nonadherence in adults with chronic heart failure

Vaughan Dickson, V., Riegel, B., & Dickson, V. V. (2016). (Vols. 45, Issues 6, pp. 468-474). 10.1016/j.hrtlng.2016.08.003
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Objective To explore factors contributing to intentional and unintentional medication nonadherence in adults with chronic heart failure (HF). Background Medication nonadherence is prevalent in HF but the factors contributing to it are not well understood. Methods This secondary data analysis of qualitative data explored narrative accounts about medication adherence from four previous studies (N = 112). The Necessity–Concerns–Framework derived from the Common Sense Model (CSM) of Self-Regulation guided the interpretation of themes. Results In this diverse sample (39% Black, 6% Hispanic, 63% male; mean age 59 ± 15 years), 90% reported at least intermittent nonadherence. For many (60%), missing medication was unintentional but 27% reported intentional nonadherence. Four interconnected patterns of behavior emerged: 1) rarely nonadherent, 2) frequently nonadherent, 3) intentionally nonadherent, and 4) reformed nonadherent. Misperceptions about HF, beliefs, concerns, and contextual factors contributed to both intentional and unintentional nonadherence. Conclusion Medication nonadherence is prevalent in HF and influenced by modifiable factors.

The situation-specific theory of heart failure self-care revised and updated

Vaughan Dickson, V., Riegel, B., Dickson, V. V., & Faulkner, K. M. (2016). (Vols. 31, Issues 3, pp. 226-235). 10.1097/JCN.0000000000000244
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Background: Since the situation-specific theory of heart failure (HF) self-care was published in 2008, we have learned much about how and why patients with HF take care of themselves. This knowledge was used to revise and update the theory. Objective: The purpose of this article was to describe the revised, updated situation-specific theory of HF self-care. Result: Three major revisions were made to the existing theory: (1) a new theoretical concept reflecting the process of symptom perception was added; (2) each self-care process now involves both autonomous and consultative elements; and (3) a closer link between the self-care processes and the naturalistic decision-making process is described. In the revised theory, HF self-care is defined as a naturalistic decision-making process with person, problem, and environmental factors that influence the everyday decisions made by patients and the self-care actions taken. The first self-care process, maintenance, captures those behaviors typically referred to as treatment adherence. The second self-care process, symptom perception, involves body listening, monitoring signs, as well as recognition, interpretation, and labeling of symptoms. The third self-care process, management, is the response to symptoms when they occur. A total of 5 assumptions and 8 testable propositions are specified in this revised theory. Conclusion: Prior research illustrates that all 3 self-care processes (ie, maintenance, symptom perception, and management) are integral to self-care. Further research is greatly needed to identify how best to help patients become experts in HF self-care.

Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF) : Study design and methods

Vaughan Dickson, V., Masterson Creber, R., Patey, M., Dickson, V. V., DeCesaris, M., & Riegel, B. (2015). (Vols. 41, pp. 62-68). 10.1016/j.cct.2014.12.019
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Abstract
Objective: Lack of engagement in self-care is common among patients needing to follow a complex treatment regimen, especially patients with heart failure who are affected by comorbidity, disability and side effects of poly-pharmacy. The purpose of Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF) is to test the feasibility and comparative efficacy of an MI intervention on self-care, acute heart failure physical symptoms and quality of life. Methods: We are conducting a brief, nurse-led motivational interviewing randomized controlled trial to address behavioral and motivational issues related to heart failure self-care. Participants in the intervention group receive home and phone-based motivational interviewing sessions over 90-days and those in the control group receive care as usual. Participants in both groups receive patient education materials. The primary study outcome is change in self-care maintenance from baseline to 90-days. Conclusion: This article presents the study design, methods, plans for statistical analysis and descriptive characteristics of the study sample for MITI-HF. Study findings will contribute to the literature on the efficacy of motivational interviewing to promote heart failure self-care. Practical implications: We anticipate that using an MI approach can help patients with heart failure focus on their internal motivation to change in a non-confrontational, patient-centered and collaborative way. It also affirms their ability to practice competent self-care relevant to their personal health goals.

Predictors of hospitalization and quality of life in heart failure : A model of comorbidity, self-efficacy and self-care

Vaughan Dickson, V., Buck, H. G., Dickson, V. V., Fida, R., Riegel, B., D'Agostino, F., Alvaro, R., & Vellone, E. (2015). (Vols. 52, Issues 11, pp. 1714-1722). 10.1016/j.ijnurstu.2015.06.018
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Background: Comorbidity is associated with decreased confidence or self-efficacy to perform self-care in heart failure patients which, in turn, impairs self-care behaviors. Comorbidity is also associated with increased hospitalization rates and poorer quality of life. Yet the manner in which comorbidity and self-efficacy interact to influence self-care, hospitalization, and quality of life remains unclear. Objectives: The purpose of this study was to test an explanatory model. The research questions were (1) What is the contribution of comorbidity to heart failure self-care behaviors and outcomes (i.e. hospitalization, quality of life)? and (2) Is comorbidity a moderator of the relationship between self-efficacy and heart failure self-care behaviors? Design: This was an analysis of an existing dataset of 628 symptomatic, older (mean age = 73, standard deviation (SD) = 11) male (58%) Italian heart failure patients using structural equation modeling and simple slope analysis. Results: Higher levels of self-care maintenance were associated with higher quality of life and lower hospitalization rates. Higher levels of comorbidity were associated with lower levels of self-care management. Comorbidity moderated the relationship between self-efficacy and self-care maintenance, but not self-care management. Post hoc simple slopes analysis showed significantly different slope coefficients (pdiff < .05). Specifically, in patients with less comorbidity, the relationship between self-efficacy and self-care was significantly stronger than in patients with higher comorbidity. Conclusions: Self-efficacy is important in the self-care maintenance process at each level of comorbidity. Because higher comorbidity weakens the strength of the relationship between self-efficacy and self-care maintenance, tailoring interventions aimed at improving self-efficacy to different levels of comorbidity may be key to impacting hospitalization and quality of life.

Predictors of medication nonadherence differ among black and white patients with heart failure

Vaughan Dickson, V., Dickson, V. V., Knafl, G. J., & Riegel, B. (2015). (Vols. 38, Issues 4, pp. 289-300). 10.1002/nur.21663
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Heart failure (HF) is a global public health problem, and outcomes remain poor, especially among ethnic minority populations. Medication adherence can improve heart failure outcomes but is notoriously low. The purpose of this secondary analysis of data from a prospective cohort comparison study of adults with heart failure was to explore differences in predictors of medication nonadherence by racial group (Black vs. White) in 212 adults with heart failure. Adaptive modeling analytic methods were used to model HF patient medication nonadherence separately for Black (31.7%) and White (68.3%) participants in order to investigate differences between these two racial groups. Of the 63 Black participants, 33.3% had low medication adherence, compared to 27.5% of the 149 White participants. Among Blacks, 16 risk factors were related to adherence in bivariate analyses; four of these (more comorbidities, lower serum sodium, higher systolic blood pressure, and use of fewer activities compensating for forgetfulness) jointly predicted nonadherence. In the multiple risk factor model, the number of risk factors in Black patients ranged from 0 to 4, and 76.2% had at least one risk factor. The estimated odds ratio for medication nonadherence was increased 9.34 times with each additional risk factor. Among White participants, five risk factors were related to adherence in bivariate analyses; one of these (older age) explained the individual effects of the other four. Because Blacks with HF have different and more risk factors than Whites for low medication adherence, interventions are needed that address unique risk factors among Black patients with HF.

Process evaluation of an exercise counseling intervention using motivational interviewing

Vaughan Dickson, V., McCarthy, M. M., Dickson, V. V., Katz, S. D., Sciacca, K., & Chyun, D. A. (2015). (Vols. 28, Issues 2, pp. 156-162). 10.1016/j.apnr.2014.09.006
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Aim: To describe the results of the process evaluation of an exercise counseling intervention using motivational interviewing (MI). Background: Exercise can safely be incorporated into heart failure self-care, but many lack access to cardiac rehabilitation. One alternative is to provide exercise counseling in the clinical setting. Methods: This process evaluation was conducted according to previously established guidelines for health promotion programs. This includes an assessment of recruitment and retention, implementation, and reach. Results: Desired number of subjects were recruited, but 25% dropped out during study. Good fidelity to the intervention was achieved; the use of MI was evaluated with improvement in adherence over time. Dose included initial session plus 12 weekly phone calls. Subjects varied in participation of daily diary usage. Setting was conducive to recruitment and data collection. Conclusions: Evaluating the process of an intervention provides valuable feedback on content, delivery and fidelity.

Psychometric evaluation of the stroke impact scale 3.0

Vaughan Dickson, V., Vellone, E., Savini, S., Fida, R., Dickson, V. V., Melkus, G. D., Carod-Artal, F. J., Rocco, G., & Alvaro, R. (2015). (Vols. 30, Issues 3, pp. 229-241). 10.1097/JCN.0000000000000145
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Background: The Stroke Impact Scale 3.0 (SIS 3.0) is widely used to measure quality of life in stroke survivors; however, previous studies have not tested the original 8-factor structure of the scale. In addition, previous studies have shown floor and ceiling effect and weak reliability within the scale. Objective: The aim of this study was to evaluate the psychometric characteristics of the SIS 3.0, including its construct validity (factorial structure, concurrent and contrasting group validity), floor and ceiling effect, and reliability. Method: A cross-sectional design was used to study 392 stroke survivors enrolled in 16 rehabilitation facilities across Italy. Factorial structure of the SIS 3.0 was tested with confirmatory factor analysis. Concurrent and contrasting group validities were evaluated with other scales measuring functional capacities, neurological functions, cognition, anxiety, depression, and generic quality of life. Floor and ceiling effects were evaluated by determining the percentages of patients with the minimum and the maximum score at SIS 3.0. Reliability was determined by Cronbach's α and test-retest. Results: Participants were 71 years old on average (SD, 11 years); 55% were men. Confirmatory factor analysis revealed a new 4-factor structure that fitted the data better than the original 8-factor structure did. Concurrent and contrasting group validity of the new 4-factor structure was supportive and no floor and ceiling effects were found. Internal consistency and test-retest reliability ranged between 0.79 and 0.98. Conclusion: The new factorial structure of the SIS 3.0 with 4 factors showed better psychometric properties than the original 8-factor structure did. This evidence supports further use of the SIS 3.0 in clinical practice and research.

Quality of life in stroke survivor-caregiver dyads : A new conceptual framework and longitudinal study protocol

Vaughan Dickson, V., Savini, S., Buck, H. G., Dickson, V. V., Simeone, S., Pucciarelli, G., Fida, R., Matarese, M., Alvaro, R., & Vellone, E. (2015). (Vols. 71, Issues 3, pp. 676-687). 10.1111/jan.12524
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Aim: To describe a new conceptual framework and the research protocol of a study designed to examine the quality of life in stroke survivor-caregiver dyads. Background: Stroke has a significant impact on the patient-caregiver dyad. Few studies have been guided by a specific conceptual framework which considers the interactions among pre-existing situations prior to stroke, the new situation caused by the stroke and the moderating effects of environmental and caregiver-related variables. Design: Longitudinal study. Methods: A sample of stroke survivor-caregiver dyads will be enrolled at patient discharge from rehabilitation hospitals and will be surveyed every 3 months for 1-year. Hypotheses generated from the conceptual framework will test predictors, mediators and moderators of stroke survivor and caregiver quality of life from the pre-existing situation prior to the stroke, the new situation mediation poststroke and situation moderators. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship, Rome, December 2013. Discussion: This study seeks to identify variables in the pre-existing situation prior to the stroke (e.g. living condition), the new situation mediation poststroke (e.g. type of stroke and caregiver burden) as well as situation moderators (e.g. social support) that influence stroke survivor-caregiver dyad's quality of life across the stroke trajectory. Also, the study will inform clinical practice and research by identifying variables that are potentially modifiable and therefore amenable to intervention. The proposed framework will also be helpful for future research focused on stroke survivor-caregiver dyads.

Racial differences in clinical treatment and self-care behaviors of adults with chronic heart failure

Vaughan Dickson, V., Dickson, V. V., Knafl, G. J., Wald, J., & Riegel, B. (2015). (Vols. 4, Issues 4). 10.1161/JAHA.114.001561
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Background-In the United States, the highest prevalence of heart failure (HF) is in blacks followed by whites. Compared with whites, blacks have a higher risk of HF-related morbidity and mortality and HF-related hospitalization. Little research has focused on explaining the reasons for these disparities. The purpose of this study was to examine racial differences in demographic and clinical characteristics in blacks and whites with HF and to determine if these characteristics influenced treatment, or together with treatment, influenced self-care behaviors. Methods and Results-This was a secondary analysis of existing data collected from adults (n=272) with chronic HF enrolled from outpatient sites in the northeastern United States and followed for 6 months. After adjusting for sociodemographic and clinical characteristics within reduced (HFrEF) and preserved ejection fraction (HFpEF) groups, there were 2 significant racial differences in clinical treatment. Blacks with HFrEF were prescribed ACE inhibitors and hydralazine and isosorbide dinitrate (H-ISDN) more often than whites. In the HFpEF group, blacks were taking more medications and were prescribed digoxin and a diuretic when symptomatic. Deficits in HF knowledge and decreased medication adherence, objectively measured, were more prominent in blacks. These racial differences were not explained by sociodemographic or clinical characteristics or clinical treatment variables. Premorbid intellect and the quality of support received contributed to clinical treatment and self-care. Conclusion-Although few differences in clinical treatment could be attributed solely to race, knowledge about HF and medication adherence is lower in blacks than whites. Further research is needed to explain these observations, which may be targets for future intervention research.