A. Fuchsia Howard, PhD, RN

Associate Professor

Dr. Howard’s research examines the health service needs of survivors of acute life-threatening illness, specifically cancer and critical illness. She promotes socially responsive scholarship; generating evidence of survivor priorities vital for enhancing the accessibility and quality of health services. The overarching aim of Dr. Howard’s research is to generate patient- and family- perspective evidence of their health and disability challenges as the foundation to designing and evaluating patient-centred healthcare to address the complications of critical illness survivorship and the long-term burden of illness.

Research Spotlight


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Refereed Publications


  1. Howard AF, Crowe S, Choroszewski L, Kovatch J, Kelly M, Haljan G. When chronic critical illness is a family affair: A multi-perspective qualitative study of family involvement in long-term care. Chronic Illness. 2022;0(0). doi:10.1177/17423953221141134
  2. Howard AF, Lynch K, Thorne S, Porcino A, Lambert L, De Vera MA, Wolff AC, Hedges P, Beck SM, Torrejón M-J, Kelly MT, McKenzie M. Occupational and Financial Setbacks in Caregivers of People with Colorectal Cancer: Considerations for Caregiver-Reported Outcomes. Current Oncology. 2022; 29(11):8180-8196. https://doi.org/10.3390/curroncol29110646
  3. Howard AF, Li H, Lynch K, Haljan G. Health Equity: A Priority for Critical Illness Survivorship Research. Crit Care Explor. 2022 Oct 25;4(10):e0783. doi: 10.1097/CCE.0000000000000783. PMID: 36311557; PMCID: PMC9605741.
  4. Howard, A.F., Crowe, S., Choroszewski, L., Kovatch, J., Jansen Haynes, A., Ford, J., Beck, S., Haljan, G. (2021). Health expectations of the chronically critically ill: A multi-perspective qualitative study. BMC Palliative Care. 1-12, Online first. https://doi.org/10.1186/s12904-020-00696-w
  5. Howard, A.F., Crowe, S., Choroszewski, L., Kovatch, J., Jansen Haynes, A., Ford, J., Beck, S., Haljan, G. (2020). Sources of distress for the chronically critically ill. Qualitative Health Research, Online first. https://doi.org/10.1177/1049732320976373
  6. Crowe, S., Howard, A.F., Vanderspank-Wright, B., Gillis, P., McLeod, F., Penner, C., Haljan, G. (2020). Canadian Critical Care Nurses experiences of providing patient care during the early phase of the COVID-19 pandemic. Intensive and Critical Care Nursing. Online first. https://doi.org/10.1016/j.iccn.2020.102999.
  7. Moreira, C.B., Dahinten, V.S., Howard, A.F., Fernandes AFC, Schirmer, J. (2020). Factors related to mammography adherence among women in Brazil: a scoping review. Nursing Open, Online first. https://doi.org/10.1002/nop2.706
  8. Gurney, L.N., MacPhee, M., Howard, A.F., Rodney, R. (2020). Exploring the relational intervention of storytelling: A qualitative study of the Patient Stories Project in a single ICU. Critical Care Explorations. 2(10), pe0224. doi: 10.1097/CCE.0000000000000224
  9. Newton, K., Howard, A.F., Thorne, S., Kelly, M., Goddard, K. (2020). Facing the unknown: Uncertain fertility in adult survivors of childhood cancer. Journal of Cancer Survivorship. Online first https://doi.org/10.1007/s11764-020-00910-x
  10. Howard, A.F., Medhurst, K., Manhas, D., Yang, L., Brown, S., Brown, E., Olson, R. (2020). The usefulness of patient-reported outcomes and the influence on palliative oncology patients and health services: A qualitative study of the Prospective Outcomes and Support Initiative (POSI). Cancer Nursing. Online first.  doi:10.1097/NCC.0000000000000840. 
  11. Moreira, C.B., Dahinten, V.S., Howard, A.F., Fernandes, A.F.C. (2020). The Revised Champion's Health Belief Model: Predictive validity among Brazilian women. Sage Open Nursing. 6, 1-11. doi:10.1177/2377960820940551/ ID: SON-20-0003.R1
  12. Moreira, C., Fernandes, A.F., Champion, V., Dahinten, S.V., Vila, V., Howard, A.F., Oria, M., Schirmer, J. (2020). Champion’s Health Belief Model scale validity evidence for Brazil. Acta Paulista de Enfermagem. 33, 1-8. doi:10.37689/acta-ape/2020ao0264.
  13. Hamilton, S.N., Arshad, O., Kwok, J., Tran, E., Howard, A.F., Serrano, I., Goddard, K. (2019). Documentation and incidence of late effects and screening recommendations for adolescent and young adult head and neck cancer survivors treated with radiotherapy. Supportive Care in Cancer, 27(7), 2609-2616. doi:10.1007/s00520-018-4559-5.
  14. Hasan, H., Goddard, K., Howard, A.F. (2019). Utility of the number needed to treat in paediatric haematological cancer randomised controlled treatment trials: A systematic review. BMJ Open, 9(2), e022839. doi:10.1136/bmjopen-2018-022839.
  15. Howard, A.F., Bungay, V., Currie, L., McDermid, R., Ryce, A., Crowe, S., Harding, W., Haljan, G. (2019) Health solutions to improve post-intensive care outcomes: A realist review protocol. Systematic Reviews, 8:11. https://doi.org/10.1186/s13643-018-0939-7
  16. Hamilton, S., Arshad, O., Kwok, J., Tran, E., Howard, A.F., Serrano, I., & Goddard, K. (2018). Documentation and incidence of late effects and screening recommendations for adolescent and young adult head and neck cancer survivors treated with radiotherapy. Supportive Care in Cancer. https://doi.org/10.1007/s00520-018-4559-5
  17. Howard, A.F., Goddard, K., Samargandit, O.A., Rassekh, S.R., Hasan, H. (2018). Clinical significance in randomized control trials in pediatric oncology: A systematic review. Trials. 19(1): 538. https://doi.org/10.1186/s13063-018-2925-8
  18. Howard, A.F., Tran, J., Aparicio, A., Lo, A., Ullett, M., McKenzie, M., Srikanthan, A., Goddard, K. (2018). Documentation of late-effects risks and screening recommendations for adolescent and young adult central nervous system, soft tissue, or bone tumor survivors in British Columbia, Canada. Journal of Adolescent and Young Adult Oncology, Oct 9. https://doi.org/10.1089/jayao.2018.0081
  19. Lambert, L.K., Balneaves, L.G., Howard, A.F., Chia, S.L.K., Gotay, C.C. (2018). Understanding adjuvant endocrine therapy persistence in breast cancer survivors. BMC Cancer, 18:732. https://doi.org/10.1186/s12885-018-4644-7
  20. Hasan, H., Shaikh, M.O., Rassekh, S.R., Howard, A.F., Goddard, K. (2018). Reply to: Allergic Rates to IV and IM PEG-ASP in pediatric ALL. Pediatric Blood & Cancer, 65:8. https://doi.org/10.1002/pbc.27106
  21. Olson, R.A., Howard, A.F., Lapointe, V., Schellenberg, D., Nichol, A., Ozier, D., Bowering, G., Curtis, S., Walter, A., Brown, S., Thompson, C., Bergin, J., Lomas, S., Halperin, R., Tyldesley, S., Beckham, W. (2018). Provincial development of a patient reported outcome initiative to guide patient care, quality improvement, and research. Healthcare Management Forum, 31(1), 13-17. https://doi.org/10.1177/0840470417715478
  22. Howard, A.F., Kazanjian, A., Newton, K., Pritchard, S., Olson, R. Hasan, H., Goddard, K. (2017). Healthcare system barriers to long-term follow-up for adult survivors of childhood cancer in British Columbia, Canada: A qualitative study. Journal of Cancer Survivorship: Research and Practice, 12:277–290. https://doi.org/10.1007/s11764-017-0667-3
  23. Lambert, L.K., Balneaves, L.G., Howard, A.F., Gotay, C.C. (2017). Patient-reported factors influencing adherence to adjuvant endocrine therapy for breast cancer: An integrative review. Breast Cancer Research and Treatment. 167: 615-633. https://doi.org/10.1007/s10549-017-4561-5
  24. Hasan, H., Muhammed, T., Yu, J., Taguchi, K., Samargandit, O.A., Howard, A.F., Lo, A.C., Olson, R., Goddard, K. (2017). Assessing the methodological quality of systematic reviews in radiation oncology: A systematic review. Cancer Epidemiology, 50(A), 141-149.
  25. Yang, L.Y., Manhas, D.S., Howard, A.F., Olson, R. (2017). Patient reported outcome use in oncology: A systematic review of the impact on patient-clinician communication. Supportive Care in Cancer, https://doi.org/10.1007/s00520-017-3865-7
  26. Jeddian, A., Lindenmier, A., Marshal, T., Howard, A.F., Rashidian, A., Malekzadeh, R., Jafari, N., Sayadi, L. (2017). Implementation of a critical care outreach service: A qualitative study. International Nursing Review. Epub ahead of print: http://onlinelibrary.wiley.com/doi/10.1111/inr.12377/full.
  27. Hasan, H., Shaikh, M.O., Rassekh, S.R., Howard, A.F., Goddard, K. (2016). Comparison of hypersensitivity rates to intravenous and intramuscular PEG-Asparaginase in children with acute lympoblastic leukemia: A meta-analysis and systematic review. Pediatric Blood & Cancer. Epub ahead of print: http://onlinelibrary.wiley.com/doi/10.1002/pbc.26200/full
  28. Howard, A.F., Goddard, K., Tan de Bibiana, J., Pritchard, S., Olson, R., Kazanjian, A. (2016). Adult childhood cancer survivors’ narratives of managing their health: The unexpected and the unresolved. Journal of Cancer Survivorship: Research and Practice. 10(4), 711-725. DOI 10.1007/s11764-016-0517-8
  29. Lo, A., Howard, A.F., Nichol, A., Hasan, H., Martin, M., Heran, M., Goddard, K. (2016). A cross-sectional cohort study of cerebrovascular disease and late effects after radiation therapy for craniopharyngioma. Pediatric Blood and Cancer.
  30. Hasan, H., Hendson, G., Howard, A.F., Hukin, J., Dunham, C., Ahmed, T., Lo, A., Bradley, N., Goddard, K.  (2015). Assessing the accuracy of death records and pre-mortem clinical diagnoses in children diagnosed with brain tumors: A retrospective chart review of children in British Columbia, Canada. Pathology Research and Practice.
  31. Hasan, H., Howard, A.F., Alassiri, A.H., Ng, T.L., McGregor, G., Goddard, K. (2015). PEComa of the terminal ileum mesentery as a secondary tumour in an adult survivor of embryonal rhabdomyosarcoma. Current Oncology. 22(5), e383-e386.
  32. Hamilton, S., Hasan, H., Parsons, C., Tyldesley, S., Howard, A.F., Bobinski, M.A., & Goddard, K. (2014). Canadian radiation oncologists’ opinions regarding peer review – A national survey. Practical Radiation Oncology. 2014 July 23 [Epub ahead of print]. DOI:10.1016/j.prro.2014.06.002.
  33. Howard, A.F., Smillie, K., Turnbull, K., Munroe, D., Ward, A., Tobin, P., Kazanjian, A., & Olson, R. (2014). Access to medical and supportive care for rural and remote cancer survivors in northern British Columbia. The Journal of Rural Health. 30(3), 311-321. DOI:10.1111/jrh.12064.
  34. Howard, A.F., Hasan, F., Bobinski, M.A., Olson, R., Parkinson, M., Nurcombe, W., & Goddard, K. (2014). Parents’ perspectives of life challenges experienced by long-term paediatric brain tumour survivors: Work and financial, daily and social functioning, and legal difficulties. Journal of Cancer Survivorship: Research and Practice. 8(3), 372-383. DOI:10.1007/s11764-013-0331-5.
  35. Hasan, H., Howard, A.F., Metzger, D.L., Gill, S., Johnson, M., Lo, A.C., & Goddard, K. (2014). Canadian endocrinologists’ views on growth hormone replacement therapy in adult survivors of pediatric brain tumors following achievement of final height. BC Medical Journal. 56(5), 230-235.
  36. Hasan, H., Howard, A.F., Morgan, S.G., Metzger, D.L., Gill, S., Johnson, M., Lo, A., & Goddard, K.J.  (2014). Provincial disparities of growth hormone coverage for young adult survivors of paediatric brain tumours across Canada. Healthcare Policy, 9(3), 80-96.
  37. Lo, A., Howard, A.F., Nichol, A., Sidhu, K., Abdulsatar, F., Hasan, H., & Goddard, K. (2014). Long-term outcomes and complications in patients with craniopharyngioma: The British Columbia Cancer Agency experience. International Journal of Radiation Oncology Biology Physics, 88(5), 1011-1018. DOI:10.1016/j.ijrobp.2014.01.019.
  38. Valizadeh, L., Zamanzadeh, V., Sayadi, L., Taleghani, F., Howard, A.F., & Jeddian, A. (2014). Truth-telling and hematopoietic stem cell transplantation: Iranian nurses’ experiences. Nursing Ethics. 21(5), 518-529. DOI:10.1177/0969733013511359.
  39. Olson, R., Howard, A.F., Turnbull, K., Munroe, D., Zirul, C., Manji, R., Tobin, P., & Ward, A. (2014). Prospective evaluation of unmet needs of rural cancer survivors in northern British Columbia. Current Oncology. 21(2), 179-185. DOI:10.3747/co.21.1729.
  40. Howard, A.F., Tan de Bibiana, J., Smillie, K., Goddard, K., Pritchard, S., Olson, R., & Kazanjian, A. (2014). Trajectories of social isolation in adult survivors of childhood cancer. Journal of Cancer Survivorship: Research and Practice. 8, 80-93. DOI: 10.1007/s11764-013-0321-7.
  41. Rahmani, A., Howard, F., Sattarzadeh, N., Ferguson, C., Asgari, A., & Ebrahimi, H. (2014). Viewpoints of fertile women regarding gestational surrogacy in East Azerbaijan Province, Iran. Indian Journal of Medical Ethics. 11(1), 29-33.
  42. Howard, A.F., Smillie, K., Chan, V., Cook, S., & Kazanjian, A. (2013). The Knowledge Exchange-Decision Support Model: Application to cancer navigation programs. Supportive Care in Cancer. 22(2), 367-374. DOI: 10.1007/s00520-013-1982-5.
  43. Zamanzadeh, V., Valizadeh, L., Howard, A.F. & Jamshidi, F. (2013). A supportive-educational intervention for heart failure patients in Iran: The effect on self-care behaviours. Nursing Research and Practice. http://dx.doi.org/10.1155/2013/492729.
  44. Zamanzadeh, V., Valizadeh, L., Sayadi, L., Taleghani, F., Howard, A.F., & Jeddian, A. (2013). Emotional labour of caring for hematopoietic stem cell transplantation patients: Iranian nurses’ experiences. Asian Nursing Research. 7(2), 91-97. DOI:10.1016/j.anr.2013.04.004.
  45. Slocum-Gori, S., Howard, A.F., Kazanjian, A., & Balneaves, L.G., (2013). Investigating the feasibility of integrative medicine in a conventional oncology setting: Yoga therapy as a treatment for breast cancer survivors. Integrative Cancer Therapies. 12(2), 103-112. DOI:10.1177/1534735412443851.
  46. Zamanzadeh, V., Rahmani, A., Valizadeh, L., Ferguson, C., Hassan-Khani, H., Nikanfar, A., Howard, A.F. (2013). The taboo of cancer: The experiences of Iranian cancer patients, their family members and physicians. Psycho-Oncology. 22(2), 396-402. DOI: 10.1002/pon.2103.
  47. Valizadeh, L., Zamanzadeh, V., Rahmani, A., Howard, A.F., Ferguson, C., & Nikanfar, A. (2012). Cancer disclosure: The experiences of Iranian cancer patients. Nursing and Health Sciences, 14(2): 250-256. DOI: 10.1111/j.1442-2018.2012.00686.x.
  48. Kazanjian, A., Smilie, K., Howard, A.F., Ward, A., & Doll, R. (2012). A structured approach to knowledge exchange: Understanding the implementation of a Cancer Survivor Program. European Journal of Oncology Nursing, 16, 399-405. Doi:10.1016/j.ejon.2011.09.002.
  49. Howard, A.F., Pirotta, M., & Balneaves, L.G. (2011). Psychological sequelae of ovarian cancer screening and genetic testing for ovarian cancer susceptibility. Current Women’s Health Reviews, 7, 358-366.  http://dx.doi.org/10.2174/157340411799079544.
  50. Howard, A.F., Balneaves, L.G., Bottorff, J.L. & Rodney, P., (2011). Preserving the self: The process of decision making about hereditary breast and ovarian cancer risk-reduction. Qualitative Health Research, 21(4), 502-519. DOI: 10.1177/1049732310387798.
  51. Howard, A.F., Bottorff, J.L., Balneaves, L.G., & Kim-Sing, C., (2010). Women’s constructions of the ‘right time’ to consider decisions about risk-reducing mastectomy and risk-reducing oophorectomy. BMC Women’s Health, 5(10), 24. DOI:10.1186/1472-6874-10-24.
  52. Howard, A.F., Balneaves, L.G., & Bottorff, J.L. (2009). Women’s decision making about risk-reducing strategies in the context of hereditary breast and ovarian cancer: A systematic review. Journal of Genetic Counseling, 18(6), 578-597. DOI:10.1007/s10897-009-9245-9.
  53. Howard, A. F., Bottorff, J.L., & Balneaves, L.G., & Grewal, S.K. (2007). Punjabi immigrant women’s breast cancer stories. Journal of Immigrant & Minority Health, 9(4), 269-279. DOI:10.1007/s10903-007-9044-z.
  54. Howard, A.F., Balneaves, L.G., & Bottorff, J.L. (2007). Ethnocultural women's experiences of breast cancer: A qualitative meta-study. Cancer Nursing, 30(4), E27-35. DOI:10.1097/01.NCC.0000281737.33232.3c.
  55. Balneaves, L.G., Bottorff, J.L., Grewal, S.K., Naidu, P., Johnson, J.L., & Howard, A.F. (2007). Family support of Punjabi women with breast cancer. Family & Community Health, 30(1), 16-28.

Book Chapters

  1. Howard, A.F., Balneaves, L.G., & Kazanjian, A. (2013). Mastectomy to prevent breast cancer: Psychosocial aspects of women’s decision making. In B.I. Carr & J.L. Steel (Eds.), Psychological Aspects of Cancer. NY: Springer.

Non-refereed Publications

  1. Sexual Pain and Endometriosis. A website to educate and empower people affected by endometriosis-associated sexual pain. https://endopain.endometriosis.org/
  2. Mitchell, L., Wilkins, K., & Howard, A.F. (2020). Survivorship issues of adolescents and young adults (AYA) with cancer. Canadian Association of Nurses in Oncology (CANO) Survivorship Module. Adult Cancer Survivorship: A Self-Learning Resource for Nurses. https://www.cano-acio.ca/page/survivorship_manual
  3. Howard, A.F., & Goddard, K. (2011). Late effects: Psychosocial. Pediatric Oncology Education Materials. http://www.pedsoncologyeducation.com
  4. Kazanjian, A., Chan, V., Smilie, K., Howard, F. (2010). Knowledge Exchange-Decision Support (KE-DS) Toolkit. University of British Columbia, School of Population and Public Health,  http://www.spph.ubc.ca/?p2=/modules/hce/facultyresearch/facultyresearch.jsp&fresearchId=27
  5. Howard, A.F., & Scott-Findlay, S. (2006). Breast self-examination: When research contradicts accepted practice. AWHONN Lifelines, 10(1), 66-70.

Supervisor eligibility: 

  • MN
  • MSN – thesis
  • MSN – non-thesis
  • PhD