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)

Patient and Cardiologist Perspectives on Shared Decision Making in the Treatment of Older Adults Hospitalized for Acute Myocardial Infarction

Grant, E. V., Summapund, J., Matlock, D. D., Vaughan Dickson, V., Iqbal, S., Patel, S., Katz, S. D., Chaudhry, S. I., & Dodson, J. A. (2020). (Vols. 40, Issues 3, pp. 279-288). 10.1177/0272989X20912293
Abstract
Abstract
Background. Medical and interventional therapies for older adults with acute myocardial infarction (AMI) reduce mortality and improve outcomes in selected patients, but there are also risks associated with treatments. Shared decision making (SDM) may be useful in the management of such patients, but to date, patients’ and cardiologists’ perspectives on SDM in the setting of AMI remain poorly understood. Accordingly, we performed a qualitative study eliciting patients’ and cardiologists’ perceptions of SDM in this scenario. Methods. We conducted 20 in-depth, semistructured interviews with older patients (age ≥70) post-AMI and 20 interviews with cardiologists. The interviews were transcribed and analyzed using ATLAS.ti. Two investigators independently coded transcripts using the constant comparative method, and an integrative, team-based process was used to identify themes. Results. Six major themes emerged: 1) patients felt their only choice was to undergo an invasive procedure; 2) patients placed a high level of trust and gratitude toward physicians; 3) patients wanted to be more informed about the procedures they underwent; 4) for cardiologists, patients’ age was not a major contraindication to intervention, while cognitive impairment and functional limitation were; 5) while cardiologists intuitively understood the concept of SDM, interpretations varied; and 6) cardiologists considered SDM to be useful in the setting of non-ST elevated myocardial infarction (NSTEMI) but not ST-elevated myocardial infarction (STEMI). Conclusions. Patients viewed intervention as “the only choice,” whereas cardiologists saw a need for balancing risks and benefits in treating older adults post-NSTEMI. This discrepancy implies there is room to improve communication of risks and benefits to older patients. A decision aid informed by the needs of older adults could help to better convey patient-specific risk and increase choice awareness.

That was a game changer : Clinical impact of an emergency department-based palliative care communication skills training workshop

Wright, R., Hayward, B., Kistler, E., Vaughan Dickson, V., & Grudzen, C. (2020). (Vols. 37, Issues 5). 10.1136/emermed-2019-208567
Abstract
Abstract
Objective: To explore the impact of an adapted goals-of-care communications skills workshop created for ED physicians from the physicians' perspective. Methods: Semi-structured, one-on-one audio-recorded interviews lasting 30-60 min were conducted with twelve physicians who had completed the training workshop. Interviews explored the experience of undertaking the workshop, its impact on their clinical practice and their ability to teach new skills to other clinicians using learnt techniques. Descriptive content analysis was performed on interview transcripts. Results: Participants reported positive experiences of the workshop. The analysis identified four main themes and ten subthemes dealing with workshop content and its impact on subsequent ED-based clinical practice. There were: 1) value and future improvements for the course; 2) value of the course to practice; 3) value of the course for teaching residents and 4) barriers to application of learning. Specifically recommended components include the use of mnemonics, mechanisms to introduce difficult conversations and a positive feedback environment. Participant-recommended refinements to the workshop included emphasising urgency, replicating the chaotic ED environment and expanding content to include more ED-focused goals-of-care discussions. Conclusion: A short, focused training workshop directed at improving palliative care communication skills among ED clinicians appears to be welcomed and useful.

Validity and reliability of the self-care of hypertension inventory (SC-HI) in a Brazilian population

Vaughan Dickson, V., Silveira, L. C., De Maria, M., Dickson, V. V., Avila, C. W., Rabelo-Silva, E. R., & Vellone, E. (2020). (Vols. 49, Issues 5, pp. 518-523). 10.1016/j.hrtlng.2020.02.048
Abstract
Abstract
Background: Poor self-care in patients with hypertension is associated with worse patient outcomes. The Self-Care of Hypertension Inventory (SC-HI) measures self-care in patients with hypertension and includes three scales: self-care maintenance, which measures adherence to prescribed treatments and behaviors; self-care management, which evaluates the responses to signs and symptoms of high blood pressure; and self-care confidence, which measures self-efficacy in dealing with the entire process. Objective: To test the psychometric characteristics of the Brazilian version of the SC-HI. Methods: We enrolled a sample of 360 patients with hypertension and performed confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) to test the factorial structure of the SC-HI and computed the factor score determinacy coefficient to evaluate the SC-HI internal consistency reliability. Results: The sample was predominantly female (65%), mean age of 65 years (SD = 10), white (70%). The self-care maintenance scale resulted in a unidimensional scale, with supportive fit indices (CFI = 0.901, RMSEA = 0.048); the self-care management did not reflect the original factorial structure and had unsupportive fit indices. EFA showed a different factorial solution in reference to the original study. Finally, the self-care confidence scale resulted in a unidimensional scale with supportive fit indices (CFI = 0.940, RMSEA = 0.093). The reliability of the self-care maintenance, management, and confidence scales resulted in factor score determinacy coefficients of 0.83, 0.78, and 0.97 respectively. Conclusion: This study shows that the SC-HI is a valid and reliable tool to measure self-care in patients with hypertension among the Brazilian population.

Caregiver Contribution to Self-care in Patients With Heart Failure : A Qualitative Descriptive Study

Durante, A., Paturzo, M., Mottola, A., Alvaro, R., Vaughan Dickson, V., & Vellone, E. (2019). (Vols. 34, Issues 2, pp. E28-E35). 10.1097/JCN.0000000000000560
Abstract
Abstract
Background: Caregiver contribution to heart failure (HF) self-care maintenance and management is important in HF care. Literature remains unclear regarding which practices caregivers perform to contribute to self-care for patients with HF, especially in Southern Europe. Objective: The objective of this study was to describe caregiver contributions to HF self-care maintenance (ie, treatment adherence and symptom monitoring) and management (ie, managing HF symptoms when they occur). Methods: Forty HF caregivers were enrolled from 3 outpatient clinics in Italy for a qualitative descriptive study. Data were collected with a semistructured interview and analyzed using content analysis. Results: Caregivers were 53.6 years old on average and mostly female (63.5%). Caregiver contributions to self-care maintenance included practices related to (1) monitoring medication adherence, (2) educating patients about HF symptom monitoring, (3) motivating patients to perform physical activity, and (4) reinforcing dietary restrictions. However, some of these practices were incorrect (eg, weighing the patient only once a week). Caregiver contributions to self-care management included practices related to (1) symptom recognition and (2) treatment implementation. Caregivers were able to recognize symptoms of HF exacerbation (eg, breathlessness) but lacked confidence regarding treatment implementation (eg, administering an extra diuretic). Conclusions: Although caregivers described contributing to patients' HF self-care maintenance and management, some of their practices were incorrect. Because the caregiver contributions to HF self-care can improve patient outcomes, clinicians should routinely assess caregiver HF self-care practices and provide education and reinforcement regarding evidence-based practices.

Corrigendum to “Type 2 Diabetes Mellitus and Heart Failure, A Scientific Statement From the American Heart Association and Heart Failure Society of America” (Journal of Cardiac Failure (2019) 25(8) (584–619), (S1071916419305214), (10.1016/j.cardfail.2019.05.007))

Vaughan Dickson, V. (2019). (Vols. 25, Issues 10, p. 851). 10.1016/j.cardfail.2019.08.006
Abstract
Abstract
In the above article a correction is needed. On page 601, left hand column, in the “Use of Glucose-Lowering Medications With CKD” section, first paragraph, the last sentence read, “Although current recommendations are that SGLT-2 inhibitors should not be used with eGFR

Exploring the Mechanism of Effectiveness of a Psychoeducational Intervention in a Rehabilitation Program (CopenHeartRFA) for Patients Treated with Ablation for Atrial Fibrillation : A Mixed Methods Study

Vaughan Dickson, V., Risom, S. S., Lind, J., Dickson, V. V., & Berg, S. K. (2019). (Vols. 34, Issues 4, pp. 336-343). 10.1097/JCN.0000000000000584
Abstract
Abstract
Background Patients treated for atrial fibrillation with an ablation can experience decreased mental health. Little is known about the effect of a psychoeducation intervention on this patient group. Objectives The aim of this study was to explore the effect of a psychoeducation intervention on patients' mental health after participating in a cardiac rehabilitation program, with a focus on elaborating on the lack of mental health improvements. Method Sequential explanatory mixed methods including secondary analysis of qualitative and quantitative data collected in a randomized rehabilitation trial was performed. Perceived health was measured by a questionnaire (n = 95), and qualitative interviews were performed (n = 10). Results Patients scoring high on perceived health experienced positive effects of the intervention. Patients scoring low appear to have either low physical capacity and severe atrial fibrillation symptoms, bigger life issues, or lack of social support. Conclusion: A more in-depth understanding of the effect of a psychoeducational intervention included in a cardiac rehabilitation program has been achieved.

The Occupational Health of Nurses in the Economic Community of West African States : A Review of the Literature

Vaughan Dickson, V., Ridge, L. J., Dickson, V. V., & Stimpfel, A. W. (2019). (Vols. 67, Issues 11, pp. 554-564). 10.1177/2165079919859383
Abstract
Abstract
Nurses provide the majority of health care in sub-Saharan Africa, which has high rates of Hepatitis B Virus (HBV) and human immunodeficiency virus (HIV). This systematic review used PRISMA methodology to synthesize the literature published between January 2008 and December 2018 examining the occupational health of nurses practicing in the Economic Community of West African States (ECOWAS). The United States’ National Institute for Occupational Safety and Health’s Hierarchy of Controls is used to frame the findings. This research was mostly conducted in Nigeria and Ghana and focused on administrative controls. Nurses practicing in ECOWAS are at high risk of acquiring a bloodborne illness due to inadequate engineering and administrative controls, as well as limited access to personal protective equipment (PPE). These findings indicate interventions to improve these controls would likely lower the occupational risks faced by nurses practicing in ECOWAS. Research in more countries in ECOWAS would likely find differences in occupational health practices in Nigeria and Ghana, which are relatively wealthy, and other countries in the region. This literature showed nurses practicing in ECOWAS did not have adequate protection from biological hazards. Regional health groups, such as the West African Health Organization, should commit to improving occupational health practice. Needle recapping and double gloving must be discontinued, and PPE must be made more widely available in ECOWAS. Occupational health professionals in the region should advocate for better distribution of PPE and consider offering trainings on these behaviors.

Patient Barriers and Facilitators to Medications for Opioid Use Disorder in Primary Care

Vaughan Dickson, V., Tofighi, B., Williams, A. R., Chemi, C., Suhail-Sindhu, S., Dickson, V., & Lee, J. D. (2019). (Vols. 54, Issues 14, pp. 2409-2419). 10.1080/10826084.2019.1653324
Abstract
Abstract
Introduction: This study explored factors influencing patient access to medications for opioid use disorder (OUD), particularly for individuals eligible but historically suboptimal follow-up with in-house referrals to office-based opioid treatment (OBOT). Objectives: In-depth qualitative interviews among a mostly underserved sample of adults with OUD elicited: 1) knowledge and experiences across the OUD treatment cascade; and 2) more nuanced elements of patient-centered care, including shared decision making with providers, experiences in OBOT versus specialty addiction treatment, transitioning from methadone to buprenorphine or extended-release naltrexone (XR-NTX), and voluntary discontinuation of medications for OUD. Methods: We conducted semi-structured qualitative interviews between January and February of 2018 among adult inpatient detoxification program patients with OUD (n = 23). Preliminary analysis of interviews yielded key themes and ideas that were coded from a grounded theory approach. Results: Willingness to engage with OBOT was influenced by a complex array of practical considerations, including access to patient-centered care in OBOT settings, positive experiences with illicitly obtained buprenorphine, and differential experiences pertaining to OBOT versus specialty addiction treatment. Responses were generally favorable towards OBOT with buprenorphine, yet knowledge regarding extended-release naltrexone was limited. Respondents were often frustrated by clinicians when requesting to transition from methadone to buprenorphine or XR-NTX. Lastly, participants elucidated limited access to OBOT programs in underserved neighborhoods and suburban settings. Conclusion: Limited access to patient-centered care in OBOT with buprenorphine and extended-release naltrexone may exacerbate challenges to retention and/or reengagement with OUD care.

Patient decision-making regarding left ventricular assist devices : A multiple case study

Vaughan Dickson, V., Dillworth, J., Dickson, V. V., Reyentovich, A., & Shedlin, M. G. (2019). (Vols. 51, pp. 7-14). 10.1016/j.iccn.2018.10.004
Abstract
Abstract
Objectives: To understand how patients make decisions regarding a left ventricular assist device (LVAD). Design: A qualitative multiple case study design was used to explore the context and influence of individuals regarding patients’ decision-making processes through: 1) detailed, in-depth interviews of those mostly involved in the patient's decision and 2) pertinent data including observations, medical records, educational information and physical artifacts. Data clusters and patterns of co-occurring codes were examined using thematic analysis. Main outcome measures: Themes were extrapolated from individual case summaries to provide an in-depth analysis of each case and a cross-case analysis across the multiple cases. The predominant theme, consistent with other studies, was the salience of survival. Findings: This case study approach revealed new themes beyond those of prior studies. Patients considered: 1) self-care management for patients without a caregiver, 2) acceptability and future expectations of the LVAD and 3) the role of nurses in eliciting patients’ fears, values and preferences. Conclusion: The patients’ decision-making processes regarding an LVAD involve a cost-benefit analysis of the anticipated needs and consequences of the LVAD. Acceptability of the device is relevant to clinical practice and public policy. Nurses have a unique role in seeking patients’ concerns, an essential component of shared decision-making.

Perceived stress among patients with heart failure who have low socioeconomic status : A mixed-methods study

Vaughan Dickson, V., Dickens, C., Dickson, V. V., & Piano, M. R. (2019). (Vols. 34, Issues 3, pp. E1-E8). 10.1097/JCN.0000000000000562
Abstract
Abstract
Background: Patient populations with low socioeconomic status (SES) experience psychological stress because of social determinants of health. Social determinants of health contribute to self-care - especially among patients with heart failure (HF). Objective: We sought to describe the influence of stress and social determinants of health on self-care in patients with HF who have low SES. Methods: In this mixed-methods, concurrent embedded study, participants (N = 35) were recruited from 2 urban hospitals in Chicago if they had low SES and were readmitted within 120 days of an exacerbation of HF. We conducted semistructured interviews to collect qualitative data about stressors associated with patients' living circumstances, strategies patients used to foster self-care, family dynamics, and coping strategies patients used to decrease stress. We measured psychological stress (Perceived Stress Scale [PSS-10]), and self-care (Self-care of Heart Failure Index). Content analysis was used to analyze the qualitative data, and descriptive statistics were used to describe the sample. In the final analytic phase, the qualitative and quantitative data were integrated. Results: Self-care was poor: 91.5% of participants had Self-care of Heart Failure Index subscale scores lower than 70. Perceived stress was high: 34% of participants had PSS-10 scores of 20 or higher. Several social determinants of health emerged as affecting self-care: financial stress, family personal health, past impactful deaths, and a recent stressful event (eg, child's death). Participants lived in areas with high crime and violence, and participants described many stressful events. However, among participants whose PSS-10 scores were lower than 20 (indicating lower stress), there was discordance among the description of factors impacting self-care and their PSS-10 score. Conclusions: Social determinants of health negatively impact the ability of low-SES patients to manage their HF symptoms and adhere to a medication and dietary regimen. It is important that healthcare providers assess patients' stressors so appropriate referral to services can occur.