Yu-Ping Chang, Susan Grinslade, Sharon Hewner, Maeve Howett, Pamela Paplham, Annette B. Wysocki
Emeritus: Carol Brewer, Jean K. Brown, Patricia Burns, Nancy Campbell, Patricia T. Castiglia, Juanita Hunter, Mary Ann Jezewski, Carla Jungquist, Marsha L. Lewis, Patricia McCartney
Emeritus: Nancy Campbell
Tania Von Visger
Emeritus: Nancy Campbell
Annette B. Wysocki
School of Nursing
University at Buffalo
201 F Wende Hall
Buffalo, NY 14214-3079
Tania Von Visger’s program of research centers on symptom management and quality of life enhancement using integrative approaches, particularly mindfulness-based interventions.
Currently, she is a co-investigator and study interventionist on “Mellowing Mind,” a Patient-Centered Outcomes Research Institute (PCORI) funded study that compares two ways to mitigate the impact of the COVID-19 pandemic on mental health among adults from underserved and racial minority communities. She is also completed her post-doctoral training at the Primary Care Research Institute at the UB Jacobs School of Medicine and Biomedical Science with a focus on implementation science research that is supported by the Health Services Research Administration.
During Von Visger’s 13 years of experience as critical care clinical nurse specialist at The Ohio State University Wexner Medical center, she covered nursing specialty areas in critical care, abdominal solid-organ transplant hemodialysis and acute care surgery. She also provided clinical consultation, quality improvement, education, research and leadership throughout the institution.
Von Visger’s array of educational, practice and research experiences across the country have instilled a great sense of cultural humility and empathy.
“My appreciation for cultural diversity, coupled with the opportunity to live and work in many geographic regions of the US (the West Coast, East Coast, Northeast, and Midwest), has afforded me productive and fulfilling life experiences,” says Von Visger. “While people's way of life may vary slightly in a different part of the country, they all have similar basic human needs - to be understood and respected.”
Von Visger’s dedication to stellar patient care and advancing to the profession is evidenced by her service as a member of several professional organizations. As a member of the Pulmonary Hypertension Association Clinical Practice Committee and co-chair on the American Thoracic Society Integrative Therapy Interest Group, for example, she is committed to serving and advocating for patients. She is also an active member of the Eastern Nursing Research Society (ENRS), where she serves the nursing community by leading, mentoring and coaching young nurse researchers.
Von Visger previously served as a research assistant professor at UB's Department of Family Medicine and as an adjunct faculty for UB’s School of Nursing. She has also served as faculty at The Ohio State University, Boston College, Johns Hopkins University, and the Union Memorial Hospital in Baltimore, Maryland. Von Visger received her bachelor’s degree in biology from the University of California at Los Angeles, her bachelor's and master’s degrees in nursing from the University of Maryland and her PhD in nursing from The Ohio State University.
Li, H., Zheng, E., Zhong, Z., Xu, C., Roma, N., Lamkin, S., Von Visger, T. T., Chang, Y.-P., & Xu, W. (2022). Stress prediction using micro-EMA and machine learning during COVID-19 social isolation. Smart Health, 23. Advance online publication. doi:10.1016/j.smhl.2021.100242
Von Visger, T., Lee, D., Lyons, A., & Chang, Y.-P. (2021). Integrated systematic review of psychosocial and behavioral health assessments and interventions in pulmonary hypertension. Nursing Research, 70(2),150-161. https://doi.org/10.1097/nnr.0000000000000490
Von Visger, T., Thrane, S. E., Klatt, M. D., Chang, Y.-P., & Happ, M. B. (2021). Deep relaxation experience with complementary Urban Zen Integrative Therapy: Qualitative thematic analysis. Western Journal of Nursing Research, 43(8), 723-731. https://doi.org/10.1177/0193945920973941
Liang, N.-L., Von Visger, T., Devereaux, A., & Sockrider, M. (2020). Mindfulness for those with COPD, asthma, lung cancer and lung transplantation: American Thoracic Society patient education information series. Am J Respir Crit Care Med, 202(4), P11-P12. https://doi.org/10.1164/rccm.2024P11
Von Visger, T., Thrane, S. E., Klatt, M. D., DeVito Dabbs, A., Chlan, C. L., Tan, A., & Happ, M. B. (2019). The Impact of Urban Zen Integrative Therapy on symptoms and health-related quality of life for patients with pulmonary hypertension. Journal of Palliative Medicine, 23(5), 703-711. https://doi.org/10.1089/jpm.2019.0359
Von Visger, T., Thrane, S. E., Klatt, M. D., DeVito Dabbs, A., Chlan, C. L., & Happ, M. B. (2019). Intervention fidelity monitoring of Multicomponent Complementary Therapy: Urban Zen Integrative Therapy (UZIT) for persons with pulmonary hypertension. Complementary Therapies in Medicine, 45, 45-49. https://doi.org/10.1016/j.ctim.2019.03.008
Von Visger, T. T., Kuntz, K. K., Phillips, G. S., Yildiz, V. O., & Sood, N. (2018). Quality of life and psychological symptoms in patients with pulmonary hypertension. Heart & Lung: Journal of Acute and Critical Care, 47(2), 115-121. https://doi.org/10.1016/j.hrtlng.2017.12.004
Chipps, E. M., Carr, M., Kearney, R., MacDermott, J., Von Visger, T., Calvetti, K., . . . Landers, T. (2016). Outcomes of an oral care protocol in post-mechanically ventilated patients. Worldviews on Evidence-Based Nursing, 13(2), 102-111. https://doi.org/10.1111/wvn.12124
Von Visger, T. (2021). Practicing mindfulness: Tools to decrease stress for patients with PH and caregivers. American College of Cardiology.
National Academies of Sciences, Engineering, and Medicine. (2022). COVID-19, health equity, and the Asian American, Native Hawaiian, and Pacific Islander communities: Proceedings of a workshop in brief. Washington, DC: The National Academies Press. https://doi.org/10.17226/26700.
Role: Co-investigator, study interventionist (PI: Yu-Ping Chang)
Funding Source: Person-Centered Outcomes Research Institute (PCORI)
Award Amount: $2,500,000
Abstract: Worry is defined as “a chain of thoughts and images, negatively affect-laden and relatively uncontrollable”. It has been conceptualized as a coping strategy to reduce the experience of anxiety. Though worry is a normal part of life, when it is persistent, it may exceed one’s ability to cope and become harmful stress. In a recent Kaiser Family Foundation poll, nearly half of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the COVID-19 virus. This stress manifests itself physiologically, leading to increased incidence of multiple health problems which are already a concern for many African Americans and others living in disadvantaged communities across the country. The introduction of COVID-19 has further exacerbated the profound inequities in health care for communities of color. Due to shelter-in-place orders and social distancing policies, patients and the healthcare system have encountered challenges as behavioral health interventions have traditionally been delivered in-person. With the emergence of COVID-19, there is an urgency to expand the use of technology to help people who need routine behavioral health care, while also keeping vulnerable populations in their homes to ensure safety while maintaining access to the care they need. The proposed research aims to use a randomized, controlled, comparative-effectiveness trial to: (1) compare the effectiveness of a teleconference mindfulness-based stress reduction (MBSR) vs. an MBSR mobile app in reducing worry (primary outcome) and improving other mental health outcomes including anxiety, stress, depression, loneness, isolation, sleep quality and quality of life (secondary outcomes) among adults living in predominantly low-income, mental health-underserved and minority neighborhoods: and (2) examine if the effectiveness of these two MBSR interventions can sustain at three month follow-up. We will also examine the implementation potential of teleconferencing and the mobile app MBSR. A total of 224 participants (112 for each group) will be recruited. Inclusion criteria include: (1) age 18 years and older; (2) a baseline score ≥26 on the Penn State Worry Questionnaire-Abbreviated; (3) have access to a smart phone; (4) can communicate in English; (5) have a reading level of 6 or higher; and (6) reside in one of the census-identified underserved, primarily African American Communities in Buffalo, NY. Exclusion criteria will include: (1) severe depression (patient Health Questionnaire [PHQ-9] ≥ 20); (2) active suicidal intent; (3) moderate or severe substance use disorder in the past month, psychosis, or bipolar disorder; (4) global cognitive impairment, (5) currently receiving psychotherapy behavioral counseling, (6) change in psychotropic medications within the last month, and (7) unable to communicate. This study addresses an important question of finding ways to effectively address mental health concerns during the COVID-19 pandemic expressed by our community partners, and will provide guidance for providers on ways to overcome barriers of access to mental health care in underserved communities that are being disproportionately affected by the pandemic, both during COVID-19 and beyond, yielding lessons on strategies for personalized and culturally-appropriate tailoring of interventions considering mental health needs, social determinates of health, and cultural values of African American communities. The technology involved in the proposed study including teleconferencing and a mobile app has been currently utilized in clinical settings and is not technology that needs extensive development. Furthermore, the MBSR is an evidence-based manualized intervention with flexibility for personalization. Therefore, our study, if successful, will provide actionable findings that can be immediately adopted by healthcare providers, patients, and the community during the COVID-19 pandemic while following necessary public health safety measures, and can be easily replicated throughout the country.
Role: Principal Investigator
Funding Source: UB CTSI Pilot Study Award: NIH National Center for Advancing Translational Sciences (NCATS)
Award Amount: $38,943
Abstract: Adults with Pulmonary Hypertension (PH), a chronic, life-limiting cardiopulmonary condition, experience high symptom burden, and psychological distress; all can interfere with symptom self-management. Evidence is limited regarding effective self-management strategies to reduce symptom burden among under-served racial minority (URM) patients with PH. Early diagnosis and prompt initiation of pharmacological treatment have improved clinical outcomes, two critical ingredients often not available to URM adults. Among patients with a sub-type of PH, PAH (pulmonary arterial hypertension), African-Americans (AA) have higher mortality rates than Caucasians, and AA women have the highest mortality rates. Mindfulness-based intervention (MBI) reduces depression and anxiety across chronic health conditions, including PH. However, these benefits were demonstrated among those who had access to and adhered to the intervention. For URM persons with PH, attending in-person MBI sessions can be challenging due to health disparity. While mobile- and in-person MBI have comparable efficacy, mobile-MBI has the advantages of user-activated, “as needed” delivery, consistent dose delivery, and ease of use. There is a knowledge gap in how URM adults with PH adopt and uptake MBI via the technology-assisted method. Our inadequate or unclear understanding of the human-technology interface potentially has negative consequences of preventing URM patients from benefiting from this evidence-based intervention. Health disparity impacts PH-related health outcomes and limits access to MBI, a helpful intervention in symptom self-management and health management. Our central hypothesis is that a Mindfulness Mediation for PH program is acceptable to URM adults with PH and reduces symptom burden, depression, and anxiety. We aim to determine the feasibility, acceptability, and preliminary impacts of the Mindfulness Meditation for PH (MMPH) mobile-health program in URM adults with PH in symptom management quality of life. MMPH is an 8-week mobile-MBI program modified from the prior testing of a multicomponent in-person MBI on community-dwelling adults with PH that showed a reduction in PH symptoms, pain, anxiety, fatigue, and dyspnea, along with improvement in health-related quality-of-life.
Role: Principal investigator
Funding Source: Patricia H. Garman Behavioral Health Nursing Endowment Grant
Award Amount: $18,000
Abstract: Mindfulness-based stress reduction (MBSR) program effectively reduces depression and anxiety in persons with and without chronic conditions. However, in-person MBSR requires a lengthy time commitment, necessitating disease-specific tailored programs aptly named mindfulness-based interventions (MBI) with documented effectiveness. With the growing use of technology-assisted MBI (T-MBI), there is a scientific gap about whether patients with cardiopulmonary conditions know about T-MBI and its potential usefulness. Using mixed-method survey research, we aim to assess the level of knowledge and the current use of T-MBI as a complementary health approach in symptom self-management among community-dwelling adults with COPD and PH conditions.