Since earning her Bachelor of Science in Nursing from the University Of Arizona College of Nursing in 1998, Anabell Castro-Thompson’s star has ascended. Her professional achievements include serving as president of the National Association of Hispanic Nurses (NAHN) and working as vice president of Equity, Diversity and Inclusion for Equality Health Network. Additionally, she has scored numerous accolades, including the 2015 UA Alumni Association “Young Professional Achievement Award” and the 2011 Valle del Sol “Latino Excellence in Health and Science Award.” Castro-Thompson, MSN, RN, ANP-C, FAAN, credits her experiences at the UA College of Nursing with helping to develop the passion for inclusive excellence in health care and the strong leadership skills that have guided her success.

“It was instilled in me from a very young age that the field of health care not only offered career choices but also a process of learning directed at making a meaningful impact on people’s lives,” said Castro-Thompson, whose father is an internal medicine physician. That mode of thinking informed her choice to enroll in the UA College of Nursing BSN program, which immediately attracted her with its mix of diversity, humanistic learning and faculty dedicated to student success. “Because of these things, I felt included and well-matched,” she said. “I knew I was choosing a career that was going to make an impact on the lives of others and my own.”

“It was instilled in me from a very young age that the field of health care not only offered career choices but also a process of learning directed at making meaningful impact on people's lives." ~ Anabell Castro-Thompson

In her current role at Equality Health Network, Castro-Thompson’s expertise is focused on building culturally competent health care models that achieve better health care outcomes, higher patient satisfaction and lower costs in the Hispanic community. Equality Health is dedicated to organizing a better healthcare delivery system for cultures that have struggled with integrating into the traditional U.S. healthcare system. “As a graduate of the College of Nursing, one of my biggest goals is to decrease health care disparities in my community and around the country,” she said, recalling how her clinical rotations while a UA nursing student fed her ambition to provide competent health care tailored to a diverse society.

While a student, Castro-Thompson’s experience as president of Student Nurses of the UA (SNUA) honed her leadership prowess. “My experience there served as the foundation for the leadership I now hold nationally as NAHN president,” she said. In keeping with her value of diversity and inclusiveness, her mission as NAHN president is two-pronged: First, to strongly advocate and influence policy development which leads to a more equitable, accessible, and quality-driven healthcare for the Hispanic community. And second, to work to ensure that more Hispanic women and men, who currently only account for less than four-percent of the nursing population, join the profession to more accurately mirror the populations they serve.

 “I have a very special place in my heart for the University of Arizona CON,” said Castro-Thompson. “In many ways, it formed the person that I am now. As the College celebrates its 60^th Anniversary, my sentiment for my alma mater is rekindled. It’s a perfect opportunity for me to make sure that the opportunities that were afforded to me continue to be present and grow for future generations.”

A cancer survivor responds to stress in various detrimental ways: There are psychological problems such as anxiety and depression as well as physical issues such as high blood pressure, increased heart rate and elevated blood sugar levels. All those factors contribute to a lower quality of life for people already dealing with a debilitating health issue. But the mind may have a key to helping ease those woes.

Compassion meditation is a centuries-old practice meant to improve emotional and physical well-being, but thanks to recent scientific inquiry into integrative therapies it may find its way into contemporary cancer survivorship healing programs. University of Arizona College of Nursing Assistant Professor Thaddeus Pace, Ph.D., intends to apply a specific compassion meditation technique called CBCT® (Cognitively-Based Compassion Training) to see if it eases psychological and biological stress-related responses in patients coping with cancer and their home caregivers alike.

“MDS Manager allows users to track their own lab results, bone marrow results, transfusions, treatments and any symptoms they may be having." ~ Sandy Kurtin, UA Nursing PhD Student

Dubbed ‘Compassion Meditation,’ in previous studies, Pace’s chosen therapy has already proven effective in dampening the body’s response to stress in healthy young adults. “We’ve taken initial work on how compassion meditation may be good for modifying stress activation and have already examined indicators of its stress-reduction effect in foster care children with trauma histories,” said Pace, who theorizes that the therapy may also prove useful in the cancer survivorship arena. “The biological underpinnings of the quality of life impairments that happen in cancer survivors likely involve similar stress components.”

Created by Pace’s colleague at Emory University, Geshe Lobsang Tenzin Negi, Ph.D., CBCT® is derived from the ancient Tibetan Buddhist tradition of Lojong, a mind-training discipline that emphasizes mental calmness in difficult situations. “We have a sense that this compassion meditation program may have some beneficial impact on systemic inflammation,” said Pace. “Inflammation is highly implicated in the quality of life impairments that people experience after primary cancer treatments. Poorer quality of life also affects those surrounding cancer survivors, which is why we’re extending this work to involve not just cancer survivors but also their close, supportive caregivers as well.”

Thanks to research led by College of Nursing Professor Terry Badger and College of Social and Behavioral Sciences Professor Chris Segrin, it is evident that a complex social bonding occurs between cancer survivors and their home caregivers (family or close others). Studies involving prostate and breast cancer survivors have revealed that when the patient’s mood was down, their caregiver’s mood tended to be down, and vice versa. Based on this interplay, Pace plans to offer the multi-week compassion meditation program to both parties, promoting more tranquil moods in tough social situations, and also sustaining a calmer overall outlook. “If we boost one or both, they both really rise together dramatically,” said Pace.

He hopes that a new study underway in his laboratory will build solid scientific evidence to back up this integrative wellness strategy for breast cancer survivors and their close family members and friends. Participants will learn how to adapt their mind-body state by attending instructor-guided meditation sessions with expectations to also practice at home. Observed changes in depression, anxiety, stress and social interactions will provide insights into the body’s mental and physical responses to the therapy as well as how to improve them.

“If we showed broad effectiveness of this program we could work to have compassion meditation as a therapy available in every major cancer center,” Pace said. “People’s lives change because of cancer treatments. They can knock back cancer but they can’t always escape the sledgehammer effects cancer has on brain functions like cognition and behavior. Long-term, people arrive at a new normal which is often subpar. The goal in survivorship intervention work is to arrive at a new normal that’s optimal for good quality of life.”

A divide of misunderstanding too often separates Native American cancer patients from the nurses who care for them. UA College of Nursing assistant professor Natalie Pool, PhD, BSN, RN, hopes to heal those differences with cultural safety training developed during her most recent research.

Pool became aware of the challenging dynamic early in her career. Her work as a medical-surgical nurse serving the White Mountain Apache and Northern Ute reservations occasionally involved cancer patients dealing with the side effects of cancer treatment or end-of-life issues. She cared for similar populations working surgical-oncology in the Tucson area.  During those experiences, she noticed a disproportionate number of Native American patients experiencing significant cancer complications. “There were many end-stage patients with cancers that we consider highly preventable and treatable in the general population,” she said. “Such as cervical, colon or prostate cancer.”

One reason, Pool discovered, was the long history of wariness Native American populations had for healthcare providers and the healthcare system. Lack of access to wellness resources and adverse experiences within the system caused some communities to view health services and providers with skepticism. Many patients resisted seeking care until there was no other choice.

“Nurses want to be culturally respectful and have a meaningful connection with their patients regardless of who they are." ~ Natalie Pool, PhD, BSN, RN

Ironically the situation actually served to widen the cultural divide. Pool’s interviews with cancer nurses who cared for Native American people revealed feelings of frustration with what they interpreted as noncompliant behavior. Additionally, patients tended to have a very different perception of cancer than their caregivers, which led to conflicting expectations that often felt confusing and alienating to nurses. That dissatisfaction often led to disillusionment and high turnover rates of nursing staff.

Realizing that optimism is essential for cancer nurses, Pool theorized that the key to improving the situation for patients and nurses alike was education to raise culture-specific knowledge. “Nurses need comprehensive cultural training to better integrate into their care and understanding of the health-related issues Native American communities face,” she said, citing such challenges as food security issues, transportation dilemmas, and communication and language barriers.

“What they require are the right tools, because ultimately most nurses want to provide unbiased, inclusive care for all of their patients,” said Pool. “They want to be culturally respectful, and have a meaningful connection with their patients regardless of who they are. They want to partner with other providers serving Native American people, social workers and traditional healers in the interest of better long-term cancer care for these patients.”

Fueled by the results of the study, Pool advocates comprehensive and targeted cultural safety training designed to better equip nurses to provide culturally congruent care. “Improving the work satisfaction for the nurse will improve the patient’s experience as well,” she said. 

She hopes her findings will spur changes in how nurses learn to provide care with Native American populations, not only for those already working in the field but for those studying to become registered nurses.  That’s especially important in the Southwest, which is home to more than 20 percent of U.S. Native Americans.

She’s known as the Skin Cancer Prevention Queen, and she’s taking her passion for prevention to classrooms near and far. Lois Loescher, PhD, RN, FAAN, associate professor at the University of Arizona College of Nursing, the Mel and Enid Zuckerman College of Public Health and the Skin Cancer Institute at the UA Cancer Center will soon release results from an adaptation of her Students Are Sun-Safe (SASS) program tailored for high school students living along the U.S.-Mexico border.

Started five years ago to reach high school students who generally act invincible and often do not adequately protect themselves, the original SASS peer mentoring project trained UA Health Sciences students. Armed with a sun safety PowerPoint presentation, UA students were sent to educate local high school and middle school students about skin cancer risk. During that time more than 200 UA students reached nearly 3,000 Tucson students.

Flash forward to today: Funded by the Arizona Area Health Education Program (AzAHEC), Loescher hopes to fill statistical gaps in our knowledge of sun safety behaviors in Hispanic populations through the adapted border youth project SASS. Partnering with Nogales’ Southeast Arizona Area Health Education Center (SEAHEC) ensured that the training was age appropriate and sensitive to the culture of border youth.

“For Project SASS, we adapted the model to train 18 students in Bisbee, Douglas and Nogales High schools to be the peer educators,” said Loescher. “We recruited from school-based health career clubs that attract students who really want to go to college to build a better life. These kids are amazing. A couple of them have been accepted into Ivy League universities.”

After receiving SASS training, the students were assigned to present to at least 250 of their classmates. The results of Loescher’s study, for which she tested the students before and immediately after training as well as testing three months later, will build a bank of the border students’ knowledge, attitudes and self-reported sun safety behaviors.  “We have very little information on skin cancer risk factors in Hispanic populations,” she said. “When we’re done we’ll have numbers that give us a more accurate view.”

Stay tuned!

Caring for a loved one with a cancer diagnosis can influence every aspect of a family's quality of life. It may also lead to depression, the most common mental health disorder in the world, according to the Centers for Disease Control and Prevention (CDC).  With health care providers and supportive care services stretched thin, it’s not uncommon for cancer patients and their caregivers (family or close others) to feel left behind. That’s especially true for Latinas, a growing and particularly vulnerable population with regard to breast cancer, because they tend to be diagnosed at later stages, to be sicker and have fewer easily accessible resources to deal with their psychological distress.

Terry Badger, professor and director of the community and systems health science division at the University of Arizona College of Nursing, wants to change that in the interest of reducing health disparities. Funded by the American Cancer Society, Badger’s current research is focused on interventions intended to strengthen the psychological, physical, social and spiritual wellbeing of Latinas and their caregivers. Unique in two ways, the study aims to improve the care of a historically undeserved population and it employs a surprising familiar technology for care: the telephone.

Why did you focus on the Latina population?

When we started nobody was thinking about how to deliver emotional care to Hispanic women and their caregivers. Typically, patients who were really depressed were referred to face-to-face support groups, but at the time there were none conducted locally in the  Spanish language. If we recommended face-to-face supportive care services, only about 25 percent of people would attend, and if we referred them to a psychiatrist or a psychiatric-mental health nurse practitioner, only about 45 percent would visit due to stigma or travel concerns. We culturally tailored our program to get past these barriers.

Why focus on patients and their caregivers?

Cancer is not just the patients’ disease but really a family condition, because it alters roles, responsibilities and expectations. During various phases of the cancer journey, caregivers make tremendous changes in their lives – they may change their work hours or leave their work entirely. It impacts the entire family. Whether you yourself are ill or somebody you love, for either person or both, depression and anxiety can emerge.

Why did you choose the telephone as the way to communicate with patients?

We were compelled to develop a way to deliver emotional support counseling and education to survivors and their caregivers in a very accessible way. When we started these studies we considered other devices, but realized that people with very low economic means might not have easy access to a computer or tablets or perhaps internet access. But we found that most people, even with very limited means, will have a cell phone with some minutes on it.

How does the program work?

We call the participating women about once a week for about 30 minutes. We discuss their emotional symptoms and work out ways for self-care that will reduce them, and of course we measure their progress along the way. We learned that we are able to effectively reduce their anxiety, depression and stress, but also that when we deal with those factors, other symptoms like fatigue and pain aren’t as severe. We found that the women and their caregivers love the fact that they don’t have to arrange for childcare or pay for transportation. One woman told me, ‘Before you even talk to me, just the thought of you calling me once a week to ask me how I am has made me feel better.’ The human contact means a lot to them and a nice thing  is how it colors their whole view of their experience at the University of Arizona Cancer Center because their impression is, ‘Wow, I’m really cared about.’

How will the outcome of the study improve lives?

This program has proven to be effective in symptom and distress management, including depression, anxiety and other negative symptoms; as well as improving social and spiritual wellbeing. I hope we’re reaching a point of changing practice. For example,  cancer care centers could routinely offer this service to patients.

What do you see as the most significant impact of your research program for health care?

Right now, the majority of healthcare that’s given to cancer patients is by their home caregivers, not by formal healthcare providers. Investing upfront using low cost technology to conveniently guide people to care for themselves at home is bound to reduce relapses, lessen returns to expensive forms of health services and prevent enduring poor health. 

Terry A. Badger, PhD, RN, PMHCNS-BC, FAAN, is professor and director of the community and systems health science division at the University of Arizona College of Nursing. Her research is focused on depression in chronic illness, depression in adults and families, health outcomes and psychosocial oncology interventions with cancer survivors and their families.

The University of Arizona College of Nursing is one of only 28 schools of nursing nationwide to receive a grant to increase the number of nurses holding PhDs. Through the prestigious Robert Wood Johnson Foundation Future of Nursing Scholars program, two UA nursing students who commit to earn their PhD in three years will be provided with financial support, mentoring, and leadership development.

“The Future of Nursing Scholars program is making an incredible impact in real time. These nurses will complete their PhDs in three years, a much quicker progression than is typically seen in nursing PhD programs,” said Julie Fairman, PhD, RN, FAAN, Future of Nursing Scholars program co-director and the Nightingale professor of nursing and the chair of the Department of Biobehavioral Health Sciences at the University of Pennsylvania School of Nursing.

“We are thrilled to receive this funding to accelerate the progression of two outstanding students through our program. This generous grant is in recognition of the qualiity of our PhD program, faculty and students." ~ Anne G. Rosenfeld, PhD, RN, FAHA, FAAN

The Future of Nursing Scholars program is a multi-funder initiative. In addition to RWJF, Johnson & Johnson, Northwell Health, Cincinnati Children’s Hospital Medical Center, Sharp HealthCare, Rush University Medical Center, Care Institute Group, and Memorial Sloan Kettering Cancer Center are supporting the Future of Nursing Scholars grants this year.

The UA College of Nursing is receiving its grant from the Robert Wood Johnson Foundation. After final selection of scholars in March, two UA nursing students will begin the Future of Nursing Scholars program this summer and their PhD studies this fall.

“We are thrilled to receive this funding to accelerate the progression of two outstanding students through our PhD program,” said Anne G. Rosenfeld, PhD, RN, FAHA, FAAN, professor and director of the PhD Program. “This generous grant is in recognition of the quality of our PhD program, faculty and students.”  

In its landmark nursing report, the Institute of Medicine recommended that the country double the number of nurses with doctorates; doing so will prepare and enable nurses to lead change to advance health, promote nurse-led science and discovery, and put more educators in place to prepare the next generation of nurses. The Future of Nursing Scholars program is intended to help address that recommendation.

“We were pleased to see that enrollment in doctorate of nursing practice programs has increased 160% from 2010 to 2014. However, we want to ensure that we also have PhD-prepared nurse leaders in faculty and research roles. In the same time period, PhD enrollment has only increased by 14.6%. The nurses funded through the Future of Nursing Scholars program will make important contributions to the field and be well-prepared to mentor other nurses,” said Susan Hassmiller, PhD, RN, FAAN, co-director of the program and RWJF’s senior adviser for nursing.

The 51 nurses supported in this round will join 109 Scholars across the three previous cohorts. The program plans to add a fifth cohort which will bring the number of funded Scholars to more than 200 nurses.

As a Bachelor of Science in Nursing (BSN) student at the University of Arizona College of Nursing, Brooke Finley knew she wanted to pursue research her first day of class in Scholarly Inquiry in Evidence-Based Practice, taught by Associate Professor Janice Crist.

“I always asked ‘What’s next?’ ‘What does this mean?’” said Finley. “There’s always something more you can know. That first day, I felt like all my questions were answered and more.”

As a BSN student, Finley participated in a number of research opportunities, including working as a data collector for Associate Professor Barbara Brewer and as a research assistant for Assistant Professors Jane Carrington and Sheila Gephart.

“They were excellent mentors,” said Finley. “I really couldn’t have asked to work with better people. They were really supportive of my learning and treated me like a colleague, not a student. I really enjoyed the level of interaction we had, and that was one of the key things that made me realize I wanted to pursue research as a career.”

For her BSN honors thesis on compassion fatigue in oncology nurses, Finley worked with Clinical Associate Professor Kate Sheppard, who took her under her wing and provided data for Finley to analyze. Finley went on to present her honors thesis during a podium session at the Western Institute of Nursing annual research conference, attended by hundreds of leading nurse scientists, faculty and graduate students across 13 Western states.

After Finley graduated with her BSN degree last May, she applied to and was accepted by four different PhD programs. Ultimately, she decided to stay at the UA, where she says research is “part of the culture and the expectation.”

As a first-year Doctor of Philosophy (PhD) in Nursingstudent, Finley was one of 23 graduate students selected to receive the University Fellows Award from the UA Graduate College. The prestigious fellowship provides financial support, professional and personal development, community engagement and opportunities to interact with an interdisciplinary group of UA Fellows and distinguished faculty members.

“Receiving this fellowship was a paradigm shifter,” said Finley, who worked throughout her undergraduate career. “I don’t have to worry about surviving financially anymore and can focus solely on building my professional foundation. Personal growth and academic leadership is the aim of the Fellows program, so ultimately the Graduate College team gives you the financial and instructional support to make you the best scholar and community member possible. This is the ideal situation for any graduate student. I’m beyond grateful.”

For her PhD dissertation, Finley is focusing on how to improve the efficiency of electronic health records use by nurses and other health-care professionals. Dr. Carrington, one of her research mentors from her undergraduate career, is her dissertation chair.

“The thing that I love about Dr. Carrington is she doesn’t feel that success is a definite property,” said Finley. “It’s infinite and continuous and she’ll share it with everyone.”