Adapting ENABLE for patients with advanced cancer and their family caregivers in Singapore: a qualitative formative evaluation

Yang, Grace Meijuan; Dionne-Odom, James; Foo, Yi Han; Chung, Ariel Hui Mei; Kamal, Nur Haidah Ahmad; Tan, Laurence; Yu, Chou Chuen; Khanh, Le Mai; Koh, Audrey Rui Xuan; Teo, Irene; Yoon, Sungwon; Bakitas, Marie

doi:10.1186/s12904-021-00799-y

Cited by 7 publications

(15 citation statements)

References 30 publications

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“…64 The palliative care context was broad including; specialised palliative care in hospital and home settings ( n = 19), 3,27,41,42,45,49–55,58,59,61,63,66,67,74 general palliative care ( n = 7), 4,32,39,57,69,72 specialised and general palliative care ( n = 12), 33,35,36,38,43,44,46–48,62,64,70 , peer support ( n = 1), 37 early palliative care ( n = 3) 34,40,68 and Advance Care Planning (ACP) ( n = 4). 56,65,71,73 Patients’ diagnoses consisted mainly of cancer ( n = 19), 34,35,37 –39,42,44 –46,48–50,52,53,55,60,…”

Section: Resultsmentioning

confidence: 99%

“…The included studies ( n = 44) comprised of 19 qualitative, 3,4,27,32 –47 5 quantitative 48 –52 and 20 mixed-methods studies, 53 –74 spanning 18 countries in; North America, 4,39 –41,46–48,50,53–56,58,59,61–63,65,66,68 …”

Section: Resultsmentioning

confidence: 99%

“… 49 One study described use of various technologies to deliver palliative care; video consultations, telephone, website, online forums and social media forums, but not necessarily in combination with one another. 44 Telephone interventions were well represented, alone ( n = 5) 32 , 39 , 40 , 45 , 48 and in combination with other technologies. Several studies used websites alone ( n = 7) 34 , 42 , 56 , 60 , 61 , 65 , 73 and in combination with other technologies; website, e-mail, and online forum ( n = 2) 54 , 55 and website, online forum and social media forums ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Another value-adding benefit found is convenience 35,39,40,48,52,63 expressed as accommodating personal presence over distance, facilitating family conferences, complex decision-making in the terminal phase 3,35,48,62,64 and revealed as travellingand time-saving 36,52,62 and being in the comfort of one's own home. 36,46,63 Technological convenience may also explain why some preferred telephone-based telepalliative care, such as ENABLE telephone-based interventions, 39,40,45,68 although, some patients and families were open to video/internet use. 39,40 Some patients found video consultations too intense, 3 and fluctuations in one's The mode of technology employed affects the type of telepalliative care that can be provided; synchronous solutions provided patients and families with care and symptom management and asynchronous solutions provided patients and families with information and support.…”

Section: Themesmentioning

confidence: 99%

“…The included studies (n = 44) comprised of 19 qualitative, 3,4,27,32-47 5 quantitative [48][49][50][51][52] and 20 mixedmethods studies, spanning 18 countries in; North America, 4,[39][40][41][46][47][48]50,[53][54][55][56]58,59,[61][62][63]65,66,[68][69][70][71][72][73][74] South America, 51 Europe, 3,27,[33][34][35][36][37][38]49,52,57,60 Africa, 32,44 Asia 45,67 and Australia. 64 The palliative care context was broad including; specialised palliative care in hospital and home settings (n = 19), 3,...…”

Section: Description Of Included Studiesmentioning

confidence: 99%

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Patient and families’ perspectives on telepalliative care: A systematic integrative review

Hayes Bauer,

Schultz,

Brandt

et al. 2023

Palliat Med

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Background: Telepalliative care is increasingly used in palliative care, but has yet to be examined from a patient and family perspective. A synthesis of evidence may provide knowledge on how to plan and provide telepalliative care that caters specifically to patients and families’ needs. Objective: To synthesise evidence on patients and families’ perspectives on telepalliative care. Design: A systematic integrative review (PROSPERO #CRD42022301206) reported in accordance with PRISMA 2020 guidelines. Inclusion criteria; primary peer-reviewed studies published 2011–2022, patient and family perspective, >18 years, telepalliative care and English/Danish language. Quality was appraised using the mixed-methods appraisal tool, version 2020. Guided by Toronto and Remington, data were extracted, thematically analysed and synthesised. Data sources: MEDLINE, EMBASE, PsycINFO and CINAHL were searched in March 2022 and updated in February 2023. Results: Forty-four studies were included. Analysis revealed five themes; the effect of the Covid-19 pandemic on telepalliative care, adding value for patients and families, synchronous and asynchronous telepalliative care, the integration of telepalliative care with other services and the tailoring and timing of telepalliative care. Conclusion: Enhanced access to care and convenience, as attributes of telepalliative care, are highly valued. Patients and families have varying needs during the illness trajectory that may be addressed by early integration of telepalliative care based on models of care that are flexible and combine synchronous and asynchronous solutions. Further research should examine telepalliative care in a post-pandemic context, use of models of care and identify meaningful outcome measures from patient and family perspectives for evaluation of telepalliative care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Themesmentioning

confidence: 99%

Section: Description Of Included Studiesmentioning

confidence: 99%

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Patient and families’ perspectives on telepalliative care: A systematic integrative review

Hayes Bauer,

Schultz,

Brandt

et al. 2023

Palliat Med

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Promising Directions: A Systematic Review of Psychosocial and Behavioral Interventions with Cultural Incorporation for Advanced and Metastatic Cancer

Llave,

Cheng,

et al. 2024

Int.J. Behav. Med.

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Background Improving quality of life (QOL) in advanced and metastatic cancer is a priority with increasing survivorship. This systematic review synthesizes psychosocial and behavioral interventions incorporating culture with the goal of examining their benefit for understudied and medically underserved populations with advanced and metastatic cancer. Method Reports were systematically screened for (1) a focus on advanced and metastatic cancer survivors, (2) psychosocial or behavioral intervention intended to improve QOL, (3) evidence of incorporating the culture(s) of understudied/underserved populations, and (4) availability in English. Bias was evaluated using the JBI Critical Appraisal Checklist and the Methodological index for non‐randomized studies. Qualitative synthesis and quantitative meta-analyses were completed. Results Eighty-six reports containing 5981 participants’ data were examined. Qualitative synthesis of 23 studies identified four overarching themes relevant for incorporating culture in interventions. Meta-analysis of 19 RCTs and 4 quasi-experimental studies containing considerable heterogeneity indicated greater improvements in QOL (g = 0.84), eudaimonic well-being (g = 0.53), distress (g = −0.49), and anxiety (g = −0.37) for main intervention conditions compared to controls. Meta-analysis of 10 single-arm trials containing minimal to moderate heterogeneity found benefit for anxiety (g = −0.54), physical symptoms (g = −0.39), and depression (g = −0.38). Conclusion Psychosocial and behavioral interventions with cultural incorporation appear beneficial for improving QOL-related outcomes in advanced and metastatic cancer. Studies incorporating culture in psychosocial or behavioral interventions offer noteworthy insight and suggestions for future efforts such as attending to deep cultural structure.

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A pilot study to evaluate the feasibility and potential effectiveness of an early palliative care model: “Educate, Nurture, Advise, Before Life Ends for Singapore”

Yang,

Koh,

Natesan

et al. 2024

Pall Supp Care

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Objective The main objective was to pilot the culturally adapted “Educate, Nurture, Advise, Before Life Ends” for Singapore (ENABLE-SG) model to evaluate its feasibility and potential effectiveness. Methods A single-arm pilot trial of ENABLE-SG among patients with advanced solid tumors and caregivers of these patients was conducted in the outpatient oncology clinic setting. Enrolled participants participated in individual ENABLE-SG psychoeducational sessions weekly. Patients had 6 sessions on the topics of maintaining positivity, self-care, coping with stress, managing symptoms, exploring what matters most and life review. Caregivers had 4 sessions on the topics of maintaining positivity, self-care, coping with stress and managing symptoms. At baseline, 4, 8, and 12 months after enrolment, patient’s quality of life was measured using the Functional Assessment of Chronic Illness Therapy – Palliative Care, patient’s mood was measured using the Center for Epidemiologic Studies – Depression scale, and caregiver quality of life was measured using the Singapore Caregiver Quality of Life Scale. Results We enrolled 43 patients and 15 caregivers over a 10-month period from August 2021 to June 2022. Although there was a low approach-to-participation rate, most of those who enrolled completed all ENABLE-SG sessions – 72% for patients and 94% for caregivers. Caregivers had better quality of life over time, specifically in the subscales of mental well-being and experience-meaning. Significance of results Based on findings from this study, we are planning a randomized waitlist-controlled trial of ENABLE-SG for patients with advanced cancer and their caregivers.

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Adapting ENABLE for patients with advanced cancer and their family caregivers in Singapore: a qualitative formative evaluation

Cited by 7 publications

References 30 publications

Patient and families’ perspectives on telepalliative care: A systematic integrative review

Patient and families’ perspectives on telepalliative care: A systematic integrative review

Promising Directions: A Systematic Review of Psychosocial and Behavioral Interventions with Cultural Incorporation for Advanced and Metastatic Cancer

A pilot study to evaluate the feasibility and potential effectiveness of an early palliative care model: “Educate, Nurture, Advise, Before Life Ends for Singapore”

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