The Division of Nursing Research conducts clinical care research aimed at improving patient care and outcomes for children with catastrophic diseases.
The Division of Nursing Research actively contributes to improving patient care and patient care outcomes for all patients and families given care at St. Jude Children’s Research Hospital and its affiliates, and indirectly for children world-wide who have a catastrophic illness. We do this by creating, applying, evaluating and sharing the highest quality clinical care research.
The focus of our research is on effective methods for maximizing the patients’ emotional and physical comfort, identifying mechanisms of underlying biologic and behavioral processes that contribute to suffering, facilitating patient and family coping with illness and treatment, and promoting the practice of positive health habits.
Recently completed and on-going research projects have identified factors that influence treatment choices, including end-of-life decisions made by patients and parents; created strategies to measure fatigue and sleep changes in patients; improved methods for infusing platelets; developed a unique definition of quality of life from the perspective of a child or adolescent; and symptoms that concern parents the most during their child's final week and day of life. Current research is providing a better understanding of symptoms related to cancer and cancer therapy and the trajectory of these symptoms through the disease process into survivorship, facilitating the development of patient profiles for those at risk of symptoms, subsequent diseases, and late effects.
The Division of Nursing Research directs the Evidence-Based Practice Fellowship, an educational and experiential program designed to help clinicians at St. Jude contribute more fully to science and patient care at our hospital.
Belinda N. Mandrell, PhD, RN, PNP, Director, Nursing Research Division
Jami S. Gattuso, MSN, RN, CPON, Nursing Research Specialist III
Oral mucositis is a significant and common toxicity experienced by patients who receive chemotherapy as a preparatory regimen for a hematopoietic cell transplant (HCT). Furthermore, oral mucositis has been reported as the single most debilitating side effect reported by patients undergoing HCT. The incidence of HCT mucositis among adults is estimated to range between 76% and 89%; however, comparisons are difficult due to variability in patient ages, treatments and criteria for scoring oral mucositis.
The use of intra-oral photobiomodulation (PBM) therapy in adult patients after the development of oral mucositis is well documented and now included in the international mucositis guidelines, with limited evidence in pediatrics. This study will build evidence for the incorporation of extra-oral PBM therapy into daily nursing care of children and adolescents undergoing HCT. This intervention has potential in providing evidence for efficacy in the prevention and treatment of oral mucositis, the single most debilitating side effect reported by patients undergoing HCT.
Assessment of obstructive sleep apnea (OSA) in survivors who receive thoracic radiation and associated factors compared to a community control.
This study explores the prevalence of OSA among adult survivors of childhood cancer treated with thoracic radiation compared to community controls matched on age, sex, race and body mass index. Additionally, the study is exploring therapeutic factors, biomarkers and associations between OSA and cardiac morbidity and brain integrity.
This is a 5-year RO1 funded study through the National Cancer Institute and conducted in collaboration with Epidemiology and Cancer Control, Dr. Kevin Krull.
Modulated proton therapy for incompletely resected craniopharyngioma and observation after resection
This Nursing Research objective within the RT3CR protocol assesses the sleep quality, daytime sleepiness, circadian rhythm, fatigue, symptom distress and quality of life including association with effects of the tumor and treatment factors including grade of hypothalamic involvement.
Initial findings suggest a high prevalence of narcolepsy associated with higher grade hypothalamic involvement, and both narcolepsy and hypersomnia being associated with obesity.
In collaboration with radiation oncology, neurology and psychology, nursing research is directing an intervention for narcolepsy and hypersomnia with initiation of Modafinil for management of excessive daytime sleepiness. Click here to view the Modafinil video.
This study will administer surveys to measure the genetic/genomic knowledge, trust in health care provider, and literacy/numeracy ability in parents of children with SCD and adolescents with SCD. We will conduct semi-structured interviews in parents of SCD patients to describe parental attitudes of research involving genomic sequencing, including concerns about participation and expectations from researchers.
This study will add to the deficit of knowledge regarding the attitudes, beliefs, and expectations of parents around clinical research trials involving genomic sequencing.
This is a funded study through NHLBI U01HL133996-04 and in collaboration with Drs. Liza Johnson and Jane Hankins.
This quality improvement project will gather information to determine the areas of practice that cause moral and ethical distress among clinical nursing staff. This data will identify barriers in developing potential interventions.
This project is in collaboration with St. Jude nursing and Drs. Arshia Madni, Liza Johnson and Deena Levine
The St. Jude staff believes that hope is essential to life, and that hope can directly influence the well-being of pediatric patients. Hope can help patients make the best of difficult moments and make sense of having a serious illness. Dreams, wishes and goals point toward today or the future, and hope is what drives those thoughts. Without hope, each day can seem uncertain or even scary. Having hope, for themselves or others, helps children and teens cope with hardships.
The St. Jude staff has done extensive research on this subject. The result is a combination of information and resources that can help you and your child find hopefulness during this hard time.