Research

The primary purpose of nursing research is to create science that informs nursing practice, allowing nurses to provide the best care to their patients. Nurse scientists can help ensure that findings from nursing research studies are adapted into everyday patient care. They stay involved in practice and share findings with nurses engaged in direct patient care, and with those who have input into the development of clinical practice guidelines and standards.

Including direct care nurses in the design and implementation of studies ensures clinical relevance and feasibility and helps facilitate rapid integration of nursing research findings into clinical practice.

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A practice-based model to guide nursing science and improve the health and well-being of patients and caregivers.

Mayo Clinic nurse scientists seek solutions to complex healthcare needs among patients and their caregivers. Research falls into three broad categories:

• Caregiving science.
• Self-management science.
• Symptom science.

Research findings are used to improve the health and well-being of patients. The Mayo Clinic nursing research model serves as a guide for the conduct of clinical research in these three distinct scientific areas in a practice-based setting.

Caregiving science

Care interventions for caregivers

Lead researcher: Sherry S. Chesak, Ph.D., M.S., R.N.

Clinicians are at high risk of experiencing stress and burnout, which has consequences at both the personal and professional levels, including a negative impact on patient care. In addition, caregivers such as family, friends and others take on major responsibilities in patient care. In particular, caregivers who are thrust into their roles unexpectedly tend to experience high levels of care burden.

Dr. Chesak's research on care for the caregiver focuses on resilience-promoting interventions for both healthcare professionals and lay caregivers. It also involves developing and evaluating methods to instill a sense of belonging among healthcare professionals.

Symptom science

Acute pain management and moral distress

Nurse scientist: Melissa A. Wilson, Ph.D., R.N., FAAN

Mayo Clinic nurse scientists develop and test innovative technology solutions for acute pain management in patients and moral distress in healthcare professionals.

The goals of Dr. Wilson's acute pain research are to:

• Empower patient involvement in care delivery.
• Offer pain management options other than medicine.
• Prevent complications such as chronic pain, substance use disorder and other negative outcomes.
• Reduce the administrative burden on healthcare professionals.

The division's research on moral distress aims to better understand and reduce the harmful effects experienced either when healthcare professionals provide care or when barriers prevent them from providing care, which is known as moral distress. Dr. Wilson studies moral distress in both civilian and military healthcare professionals. She tests comprehensive, precision-based interventions delivered on digital platforms. This research is important because moral distress can lead to moral injury, post-traumatic stress and burnout. It also can result in poor outcomes for patients as well as healthcare professionals, teams and organizations.

Cancer and psychology

Lead researcher: Cindy Tofthagen, Ph.D., R.N., ARNP, AOCNP, FAANP, FAAN

Dr. Tofthagen and colleagues study psychological symptoms among people with cancer and their family caregivers. The research team develops and tests interventions to address traumatic memories that contribute to psychological symptoms such as distress, anxiety, depression and grief. This research benefits people with cancer and their families by building resilience and helping them cope with the psychological effects of cancer diagnosis and treatment, as well as to process feelings of loss and grief associated with such a diagnosis.

Delirium prevention and symptom management in older adults

Lead researcher: Heidi L. Lindroth, Ph.D., R.N.

Dr. Lindroth's vision is a world without delirium. Her research works toward that vision by partnering with patients, families and clinicians to co-design evidence-based digital tools to predict, detect and monitor delirium severity over time. Her team's recent accomplishments include an AI algorithm to identify delirium and gauge how serious it is, a passive digital marker for delirium severity, and an evidence-based website to help patients and families prepare for delirium with tools and strategies to prevent it.

If you are interested in or frustrated by delirium, Dr. Lindroth invites you to email her at lindroth.heidi@mayo.edu.

Gut microbiome link to chemotherapy-induced nausea

Lead researcher: Komal P. Singh, Ph.D., R.N.

People with cancer experience several neuropsychological and gastrointestinal symptoms during and after treatment. Debilitating symptoms include:

• Fatigue.
• Depression.
• Cognitive changes.
• Sleep disturbance.
• Nausea.
• Lack of appetite.
• Diarrhea.
• Change in taste.

Investigating patient risk factors associated with these symptom experiences can help identify people at high risk of symptom burden. In addition, omics-based methodologies can help pinpoint underlying biological mechanisms associated with patient symptoms.

Dr. Singh is part of a multidisciplinary team at Mayo Clinic that collaborates with other academic institutions to advance research in this area. The team studies how the symptoms experienced by patients with cancer are associated with chemotherapy-induced changes in the microbiome-gut-brain axis. Identifying precise changes in patients most at risk of experiencing severe symptoms after chemotherapy can help scientists develop targeted interventions to ease cancer treatments' harmful side effects.

Inflammatory bowel disease (IBD) and sleep

Lead researcher: Samantha Conley, Ph.D., R.N.

Research in this area focuses on understanding the relationship between sleep and symptoms of IBD. People with IBD experience a high symptom burden that is associated with short and irregular sleep. However, few interventions are available for people with IBD to improve their symptoms and sleep.

Dr. Conley and colleagues develop and test symptom self-management interventions for people with chronic conditions such as IBD to improve their day-to-day functioning and overall well-being. The research team often finds that people with IBD are excited to participate in research in hopes that it can ultimately improve how they feel.

Reducing symptom burden and improving functioning among patients with chronic diseases

Lead researcher: Melissa D. Pinto, Ph.D., R.N., FAAN

The Division of Nursing Research studies ways to reduce symptom burden and improve functioning among patients with chronic diseases who also experience depression and anxiety.

People with chronic conditions are highly susceptible to co-occurring mental health conditions such as depression and anxiety. Yet while people with chronic conditions can manage physical symptoms to improve their daily functioning and quality of life, patients and healthcare professionals often overlook mental health concerns. There is an unmet need to consider mental health when developing effective interventions that optimize health and well-being.

Dr. Pinto and colleagues conduct symptom science research to better understand how symptoms co-occur in people with chronic conditions. Through self-management research, they also seek to understand and develop interventions that help patients best manage symptoms of chronic conditions. This research lies at the intersection of chronic health conditions and co-occurring depression and anxiety. It includes:

• Using multiple data types and artificial intelligence to develop sets of signs and symptoms related to specific diseases and conditions, and to create personalized approaches to manage such symptoms.
• Examining how biology and behavior can be used together to inform new ways to manage treatments, especially using a mind-body framework.
• Exploring patterns of symptoms for various syndromes and illnesses, including long COVID, that disproportionately affect women during midlife — and looking for treatments for such conditions.

Symptom management for patients on mechanical ventilators in the ICU

Lead researcher: Linda L. Chlan, Ph.D., R.N., ATSF, FAAN

Research in this area develops and tests interventions to help patients manage feelings of anxiety. Patients often feel anxiety when receiving mechanical ventilatory support in the intensive care unit (ICU). Dr. Chlan's research team seeks solutions for how to best assess and empower patients to co-manage or self-manage symptoms safely while in the ICU.

Transplant

Post-doctoral nursing research scholar: Stacy A. Al-Saleh, Ph.D., R.N., C.C.T.C.

The division's transplant research aims to promote the highest level of health and well-being for all patients receiving organ transplant. Dr. Al-Saleh's research examines relationships between symptoms — such as fatigue and cognitive problems — sleep characteristics, and disability after transplantation. This work will allow healthcare professionals to better identify patient needs and match interventions to those needs to optimize the health and well-being of people receiving transplants.