Diana J Wilkie

Diana J Wilkie
University of Florida | UF · Biobehavioral Nursing Science

PhD, RN. FAAN

About

340
Publications
30,709
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5,810
Citations
Citations since 2017
139 Research Items
2896 Citations
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20172018201920202021202220230100200300400500

Publications

Publications (340)
Article
Full-text available
Aim In patients with sickle cell disease (SCD), negative physical and emotional experiences result from intense chronic and acute pain episodes, but factors underlying these, and their interactions, are not well understood. The arginine vasopressin receptor 1a gene ( AVPR1A ) single nucleotide polymorphism rs10877969 has been previously associated...
Article
Aim: Racial disparities in pain are well known, but most hospice studies included few underrepresented minority patients, which limits understanding of pain disparities among cancer patients receiving hospice care. Our study purpose was to explore age and racial/ethnic associations with the sensory, affective, evaluative, and temporal dimensions of...
Article
Aim: As a brief psychotherapy for individuals facing mortal threat, Dignity Therapy (DT) effects on spiritual outcomes are unknown, especially as an intervention to support cancer health equity for racial minority patients. Our study aim was to compare usual outpatient palliative care and such care along with nurse-led or chaplain-led DT groups for...
Article
Background: Pain management is a substantial component of the care of patients with pancreatic cancer (PC). PC-related pain occurs in up to 75% of patients at diagnosis, 90% of patients with late-stage disease, and overall is the most frequently reported adverse event in this patient population. PC-related pain is multifactorial and includes viscer...
Article
Introduction: Pain is one of the complications of cancer or cancer treatment and affects the quality of life of cancer patients. Unfortunately, factors that alleviate cancer pain have been understudied despite pain being one of the most common symptoms of cancer. The purpose of this secondary comparative analysis study was to identify factors that...
Article
Background: Pancreatic cancer (PC) has been associated with detrimental impacts on psychological wellbeing. Reported PC-related depression and anxiety rates are higher than in other types of cancer. A substantial component to improve psychological well-being in patients with PC is the use of drug therapy to provide symptomatic relief. The presence...
Preprint
BACKGROUND The proliferation of health care data presented in electronic health records (EHRs) is fueling the need to consolidate and present the salient aspects in ways that reduce cognitive processing time and promote accurate use. The format in which data are presented can play a key role in achieving the desired patient outcomes while reducing...
Article
Full-text available
Background The spread of unvetted scientific information about COVID-19 presents a significant challenge to public health, adding to the urgency for increased understanding of COVID-19 information-seeking preferences that will allow for the delivery of evidence-based health communication. This study examined factors associated with COVID-19 informa...
Article
There is surmounting levels of evidence on the health disparities within cancer treatment in the United States (US). Most of the research focused on cancer specific factors including anticancer incidence, screening, treatment and follow‐up, and clinical outcomes such as overall survival (OS). Less is known about the disparities present with support...
Article
Full-text available
Background Vulvodynia, vulvar pain of unknown origin lasting at least 3 months, affects 7% of American women. Dyspareunia, its frequent companion, renders sexual intercourse virtually impossible. Although few therapies are efficacious and rapid pain relief is rarely possible, there have been no sham/placebo-controlled studies of acupuncture for vul...
Article
Background American Indian adults have the highest prevalence of type 2 diabetes (T2D) in any racial or ethnic group and experience high rates of comorbidities. Uncontrolled cardiometabolic risk factors—insulin resistance, resulting in impaired glucose tolerance, dyslipidemia, and hypertension—increase the risk of mortality. Mortality is significan...
Article
Background Pain intensity remains a primary focus clinically for sickle cell disease pain assessment despite the fact that pain quality and pain location and distribution are critical for clinical diagnosis and treatment of its etiology. However, in part because of measurement issues, scant evidence is available about pain location or its relations...
Article
Introduction: Vulvodynia is vulvar pain lasting at least 3-months without clear identifiable cause that may have other associated factors. The aim, to explore motivations of women participating in a double-blind randomized controlled trial of acupuncture for vulvodynia. Methods: Responses to the question: "Tell me about why you decided to participa...
Article
Patient-reported pain locations are critical for comprehensive pain assessment. Our study aim was to introduce an automated process for measuring the location and distribution of pain collected during a routine outpatient clinic visit. In a cross-sectional study, 116 adults with sickle cell disease-associated pain completed PAINReportItⓇ. This comp...
Article
Background: Death anxiety is powerful, potentially contributes to suffering, and yet has to date not been extensively studied in the context of palliative care. Availability of a validated Death Anxiety and Distress Scale (DADDS) opens the opportunity to better assess and redress death anxiety in serious illness. Objective: We explored death anxiet...
Article
Our study purpose was to evaluate the variation and accuracy of tailored parenting plans individually generated as a supplement to reproductive health education on the genetic inheritance of sickle cell disease or sickle cell trait. We present a secondary data analysis of experimental group data from a randomized controlled trial. Participants comp...
Article
Full-text available
Objective To determine the factors predicting the engagement of young adults who have sickle cell disease (SCD) or sickle cell trait (SCT) with an online reproductive health education intervention and engagement effects on knowledge. Methods The cross-sectional study included 167 participants who completed the web-based intervention either face-to...
Article
Introduction: American Indians (AIs) have high rates of type 2 diabetes (T2D) and comorbidities. Mortality risk is increased by uncontrolled cardio-metabolic factors and significantly reduced by antihypertensive, glucose- and lipid-lowering medication adherence. Medication adherence is low among AIs living in non-Indian Health Services (IHS) health...
Article
Full-text available
Purpose Our specific aim was to develop and assess the consensus-based validity of common measures for understanding health behaviors and ancestry in Florida’s population subgroups and establish the feasibility of wide-scale implementation of the measures and biospecimen collection within three cancer centers’ catchment areas. Methods Using the Na...
Article
Professional massages reduce symptoms experienced by cancer patients, but are costly. A cost-effective way to include this therapy routinely in hospice care is to teach family caregivers to give massages as part of their caregiving activities. However, the burden on caregivers is unknown and might offset patient benefits or cost savings. The pilot...
Article
Background: A Spanish language computerized tool would facilitate cancer pain assessment and management for the underserved population of native Spanish speakers who do not speak or lack command of the English language. Objective: Our aim was to identify Spanish-speaking adults' understanding and interpretation of the PAINReportIt-Spanish items...
Article
Objective: The objective of the study was to investigate functional performance and pain intensity outcomes for associations with negative cognitive orientations, avoidance behaviors, and fear of pain in older Black men with low back pain (LBP). Methods: Sixty Black men aged 60 and older (70 years[Formula: see text]) with LBP completed the Short...
Article
Full-text available
Aim Exercise can be an effective treatment for cancer-related fatigue, but exercise is not prescribed for many cancer patients. Our specific aim was to compare usual care and a tablet-based fatigue education and prescription program for effects on level of fatigue (primary outcome) and satisfaction with fatigue and amount of exercise (secondary out...
Article
A previous exploratory analysis of a COMT gene single-nucleotide polymorphism (SNP) and a DRD3 SNP by our group suggested possible contributions to pain-related acute care utilization in people with sickle cell disease (SCD). Our aim was to extend the analysis to gene-spanning haplotypes of COMT SNPs and DRD3 SNPs to investigate possible associatio...
Article
Background It is unknown whether nurses' knowledge about pain among patients with sickle cell disease (SCD) reflects the current standard of care. The authors evaluated changes in nurses' knowledge and simulated practice behavior after a continuing education program. Method Inpatient nurses completed an e-learning program on SCD pain; a pretest and...
Article
Objective: To characterize adolescents' practical knowledge of asthma self-management and experiences during acute asthma episodes, and compare practical knowledge between minority and non-minority groups. Methods: We conducted a secondary analysis using a qualitative descriptive design of textual data collected from 126 adolescents that partici...
Article
Background: Adherence to prescribed analgesics for patients seriously ill with cancer pain is essential for comfort. Objective: The objective of this study was to determine the analgesic adherence in seriously ill patients with cancer and its association with clinical and demographic characteristics. Methods: This is a cross-sectional study. A...
Article
Aims Patients with cancer have pain due to their cancer, the cancer treatment and other causes, and the pain intensity varies considerably between individuals. Additional research is needed to understand the factors associated with worst pain intensity. Our study aim was to determine the association between worst pain intensity and sociodemographic...
Article
Clinical Decision Support (CDS) systems, patient specific evidence delivered to clinicians via the electronic health record (EHR) at the right time and in the right format, has the potential to improve patient outcomes. Unfortunately, outcomes of CDS research are mixed. A potential cause lies in its testing. Many CDS are implemented in practice wit...
Article
Background Accurate assessment of asthma symptoms is central to appropriate treatment and management; however effective communication about symptoms−how it is perceived and reported−remain challenging in pediatric clinical and research settings. Objective To synthesize the existing pediatric literature on children's and adolescents’ word descripto...
Article
Introduction: Despite increasing evidence of the benefits of spiritual care and nurses' efforts to incorporate spiritual interventions into palliative care and clinical practice, the role of spirituality is not well understood and implemented. There are divergent meanings and practices within and across countries. Understanding the delivery of spir...
Article
Aims: Better documentation of vulvar pain is needed. We examined pain locations marked on general body and genital specific outlines among women with vulvodynia. Methods: 62 women (mean age 32.1 ± 9.5 years) with vulvodynia marked their pain on a digital genital specific outline (22 segments) and 59 of those women also marked their pain on a digita...
Article
Full-text available
This review outlines the current clinical research investigating how the haptoglobin (Hp) genetic polymorphism and stroke occurrence are implicated in sickle cell disease (SCD) pathophysiology. Hp is a blood serum glycoprotein responsible for binding and removing toxic free hemoglobin from the vasculature. The role of Hp in patients with SCD is cri...
Article
Full-text available
Objectives Intervention fidelity is imperative to ensure confidence in study results and intervention replication in research and clinical settings. Like many brief protocol psychotherapies, Dignity Therapy lacks sufficient evidence of intervention fidelity. To overcome this gap, our study purpose was to examine intervention fidelity among therapis...
Conference Paper
Purpose: Smoking rates are higher in rural regions compared to urban regions. Given the mobility within the United States, rural norms around tobacco use may persist even after individuals move to urban areas. Little research is available regarding the difference in smoking history by demographics and rural residence history. The purpose of the stu...
Article
Individuals with sickle cell disease (SCD) and individuals with sickle cell trait (SCT) have different health trajectories, but it is unknown whether sociodemographic and clinical characteristics are associated with their likelihood to be a parent. The purpose of this study was to examine the sociodemographic and clinical characteristics associated...
Article
Full-text available
Objective Dignity therapy (DT) is a guided process conducted by a health professional for reviewing one's life to promote dignity through the illness process. Empathic communication has been shown to be important in clinical interactions but has yet to be examined in the DT interview session. The Empathic Communication Coding System (ECCS) is a val...
Preprint
BACKGROUND The purpose of this article is to describe the research protocol for a randomized controlled trial of a self-management intervention for adults diagnosed with sickle cell disease (SCD). People living with SCD suffer with lifelong recurrent episodes of acute and chronic pain, both of which are exacerbated by stress. OBJECTIVE The aims of...
Article
Background: This paper describes the research protocol for a randomized controlled trial of a self-management intervention for adults diagnosed with sickle cell disease (SCD). People living with SCD experience lifelong recurrent episodes of acute and chronic pain, which are exacerbated by stress. Objective: This study aims to decrease stress and...
Article
Full-text available
Purpose Collecting patients’ pain features for congruent pain relief treatment is time-consuming. We sought to identify implementation issues and evaluate the efficacy of an electronic patient self-reporting pain device in community-based cancer clinics. Methods In a 2-phase descriptive pilot and randomized controlled trial (RCT) with pretest/post...
Article
Context : Enhancing quality of life (QoL) is a goal of palliative care. Existential QoL is an important aspect of this. Objectives : This study sought to advance our understanding of existential QoL at the end of life through examining levels of Preparation and Completion, subscales of the QUAL-E, and their associated factors. Methods : We used d...
Article
Full-text available
Circulating hemopexin is the primary protein responsible for the clearance of heme; therefore, it is a systemic combatant against deleterious inflammation and oxidative stress induced by the presence of free heme. This role of hemopexin is critical in hemolytic pathophysiology. In this review, we outline the current research regarding how the dynam...
Article
Background Dignity Therapy (DT) has been implemented over the past 20 years, but a detailed training protocol is not available to facilitate consistency of its implementation. Consistent training positively impacts intervention reproducibility. Objective The objective of this article is to describe a detailed method for DT therapist training. Met...
Article
Background: Media advertisements displaying aggression and violence in public transit spaces represent a public health concern. The high visibility of ads likely contributes to increased levels of aggression among New York City (NYC) youths traveling across boroughs. Given the importance of the physical, psychological and social environment in shap...
Article
Objectives Age group differences have been reported for pain and symptom presentations in outpatient and inpatient oncology settings, but it is unknown if these differences occur in hospice. We examined whether there were differences in pain, symptom distress, pain barriers, and comorbidities among three age groups (20–64 years, 65–84 years, and 85...
Article
Context Religion and spirituality (r/s) are important resources in coping with cancer. However, there are aspects of r/s, such as religious and spiritual struggles, found to be associated with poorer outcomes. A new measure has been adapted from the Religious and Spiritual Struggles Scale (RSS) to assess r/s struggles: the RSS-14. This concise meas...
Article
The purpose of this article is to describe the method of developing an internet-based reproductive options intervention to increase informed reproductive decision-making among individuals with sickle cell disease (SCD) or sickle cell trait (SCT). An interprofessional team of graphics and media specialist, nurses, physicians, and researchers collabo...
Article
Background Nearly 500,000 older Americans die a cancer-related death annually. Best practices for seriously ill patients include palliative care that aids in promoting personal dignity. Dignity Therapy is an internationally recognized therapeutic intervention designed to enhance dignity for the seriously ill. Theoretically, Dignity Therapy provides...
Article
Background: End-of-life discussions and documentation of preferences are especially important for older cancer patients who are at high risk of morbidity and mortality. Objective: To evaluate influence of demographic factors such as religiosity, education, income, race, and ethnicity on treatment preferences for end-of-life care. Methods: A retro...
Article
Full-text available
Sickle cell disease (SCD), an inherited blood disorder, impacts 2% of newborns in Nigeria and Ghana. Despite devastating health consequences, SCD prevention is not a priority in either country. This article describes our U.S. research team’s feasibility assessment for adapting CHOICES, a computer-based SCD education program, for use in Ghana and Ni...
Article
A routine threat to palliative care research is participants not completing studies. The purpose of this analysis was to quantify attrition rates mid-way through a palliative care study on Dignity Therapy and describe the reasons cited for attrition. Enrolled in the study were a total of 365 outpatients with cancer who were receiving outpatient spe...
Article
Full-text available
PurposeThe USA has observed a significant increase in the use of palliative care for patients diagnosed with advanced cancer. However, it is unknown how geographic variation affects patients’ use of palliative care services. We examined temporal and demographic trends in receipt of and timing of palliative care by state and region.MethodsA retrospe...
Article
Full-text available
Pain impacts wellbeing and is among the most common symptoms of cancer. Factors that decrease pain severity have been understudied despite their importance for high-quality cancer care. The study purpose was to describe pain alleviating factors and their association with type of cancer. This secondary comparative analysis included 579 participants...
Article
Full-text available
Purpose: Emotional stress is a known pain trigger in patients with sickle cell disease (SCD). The Arginine vasopressin receptor 1A gene (AVPR1A), SNP rs10877969, is associated with acute pain and stress-related pain. Our study investigated the association between AVPR1A genotype with stress and age in adults with SCD pain. Methods: 169 participants...
Conference Paper
Introduction: It is unknown if the body surface area measure is sensitive to the change in pain over the first four days after lung cancer surgery. Known for cancer health disparities, improving pain outcomes for patients with lung cancer could have implications for reducing disparities. The purpose of this study was to compare body surface area ov...
Conference Paper
INTRODUCTION Citizen scientists are an essential part of research. After a successful pilot in 2019, the Florida-California Cancer Research Education and Engagement (CaRE2) Health Equity Center held a full CaRE2 Cancer Citizen Scientist Training Program in 2020. However, COVID-19 forced a program reliant on in-lab experiences to develop a cadre of...
Conference Paper
Introduction: Little research has been done to determine if the wound pain markings correlate with the changes in measured wound size. For cancer patients, wound pain could be caused by the tumor or cancer treatments. The study purpose was to evaluate the validity of patient pain markings (body surface area) as an indicator of wound size and change...
Conference Paper
Introduction. Vulvar pain can be a symptom of vulvar cancer, which is frequently detected at late stage for elderly women, and has racial disparities. Better documentation, detection, and monitoring of vulvar pain, may eventually lead to early detection of vulvar cancer to reduce age and racial disparities in this cancer. Unfortunately, typical bod...
Article
Purpose: ASCO recommends early integration of palliative care in treating patients diagnosed with metastatic lung cancer. Our study sought to examine utilization of timely specialty palliative care (SPC) and its association with survival and cost outcomes in patients diagnosed with metastatic non-small-cell lung cancer (NSCLC). Methods: The 2001...
Article
Full-text available
Objectives Several delivery models of palliative care are currently available: hospital-based, outpatient-based, home-based, nursing home-based, and hospice-based. Weighing the differences in costs of these delivery models helps to advise on the future direction of expanding palliative care services. The objective of this review is to identify and...
Article
Background: In children with sickle cell disease (SCD), comorbid asthma is associated with increased disease severity and morbidity, but it remains underdiagnosed and optimal management paradigms are not well defined. The purpose of this study was to determine the feasibility and preliminary outcomes of an integrated pediatric SCD and pulmonary ca...
Article
Background Public knowledge and awareness of palliative care (PC) is important to its effective use. However, it remains unclear whether the geographic variation in knowledge of PC exits in the United States. This study examined the national geographic variation in knowledge of PC. Methods The study sample was obtained from the 2018 National Cance...
Article
Full-text available
A de‐identified data repository of electronic medical record data, i2b2 (Informatics for Integrating Biology and the Bedside), including four geographically diverse academic medical centers, was queried to determine the use of diagnostic spirometry testing in African American children and young adults of age 5‐34 years with sickle cell disease (SCD...
Article
Background Clinical trial articles often lack detailed descriptions of the methods used to randomize participants, conceal allocation, and blind subjects and investigators to group assignment. We describe our systematic approach to implement and measure blinding success in a double-blind phase 2 randomized controlled trial testing the efficacy of a...
Article
Introduction Palliative care provides clinical and economic benefits for patients diagnosed with life limiting illness and their family caregivers. The extent to which variation in knowledge of palliative care exits in racial groups and geographic regions within the United States is not known. The aim of the study was to present the up-to-date data...
Article
Co-morbid Diabetes and Cancer: Differences by Patient Characteristics and Symptom Outcomes More than 32 million Americans have diabetes and 1.8 million new cancer diagnoses are expected in 2020. Epidemiologically, a strong link exists between diabetes and several forms of cancer including pancreatic, colorectal, lung, and liver cancers. As a result...
Conference Paper
Introduction: Although pain is subjective and highly variable between individuals, little is known about the amount of body surface area (BSA) that represents chronically painful locations reported by patients with cancer. The purpose of this study was to explore associations between BSA and demographic, cancer, and other pain variables. Methodolog...
Conference Paper
Introduction: More than 100 million Americans have diabetes or pre-diabetes and 1.7 million new cancer diagnoses are expected in 2019. A strong link exists between type 2 diabetes (T2D) and several forms of cancer including liver, pancreatic, and colorectal cancers. Additionally, the prevalence of comorbidities such as hypertension, cardiovascular...
Conference Paper
Introduction: Approximately 70% of individuals living with cancer experience persistent pain. Previous studies showed racial/ethnic differences existing across various cancer-related outcomes. Yet, few studies have examined the racial/ethnic differences in worst pain intensity among cancer patients. Thus, the goal of this secondary data analysis wa...
Conference Paper
Introduction: Only a few studies have reported quantitative sensory testing (QST) reference values for healthy African Americans, and those studies are limited in sample size and range of age of participants. The intent of our study was to fill a gap in the understanding of pain and somatosensory function in African Americans by generating QST valu...
Conference Paper
Introduction: Florida Agricultural & Mechanical University (FAMU), University of Florida (UF) and University of Southern California (USC) have partnered to build a strong pathway to workforce diversity in Florida and California. Combined, the three institutions have unique expertise to support research education for Black and Latino students. FAMU...
Article
Lack of substantive research experiences and technical skills mentoring during undergraduate studies leaves many underrepresented minority (URM) students unprepared to apply to competitive graduate programs. As a part of our ongoing effort to increase the pipeline for the development and training of successful URM scientists in biomedical sciences...
Article
Full-text available
Background Pain in sickle cell disease (SCD) is severe and multifaceted resulting in significant differences in its frequency and intensity among individuals. In this study, we examined the influence of S100B gene single nucleotide polymorphisms (SNP) on acute and chronic pain variability in SCD. Methods Composite pain index (CPI) scores captured...
Article
Background and Objectives African-American family caregivers may have insufficient knowledge to make informed end-of-life (EOL) decisions for relatives with dementias. Advance Care Treatment Plan (ACT-Plan) is a community-based education intervention to enhance knowledge of dementia and associated EOL medical treatments, self-efficacy, intentions,...
Article
Aim: Phenylethanolamine N-methyltransferase (PNMT) catalyzes the conversion of sympathetic neurotransmitter norepinephrine to epinephrine. We examined the association of PNMT polymorphisms with acute and chronic pain in sickle cell disease (SCD). Methods: Utilization of emergency care owing to painful crisis was used as a marker for acute pain in 1...
Article
Background: The presence of cognitive impairment (CI) among hospitalized older adults (aged 85 and older) could interfere with the identification and treatment of other important symptoms experienced by these patients. Little is known, however, about the nursing care provided to this group. Contrasting the nursing care provided to patients with an...
Article
Background: The optimal route for immediate-release morphine administration is controversial. The known physical characteristics of morphine that allow absorption are counter to the unproven belief that sublingual morphine is absorbed more quickly. Objective: The aim of this study was to compare swallowed and sublingual morphine for effects on p...
Article
Full-text available
Purpose Frequencies of single nucleotide polymorphisms (SNPs) from pain related candidate genes are available for individuals with sickle cell disease (SCD). One of those genes, the arginine vasopressin receptor 1A gene (AVPR1A) and one of its SNPs, rs10877969, has been associated with pain and disability in other pain populations. In patients with...
Article
Context: Unrelieved cancer pain at the end of life interferes with achieving patient-centered goals. Objective: To compare effects of usual hospice care and PAINRelieveIt® on pain outcomes in patients and their lay caregivers. Methods: In a 5-step, stepped wedge randomized, controlled study, 234 patients (49% male, 18% Hispanic, 51% racial min...
Article
Evidence supports, but is inconclusive that sensitization contributes to chronic pain in some adults with sickle cell disease (SCD). We determined the prevalence of pain sensitization among adults with SCD pain compared with pain-free healthy adults. In a cross sectional, single session study of 186 African American outpatients with SCD pain (age 1...