Current Environment: Production

Medical Services

Languages

  • English

Professional History

Dr. DiFazio received a BSN from Fitchburg State University and an MSN and PhD from Boston College. In addition to her roles as a nurse practitioner and nurse scientist in the Orthopaedic Center at Boston Children’s Hospital, she holds appointments as an Instructor at the Harvard School of Medicine and Fitchburg State University.

Dr. Difazio fully appreciates that for the best clinical outcomes for patients and their families, a nexus of factors including clinical efficacy, cost-effectiveness of care, and more important, the needs of patients and families across the trajectory of health and illness must be considered. These serve as the foundation for her research, clinical practice, and teaching.

Specifically, her clinical expertise and research focus on improving delivery of the complex care required by children with severe, chronic disabilities, including focused attention on the impact of their condition and care needs on their families. Findings from her studies on health-related quality of life, caregiver burden, and non-medical out-of-pocket expenses are being translated into practice. Most recently, her work is laying the foundation for an integrated transition program in the Orthopaedic Center for young adults with cerebral palsy who are transitioning from pediatric to adult care services. These studies, funded through grants and awards from Boston Children’s Hospital and numerous professional organizations and private foundations, have resulted in cross-disciplinary publications designed to bridge gaps in knowledge and practice between nursing and medicine.

Dr. DiFazio’s expertise extends well beyond the borders of New England. For more than two decades, she advocated for the advancement of nursing education and scholarship in Russia. Outcomes of capacity-building activities within Russian nursing include helping to establish the first university level nursing program; coordinating numerous professional conferences and exchanges; and leading a series of joint scholarly projects between Russian and American nurses that advance evidence-based practice. Of specific note was the English language textbook for Russian nurses she co-edited, which was approved by the Russian Ministries of Education and Health as a primary text for university-based nursing programs in Russia and Russian-speaking countries.

Dr. DiFazio is a fellow in the American Academy of Nursing and uses this platform to help advance policies designed to improve family-centered care. She has received numerous awards for her research, advancements in clinical practice, and international advocacy. Dr. DiFazio is committed to helping prepare future generations of nurses and medical residents while championing evidence-based patient care.

Publications

  1. Children and Youth with Special Health Care Needs: Progress Towards More Family-Centered Systems of Care. Matern Child Health J. 2024 Nov 01. View Abstract

  2. Comparison of two modeling approaches for the identification of predictors of complications in children with cerebral palsy following spine surgery. BMC Med Res Methodol. 2024 Oct 11; 24(1):236. View Abstract

  3. Tools used to measure the impact of comorbidities on surgical outcomes in children with complex chronic conditions: A scoping review. Dev Med Child Neurol. 2024 Oct; 66(10):1289-1300. View Abstract

  4. Parental Caregiver Expectations and Satisfaction Following Hip Reconstruction and Spinal Fusion in Children With Cerebral Palsy. Orthop Nurs. 2023 Mar-Apr 01; 42(2):94-102. View Abstract

  5. Parental caregivers' perception of their transition from hospital to home in children with cerebral palsy who have undergone orthopedic surgery. J Pediatr Nurs. 2023 Mar-Apr; 69:47-55. View Abstract

  6. Determining Incidence and Risk Factors of Pressure Injury After Orthopaedic Surgery in Children and Adolescents With Neuromuscular Complex Chronic Conditions. J Pediatr Orthop. 2022 Nov-Dec 01; 42(10):564-570. View Abstract

  7. Barriers to Discharge After Hip Reconstruction Surgery in Non-ambulatory Children With Neurological Complex Chronic Conditions. J Pediatr Orthop. 2022 09 01; 42(8):e882-e888. View Abstract

  8. Pneumonia after hip surgery in children with neurological complex chronic conditions. Dev Med Child Neurol. 2023 02; 65(2):232-242. View Abstract

  9. What makes a good reviewer? J Pediatr Nurs. 2022 Mar-Apr; 63:A8-A9. View Abstract

  10. Standardizing Opioid Prescribing in a Pediatric Hospital: A Quality Improvement Effort. Hosp Pediatr. 2022 02 01; 12(2):164-173. View Abstract

  11. Is There a Relationship Between Youth Bullying and Internet Addiction? An Integrative Review. Int J Ment Health Addict. 2022 Jan 06; 1-25. View Abstract

  12. Retrospective study of patterns of vitamin D testing and status at a single institution paediatric orthopaedics and sports clinics. BMJ Open. 2021 12 09; 11(12):e047546. View Abstract

  13. Health-related quality of life and caregiver burden after hip reconstruction and spinal fusion in children with spastic cerebral palsy. Dev Med Child Neurol. 2022 01; 64(1):80-87. View Abstract

  14. Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions. Dev Med Child Neurol. 2021 02; 63(2):204-210. View Abstract

  15. Hip Reconstruction in Nonambulatory Children With Cerebral Palsy: Identifying Risk Factors Associated With Postoperative Complications and Prolonged Length of Stay. J Pediatr Orthop. 2020 Nov/Dec; 40(10):e972-e977. View Abstract

  16. Team Approach: The Perioperative Management of Reconstructive Hip Surgery for the Non-Ambulatory Child with Cerebral Palsy and Spastic Hip Disease. JBJS Rev. 2020 07; 8(7):e1900185. View Abstract

  17. Preventing Childhood Addiction and Caring for the Child with Addictive Behaviors: Implications for Clinical Practice, Education, Policy, and Research. J Pediatr Nurs. 2019 Nov - Dec; 49:A7-A8. View Abstract

  18. Identifying Bullied Youth: Re-engineering the Child-Adolescent Bullying Scale into a Brief Screen. J Appl Meas. 2019; 20(4):367-383. View Abstract

  19. Building and Sustaining a Culture of Clinical Inquiry in a Pediatric Quaternary Hospital. J Nurs Adm. 2019 Jan; 49(1):28-34. View Abstract

  20. The incidence and outcomes of nurse bullying in the Russian Federation. Int Nurs Rev. 2019 Mar; 66(1):94-103. View Abstract

  21. Item Generation and Content Validity of the Child-Adolescent Bullying Scale. Nurs Res. 2018 Jul/Aug; 67(4):294-304. View Abstract

  22. The Child Adolescent Bullying Scale (CABS): Psychometric evaluation of a new measure. Res Nurs Health. 2018 06; 41(3):252-264. View Abstract

  23. Intrathecal Baclofen Therapy Prior to Spinal Fusion for Patients With Gross Motor Function Classification System IV-V Cerebral Palsy. Orthop Nurs. 2018 Mar/Apr; 37(2):136-143. View Abstract

  24. Reducing the Incidence of Cast-related Skin Complications in Children Treated With Cast Immobilization. J Pediatr Orthop. 2017 Dec; 37(8):526-531. View Abstract

  25. Impact of Non-medical Out-of-pocket Expenses on Families of Children With Cerebral Palsy Following Orthopaedic Surgery. J Pediatr Nurs. 2017 Nov - Dec; 37:101-107. View Abstract

  26. Noise Reduction to Reduce Patient Anxiety During Cast Removal: Can We Decrease Patient Anxiety With Cast Removal by Wearing Noise Reduction Headphones During Cast Saw Use? Orthop Nurs. 2017 Jul/Aug; 36(4):271-278. View Abstract

  27. Technology-enhanced focus groups as a component of instrument development. Nurse Res. 2017 Jun 22; 25(1):16-23. View Abstract

  28. Health-Related Quality of Life and Care Giver Burden Following Spinal Fusion in Children With Cerebral Palsy. Spine (Phila Pa 1976). 2017 Jun 15; 42(12):E733-E739. View Abstract

  29. "I Didn't Even Know You Cared About That Stuff": Youths' Perceptions of Health Care Provider Roles in Addressing Bullying. J Pediatr Health Care. 2017 Sep - Oct; 31(5):536-545. View Abstract

  30. Pediatric Orthopaedic Providers' Views on Transition From Pediatric to Adult Care. J Pediatr Orthop. 2016 Sep; 36(6):e75-80. View Abstract

  31. Effect of Hip Reconstructive Surgery on Health-Related Quality of Life of Non-Ambulatory Children with Cerebral Palsy. J Bone Joint Surg Am. 2016 Jul 20; 98(14):1190-8. View Abstract

  32. Postoperative Complications After Hip Surgery in Patients With Cerebral Palsy: A Retrospective Matched Cohort Study. J Pediatr Orthop. 2016 Jan; 36(1):56-62. View Abstract

  33. Differences in health-related quality of life and caregiver burden after hip and spine surgery in non-ambulatory children with severe cerebral palsy. Dev Med Child Neurol. 2016 Mar; 58(3):298-305. View Abstract

  34. Enhancing Care Coordination Through Patient- and Family-Initiated Telephone Encounters: A Quality Improvement Project. J Pediatr Nurs. 2015 Nov-Dec; 30(6):915-23. View Abstract

  35. Measuring the youth bullying experience: a systematic review of the psychometric properties of available instruments. J Sch Health. 2014 Dec; 84(12):819-43. View Abstract

  36. Opportunities lost and found: experiences of patients with cerebral palsy and their parents transitioning from pediatric to adult healthcare. J Pediatr Rehabil Med. 2014; 7(1):17-31. View Abstract

  37. Youth bullying: a review of the science and call to action. Nurs Outlook. 2013 Sep-Oct; 61(5):337-45. View Abstract

  38. Non-medical out-of-pocket expenses incurred by families during their child's hospitalization. J Child Health Care. 2013 Sep; 17(3):230-41. View Abstract

  39. Increasing meaning in measurement: a Rasch analysis of the Child-Adolescent Teasing Scale. Nurs Res. 2012 May-Jun; 61(3):159-70. View Abstract

  40. Incidence of skin complications and associated charges in children treated with hip spica casts for femur fractures. J Pediatr Orthop. 2011 Jan-Feb; 31(1):17-22. View Abstract

  41. Nonmedical out-of-pocket expenses: a hidden cost of hospitalization. J Pediatr Nurs. 2011 Feb; 26(1):78-84. View Abstract

  42. Congenital scoliosis with associated rib fusions: nursing care of patients following VEPTR insertion. Orthop Nurs. 2010 Jan-Feb; 29(1):4-8; quiz 9-10. View Abstract

  43. Bullying, harassment, and horizontal violence in the nursing workforce: the state of the science. Annu Rev Nurs Res. 2010; 28:133-57. View Abstract

  44. International education: developing site visit guidelines to enhance understanding. J Contin Educ Nurs. 2009 Feb; 40(2):91-6. View Abstract

  45. Extremity fractures in children: when is it an emergency? J Pediatr Nurs. 2005 Aug; 20(4):298-304. View Abstract

  46. Waterproof casts for immobilization of children's fractures and sprains. J Pediatr Orthop. 2005 Jan-Feb; 25(1):56-9. View Abstract

  47. Nursing in Russia: A "travelogue". J Pediatr Nurs. 2004 Apr; 19(2):150-6. View Abstract

  48. Creating a halo traction wheelchair resource manual: using the EBP approach. J Pediatr Nurs. 2003 Apr; 18(2):148-52. View Abstract

  49. Coxa vara with proximal femoral growth arrest in patients who had neonatal extracorporeal membrane oxygenation. J Pediatr Orthop. 2003 Jan-Feb; 23(1):20-6. View Abstract
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