STEM Spotlight

YSN scientists have an outsized impact on shaping the world’s view of nursing. Nursing is the discipline at the forefront of applying science and research to clinical practice, and our faculty lead the way in integrating evidence-based care in order to meet our social mandate of better health for all people

Dena Schulman-Green

Extending the Reach of Palliative Care

YSN is proud of its role in the development of palliative and end-of-life care, its faculty under former Dean Florence Wald having been instrumental in introducing hospice to the US in the 1970s. Despite the transformation of cancer treatment and survival rates since those days, palliative care is still an underused, even misunderstood resource. The work of research scientist Dr. Dena Schulman-Green, of YSN and the Yale Cancer Center, seeks to help change that.

Schulman-Green has gained recent recognition for her palliative care research, having been tapped by the Israeli Ministry of Health this year to help expand Israel’s palliative care infrastructure.

At Yale, her research expands the reach of palliative care in clinical applications as well: Schulman-Green and colleagues have developed an intervention in the form of written guidance about self-management of care for breast cancer patients and their families. The seven-module intervention, titled Managing Cancer Care, seeks to introduce palliative care into self-management of cancer by increasing palliative care literacy.

Two pilot randomized controlled trials, described by Schulman-Green in Contemporary Clinical Trials, are underway to test the protocol for a further, large-scale trial of the intervention.

As Schulman-Green points out, some health care providers are reluctant to introduce palliative care until far too late during treatment. Patients may also be hesitant to discuss this option, “because it is frequently mistaken as being only for patients at the end of life.” In fact, she explains, “palliative care is a care option for seriously ill patients at all points on the care trajectory.”

Palliative care is specifically developed to help relieve the physical, psychological, social, and spiritual hardships of living with serious illnesses and– crucially – may be offered alongside curative care as part of self-management of the disease. Sometimes a psychological barrier to communication – in this case, sensitivity about acknowledging the threat of death inherent in cancer – can be all that stands between patients and more effective care. Schulman-Green seeks a solution through empowering the patient to understand and choose from the widest range of options available, including palliative care.