Patient and Caregiver Perspectives on a Coaching-Based Early Palliative Care Program (Enable, Nurture, Advise, Before Life Ends for Singapore): A Qualitative Study.

Background: Integrating early palliative care within oncology care is strongly recommended. Evidence suggests that early palliative care has the potential to improve symptom management for patients with cancer, increase care satisfaction, and improve quality of life for both patients and caregivers. The ENABLE-SG (Educate, Nurture, Advise, Before Life Ends for Singapore) program, culturally adapted from Project ENABLE in United States, aims to empower patients with cancer and their caregivers with essential self-management skills such as problem-solving, decision making, and communication. ENABLE-SG was pilot tested in an ambulatory oncology setting in Singapore. Aim: This study aimed to explore patient and caregiver experiences after they have completed ENABLE-SG. Design: A qualitative descriptive study was conducted. Setting/Participants: Seventeen patients with advanced cancer and 13 caregivers who completed the ENABLE-SG program were recruited and interviewed via telephone. Interviews were transcribed verbatim, and reflexive thematic analysis was adopted to analyze the interview data. Results: Three main themes were developed from participant experiences and their views on program elements: (1) personalized program delivery can optimize benefits for participants, (2) the coach-participant relationship lies at the core of ENABLE-SG, and (3) participant circumstances and attitudes impact usefulness of coaching. Conclusions: Study findings have wider implications for improving current early palliative care programs and designing future interventions. Developing inclusive and accessible coaching resources for patients and caregivers of varying health literacy, building strong coach-participant relationships during the coaching process, and introducing the program at an appropriate time potentially improve program outcomes. Future evaluation is required to assess the sustainability and implementation of the ENABLE program.