To study end-of-life issues

News Release: DAY, DATE

The BEST Center (Building End-of-Life Science through Positive Human Strengths and Traits) at the Frances Payne Bolton School of Nursing at Case Western Reserve has supported the hiring of two new and one returning assistant professor.

With National Institute of Nursing Research funds, Maryjo Prince-Paul and Jacquelyn Slomka from the nursing school and Jung-Won Lim from the Mandel School of Applied Social Sciences will launch pilot research projects to improve the quality of life for those with advanced or terminal illnesses.

Over the next year, these faculty members will receive support to concentrate 75 percent of their time on research.

Each faculty member received $30,000 to launch a new project. As part of their hiring requirements, researchers had to have a project ready to go at their start date.

These faculty members join a group of approximately 20 university researchers that have focused on end-of-life issues. As one function of the BEST Center, the Palliative Care Education And Research Leadership (PEARL) group meets regularly with the opportunity to collaborate and share ideas and findings.

Maryjo Prince-Paul

“Many people want the end-of-life experience to be meaningful,” says Prince-Paul, assistant professor of nursing at the Frances Payne Bolton School of Nursing and advanced practice palliative care nurse at Hospice of the Western Reserve. For nearly 20 years, she has cared for patients with life-limiting illness and their families.

Prince-Paul is one of the new BEST assistant professors. She will share her time with the nursing school and the Hospice of the Western Reserve, where she will continue work as a hospice and palliative care clinician and oversee various research projects.

She also continues working closely with Case Western Reserve faculty member and clinical psychologist Dr. Julie Exline on two projects: one with advanced cancer patients to understand the emotional and communication needs they have as they struggle with their illness over the cancer trajectory and the other with family members whose loved one is enrolled in hospice care.

The BEST support enables Prince-Paul to work on end-of-life issues with veterans from wars of the past 65 years. Her pilot study, titled “No Regrets: A Communication Intervention Model for Veterans Enrolled in Hospice Care,” Prince-Paul will examine relationship and communication issues that veterans may have at the end of their lives.

These may involve forgiveness of self or other, reuniting with family members, resolving unfinished business before dying, or simply expressing words of gratitude and love.

Some 54,000 veterans from WWII and the Korean War die each month. Approximately 20,000 from Ohio will die this year. Some 600 veterans have been involved in care through the Hospice of the Western Reserve in the first six months of this year.

Prince-Paul and Steven Zyzanski, a psychometrician from the Department of Family Medicine, have developed a new instrument to help individuals identify those areas of relational communication that may require attention. Specifically, Prince-Paul and Exline will focus on veterans enrolled in hospice care.

“This clinically useful screening instrument will provide palliative care clinicians with the ability to target specific relational and communication needs of the patients with serious illnesses,” Prince-Paul said.

Jung-Won Lim

Arriving from the City of Hope National Medical Center in Duarte, Calif., where she was a research fellow, Lim recently joined the faculty at the social work school.

While in California, Lim started looking at how families from different ethnic groups communicate when someone has cancer. She has studied those differences among Asian American and Latino American families.

“My ultimate goal is to find out if better family communications increase the quality of life for cancer patients and their family members considering their cultural contexts,” she said.

Because the cancer disease affects the whole family, she said communicating and coping are important issues.

She gave the example that in Asian American family, harmony is very important, which can mean that there might be closed (little) communication about cancer between cancer survivors and their family members. However, it may lead to a poor quality of life.

It is important to go look at the different subgroups in the Asian American population for their family communication styles, Lim said.

Thus, Lim is interested if there are differences between Korean and Chinese family communications.

She is breaking ground on a new research field by delving deeper into ethnic differences in these family communications and coping.

Studying family communications in the various sub ethnic groups in the Asian population is a new field with almost no research available, Lim said.

With BEST support, she will expand her studies to look at partner communications for women with breast cancer, men with prostate cancer and men and women with colorectal cancer. These survivors and their partners will include Asian American, African American and Caucasians. She will analyze data for both gender and ethnic differences.

She will start with a pilot study to find out issues facing these survivors and then design and apply for a major grant to continue the research.

Lim received her BA and MA in social work from EWHA Womans University in Seoul, Korea. She earned her PhD from the University of Southern California School of Social Work in 2006.

She has published or contributed to more than 26 research papers.


Because of continuing advances in treatment, people with HIV are living longer with their illness, some as long as 20 years or more. Medications have played the major role in increasing longevity, but do other factors, such as personal strengths and traits, contribute to long-term survival?

In her new role as a BEST faculty member, Slomka will build on research related to how people marshal strengths to cope with HIV infection. She started research on behavioral aspects of HIV as an assistant professor at School of Public Health at the University of Texas Health Science Center at Houston.

People with HIV infection face a chronic illness that can happen at any point in life. She will look at several groups of individuals, from those with new diagnoses to those who have lived with the disease for as long as 20 years at the onset of the AIDS epidemic.

Slomka wants to understand what it is that people pull from personal strengths that helps them overcome some of the challenges of the illness and the side effects of treatment. She is particularly interested in the long-time survivors who are now 50 and older.

She speculates that older adults and those who have been diagnosed for a longer time period may have positive strengths that enable them to respond differently to the challenges of managing their illness. These individuals have seen the spectrum of treatments for diagnoses at a time when medications were not available, then AZT, followed by a cocktail of many medications to the current highly active antiretroviral therapy (HAART).

Drawing from positive psychology, Slomka plans to survey HIV patients recruited from University Hospitals Case Medical Center for personal strengths and traits that promote coping and well-being.

She also will look at biomarkers to measure stress and other physical changes to see if there is a correlation between marshaling personal strengths with improved health.

Prior to going to Texas, Slomka worked at the Department of Bioethics at the Cleveland Clinic from 1989 to 2000. She is a graduate of Ohio State University and has a PhD in anthropology from the University of Michigan. She is originally from Toledo where her extended family still lives.


Posted by: Susan Griffith, October 12, 2010 01:57 PM | News Topics: Official Release