Acceptability and feasibility of a Patient Support Coordinator (PSC) model to facilitate serious illness...

Conventional serious illness conversations (SICs) are frequently impeded by clinical time constraints and a lack of psychological readiness among patients. To address these barriers, this study evaluates the acceptability and feasibility of a novel Patient Support Coordinator (PSC)-delivered intervention that nests values and goals exploration within a non-directive supportive listening intervention facilitated by a non-clinician. Conceptualized as a preparatory adjunct to clinician-delivered SICs, this approach facilitates the open-ended exploration of patient-defined interests and concerns at a pace that respects individual preferences and coping strategies.

This single-arm, non-randomized pilot study used a convergent parallel mixed-methods design in outpatient oncology. Acceptability was assessed through Feeling Heard and Understood (FHU) and Client Satisfaction (CSQ) surveys with a predefined threshold ≥ 12/16. Qualitative interviews with patients (n = 21) and oncologists (n = 2) provided data on intervention acceptability and implementation feasibility.

Enrollment (90.3%) and retention (85.7%) rates surpassed feasibility targets. High acceptability was demonstrated by median scores of 13/16 for the FHU (n = 19) and 15/16 for the CSQ (n = 20). While most participants met the FHU threshold, four scored below 12 due to gendered discomfort, mismatched expectations, and perceptions that they were coping well and had no need of supportive listening. Qualitatively, the PSC was described as having provided a safe emotional outlet and humanized care by addressing psychosocial needs that participants felt their treating oncologists had no room to manage. The coordinator's status as a non-clinician and capacity to demonstrate sensitivity and care were found to facilitate rapport-building, thereby enabling meaning-making and biographical reflection. Clinicians reported minimal workflow disruption and valued the PSC's ability to surface patient concerns and treatment misconceptions that often remain unvoiced in routine clinic consultations.

Nesting values-based exploration within supportive listening is a feasible and acceptable framework for oncology care. By providing a non-clinical space for reflection, the PSC model may address common barriers to SIC initiation, enhance the patient care experience, and thus serve as an adjunct to support clinicians in SIC initiation. Future research should evaluate the model's scalability and its comparative utility against conventional clinician-led models.

ClinicalTrials.gov NCT07428655, retrospectively registered on 23 February 2026.