
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
vdickson@nyu.edu
1 215 704 7223
433 FIRST AVENUE
NEW YORK, NY 10010
United States
Victoria Vaughan Dickson's additional information
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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.
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PhD - University of PennsylvaniaMSN - University of PennsylvaniaBSN - Temple University
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Non-communicable diseaseCardiologyGerontology
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American Academy of Nurse PractitionersAmerican Academy of NursingAmerican Association of Occupational Health NursesAmerican Heart AssociationAmerican Nurses AssociationCouncil on the Advancement of NursingEastern Nursing Research SocietyEuropean Society of CardiologyGerontological Society of AmericaHeart Failure Society of AmericaNew York Academy of MedicineNew York Nurse Practitioners AssociationSigma Theta Tau, XI ChapterSigma Theta Tua International Honor Society
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Faculty Honors Awards
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) -
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Publications
How do depressive symptoms influence self-care among an ethnic minority population with heart failure?
AbstractVaughan Dickson, V., Dickson, V. V., McCarthy, M. M., & Katz, S. M. (2013). (Vols. 23, Issue 1, pp. 22-28).AbstractObjectives: 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. Design: In this mixed methods study, 30 Black patients (mean age 59.63 SD 615 years; 60% male) participated in in-depth interviews about HF self-care and mood; and completed standardized instruments measuring self-care, depression, and physical functioning. Thematic content analysis was used to explore the meaning of depression and elicit themes about how depressive symptoms affect daily self-care practices. Qualitative and quantitative data were integrated in the final analytic phase. Results: Self-care was very poor in the sample. Forty percent of the sample had evidence of depressive symptoms (PHQ-9≥10; mean 7.59 ± 6 5.29, range 0 to 22). Individuals with depressive symptoms had poorer self-care (P=.029). In the qualitative data, individuals described depressive mood as "feeling blue⋯ like I failed." "Overwhelming" sadness and fatigue influenced self-care and resulted in treatment delays. For many, spirituality was central to coping with sadness. Few discussed depressive feelings with health care providers. Conclusions: Depression in ethnic minority patients with HF may be difficult to assess. Research to develop and test culturally sensitive interventions is critically needed, since depression influences self-care and minority populations continue to experience poorer outcomes.How older workers with coronary heart disease perceive the health effects of work
AbstractVaughan Dickson, V., & Dickson, V. V. (2013). (Vols. 61, Issues 11, pp. 486-494). 10.3928/21650799-20131025-17AbstractMore than 3.4 million workers have coronary heart disease (CHD) with significant work limitations and disability. Although the cohort of aging workers with CHD is growing, little is known about how older workers with CHD perceive the relationship between the work environment, including job stress, and their health. The purpose of this qualitative, descriptive study was to explore the perceptions of the health effects of work among older workers with CHD and describe how they cope with work stress. The sample was 47% female and 33% African American. Their mean age was 59.21 (± 5.4) years, and most (55%) worked in professional or managerial jobs. Themes emerged about perceptions of the health effects of work and coping strategies. Because older employees are a vulnerable work group, understanding the perceived health effects of work may guide future workplace program development and policy.Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy
AbstractVaughan Dickson, V., Dickson, V. V., Buck, H., & Riegel, B. (2013). (Vols. 62, Issue 1, pp. 2-9). 10.1097/NNR.0b013e31827337b3AbstractBackground : Most heart failure patients have multiple comorbidities. Objective: This study aims to test the moderating effect of comorbidity on the relationship between self-efficacy and self-care in adults with heart failure. Methods: Secondary analysis of four mixed methods studies (n = 114) was done. Self-care and self-efficacy were measured using the Self-Care of Heart Failure Index. Comorbidity was measured with the Charlson Comorbidity Index. Parametric statistics were used to examine the relationships among self-efficacy, self-care, and the moderating influence of comorbidity. Qualitative data yielded themes about self-efficacy in self-care and explained the influence of comorbidity on self-care. Results: Most (79%) reported two or more comorbidities. There was a significant relationship between self-care and the number of comorbidities (r =-.25; p = .03). There were significant differences in self-care by comorbidity level (self-care maintenance, F[1, 112], 5.96, p = .019, and self-care management, F[1, 72], 4.66, p = .034). Using moderator analysis of the effect of comorbidity on self-efficacy and self-care, a significant effect was found only in self-care maintenance among those who had moderate levels of comorbidity (b = .620, p = .022, Fchange df[6,48], 5.61, p = .022). In the qualitative data, self-efficacy emerged as an important variable influencing self-care by shaping how individuals prioritized and integrated multiple and often competing self-care instructions. Discussion: Comorbidity influences the relationship between self-efficacy and self-care maintenance, but only when levels of comorbidity are moderately high. Methods of improving self-efficacy may improve self-care in those with multiple comorbidities.Presenteeism among older workers (≥ 45 years) with coronary heart disease : An integrative literature review
AbstractVaughan Dickson, V. (2013). (Vols. 6, pp. 31-41). 10.2174/1874944501306010031AbstractAs the American workforce ages, health problems associated with the aging process, like coronary heart disease (CHD) raise new occupational health issues. To date, research on employment among patients with CHD has focused on return to work after an adverse event (e.g., heart attack) as an outcome with little attention paid to how workers function once back at work. The purpose of this integrative literature review was to examine presenteesim among older workers with CHD. The electronic databases that were utilized for this review include: Pubmed, CINAHL, Medline, and PsycInfo with limitations set as published in English from 1992 to 2012 and adults over age 45 (to capture studies focused on older workers). Twelve studies in which presenteeism was measured in older workers with CHD were reviewed. There were 3 key findings: 1) definitions and measurement of presenteeism and CHD diagnosis were inconsistent, 2) the primary focus was on quantifying the economic impact of presenteeism, and 3) job-level and individual-level factors that potentially influence presenteeism were not addressed. Implications for future research include the need for methods that address the gaps identified in this review. Recommendations include the need for longitudinal studies that specifically focus on older workers with CHD and development and testing of theoretical frameworks to guide research design.Qualitative analysis of naturalistic decision making in adults with chronic heart failure
AbstractVaughan Dickson, V., Riegel, B., Dickson, V. V., & Topaz, M. (2013). (Vols. 62, Issues 2, pp. 91-98). 10.1097/NNR.0b013e318276250cAbstractBACKGROUND: Self-care of heart failure has been described as a naturalistic decision-making process, but the data available to defend this description are anecdotal. OBJECTIVES: The aim of this study was to explore the process used by adults with chronic heart failure to make decisions about their symptoms. METHODS: This was a secondary analysis of data obtained from four mixed methods studies. The full data set held qualitative data on 120 adults over the age of 18 years. For this analysis, maximum variation sampling was used to purposively select a subset of 36 of the qualitative interviews to reanalyze. RESULTS: In this sample, equally distributed by gender, 56% Caucasian, between 40 and 98 years, the overarching theme was that decisions about self-care reflect a naturalistic decision-making process with components of situation awareness with mental simulation of a plausible course of action and an evaluation of the outcome of the action. In addition to situation awareness and mental simulation, three key factors were identified as influencing self-care decision making: (a) experience; (b) decision characteristics such as uncertainty, ambiguity, high stakes, urgency, illness, and involvement of others in the decision-making process; and (c) personal goals. DISCUSSION: These results support naturalistic decision making as the process used by this sample of adults with heart failure to make decisions about self-care.Sociocultural influences on heart failure self-care among an ethnic minority black population
AbstractVaughan Dickson, V., Dickson, V. V., Mccarthy, M. M., Howe, A., Schipper, J., & Katz, S. M. (2013). (Vols. 28, Issues 2, pp. 111-118). 10.1097/JCN.0b013e31823db328AbstractBACKGROUND:: 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. OBJECTIVES:: Because culture is central to the development of self-care, we sought to describe the self-care practices and sociocultural influences of self-care in an ethnic minority black population with HF. METHODS:: In this mixed-methods study, 30 black patients with HF (mean [SD] age, 59.63 [15] years; 67% New York Heart Association class III) participated in interviews about self-care, cultural beliefs, and social support and completed standardized instruments measuring self-care and social support. Thematic content analysis revealed themes about sociocultural influences of self-care. Qualitative and quantitative data were integrated in the final analytic phase. RESULTS:: Self-care was very poor (standardized mean [SD] Self-care of Heart Failure Index [SCHFI] maintenance, 60.05 [18.12]; SCHFI management, 51.19 [18.98]; SCHFI confidence, 62.64 [8.16]). The overarching qualitative theme was that self-care is influenced by cultural beliefs, including the meaning ascribed to HF, and by social norms. The common belief that HF was inevitable ("all my people have bad hearts") or attributed to "stress" influenced daily self-care. Spirituality was also linked to self-care ("the doctor may order it but I pray on it"). Cultural beliefs supported some self-care behaviors like medication adherence. Difficulty reconciling cultural preferences (favorite foods) with the salt-restricted diet was evident. The significant relationship of social support and self-care (r = 0.451, P = .01) was explicated by the qualitative data. Social norms interfered with willingness to access social support, and "selectivity" in whom individuals confided led to social isolation and confounded self-care practices. CONCLUSIONS:: Research to develop and test culturally sensitive interventions is needed. Community-based interventions that provide culturally acceptable resources to facilitate self-care should be explored.Special issue on self-care and chronic disease editorial
AbstractVaughan Dickson, V., Clark, R., Rabela-Silvo, E., & Buck, H. (2013).Abstract~Utilization of a benchmarking database to inform NICHE implementation
AbstractVaughan Dickson, V., Capezuti, E., Boltz, M. P., Shuluk, J., Denysyk, L., Petra Brouwer, J., Roberts, M. C., Dickson, V. V., Cline, D. D., Wagner, L. M., Fairchild, S., Kim, H., & Secic, M. (2013). (Vols. 6, Issues 3, pp. 198-208). 10.3928/19404921-20130607-01AbstractAn integral part of NICHE (Nurses Improving Care for Healthsystem Elders) is a benchmarking service that provides member sites with the ability to evaluate staff perceptions of the care environment compared with other NICHE sites. The NICHE Database includes more than 100,000 surveys (Geriatric Institutional Assessment Profile). This study aimed to explain how secondary analyses of this aggregate database can inform effective geriatric programming in hospitals. We found that nurse age and experience influence nurse perceptions of organizational alignment to NICHE guiding principles and that those perceptions improve following NICHE implementation. The NICHE Database addresses knowledge generation in key areas of geriatric nursing practice and assists hospitals' systemic capacity to effectively embed NICHE Guiding Principles: evidence-based geriatric knowledge, patient-family centered care, healthy and productive practice environment, and multidimensional metrics of quality. It contributes to the growing field of implementation science that seeks to promote the uptake of research findings into clinical practice.Chief nursing officers' perspectives on Medicare's hospital-acquired conditions non-payment policy : implications for policy design and implementation
AbstractVaughan Dickson, V., Wald, H., Richard, A., Dickson, V. V., & Capezuti, E. (2012). (Vols. 7, Issue 1). 10.1186/1748-5908-7-78AbstractBackground: Preventable adverse events from hospital care are a common patient safety problem, often resulting in medical complications and additional costs. In 2008, Center for Medicare and Medicaid Services (CMS) implemented a policy, mandated by the Deficit Reduction Act of 2005, targeting a list of these 'reasonably' preventable hospital-acquired conditions (HACs) for reduced reimbursement. Extensive debate ensued about the potential adverse effects of the policy, but there was little discussion of its impact on hospitals' quality improvement (QI) activities. This study's goals were to understand organizational responses to the HAC policy, including internal and external influences that moderated the success or failure of QI efforts.Methods: We employed a qualitative descriptive design. Representatives from 14 Nurses Improving Care of Health System Elders (NICHE) hospitals participated in semi-structured interviews addressing the impact of the HAC policy generally, and for two indicator conditions: central-line associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). Within-case analysis identified the key components of each institution's response to the policy; across-case analysis identified themes. Exemplar cases were used to explicate findings.Results: Interviewees reported that the HAC policy is one of many internal and external factors motivating hospitals to address HACs. They agreed the policy focused attention on prevention of HACs that had previously received fewer dedicated resources. The impact of the policy on prevention activities, barriers, and facilitators was condition-specific. CLABSI efforts were in place prior to the policy, whereas CAUTI efforts were less mature. Nearly all respondents noted that pressure ulcer detection and documentation became a larger focus stemming from the policy change. A major challenge was the determination of which conditions were 'hospital-acquired.' One opportunity arising from the policy has been the focus on nursing leadership in patient safety efforts.Conclusions: While the CMS's HAC policy was just one of many factors influencing QI efforts, it may have served the important role of drawing attention and resources to the targeted conditions-particularly those not previously in the spotlight. The translational research paradigm is helpful in the interpretation of the findings, illustrating how the policy can advance prevention efforts for HACs at earlier phases of research translation as well as pitfalls associated with earlier phase implementation. To maximize their impact, such policies should consider condition-specific contextual factors influencing policy uptake and provide condition-specific implementation support.Developing a Culturally-Relevant Self-Care Intervention for Hispanic Adults with Heart Failure
AbstractVaughan Dickson, V., Dickson, V. V., Combellick, J. L., Malley, M., Sanchez, L., Squires, A. P., Katz, S., & Riegel, B. (2012). (Vols. 18, Issues 8, pp. S104-S105). 10.1016/j.cardfail.2012.06.401 ; http://linkinghub.elsevier.com/retrieve/pii/S1071916412005970 ; http://www.mendeley.com/research/developing-culturallyrelevant-selfcare-intervention-hispanic-adults-heart-failureAbstractBackground: Heart failure (HF) places a disproportionate burden on ethnic minority populations, who experience poorer outcomes. Hispanics are particularly susceptible to the consequences of HF. Self-care, which encompasses adherence to diet, medication and symptom management, can significantly improve HF outcomes. Yet the availability of culturally-appropriate interventions are limited. Purpose: To culturally adapt a self-care intervention for use in a sample of Hispanic older adults with HF, translate instruments into Spanish and establish cultural relevance content validity. Methods: The ADAPT-ITT framework guided translation of a cognitive-behavioral, self-care intervention to a culturally-appropriate program for Hispanic older adults with HF. First, focus groups of Hispanic older adults with HF were conducted to elicit the reactions to existing patient education materials and guided the cultural adaptation of the intervention materials by bilingual experts. Instruments were translated into Spanish. Cultural relevance and translation accuracy were measured by calculating a modified Kappa score for each instrument. Results: Focus group feedback revealed that culturally-appropriate content that focused on favorite foods and incorporated social support was needed: My daughter prepares meals.we need to know about low salt in our food.tortillas.chorizo. Participants expressed willingness to participate in a group program and preferred a local community setting that is "easy to get to.". Translated instruments were reviewed by a panel of 7 bilingual experts and found to be culturally relevant (S-CVI Kappa scores >.77) and accurately translated for Hispanic population (Translation TS-CVI Kappa scores >.74). Discussion: The ADAPT-ITT framework is a feasible method to culturally adapt a HF self-care intervention. Since health disparities that older Hispanics with HF face are shaped by multiple socioeconomic and cultural factors, availability of a culturally-appropriate self-care intervention may facilitate the development of the skills necessary for better self-care and improve HF outcomes in ethnically-diverse populations.