Clinical Research

​​​​​​Dr. Huda Abu-Saad Huijer RN, PhD, FEANS, FAAN
Research focus: Pain Management & Palliative Care across the Life Span. 
A number of funded studies were conducted in Lebanon. The first national study, funded by MPP and URB ‘Palliative Care in Lebanon; Needs Assessment for Palliative Care Services for Adults and Children’ included 15 geographically spread hospitals in the country. This was followed by two CNRS funded studies on Quality of Palliative Care in Lebanon, the Perspectives of Adults with Cancer’ and ‘Quality of Palliative Care in Lebanon, the Perspectives of Children with Cancer’. These studies resulted in numerous articles in national and international refereed journals and in psychometrically testing some of the tools used in these studies. Currently two main studies are being completed on ‘Chronic pain in Adults’ funded by Pfizer and ‘Palliative Care in Older Adults’ funded by CNRS. Results of these studies have influenced policy development in Lebanon. 

Marina Adra PhD, RN 
The concept of a culture of community in care homes is reported in the literature as a Westernized construct and so far little is known about its meanings from a Middle-Eastern cultural perspective and context. Dr. Adra is exploring the existing relationships between residents, staff and family in the environment of care homes in Lebanon and how establishing positive relationships promotes a culture of community. Understanding the complex nature of developing a culture of community will add insight as to how it will influence the provision of care and quality of life of older residents. The findings will lay the foundation for establishing community development programs for care home managers and will have implications for developing policy and practice in care homes. They will also encourage the departure from traditional routine care patterns towards relationship-centered care. 

Nour Alayan, PhD, MSN, RN
Dr. Alayan’s research focuses on the treatment and prevention of addictive behaviors. She is specifically interested in bio behavioral​ interventions and studied the effectiveness of heart rate variability biofeedback in reducing substance craving in college students recovering from substance use disorder. Her study found that heart rate variability biofeedback enhanced the efficacy of conventional treatment by creating craving reductions beyond the effects of conventional therapeutic support. 
In the area of substance use prevention, Dr. Alayan will conduct the first national study to explore the attitudes, perceptions, and practices of nurses and physicians in Lebanon regarding Screening, Brief Intervention, and Referral to Treatment (SBIRT) for adolescent substance use. This study constitutes a preliminary step towards the integration of standardized adolescent SBIRT, an evidence-based practice for the early recognition and prevention of substance use among adolescents.

Ghada Najjar Assaf, PhD, RN
Dr. Najjar’ s research agenda focuses on psychological wellbeing in overweight and obese adolescents enrolled in Lebanese schools. The research will examine self-esteem, self image, bullying, eating habits, physical activities, smoking and other psychosocial factors related to body weight. Results will be useful in the development of management programs directed at adolescents.
The study will aim to investigate whether the overweight and obesity are risk factors for psychological wellbeing among adolescents. This cross-sectional study will recruit students from grade 5-12 studying at private and public schools in Lebanon.

Hala Darwish, Ph.D, R.N, MSCN, MSNS
Dr. Darwish's research focus is on factors that lead to impairment or enhancement of cognitive function. Using basic and translational clinical neuroscience research, she found that vitamin D affects cognitive function in aging rats; this finding led to studies with human samples. As with animal models, she found that vitamin D levels were positively associated with cognitive performance in adults and older adults. Building on these results, she investigated the effect of vitamin D supplementation on cognitive performance in multiple sclerosis patients. These results are contributing to changes in clinical practice and emphasizing the importance of monitoring vitamin D levels.
With funding from the US Department of Defense, in her basic neuroscience research, along with her collaborators, she is examining the microglial activation pattern after traumatic brain injury and associated memory deficits. 
Dr. Darwish intends to build on her research findings to develop an evidence-based cognitive rehabilitation program.

Souha Fares, PhD 
First line is on time series (TS) analysis and hypertension.  Dr Fares is studying the effect of novel measures of the variability of blood pressure (BP) signals, specifically complexity measures and detrended fluctuation analysis (DFA) on prognosis. Her latest research project aims to assess whether the reduction in BP which follows bariatric surgery is in fact associated with normalization of abnormal blood pressure variability and complexity in these populations. In addition, the study will examine the effect of demographic factors (age, gender, family history) on blood pressure complexity and fluctuation among obese normotensive, pre-hypertensive, and hypertensive patients.
Second line of research is on Psychometric analysis of research instruments. Measuring instruments are widely used for nursing research and health care research in general. Validation of these instruments in the Arabic Language and in the Lebanese context are essential, as the quality of the data and the inferences made are based on the scores generated from these instruments.
In addition Dr Fares collaborates with HSON faculty members on projects related to cardiovascular research, quality of life, mental Health, and nursing Workforce.

Laila F. Farhood, Ph.D., C.S.,​ R.N 
Dr. Farhood’s research agenda focuses on complex issues contributing to the physical and psychological wellbeing of civilian population at risk in a war torn country. Her research focuses on PTSD (Post Traumatic Stress Disorder), depression, coping and social support and their predictors in Beirut and the South of Lebanon in addition to vulnerable populations such as women and hostages of war (detained in the Khiam prison). Dr. Farhood studied the civilian population before and after 2006 war on Lebanon, an important work that had implications on the community and on clinical practice.
Her present Intervention study focuses on promoting psychosocial and mental health care through community-based educational workshops for teachers and parents in two schools in South Lebanon. The aim was to address the needs of children through a school-based mental health intervention involving parents and teachers. This study is a second phase of a larger study, whereby in the first phase audio taped focus groups with teachers and parents were conducted in order to identify their attitudes and beliefs towards mental health. This second phase employed a quantitative, quasi-experimental pre-post design in which community-based educational programs were implemented. 

Dina Madi, PhD, RN
Dr. Madi's research focus is guided by an interest  to offer evidence-based recommendations for pain assessment and management in children with cancer.  Her study provides an in-depth description of the characteristics of pain experienced by children with cancer and the coping strategies that children use and the strategies they suggested for better pain management. In addition , the study has resulted in the validation of two research instruments in Arabic, the APPT and FDI,  that can be used to investigate cancer pain in future studies in Arabic speaking countries. 

Her research is expected to provide direction for education and practice in the development of an advanced practice role for pediatric cancer nurses in pain management. It has filled a gap in the knowledge about the experience of cancer pain in Lebanese children. Study results were similar to results from studies around the world which strongly suggests that cancer pain is a universal experience.​

The findings of the study have rich implications for future research into pain assessment and pain management for children with cancer in Lebanon and in the Eastern Mediterranean region.



Angela Massouh, PhD, MScN, CNS
Dr. Massouh’s research focus is driven by a keen interest in narrowing the gap between research, theory, and clinical practice in symptom science.
H​er research is expected to provide new perspectives in understanding heart failure self-care in Lebanon and the MENA region. Her first study on Determinants of Self-Care in Lebanese Patients with Heart Failure was able to critically bridge the gap in literature on self-care in developing countries like Lebanon. Findings of this study point out to an international perspective, a social context, as well as cultural sensitivity of self-care. A plan is underway for this work to be replicated in 3 countries of the MENA region. The aggregated data on determinants of self-care is expected to inform a change in practice in the care of patients with Heart Failure.
Findings of the first study highlighted a very prominent role of informal caregivers in self-care; this relationship is complex and multifaceted. Yet, research that recognizes the interdependence between patients and their caregivers and examines patients and caregivers within the context of the dyad is rare. The primary aim of a new study is to identify patient and dyadic determinants of selfcare in heart failure  care dyads while controlling for dyadic interdependence. 

Samar Noureddine, PhD, RN, FAHA, FAAN
Two​ lines of research
With survival rate of out of hospital cardiac arrests at only 4.5%  and lack of good Samaritan laws in Lebanon, Dr. Noureddine is exploring current practices, knowledge and attitudes of health professional groups related to out of hospital resuscitation. This multidisciplinary research is supported by the Vascular Medicine Program at AUBMC and the Order of Nurses in Lebanon. The findings will be used to develop a national policy on resuscitation and improve survival rates.
Given the rising trends of sedentary lifestyle, suboptimal dietary patterns and their related risk factors (diabetes mellitus, obesity, hypertension and heart disease), Dr. Noureddine will test the effect of a culturally tailored diet and exercise intervention that uses social media in obese and overweight adults in reducing cardiovascular risk.