If you’ve ever left a medical appointment thinking, “Welp… I forgot every question I had the moment I saw the exam table paper,”
you already understand the problem Teresa Hagan Thomas, PhD, BA, RN, studies for a living: self-advocacy in health care.
And not the fluffy, poster-on-the-wall kindreal, practical, evidence-based skills that help people with serious illness get care that
actually matches their needs, priorities, and day-to-day reality.

Dr. Thomas is an oncology and palliative care nurse scientist and academic leader whose work sits at the intersection of patient empowerment,
symptom management, caregiver support, and (yes) game designbecause sometimes the most effective “training module” is a story-driven app that
teaches you how to speak up when you’re exhausted, scared, and overloaded with information.

Who Is Teresa Hagan Thomas?

Teresa Hagan Thomas is an Associate Professor and Associate Dean for Research and Scholarship at the University of Pittsburgh School of Nursing.
She is also affiliated with the University of Pittsburgh’s Palliative Research Center (PaRC), where she has held a mentorship and nursing research leadership role.
Her clinical emphasis includes oncology and palliative caretwo fields where “the right care” is rarely one-size-fits-all.

Her educational path is notably interdisciplinary. She earned a BA in anthropology and international peace studies from the University of Notre Dame,
then completed an accelerated BSN and PhD in nursing at the University of Pittsburgh. Along the way, she earned a certificate in Consumer Health Advocacy
through the University of Wisconsin–Madison’s Center for Patient Partnerships and completed postdoctoral fellowship training in supportive oncology at
Massachusetts General Hospital and Harvard Medical School.

Translation: she brings together the human-story lens of anthropology, the rigor of nursing science, and the practical “how do patients actually navigate this?”
focus of health advocacy. That combination shows up everywhere in her workfrom the tools she builds to the way she studies real-world barriers to speaking up.

Why Self-Advocacy in Cancer Care Matters (and Why It’s Harder Than It Sounds)

“Self-advocacy” can sound like a motivational slogan. In reality, it’s a skill set that becomes urgent when patients are facing complex decisions,
heavy symptom burdens, financial stress, and a health system that speaks fluent Acronym.

In advanced cancer settings especially, people may be dealing with fatigue, pain, nausea, anxiety, “chemo brain,” and the emotional whiplash of new information.
Even when clinicians are compassionate and thorough, the pace and complexity of care can make it hard for patients to ask questions, clarify priorities, or say,
“Actually, that plan won’t work for me.”

Dr. Thomas’ work emphasizes that patient-centered care isn’t just about offering choicesit’s about helping patients build the confidence and tools to use those
choices effectively. That means studying how self-advocacy works, how to measure it, and how to teach it in ways that are accessible to different backgrounds,
literacy levels, and life circumstances.

Core Research Themes: What Dr. Thomas Studies (and Builds)

1) Measuring Self-Advocacy: Turning “Speak Up” Into Science

A major contribution of Dr. Thomas’ program is instrument developmentcreating ways to measure self-advocacy reliably. Measurement matters because
health care can’t improve what it can’t define. If a clinic launches a “patient empowerment initiative” (cue the confetti), we still need to know:
Did it change anything that affects outcomes, quality of life, or health care utilization?

Dr. Thomas developed a model and measure focused on self-advocacy within cancer experiences, including work on a self-advocacy scale designed for women in
cancer survivorship contexts. These tools help researchers evaluate interventions and help clinicians understand which skills patients may need support developing.

2) Serious Games for Health: “Choose Your Own Adventure,” but With Real Stakes

One of the most widely discussed projects connected to Dr. Thomas is Strong Together, a narrative “serious game” designed to teach self-advocacy skills
to women with advanced breast or gynecologic cancer. The phrase “serious game” sounds like a contradictionlike “jumbo shrimp”but it’s a real category of
health intervention: game-based tools built for learning, behavior change, and support.

The premise is simple: when you’re not feeling well, it can be extremely difficult to navigate treatment decisions and communicate effectively.
So the intervention uses story and simulation to let patients practice skills in a low-stress environmentbefore they need those skills in a high-stress clinic visit.

The game centers on three core self-advocacy dimensions commonly highlighted in this work:
informed decision-making, effective communication with clinicians, and “connected strength” (support through relationships and community).

3) Symptom Management and Palliative Care: Making Quality of Life Non-Negotiable

Symptom burden is one of the biggest reasons people with cancer struggle to engage in care decisions.
Dr. Thomas’ work aligns symptom management with advocacy: when symptoms are uncontrolled, the best plan on paper can become impossible in real life.
This is where her palliative care research perspective adds a practical edgesupporting well-being and priorities throughout illness, not only at end of life.

Her scholarly trajectory includes supportive oncology and palliative care training and affiliations, including published work and leadership roles connected to
palliative research organizations and collaborative groups.

4) Caregivers and Family Systems: Because Cancer Doesn’t Happen to One Person

Another signature part of Dr. Thomas’ work is integrating caregivers into cancer care in meaningful, structured ways. She has leadership and clinical partnership
roles connected to the Family CARE Center at UPMC Magee-Womens Hospital, which focuses on caregiver advocacy, research, and education within outpatient oncology.

This matters because informal caregiverspartners, adult children, siblings, close friendsoften coordinate medications, appointments, symptom monitoring,
and the emotional labor of uncertainty, all while trying to keep their own lives functioning. Supporting caregivers isn’t a “nice extra.”
It can directly affect patient outcomes and caregiver health.

Spotlight on Strong Together: A Self-Advocacy Intervention You Can Actually Imagine Using

Strong Together is often described as a “choose your own adventure” narrative. But what makes it clinically interesting is how it uses the story mechanics
to show consequences without punishing the user. Decisions change the storyline. When characters advocate effectively, the environment becomes brighter and more
upbeat; when they don’t, the story reflects declining well-being. The feedback is designed to teachnot shame.

Importantly, the game was developed in collaboration with patients and patient advocates, aiming for accessibility across different levels of health and tech literacy.
In reported pilot work, participants were recruited from a cancer center setting, and the study examined feasibility and acceptability alongside early signals of impact
on self-advocacy skills and quality of lifeexactly the kind of “Does this work in the real world?” testing that keeps digital health from becoming gimmicky.

From a research perspective, this approach tackles a classic problem: educational pamphlets are helpful, but they rarely build confidence under pressure.
A narrative simulation can help patients rehearse language and decisions, so they’re not inventing courage from scratch during a stressful appointment.

From Anthropology to Oncology Nursing: Why Her Background Fits the Problem

Self-advocacy is not only a medical issueit’s cultural, social, and psychological. People bring beliefs about authority, gender roles, health literacy,
fear of “being difficult,” prior experiences of discrimination, and financial constraints into clinical conversations.

Dr. Thomas’ early academic training in anthropology and peace studies supports a broader view of health: it’s shaped by systems, power dynamics,
communication norms, and what people are “allowed” to ask for. That lens helps explain why her research doesn’t just tell patients to speak up.
It studies what makes speaking up possible.

Public profiles describing her background also note formative experiences (including study abroad) that influenced her interest in the human body,
health, and well-beingan origin story that feels especially fitting for someone devoted to helping patients navigate health systems with more agency.

Leadership, Mentorship, and the “Research That Travels” Factor

In addition to her research, Dr. Thomas holds significant academic leadership responsibility as Associate Dean for Research and Scholarship.
She is also described as an active mentor to undergraduate, graduate, and clinical trainees, a role that matters in nursing science where mentorship often
determines whether promising ideas become sustainable programs of research.

Her profiles and academic materials highlight funding support from major institutions and organizations (including NIH institutes and cancer-focused funders),
and she has received recognition tied to research and innovationsuch as awards connected to health care game design and nursing scholarship.

The larger point isn’t the trophy shelf. It’s that her work “travels”: it moves from theory to measurement, from measurement to intervention,
from intervention to real clinical partnerships. That pipeline is how nursing research becomes something patients and caregivers can actually use.

Practical Examples: What Self-Advocacy Looks Like on a Tuesday

Self-advocacy isn’t about being loud. It’s about being clear. Here are concrete, clinic-ready examples aligned with the self-advocacy dimensions that show up
in Dr. Thomas’ work:

Informed decision-making

• Ask for the “why” and the “what if”: “What’s the goal of this treatmentshrinking the tumor, symptom relief, or time?”
• Request plain-language tradeoffs: “If I choose Option A, what am I gaining, and what am I giving up?”
• Bring your priorities forward early: “Staying functional for work is my top priorityhow does that affect our plan?”

Effective communication

• Use “repeat-back”: “Let me make sure I understood…” (This catches misunderstandings fast.)
• Name the barrier: “I’m overwhelmed. Can we slow down and focus on the next two steps?”
• Turn symptoms into data: Track severity, timing, triggers, and impact on daily life to make symptom conversations actionable.

Connected strength

• Bring a second brain: A friend or caregiver can take notes, ask follow-ups, and help you remember decisions.
• Use patient navigation and peer support: If available, peer navigators can help translate the system and reduce isolation.
• Make caregiving visible: “My caregiver needs training on symptom monitoringwho can help us with that?”

Notice what’s missing: the fantasy that patients should manage everything alone. In Dr. Thomas’ world, self-advocacy is supported by systems,
tools, and relationshipsnot just personal grit.

Conclusion: Why Teresa Hagan Thomas’ Work Resonates

Teresa Hagan Thomas, PhD, BA, RN represents a modern nursing science approach: patient-centered, measurable, collaborative, and deeply practical.
She studies self-advocacy not as a slogan, but as a set of skills and supports that can be taught, practiced, evaluated, and embedded into care.

Whether through instrument development, caregiver-centered clinical partnerships, or narrative serious games like Strong Together,
the throughline is consistent: better outcomes and better experiences happen when patients’ needs and priorities are not an afterthought.
They are the starting point.

Experiences Related to Teresa Hagan Thomas’ Work (Extended Section)

To understand why Dr. Thomas’ focus on self-advocacy hits home for so many patients and clinicians, it helps to picture the lived reality behind the research.
“Self-advocacy” isn’t an abstract concept floating around in a grant proposalit’s the moment a patient realizes they don’t understand what the oncologist just said,
but they’re afraid to ask because the clinic is busy and the questions feel “too basic.” It’s the moment a caregiver is trying to remember whether the nausea started
before the new medication or after it. It’s the moment someone quietly wonders, “If I say I can’t tolerate this, will they think I’m giving up?”

One experience that shows up repeatedly in serious illness care is decision fatigue. Patients are asked to choose between treatments, weigh side effects against benefit,
and coordinate logisticsall while not sleeping, not eating well, and trying to keep their regular life from collapsing like a poorly assembled folding chair.
Dr. Thomas’ research makes room for the fact that a patient might have the “right” question in their head, but not the energy to shape it into a sentence.
That’s one reason the idea of practicing skills in a low-stakes settinglike a narrative gamecan be powerful. You rehearse the language when you’re calm enough to learn,
so you can access it when you’re not.

The design choices described in public accounts of Strong Together feel especially grounded in these realities. Instead of turning self-advocacy into a lecture,
the game uses story and consequence: if the character asks questions, clarifies options, or leans on support, the storyline reflects better well-being. If not, the story
doesn’t “punish” the playerit shows how quickly quality of life can slide when needs aren’t voiced. That mirrors real clinic life, where small communication gaps can
snowball into unmanaged symptoms or avoidable distress. And because the game was developed with patient and advocate collaboration, the scenarios are meant to resemble what
patients actually face: confusing instructions, competing priorities, and the emotional complexity of being “the patient” while still being a parent, partner, employee,
or caregiver yourself.

Caregiver-centered experiences are another major thread. In programs like the Family CARE Center model, caregiver support isn’t treated as optional.
Caregivers often become the de facto care coordinatorstracking symptoms, managing appointments, handling insurance calls, and doing the quiet work of steadying someone
who is scared. Real support can look like education about symptom monitoring, scripts for communicating with clinicians, and connection to resources for financial, legal,
or practical needs. When caregivers are trained and supported, they are better equipped to help patients stay aligned with their goalsand they can protect their own
health too, instead of burning out in silence.

Finally, there’s the deeply personal side of serious illness that researchers sometimes acknowledge through narrative writing. Dr. Thomas has published a short piece in
a major oncology journal reflecting on hospice and end-of-life decision-making, underscoring that the systems issues she studies are not theoretical.
Many clinicians and researchers carry these experiences in their own families, and it often sharpens their commitment to making care more humane and navigable.
In that sense, the “experience” behind the work is both clinical and human: it’s about helping people ask the questions they deserve to askespecially when it’s hardest.

Editorial References (No Links)

1. University of Pittsburgh School of Nursing faculty profile for Teresa Hagan Thomas
2. University of Pittsburgh Self-Advocacy research site (team and scale information)
3. Healthline author biography for Teresa Hagan Thomas, PhD, BA, RN
4. UPMC/Pitt Health Sciences News feature on Strong Together and pilot study details
5. NIH PubMed record for “Three Days Was Enough” (Journal of Clinical Oncology)
6. National Center on Family Support (caregiving.pitt.edu) overview of the Gynecologic Oncology Family CARE Center
7. University of Pittsburgh School of Nursing CV (May 2024) for Teresa Hagan Thomas
8. Pittsburgh Magazine profile featuring Teresa Hagan Thomas (Excellence in Nursing)
9. ScienceDirect open-access paper describing the narrative serious game approach and self-advocacy dimensions
10. NIH PubMed/PMC records related to the feasibility/acceptability study of a self-advocacy serious game intervention
11. University of Virginia School of Medicine post referencing her talk on serious games in advanced cancer
12. Cancer Nursing Today author page describing her focus areas and public-facing writing