Yale Pediatric Advanced Care Team (YPACT)
Formerly called The Dignity Project, YPACT is a palliative care consult service provided to pediatric patients with a chronic or terminal illness and their families at Yale-New Haven Children's Hospital (YNHCH). The goal of the service is to improve pain and symptom management, enhance communication between patient, family, and staff, and assist families in making tough decisions. Currently there are 171 patients enrolled, which is an increase of 130 since mid-2006 when the first paid employee was hired. Anyone, including families, can request a YPACT consult. Approximately 12-20 YPACT patients are seen inpatient weekly or biweekly depending on their needs.
The team is also responsible for education of staff on topics related to palliative care, such as communicating bad news, symptom management, and alternative therapies. They coordinate bimonthly meetings with the primary interdisciplinary team to discuss the care of patients followed by YPACT. Addressing comfort and quality of life frequently includes use of complementary interventions. For example, massage and Reiki treatments can be arranged by the team. At least 50% of patients and families request these supportive interventions. The team participates in family meetings, meets with patients and families one-on-one, collaborates with the pain service, and sends bereavement cards. It has also facilitated making Reiki classes available to a growing number of practitioners. A monthly YPACT meeting reviews some of the cases or presents an educational program.
Families have identified enhanced communication and continuity as important outcomes of involvement with YPACT. This has been especially valuable when a patient is transferred to a different pediatric unit within YNHCH. They also express appreciation for the relaxing effects of massage and Reiki.
Current YPACT projects include a research survey to determine patient and guardian thoughts on YPACT and a complementary and alternative medicine (CAM) cart with aromatherapy and herbal teas for patients, families, and staff.
For more information or to be added to the YPACT informational mailing list, contact Cindy Jayanetti, NP at (203) 688-7997.
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In the News
Breast Cancer Support Group
The Cancer Support Community of Southern Connecticut (formerly The Wellness Community) has announced a Breast Cancer Support Group to be held in Branford on Tuesday & Thursday evenings. Call (203) 483-4227 for more information and to register.
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Journal Watch
The June issue of Current Opinion in Supportive and Palliative Care is largely devoted to dyspnea management. Read More >>
The supplement to the May issue of The Oncologist (Vol. 15(Supp2)) is devoted to Neuropathic Cancer Pain. Read More >>
Psychosocial care articles in Journal of the National Comprehensive Cancer Network. 2010;8(4).
- NCCN Clinical Practice Guidelines: Distress Management. V1:2010. 448-485.
- Jacobsen PB. Improving Psychosocial Care in Outpatient Oncology Settings. 368-370.
- Holland J. Why Psychosocial Care is difficult to Integrate in Routine Cancer Care: Stigma is the Elephant in the Room. 362-366.
- Loscalzo M, et al. SupportScreen: A Model for Improving Patient Outcomes. 496-504.
- Mitchell AJ. Short Screening Tools for Cancer-Related distress: A Review and Diagnostic Validity Meta-Analysis. 487-494.
Aitini E, et al. End of Life in Cancer Patients: Drugs or Words? Ann Oncol 2010;21(5): 914-915. Read More >>
Chaves MR, et al. The Diversity of Nutritional Status in Cancer: New Insights. Oncologist. 2010;15(5):523-530. (CME) Read More >>
Dhruva A, et al. Trajectories of Fatigue in Patients With Breast Cancer Before, During, and After Radiation Therapy. Cancer Nurs. 2010;33(3):201-212. Read More >>
Escalante CP, et al. Outcomes of a Cancer-Related Fatigue Clinic in a Comprehensive Cancer Center. J Pain Symptom Manage. 2010;39(4):691-701. Read More >>
Hoffman B. Cancer and Work: Protections Under the Americans With Disabilities Act. Oncology Nurse Edition. 2010;(24(4):15-21. (Free full text) Read More >>
Maggiore RJ, et al. Polypharmacy in Older Adults with Cancer. Oncologist. 2010;15(5):507-522. (CME) Read More >>
Mar Fan HG, et al. Menopausal Symptoms in Women Undergoing Chemotherapy-Induced and Natural Menopause: a Prospective Controlled Study. Ann Oncol. 2010;21(5): 983-987. Read More >>
Nagaiah G, et al. Role of Obesity and Exercise in Breast Cancer Survivors. Oncology. 2010;24(4):432-436. (Free full text) Read More >>
Raphael J, et al. Cancer Pain: Part 1: Pathophysiology; Oncological, Pharmacological, and Psychological Treatments: A Perspective from the British Pain Society Endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Med. Apr 23, 2010. Read More >>
Raphael J et al. Cancer Pain: Part 2: Physical, Interventional, and Complementary Therapies; Management in the Community; Acute, Treatment-Related, and Complex Cancer Pain: A Perspective from the British Pain Society Endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Med. Apr 26, 2010. Read More >>
Winter L, et al. Ask a Different Question, Get a Different Answer: Why Living Wills are Poor Guides to Care Preferences at the End of Life? J Palliat Med. 2010;13(5). Read More >>
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