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Wong V, Ippolito GM, Crescenze I. Integrating Patient Preferences with Guideline-Based Care in Neurogenic Lower Urinary Tract Dysfunction After Spinal Cord Injury. Urol Clin North Am 2024; 51:277-284. [PMID: 38609199 DOI: 10.1016/j.ucl.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Individual and social factors are important for clinical decision-making in patients with neurogenic bladder secondary to spinal cord injury (SCI). These factors include the availability of caregivers, social infrastructure, and personal preferences, which all can drive bladder management decisions. These elements can be overlooked in clinical decision-making; therefore, there is a need to elicit and prioritize patient preferences and values into neurogenic bladder care to facilitate personalized bladder management choices. For the purposes of this article, we review the role of guideline-based care and shared decision-making in the SCI population with neurogenic lower urinary tract dysfunction.
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Affiliation(s)
- Vivian Wong
- Department of Urology, Ohio State University, 915 Olentangy River Road, Suite 3100, Room 3105, Columbus, OH 43212, USA.
| | - Giulia M Ippolito
- Department of Urology, University of Michigan, 1733 Monterey Court, Ann Arbor, MI 48108, USA
| | - Irene Crescenze
- Department of Urology, Ohio State University, 915 Olentangy River Road, 2nd Floor Suite 2000, Columbus, OH 43212, USA
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2
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Feng TL, Stoessl AJ, Harrison RA. Integrated Care in Neurology: The Current Landscape and Future Directions. Can J Neurol Sci 2024:1-9. [PMID: 38679923 DOI: 10.1017/cjn.2024.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The rising burden of neurological disorders poses significant challenges to healthcare systems worldwide. There has been an increasing momentum to apply integrated approaches to the management of several chronic illnesses in order to address systemic healthcare challenges and improve the quality of care for patients. The aim of this paper is to provide a narrative review of the current landscape of integrated care in neurology. We identified a growing body of research from countries around the world applying a variety of integrated care models to the treatment of common neurological conditions. Based on our findings, we discuss opportunities for further study in this area. Finally, we discuss the future of integrated care in Canada, including unique geographic, historical, and economic considerations, and the role that integrated care may play in addressing challenges we face in our current healthcare system.
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Affiliation(s)
- Tanya L Feng
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
| | - A Jon Stoessl
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
- Pacific Parkinson's Research Centre, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Rebecca A Harrison
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
- British Columbia Cancer Agency, Vancouver, BC, Canada
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3
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陶 文, 文 进, 李 为. [Utilizing Patient Navigation Model in the Whole-Process Management of Lung Cancer in the Context of Medical Consortiums in China: Insights and Reflections]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:1288-1293. [PMID: 38162072 PMCID: PMC10752780 DOI: 10.12182/20231160301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Indexed: 01/03/2024]
Abstract
Patient navigation is an effective intervention measure to promote the integration of medical systems and services. By providing individualized, coordinated, and continuous care, patient navigation offers a way to address the problem of fragmented services across institutions and levels of care in the whole-process management of lung cancer, providing assistance to patients with complex healthcare needs. Herein, we reviewed the origin, the development, the models, and the application status of patient navigation in China and other countries. We also analyzed the considerations regarding introducing patient navigation in the whole-process management of lung cancer against the background of medical consortiums in China, discussing why patient navigation should be introduced, how to introduce patient navigation, as well as potential challenges and coping strategies. Patient navigation meets the current needs for equitable, accessible, systematic, continuous, and integrated prevention and treatment services for chronic diseases in the context of the Healthy China Strategy. It helps fill the gaps in the continuity and coordination of whole-process management of lung cancer patients in the context of medical consortiums. However, introducing patient navigation in medical consortiums involving multiple institutions and levels of care may face challenges, including incompatibility between the health information systems of different institutions, poor cross-institutional collaboration and communication, and limited resources. Further improvement is needed in medical informatization, coordination and communication mechanisms, and benefit distribution mechanisms within the medical consortiums. In this paper, we intend to provide insights and suggestions for developing patient navigation models that suit China's local characteristics and for promoting the implementation and development of whole-process management of lung cancer in the context of the medical consortium system.
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Affiliation(s)
- 文娟 陶
- 四川大学华西医院 医院管理研究所 (成都 610041)Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 进 文
- 四川大学华西医院 医院管理研究所 (成都 610041)Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 为民 李
- 四川大学华西医院 医院管理研究所 (成都 610041)Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 院长办公室 (成都 610041)President's Office, West China Hospital, Sichuan University, Chengdu 610041, China
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Yeh SCJ, Wang WC, Yu HC, Wu TY, Lo YY, Shi HY, Chou HC. Relationship between using cancer resource center services and patient outcomes. Support Care Cancer 2023; 31:706. [PMID: 37975908 DOI: 10.1007/s00520-023-08169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Psychological and social support are crucial in treating cancer. Cancer resource centers provide patients with cancer and their families with services that can help them through cancer treatment, ensure that patients receive adequate treatment, and reduce cancer-related stress. These centers offer various services, including medical guidance, health education, emotional assistance (e.g., consultations for cancer care), and access to resources such as financial aid and post recovery programs. In this study, we comprehensively analyzed how cancer resource centers assist patients with cancer and improve their clinical outcomes. METHODS The study participants comprised patients initially diagnosed with head and neck cancer or esophageal cancer. A total of 2442 patients from a medical center in Taiwan were included in the study. Data were analyzed through logistic regression and Cox proportional hazards regression. RESULTS The results indicate that unemployment, blue-collar work, and a lower education level were associated with higher utilization of cancer resource center services. The patients who were unemployed or engaged in blue-collar work had higher risks of mortality than did their white-collar counterparts. Patient education programs can significantly improve the survival probability of patients with cancer. On the basis of our evaluation of the utilization and benefits of services provided by cancer resource centers, we offer recommendations for improving the functioning of support systems for patients with cancer and provide suggestions for relevant future research. CONCLUSIONS We conclude that cancer resource centers provide substantial support for patients of low socioeconomic status and improve patients' survival.
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Affiliation(s)
- Shu-Chuan Jennifer Yeh
- Institute of Health Care Management & Department of Business Management, National Sun Yat-Sen University, 70 Lian Hai Road, Kaohsiung, 80424, Taiwan.
| | - Wen Chun Wang
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Hsien-Chung Yu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Tzu-Yu Wu
- National Taiwan University Hospital Research Ethics Committee Office, Taipei, Taiwan
| | - Ying-Ying Lo
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsueh-Chih Chou
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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5
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Griesemer I, Lightfoot AF, Eng E, Bosire C, Guerrab F, Kotey A, Alexander KM, Baker S, Black KZ, Dixon C, Ellis KR, Foley K, Goettsch C, Moore A, Ryals CA, Smith B, Yongue C, Cykert S, Robertson LB. Examining ACCURE's Nurse Navigation Through an Antiracist Lens: Transparency and Accountability in Cancer Care. Health Promot Pract 2023; 24:415-425. [PMID: 36582178 DOI: 10.1177/15248399221136534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There are persistent disparities in the delivery of cancer treatment, with Black patients receiving fewer of the recommended cancer treatment cycles than their White counterparts on average. To enhance racial equity in cancer care, innovative methods that apply antiracist principles to health promotion interventions are needed. The parent study for the current analysis, the Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) intervention, was a system-change intervention that successfully eliminated the Black-White disparity in cancer treatment completion among patients with early-stage breast and lung cancer. The intervention included specially trained nurse navigators who leveraged real-time data to follow-up with patients during their treatment journeys. Community and academic research partners conducted thematic analysis on all clinical notes (n = 3,251) written by ACCURE navigators after each contact with patients in the specialized navigation arm (n = 162). Analysis was informed by transparency and accountability, principles adapted from the antiracist resource Undoing Racism and determined as barriers to treatment completion through prior research that informed ACCURE. We identified six themes in the navigator notes that demonstrated enhanced accountability of the care system to patient needs. Underlying these themes was a process of enhanced data transparency that allowed navigators to provide tailored patient support. Themes include (1) patient-centered advocacy, (2) addressing system barriers to care, (3) connection to resources, (4) re-engaging patients after lapsed treatment, (5) addressing symptoms and side effects, and (6) emotional support. Future interventions should incorporate transparency and accountability mechanisms and examine the impact on racial equity in cancer care.
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Affiliation(s)
- Ida Griesemer
- VA Boston Healthcare System, Boston, MA, USA
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
| | - Alexandra F Lightfoot
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, Chapel Hill, NC, USA
| | - Eugenia Eng
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Claire Bosire
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fatima Guerrab
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- Community-Campus Partnerships for Health, Raleigh, NC
| | - Amanda Kotey
- Alliant Health Solutions, Inc., Atlanta, GA, USA
| | - Kimberly M Alexander
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- The Alexander Group, Durham, NC, USA
- Elon University, Elon, NC, USA
| | - Stephanie Baker
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- Elon University, Elon, NC, USA
| | - Kristin Z Black
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- East Carolina University, Greenville, NC, USA
| | - Crystal Dixon
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- Wake Forest University, Winston-Salem, NC, USA
| | - Katrina R Ellis
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of Michigan, Ann Arbor, MI, USA
| | - Karen Foley
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Antionette Moore
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- Winston-Salem State University, Winston-Salem, NC, USA
| | - Cleo A Ryals
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Cone Health Cancer Center, Greensboro, NC, USA
| | - Beth Smith
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Christina Yongue
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Samuel Cykert
- Greensboro Health Disparities Collaborative, Greensboro, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Doucet S, Luke A, Anthonisen G. Hospital-based patient navigation programs for patients who experience injury-related trauma and their caregivers: a scoping review. BMJ Open 2022; 12:e066260. [PMID: 36572494 PMCID: PMC9806040 DOI: 10.1136/bmjopen-2022-066260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This review's objective is to map the literature on the characteristics, impact, barriers and facilitators of hospital-based patient navigation programmes that support patients who experience injury-related trauma and their caregivers. Patients who experience injury-related trauma frequently require support from multiple care teams and face many challenges to care, both in hospital and when transitioning across settings and services. Patient navigation can improve their care. DESIGN This review is conducted according to JBI methodology for scoping reviews. The initial database search took place on 6 June 2021 and the grey literature search took place between September and October 2021. The results are presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses for Scoping Reviews flow diagram. SETTING This review considered materials where the patient navigation programmes were delivered in hospital settings. There was no geographical limit to this study. PARTICIPANTS This review focused on hospital-based patient navigation programmes for patients who experience injury-related trauma and/or their caregivers. RESULTS This review captured 11 records that describe 10 programmes. All programmes were based in the USA. Most programmes provided education, care coordination, discharge planning, and referrals to resources, services, and programmes to assist patients and/or their families in the hospital or the community. Half the programmes were based in level 1 trauma centres. Common impacts included decreases in readmission rates and increases in satisfaction rates. Barriers included difficulty recruiting or enrolling patients with short hospital stays and hospital administrators' and healthcare providers' lack of understanding of the navigator role. Navigator background, either professional or experiential, was identified as a facilitator, as was flexibility in programme delivery and communication methods. CONCLUSIONS Eleven records show a small but distinct sample. Reported characteristics, impact, barriers and facilitators were consistent with findings from other patient navigation studies. The results can inform the development and implementation of similar programmes in trauma centres and support changes in policy to improve the delivery of care.
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Affiliation(s)
- Shelley Doucet
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
- University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, New Brunswick, Canada
- Centre for Research in Integrated Care, Saint John, New Brunswick, Canada
| | - Alison Luke
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
- University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, New Brunswick, Canada
- Centre for Research in Integrated Care, Saint John, New Brunswick, Canada
| | - Grailing Anthonisen
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
- Centre for Research in Integrated Care, Saint John, New Brunswick, Canada
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Khetarpaul V, Kirby JP, Geraghty P, Felder J, Grover P. Socioecological model-based design and implementation principles of lower limb preservation programs as partners for limb-loss rehabilitation programs- A mini-review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:983432. [PMID: 36578773 PMCID: PMC9791697 DOI: 10.3389/fresc.2022.983432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022]
Abstract
People with lower limb loss, especially of dysvascular etiology, are at substantial risk for both ipsilateral and contralateral reamputation. Additionally, while not as well documented for reamputation, there is recognition that amputation incidence is influenced by not only sociodemographic factors such as sex, race, socioeconomic status, but also by system factors such as service access. A systems strategy to address this disparity within the field of limb-loss rehabilitation is for Limb-loss Rehabilitation Programs (LRP) to partner with medical specialists, mental health professionals, and Limb Preservation Programs (LPP) to provide comprehensive limb care. While LPPs exist around the nation, design principles for such programs and their partnership role with LRPs are not well established. Using a socioecological model to incorporate hierarchical stakeholder perspectives inherent in the multidisciplinary field of limb care, this review synthesizes the latest evidence to focus on LPP design and implementation principles that can help policymakers, healthcare organizations and limb-loss rehabilitation and limb-preservation professionals to develop, implement, and sustain robust LPP programs in partnership with LRPs.
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Kokorelias KM, Gould S, DasGupta T, Cass D, Hitzig SL. Assessing readiness to implement patient navigator programs in Toronto, Canada. J Eval Clin Pract 2022; 28:550-557. [PMID: 34664339 DOI: 10.1111/jep.13630] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore factors influencing the implementation of patient navigator programs within a hospital for seniors with complex care needs. METHODS A qualitative descriptive design using in-depth interviews was conducted. Participant interviews were conducted in Toronto, Ontario between September 2020 and February 2021. Data were analysed using thematic analysis. RESULTS Thirty-five semi-structured interviews were conducted with 38 participants from a large urban hospital (n = 21) and community healthcare organizations (n = 17), including organizational leaders, and acute care and rehabilitation providers. Follow-up interviews occurred with 16 participants (7 from the community and nine from the hospital). This study identified five key factors influencing organizational readiness for successful implementation of a patient navigator program for seniors with complex conditions, which included: (a) vision from senior leadership, (b) technological infrastructure, (c) existing hospital-community partnerships, (d) well-established process for referrals, and (e) staff capacity. The overarching theme of communication was also identified. CONCLUSIONS The findings of this study provide a better understanding of hospital and community professionals' needs and challenges when implementing patient navigator programs for seniors with complex care conditions. There are a number of factors that influence an organization's readiness for program uptake and delivery, with the need for clear communication being paramount. Further research to test the effects of readiness on successful implementation outcomes is warranted.
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Affiliation(s)
- Kristina M Kokorelias
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Sarah Gould
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Tracey DasGupta
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Dan Cass
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Teng LJ, Goldsmith LJ, Sawhney M, Jussaume L. Hip and Knee Replacement Patients' Experiences With an Orthopaedic Patient Navigator: A Qualitative Study. Orthop Nurs 2021; 40:292-298. [PMID: 34583375 DOI: 10.1097/nor.0000000000000789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Hip and knee replacement surgery is common, yet more than 10% of patients who undergo total hip replacement (THR) and total knee replacement (TKR) report postsurgery dissatisfaction. Recommendations for improving patient experience after total joint replacement surgery include increasing support to patients, including having a patient navigator available to patients before and after surgery. This article reports on THR and TKR patients' experiences of using an orthopaedic patient navigator. We employed qualitative description to understand THR and TKR patients' experiences of interacting with an orthopaedic patient navigator in a community teaching hospital. Telephone interviews were conducted with 15 purposefully selected total joint replacement patients (TKR: n = 11; THR: n = 4) who had at least one contact with the navigator. Interview transcripts were analyzed using thematic analysis. Patients described receiving physical support services, emotional support services, informational support services, and care coordination services from the patient navigator. All interactions with the patient navigator were positive. Knowing the patient navigator was available for any future concerns also provided indirect benefits of reassurance, comfort, and security. Patients described these direct and indirect benefits as potentially having long-lasting and resilient positive effects. An orthopaedic patient navigator can have a positive impact on patients' THR and TKR experience and fill gaps in support identified in earlier studies. Addressing patients' complex and varied care needs is well suited to a clinical nurse specialist in the role. Investing in an orthopaedic patient navigator provides reassurance to patients that their needs are a priority and will be addressed in a timely manner.
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Affiliation(s)
- Larissa J Teng
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Laurie J Goldsmith
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Monakshi Sawhney
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Linda Jussaume
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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10
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Kokorelias KM, Shiers-Hanley JE, Rios J, Knoepfli A, Hitzig SL. Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature. Health Serv Insights 2021; 14:11786329211033267. [PMID: 34349519 PMCID: PMC8287353 DOI: 10.1177/11786329211033267] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/28/2021] [Indexed: 11/15/2022] Open
Abstract
Patient navigation is a model of care that aims to improve access to care by reducing the complexity of navigating health, education, and social services across the continuum of care and care settings. Little is known about the processes that facilitate or impede the implementation of patient navigation programs (PNPs). We conducted a scoping review to identify and summarize the current state of knowledge regarding the implementation and outcomes of existing implemented PNPs. We employed a 6-stage scoping review framework to identify and review eligible articles. Sixty-articles met the inclusion criteria (58 peer-reviewed and 2 grey literature). The Consolidated Framework for Implementation Research served as the theoretical framework during analysis to help extract factors relevant to implementation of navigator programs. Results of the scoping review are reported thematically. Influences on implementation were identified: (a) planning to ensure alignment with organizational need (b) funding (c) multidisciplinary engagement (d) establishing workflow (e) mechanisms for communication (f) stakeholders to encourage buy-in (g) appropriate caseload (h) in kind resources. PNPs improve the experiences of patients and families. The findings of this scoping review provides implementation considerations of PNPs across global care settings. Strategies for overcoming pragmatic and logistical issues must be developed for optimal implementation.
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Affiliation(s)
- Kristina M Kokorelias
- St. John’s Rehab Research Program,
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
| | - Jessica E Shiers-Hanley
- Hazel McCallion Academic Learning
Centre, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science
& Occupational Therapy, Temerty Faculty of Medicine, University of Toronto
| | - Jorge Rios
- St. John’s Rehab Research Program,
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
| | - Amanda Knoepfli
- Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
- SPRINT Senior Care, Toronto, ON,
Canada
| | - Sander L Hitzig
- St. John’s Rehab Research Program,
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
- Department of Occupational Science
& Occupational Therapy, Temerty Faculty of Medicine, University of Toronto
- Rehabilitation Sciences Institute,
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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11
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Abstract
BACKGROUND Patient navigation is a complex intervention that has garnered substantial interest and investment across Canada. We conducted an environmental scan to understand the landscape of patient navigation programs within the health care system in Alberta, Canada. METHODS We included patient navigation programs within Alberta Health Services (AHS) and Alberta's Primary Care Networks (PCNs). Key informants were asked in October 2016 to identify existing programs and their corresponding program contacts. These program contacts were invited to complete a telephone-based survey from October 2016 to July 2017, to provide program descriptions and eligibility criteria, and to identify gaps in navigation. Programs were included if they engaged patients on an individual basis, and either facilitated continuity of care or promoted patient and family empowerment. We tabulated results and calculated summary statistics for program characteristics. RESULTS Ninety-five potentially eligible programs were identified by key informants. The response rate to the study survey was 73% (n = 69). After excluding programs not meeting inclusion criteria, we included a total of 58 programs in the study: 43 AHS programs and 15 PCN programs. Nearly all programs (93%, n = 54) delivered navigation via an individual acting as a navigator. A minority of programs also included nonnavigator components, such as Web-based resources (7%, n = 4) and process or structural changes to facilitate navigation (22%, n = 13). Certain patient subgroups were particularly well-served by patient navigation; these included patients with cancer, substance use disorders or mental health concerns, and pediatric patients. Gaps identified in navigation fell under 4 domains: awareness, resources, geographic distribution and integration. INTERPRETATION Patient navigation programs are common and have extended beyond cancer care, from which the construct originated; however, gaps include a lack of awareness and inequitable access to the programs. These findings will be of interest to those developing and implementing patient navigation interventions in Alberta and other jurisdictions.
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Affiliation(s)
- Karen L Tang
- Department of Medicine (Tang); Department of Community Health Sciences (Tang, Sharma); O' Brien Institute for Public Health (Tang, Ghali); W21C Research and Innovation Centre, Cumming School of Medicine (Kelly, Sharma); Office of the Vice-President (Research) (Ghali), University of Calgary, Calgary, Alta.
| | - Jenny Kelly
- Department of Medicine (Tang); Department of Community Health Sciences (Tang, Sharma); O' Brien Institute for Public Health (Tang, Ghali); W21C Research and Innovation Centre, Cumming School of Medicine (Kelly, Sharma); Office of the Vice-President (Research) (Ghali), University of Calgary, Calgary, Alta
| | - Nishan Sharma
- Department of Medicine (Tang); Department of Community Health Sciences (Tang, Sharma); O' Brien Institute for Public Health (Tang, Ghali); W21C Research and Innovation Centre, Cumming School of Medicine (Kelly, Sharma); Office of the Vice-President (Research) (Ghali), University of Calgary, Calgary, Alta
| | - William A Ghali
- Department of Medicine (Tang); Department of Community Health Sciences (Tang, Sharma); O' Brien Institute for Public Health (Tang, Ghali); W21C Research and Innovation Centre, Cumming School of Medicine (Kelly, Sharma); Office of the Vice-President (Research) (Ghali), University of Calgary, Calgary, Alta
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Nightingale G, Battisti NML, Loh KP, Puts M, Kenis C, Goldberg A, Haase KR, Krok-Schoen J, Liposits G, Sattar S, Stolz-Baskett P, Pergolotti M. Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG. J Geriatr Oncol 2021; 12:658-665. [PMID: 33172805 PMCID: PMC8102651 DOI: 10.1016/j.jgo.2020.10.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
Abstract
Most adults with cancer are over 65 years of age, and this cohort is expected to grow exponentially. Older adults have an increased burden of comorbidities and risk of experiencing adverse events on anticancer treatments, including functional decline. Functional impairment is a predictor of increased risk of chemotherapy toxicity and shorter survival in this population. Healthcare professionals caring for older adults with cancer should be familiar with the concept of functional status and its implications because of the significant interplay between function, cancer, anticancer treatments, and patient-reported outcomes. In this narrative review, we provide an overview of functional status among older patients with cancer including predictors, screening, and assessment tools. We also discuss the impact of functional impairment on patient outcomes, and describe the role of individual members of an interprofessional team in addressing functional impairment in this population, including the use of a collaborative approach aiming to preserve function.
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Affiliation(s)
- Ginah Nightingale
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Nicolò Matteo Luca Battisti
- Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, Sutton, Surrey SM1 2JP, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London SM2 5NG, United Kingdom
| | - Kah Poh Loh
- James P Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Annette Goldberg
- Department of Nutrition, Dana Farber Cancer Institute, Boston, MA, USA
| | - Kristen R Haase
- School of Nursing, University of British Columbia, Wesbrook Mall, Vancouver, British Columbia, Canada
| | - Jessica Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Gábor Liposits
- Department of Oncology, Regional Hospital West Jutland, Herning, Denmark
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Petra Stolz-Baskett
- Oncology Service, Nelson Hospital Nelson Marlborough Health, Nelson 7048, New Zealand
| | - Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical; Colorado State University, Fort Collins, CO, USA
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13
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Devictor J, Leclercq A, Hazo JB, Burnet E, Jovic L, Bouattour M, Ganne-Carrié N. Nurse coordinator roles in the management of patients with hepatocellular carcinoma: A French national survey. Clin Res Hepatol Gastroenterol 2021; 45:101650. [PMID: 33609787 DOI: 10.1016/j.clinre.2021.101650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/31/2021] [Accepted: 02/08/2021] [Indexed: 02/04/2023]
Abstract
UNLABELLED Hepatocellular carcinoma (HCC) mostly occurs in patients with chronic liver disease (CLD). HCC treatment may have a direct impact on CLD prognosis. HCC management can therefore become complex, involving multiple health care providers, such as oncologists, hepatologists, radiologists, and surgeons. In France, dedicated nurses have been involved in patient care pathways. Their impact is poorly documented. PURPOSE To determine the country-wide distribution of HCC nurse coordinators in French health care settings and to describe their roles and responsibilities. PATIENTS AND METHODS A survey using a multi-item questionnaire (including center characteristics, nurse coordinator characteristics, and quality indicators such as patient care pathway initiation timeline, scheduled length of hospital stay, diagnostic disclosure process) was conducted. All French liver cancer centers planning to participate in a prospective national cohort study for patients with HCC (CHIEF Cohort) were invited to take part in the survey. Bivariate analysis compared centers with a nurse coordinator to those without. RESULTS Among the 42 of 72 centers that replied, 14 treated fewer than 75 HCC patients. Treatment mostly took place in hepatology units (34/42). Sixteen nurse coordinators were part of the health care team in 13 of the 42 centers. Among these 13 centers, 11 were university hospitals and 11 followed more than 75 patients per year. The median number of patients followed in these centers was 300 (min-max 44-600) in 2017. All nurse coordinators were involved in providing patient information and counseling. Other roles included treatment monitoring (13/16), care coordination (12/16), psychological support (12/16) and treatment planning (11/16). Thirteen nurse coordinators conducted diagnostic disclosure nurse consultations; seven conducted initial patient contact consultations; and six held outpatient nurse consultations, with wide heterogeneity between centers. The presence of a nurse coordinator was associated with completion of the full diagnostic disclosure process (p = 0.045). CONCLUSION In France, nurse coordinators for HCC patient pathway management are present mainly in university hepatology units with a caseload of more than 75 patients per year. All provide patient information and counseling but their roles in care coordination, patient support and holistic assessment are heterogeneous and not standardized.
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Affiliation(s)
- Julie Devictor
- AP-HP, Hôpital Beaujon, DIGEST, Clichy, France; ECEVE, UMRS 1123, INSERM, Paris, France; Université de Paris, Paris, France
| | - Anne Leclercq
- AP-HP, Hôpital Beaujon, Direction des soins, Clichy, France
| | - Jean-Baptiste Hazo
- ECEVE, UMRS 1123, INSERM, Paris, France; Université de Paris, Paris, France
| | - Espérie Burnet
- AP-HP, Hôpital Cochin, Thorax, ORL et sommeil, Paris, France
| | - Ljiljana Jovic
- ECEVE, UMRS 1123, INSERM, Paris, France; Université de Paris, Paris, France
| | | | - Nathalie Ganne-Carrié
- AP-HP, Hôpital Avicenne, DMU NARVAL, Bobigny, France; Université Sorbonne Paris Nord, Bobigny, France; INSERM UMR 1138, Centre de recherche des Cordeliers, Sorbonne Université, Paris, France
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Dixit N, Rugo H, Burke NJ. Navigating a Path to Equity in Cancer Care: The Role of Patient Navigation. Am Soc Clin Oncol Educ Book 2021; 41:1-8. [PMID: 33830828 DOI: 10.1200/edbk_100026] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Notable barriers exist in the delivery of equitable care for all patients with cancers. Social determinants of health at distal, intermediate, and proximal levels impact cancer care. Patient navigation is a patient-centered intervention that functions across these overlapping determinants to increase access to cancer services throughout the cancer care continuum. There is a need to standardize patient navigation training while remaining responsive to local contexts of care and a need to implement patient navigation programs with a health equity lens to address cancer care inequities.
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Affiliation(s)
- Niharika Dixit
- University of California San Francisco/Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Hope Rugo
- The Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
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15
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Haase KR, Anderson J, Knox A, Skrutkowski M, Snow B, Moody L, Pool Z, Vimy K, Watson L. Élaboration d'un énoncé de position national sur la navigation des patients atteints de cancer au Canada. Can Oncol Nurs J 2020; 30:83-92. [PMID: 33119728 DOI: 10.5737/236880763028392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Au Canada, le paysage des soins du cancer évolue et les infirmières en oncologie sont appelées à jouer de nouveaux rôles afin d'améliorer l'expérience des patients et des familles et de répondre à leurs besoins toujours changeants. L'un de ces rôles, la navigation des patients atteints de cancer (NPC), vise principalement à coordonner les soins centrés sur la personne et à guider les patients dans le système de santé. Dans plusieurs provinces et territoires du Canada, la navigation est devenue essentielle pour offrir des soins de grande qualité aux patients cancéreux. Depuis 2016, des chefs de file des soins infirmiers oncologiques se réunissent au sein d'un groupe national pour synthétiser leur compréhension de la navigation des patients en contexte canadien afin d'élaborer un énoncé de position national sur la NPC. Dans le présent article, nous analyserons l'historique de l'élaboration de l'énoncé de position sur la NPC que publiera prochainement l'Association canadienne des infirmières en oncologie (ACIO/CANO). Nous analyserons également les commentaires des participants aux ateliers tenus dans le cadre des congrès de 2016, 2017 et 2018, de même que les comptes rendus des réunions du groupe de travail national qui ont eu lieu pendant cette même période. Le présent article se veut un sommaire historique concis de l'évolution de la NPC au Canada, ainsi qu'un modèle pour les autres groupes aspirant à rédiger un énoncé de position consensuel.
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16
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Berezowska A, Passchier E, Bleiker E. Professional patient navigation in a hospital setting: a randomized controlled trial. Support Care Cancer 2020; 29:2111-2123. [PMID: 32864723 DOI: 10.1007/s00520-020-05721-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/26/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to determine the effect of patient navigation on health-related quality of life, distress, self-care knowledge, self-efficacy, satisfaction, and healthcare usage. METHODS Patients newly diagnosed with ovarian, vulvar, endometrial, melanoma stage III/IV, lung, or renal cancer were randomly assigned to either care as usual or care as usual plus consultations with a patient navigator (i.e., specially trained oncology nurse who monitors, advises, and refers patients to supportive cancer care). Measures included the EORTC-QLQ-C30, distress thermometer, and study-specific questions inspired by the Symptom-Management Self-Efficacy Scale Breast Cancer, Patient Satisfaction with Cancer Care Scale, and the Medical Consumption Questionnaire. Measures were completed before randomization (baseline) and at 1 month, 3 months, and 5 months after baseline. RESULTS In the case of health-related quality of life, no significant difference was observed between the intervention (n = 42) and the control group (n = 47). Consumption of supportive cancer care was low for both the intervention and the control group but relatively lower for the intervention group. Also, participants who consulted the patient navigator seemed to have higher levels of self-efficacy and satisfaction. CONCLUSION Although the intervention sorted no relevant effects on health-related quality of life, it did affect patients' experience of cancer care and self-efficacy. We recommend that patient navigators monitor and advise on unmet supportive care needs, but only in the case of high-risk patients. Furthermore, considering current and prior research, it is wise to study patient navigation using more sensitive outcome measures than health-related quality of life.
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Affiliation(s)
- Aleksandra Berezowska
- Center for Quality of Life, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands
| | - Ellen Passchier
- Center for Quality of Life, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands
| | - Eveline Bleiker
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Mailbox 90203, 1006 BE, Amsterdam, Netherlands.
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17
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Patient Navigator in cancer care-A specialized oncology nurse role that contributes to high-quality, person-centred care experiences and clinical efficiencies. Can Oncol Nurs J 2020; 30:227-228. [PMID: 33118967 PMCID: PMC7583568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
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18
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[Not Available]. Can Oncol Nurs J 2020; 30:229-230. [PMID: 33118961 PMCID: PMC7583569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
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19
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Masefield SC, Megaw A, Barlow M, White PCL, Altink H, Grugel J. Repurposing NGO data for better research outcomes: a scoping review of the use and secondary analysis of NGO data in health policy and systems research. Health Res Policy Syst 2020; 18:63. [PMID: 32513183 PMCID: PMC7278191 DOI: 10.1186/s12961-020-00577-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/19/2020] [Indexed: 11/26/2022] Open
Abstract
Background Non-governmental organisations (NGOs) collect and generate vast amounts of potentially rich data, most of which are not used for research purposes. Secondary analysis of NGO data (their use and analysis in a study for which they were not originally collected) presents an important but largely unrealised opportunity to provide new research insights in critical areas, including the evaluation of health policy and programmes. Methods A scoping review of the published literature was performed to identify the extent to which secondary analysis of NGO data has been used in health policy and systems research (HPSR). A tiered analytical approach provided a comprehensive overview and descriptive analyses of the studies that (1) used data produced or collected by or about NGOs; (2) performed secondary analysis of the NGO data (beyond the use of an NGO report as a supporting reference); and (3) analysed NGO-collected clinical data. Results Of the 156 studies that performed secondary analysis of NGO-produced or collected data, 64% (n = 100) used NGO-produced reports (mostly to a limited extent, as a contextual reference or to critique NGO activities) and 8% (n = 13) analysed NGO-collected clinical data. Of these studies, 55% (n = 86) investigated service delivery research topics and 48% (n = 51) were undertaken in developing countries and 17% (n = 27) in both developing and developed countries. NGOs were authors or co-authors of 26% of the studies. NGO-collected clinical data enabled HPSR within marginalised groups (e.g. migrants, people in conflict-affected areas), albeit with some limitations such as inconsistent and missing data. Conclusion We found evidence that NGO-collected and produced data are most commonly perceived as a source of supporting evidence for HPSR and not as primary source data. However, these data can facilitate research in under-researched marginalised groups and in contexts that are hard to reach by academics such as conflict-affected areas. NGO–academic collaboration could help address issues of NGO data quality to facilitate their more widespread use in research. The use of NGO data use could enable relevant and timely research in the areas of programme evaluation and health policy and advocacy to improve health and reduce health inequalities, especially in marginalised groups and developing countries.
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Affiliation(s)
- Sarah C Masefield
- Department of Health Sciences, University of York, York, YO10 5DD, United Kingdom. .,Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.
| | - Alice Megaw
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom
| | - Matt Barlow
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of Politics, University of York, York, YO10 5DD, United Kingdom
| | - Piran C L White
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of Environment and Geography, University of York, York, YO10 5NG, United Kingdom
| | - Henrice Altink
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of History, University of York, York, YO10 5NH, United Kingdom
| | - Jean Grugel
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of Politics, University of York, York, YO10 5DD, United Kingdom
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20
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Emfield Rowett K, Christensen D. Oncology Nurse Navigation: Expansion of the Navigator Role Through Telehealth. Clin J Oncol Nurs 2020; 24:24-31. [DOI: 10.1188/20.cjon.s1.24-31] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Implementing volunteer-navigation for older persons with advanced chronic illness (Nav-CARE): a knowledge to action study. BMC Palliat Care 2020; 19:72. [PMID: 32443979 PMCID: PMC7245025 DOI: 10.1186/s12904-020-00578-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Nav-CARE is a volunteer-led intervention designed to build upon strategic directions in palliative care: a palliative approach to care, a public health/compassionate community approach to care, and enhancing the capacity of volunteerism. Nav-CARE uses specially trained volunteers to provide lay navigation for older persons and family living at home with advanced chronic illness. The goal of this study was to better understand the implementation factors that influenced the utilization of Nav-CARE in eight diverse Canadian contexts. METHODS This was a Knowledge to Action study using the planned action cycle for Nav-CARE developed through previous studies. Participants were eight community-based hospice societies located in diverse geographic contexts and with diverse capacities. Implementation data was collected at baseline, midpoint, and endpoint using qualitative individual and group interviews. Field notes of all interactions with study sites were also used as part of the data set. Data was analyzed using qualitative descriptive techniques. The study received ethical approval from three university behavioural review boards. All participants provided written consent. RESULTS At baseline, stakeholders perceived Nav-CARE to be a good fit with the strategic directions of their organization by providing early palliative support, by facilitating outreach into the community and by changing the public perception of palliative care. The contextual factors that determined the ease with which Nav-CARE was implemented included the volunteer coordinator champion, organizational capacity and connection, the ability to successfully recruit older persons, and the adequacy of volunteer preparation and mentorship. CONCLUSIONS This study highlighted the importance of community-based champions for the success of volunteer-led initiatives and the critical need for support and mentorship for both volunteers and those who lead them. Further, although the underutilization of hospice has been widely recognized, it is vital to recognize the limitations of their capacity. New initiatives such as Nav-CARE, which are designed to enhance their contributions to palliative care, need to be accompanied by adequate resources. Finally, this study illustrated the need to think carefully about the language and role of hospice societies as palliative care moves toward a public health approach to care.
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Haase KR, Anderson J, Knox A, Skrutkowski M, Snow B, Moody L, Pool Z, Vimy K, Watson L. Development of a national position statement on cancer patient navigation in Canada. Can Oncol Nurs J 2020; 30:73-82. [PMID: 33118981 DOI: 10.5737/236880763027382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
As the landscape of cancer care in Canada evolves, oncology nursing roles are developed to enhance the patient experience and address the changing needs of patients and families. Cancer Patient Navigation (CPN), an oncology nursing role focusing primarily on person-centred care coordination and system navigation, has become integral to providing high-quality cancer care in many Canadian jurisdictions. Since 2016, a national group of oncology nursing leaders have been engaged in convening and catalyzing our understanding of the role of patient navigation in the Canadian cancer context with the purpose of developing a national position statement on CPN. In this paper, we provide a historical analysis of the development of the forthcoming Canadian Association of Nurses in Oncology (CANO) position statement on CPN. We present an analysis of participant feedback from workshops at the 2016, 2017, and 2018 conferences, and meeting minutes from the National working group over this same time period. This paper serves as a concise historical summary of the evolution of CPN in Canada while providing a template for other groups looking to develop a consensus-based position statement.
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Valverde PA, Burhansstipanov L, Patierno S, Gentry S, Dwyer A, Wysocki KL, Patterson AK, Krebs LU, Sellers J, Johnston D. Findings from the National Navigation Roundtable: A call for competency-based patient navigation training. Cancer 2019; 125:4350-4359. [PMID: 31503340 DOI: 10.1002/cncr.32470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Patricia A Valverde
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado
| | | | | | | | - Andrea Dwyer
- University of Colorado Comprehensive Cancer Center, Aurora, Colorado
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24
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Schroeder SR, Agusala V, Sher DJ. Financial Toxicity and Cancer Therapy: A Primer for Radiation Oncologists. Hematol Oncol Clin North Am 2019; 33:1117-1128. [PMID: 31668210 DOI: 10.1016/j.hoc.2019.08.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The diagnosis and treatment of cancer places patients at risk for serious financial consequences, which are detrimental to overall health and well-being. The concept of financial toxicity (FT) describes monetary and health implications related to the financial burden of receiving care. To investigate this important area, the authors first explore aspects of the modern American health care insurance system that relate to cancer care. Then they summarize relevant literature across multiple domains of FT that include monetary, functional, and patient-reported measures. The authors conclude by making simple recommendations to begin addressing FT in clinical practice.
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Affiliation(s)
- Samuel R Schroeder
- Department of Radiation Oncology, UT Southwestern Medical Center, 2280 Inwood Road, Dallas, TX 75390, USA
| | - Vijay Agusala
- Department of Radiation Oncology, UT Southwestern Medical Center, 2280 Inwood Road, Dallas, TX 75390, USA
| | - David J Sher
- Department of Radiation Oncology, UT Southwestern Medical Center, 2280 Inwood Road, Dallas, TX 75390, USA.
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25
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Phelps EE, Tutton E, Griffin X, Baird J. Facilitating trial recruitment: A qualitative study of patient and staff experiences of an orthopaedic trauma trial. Trials 2019; 20:492. [PMID: 31399134 PMCID: PMC6688236 DOI: 10.1186/s13063-019-3597-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 07/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Qualitative research has been used to explore patients’ and healthcare professionals’ experiences of surgical randomised controlled trials (RCTs). From this research, reasons why patients accept or decline participation and barriers to engaging clinicians in trials have been identified. In a trauma setting, recruitment to surgical trials can be particularly difficult as patients may require urgent treatment and their ability to consider their options, ask questions and reach a decision may be hindered by the impact of their injury. Little research, however, has explored patients’ and healthcare professionals’ experiences of surgical RCTs in a trauma setting. This study aimed to understand patients’ and staff’s experiences of an orthopaedic trauma trial. Methods We carried out semi-structured interviews with 11 patients and 24 staff (10 surgeons and 14 research associates) participating in a UK multi-centre feasibility trial comparing intramedullary nails versus distal locking plates for fractures of the distal femur (TrAFFix). Interviews explored patients’ experience of TrAFFix and their reason for participating and staffs' experience of recruiting to TrAFFix and trauma trials more generally. Interviews were audio recorded and transcribed verbatim. Transcripts were analysed using thematic analysis. Results Three themes were identified. These were i) navigating research with patients after orthopaedic trauma, ii) knowing that it is the right decision and iii) making it work. These themes reflect: i) how research associates supported and guided patients through the consent process enabling them to participate, ii) the difficulty in engaging surgeons in a trial when individual equipoise and experience of the interventions are low despite the presence of community equipoise and iii) the way in which research teams worked together and encouraged the development of a research culture within the clinical teams in order to facilitate recruitment. Conclusions Our findings highlight the pivotal role of research associates (RAs) in facilitating trial recruitment. RAs supported patients to enable them to make a decision about participation and assisted in developing a research culture within the team by promoting studies and communicating research to clinical staff. Our findings also reinforce surgeons’ difficulty with equipoise and suggest that accepting community equipoise could facilitate recruitment.
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Affiliation(s)
- Emma Elizabeth Phelps
- NDORMS, Kadoorie Centre, level 3, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
| | - Elizabeth Tutton
- NDORMS, Kadoorie Centre, level 3, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK. .,Oxford University Hospitals NHS Foundation Trust, Oxford, UK. .,Warwick Research in Nursing, University of Warwick, Coventry, UK.
| | - Xavier Griffin
- NDORMS, Kadoorie Centre, level 3, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
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Wiltjer H, Seers K, Tutton E. Understanding assessment on a hospital ward for older people: A qualitative study. J Adv Nurs 2019; 75:850-861. [PMID: 30549323 DOI: 10.1111/jan.13930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 10/02/2018] [Accepted: 11/27/2018] [Indexed: 12/24/2022]
Abstract
AIM To explore assessment on a hospital ward for older people from the perspectives of patients and healthcare professionals. DESIGN A qualitative study drawing on grounded theory was undertaken between February 2015 - January 2016. METHODS Interviews with 15 patients and 22 healthcare professionals, a focus group with six healthcare professionals, 45 hr of observation and review of 18 sets of patient notes. Analysis was conducted using initial and focused coding, continuously comparing data, emerging codes and themes. FINDINGS The core category was navigating, constructed through three themes: containing complexity, networking, and situating the process. Navigating assessment was a complex, flexible, context dependent, and social process where healthcare professionals used a combination of formal, informal, visible, and invisible ways of working. Registered nurses were at the centre of networking and focused on gathering and sharing information in the multi-disciplinary team, whilst patients had a passive role despite a variety of preferences about their involvement. CONCLUSIONS Navigating the assessment of older people is contextually situated, includes networking and a professional focus on containing complexity. This process may be enhanced by: (a) making informal assessment visible to others; (b) developing the nurses' role beyond chasing information towards coordinating care; and (c) asking patients and acting on how they would like to be involved in decision-making. IMPACT Acknowledging that navigating assessment is a social, flexible and complex process, including different ways of working to meet patient needs, may enhance the usability of current assessment guidelines and their development.
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Affiliation(s)
- Hanneke Wiltjer
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kate Seers
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Elizabeth Tutton
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK.,Oxford Trauma, Kadoorie Centre, NDORMS, University of Oxford, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Evaluating a professional patient navigation intervention in a supportive care setting. Support Care Cancer 2019; 27:3281-3290. [PMID: 30612239 DOI: 10.1007/s00520-018-4622-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE Unmet supportive care needs are common among cancer patients. This study evaluates a patient navigation intervention (i.e., specially trained oncology nurse who monitors, advises, and (if needed) refers patients to supportive cancer care) in terms of need, satisfaction, advice uptake, and consumption of supportive cancer care. METHODS Using a cross-sectional design, the intervention was evaluated among healthcare professionals, patients who participated, and patients who did not participate in the intervention. All patients were newly diagnosed with breast cancer or melanoma. Data was collected through medical records and online surveys. RESULTS In total, 1091 patients were offered patient navigation. Most of these patients (755) were willing to consult the patient navigator (PN). Approximately 90% of patients who completed both the intervention and the questionnaire (N = 120, response rate 54%) perceived the PN as valuable, accessible, and reliable. Approximately 80% of respondents who needed advice regarding nutrition (n = 67), fatigue (n = 98), emotions (n = 106), and work (n = 79) were adequately informed by the PN. Of the 120 respondents, 59 used some form of supportive cancer care. Most of the responding healthcare professionals (N = 70, response rate 45%) perceived the intervention as a valuable addition to current cancer care (n = 51) and mentioned that the PN should be available to all patients (n = 54). CONCLUSIONS The intervention was perceived as valuable by both patients and healthcare professionals. The results may, however, been biased by the large number of patients who were omitted from participation due to logistical reasons.
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Hilder J, Gray B, Stubbe M. Health navigation and interpreting services for patients with limited English proficiency: a narrative literature review. J Prim Health Care 2019; 11:217-226. [DOI: 10.1071/hc18067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 08/12/2019] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
INTRODUCTIONCulturally and linguistically diverse populations (CALD) have significant health outcome disparities compared to dominant groups in high-income countries. The use of both navigators and interpreters are strategies used to address these disparities, but the intersections between these two roles can be poorly understood.
AIMTo gain an overview of the literature on health navigation and similar roles, with particular reference to the New Zealand context, and to explore the interface between these roles and that of interpreters for CALD populations with limited English proficiency.
METHODSA narrative review of the literature was conducted using a range of search strategies and a thematic analysis was conducted.
RESULTSThere are several barriers to health-care access relating to health systems and CALD populations. For over 50 years, health workers who are members of these communities have been used to address these barriers, but there are many terms describing workers with wide-ranging roles. There is some evidence of efficacy in economic, psychosocial and functional terms. For health navigation services to work, they need to have staff who are well selected, trained and supported; are integrated into health-care teams; and have clearly defined roles. There may be a place for integrating interpreting more formally into the navigator role for members of communities who have limited English proficiency.
CONCLUSIONTo achieve better access to health care for CALD populations, there is an argument for adding another member to the health team who combines clearly defined aspects of the roles of interpreter, community health worker and navigator. Organisations considering setting up such a position should have a clear target population, carefully consider the barriers they are trying to address and define a role, scope of practice and training requirements best suited to addressing those barriers.
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Pautasso FF, Zelmanowicz ADM, Flores CD, Caregnato RCA. Role of the Nurse Navigator: integrative review. ACTA ACUST UNITED AC 2018; 39:e20170102. [PMID: 30043944 DOI: 10.1590/1983-1447.2018.2017-0102] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/25/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To identify scientific literature on oncology nurses who provide patient navigation services as nurse navigators. METHODS Integrative review of literature searches in the databases LILACS, MEDLINE/PubMed, SCOPUS, SciELO, Web of Science and Science Direct based on the descriptors patient; navigation; nurse; professional; cancer; oncology; navigator; and navigators. RESULTS Seventeen articles were identified and grouped according to the following thematic approach: Care Processes; Patients; and Health Workers. It was observed that scientific literature on nurse navigators mostly comes from the United States, Australia, Canada, Sweden, and Demark, where the first nurse navigator programmes were introduced. No studies were found in local journals or populations. CONCLUSIONS The nurse navigator offer a unique service for the provision of quality care. Although international research is recent, further studies on the role of these professionals are clearly needed.
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Affiliation(s)
- Fernanda Felipe Pautasso
- Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Unidade de Promoção da Saúde e Prevenção de Doenças. Porto Alegre, Rio Grande do Sul, Brasil
| | - Alice de Medeiros Zelmanowicz
- Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Unidade de Promoção da Saúde e Prevenção de Doenças. Porto Alegre, Rio Grande do Sul, Brasil
| | - Cecília Dias Flores
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Programa de Pós- Graduação em Ensino na Saúde. Porto Alegre, Rio Grande do Sul, Brasil
| | - Rita Catalina Aquino Caregnato
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Programa de Pós- Graduação em Ensino na Saúde. Porto Alegre, Rio Grande do Sul, Brasil
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Park G, Johnston G, Urquhart R, Walsh G, McCallum M. Comparing enrolees with non-enrolees of cancer-patient navigation at end of life. Curr Oncol 2018; 25:e184-e192. [PMID: 29962844 PMCID: PMC6023567 DOI: 10.3747/co.25.3902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Cancer-patient navigators who are oncology nurses support and connect patients to resources throughout the cancer care trajectory, including end of life. Although qualitative and cohort studies of navigated patients have been reported, no population-based studies were found. The present population-based study compared demographic, disease, and outcome characteristics for decedents who had been diagnosed with cancer by whether they did or did not see a navigator. Methods This retrospective study used patient-based administrative data in Nova Scotia (cancer registry, death certificates, navigation visits) to generate descriptive statistics. The study population included all adults diagnosed with cancer who died during 2011-2014 of a cancer or non-cancer cause of death. Results Of the 7694 study decedents, 74.9% had died of cancer. Of those individuals, 40% had seen a navigator at some point in their disease trajectory. The comparable percentage for those who did not die of cancer was 11.9%. Decedents at the oldest ages had the lowest navigation rates. Navigation rates, time from diagnosis to death, and time from last navigation visit to death varied by disease site. Conclusions This population-based study of cancer-patient navigation enrolees compared with non-enrolees is the first of its kind. Most findings were consistent with expectations. However, we do not know whether the rates of navigation are consistent with the navigation needs of the population diagnosed with cancer. Because more people are living longer with cancer and because the population is aging, ongoing surveillance of who requires and who is using navigation services is warranted.
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Affiliation(s)
| | - G.M. Johnston
- School of Health Administration, Dalhousie University; and
- Cancer Care Program, Nova Scotia Health Authority, Halifax, NS
| | | | - G. Walsh
- Cancer Care Program, Nova Scotia Health Authority, Halifax, NS
| | - M. McCallum
- Cancer Care Program, Nova Scotia Health Authority, Halifax, NS
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Valverde PA, Calhoun E, Esparza A, Wells KJ, Risendal BC. The early dissemination of patient navigation interventions: results of a respondent-driven sample survey. Transl Behav Med 2018; 8:456-467. [PMID: 29800405 DOI: 10.1093/tbm/ibx080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Patient navigators (PNs) coordinate medical services and connect patients with resources to improve outcomes, satisfaction, and reduce costs. Little national information is available to inform workforce development. We analyzed 819 responses from an online PN survey conducted in 2009-2010. Study variables were mapped to the five Consolidated Framework for Implementation Research (CFIR) constructs to explore program variations by type of PN. Five logistic regression models compared each PN type to all others while adjusting for covariates. Thirty-five percent of respondents were nurse navigators, 28% lay navigators, 20% social work (SW)/counselor navigators, 7% allied health navigators, and 10% were "other" types of PNs. Most were non-Hispanic White (71%), female (94%), and at least college educated (70%). The primary differences were observed among: the core intervention tasks; position structure; work setting; health conditions navigated; navigator race/ethnicity; personal cancer experiences; navigation training; and patient populations served. Lay PNs had fewer odds of identifying as Hispanic, work in rural settings and assist underserved populations compared to others. Nurse navigators showed greater odds of clinical responsibilities, work in hospital or government settings and fewer odds of navigating minority populations compared to others. SW/counselor navigators also had additional duties, provided greater assistance to Medicare patient populations, and less odds of navigating underserved populations than others. In summary, our survey indicates that the type of PN utilized is an indicator of other substantial differences in program implementation. CFIR provides a robust method to compare differences and should incorporate care coordination outcomes in future PN research.
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Affiliation(s)
- Patricia A Valverde
- Department of Community and Behavioral Health, School of Public Health, Aurora, CO
| | - Elizabeth Calhoun
- University of Arizona, Office of the Senior Vice President for Health Sciences, Vice President for Population Health Sciences, Executive Director, Center for Population Science and Discovery, Roy P. Drachman Hall, Tucson, AZ
| | - Angelina Esparza
- Executive Staff Analyst/Chief Program Officer, Houston Department for Health and Human Services, Houston, TX
| | - Kristen J Wells
- Department of Psychology, San Diego State University, San Diego, CA
| | - Betsy C Risendal
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO
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Saria MG, Courchesne NS, Evangelista L, Carter JL, MacManus DA, Gorman MK, Nyamathi AM, Phillips LR, Piccioni DE, Kesari S, Maliski SL. Anxiety and Depression Associated With Burden in Caregivers of Patients With Brain Metastases. Oncol Nurs Forum 2018; 44:306-315. [PMID: 28635984 DOI: 10.1188/17.onf.306-315] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe and examine the relationship between caregiver burden and the affective disorders anxiety and depression in caregivers of patients with brain metastases.
. DESIGN Cross-sectional, descriptive, correlational.
. SETTING Moores Cancer Center at the University of California, San Diego.
. SAMPLE 56 family caregivers of patients with brain metastases from solid tumors at other primary sites.
. METHODS Self-administered survey.
. MAIN RESEARCH VARIABLES Caregiver burden, anxiety, and depression.
. FINDINGS With the exception of caregiver esteem, no statistically significant relationships were noted between impact on schedule, a dimension of caregiver burden, and screening positive for affective disorders.
. CONCLUSIONS Findings from this study support previous reports indicating that the odds of having anxiety and depressive symptoms are greater in family caregivers who report higher levels of caregiver burden.
. IMPLICATIONS FOR NURSING The identification and management of caregiver burden are important considerations for a comprehensive cancer care program. Addressing the needs of the cancer caregiver, who is at heightened risk for various psychological, physical, financial, and social problems, is increasingly vital.
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Affiliation(s)
- Marlon G Saria
- John Wayne Cancer Institute at Providence Saint John's Health Center
| | | | | | | | | | | | | | | | | | - Santosh Kesari
- John Wayne Cancer Institute at Providence Saint John's Health Center
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Broder-Fingert S, Walls M, Augustyn M, Beidas R, Mandell D, Wiltsey-Stirman S, Silverstein M, Feinberg E. A hybrid type I randomized effectiveness-implementation trial of patient navigation to improve access to services for children with autism spectrum disorder. BMC Psychiatry 2018; 18:79. [PMID: 29587698 PMCID: PMC5870193 DOI: 10.1186/s12888-018-1661-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 03/12/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Significant racial, ethnic, and socioeconomic disparities exist in access to evidence-based treatment services for children with autism spectrum disorder (ASD). Patient Navigation (PN) is a theory-based care management strategy designed to reduce disparities in access to care. The purpose of this study is to test the effectiveness of PN a strategy to reduce disparities in access to evidence-based services for vulnerable children with ASD, as well as to explore factors that impact implementation. METHODS This study uses a hybrid type I randomized effectiveness/implementation design to test effectiveness and collect data on implementation concurrently. It is a two-arm comparative effectiveness trial with a target of 125 participants per arm. Participants are families of children age 15-27 months who receive a positive screen for ASD at a primary care visit at urban clinics in Massachusetts (n = 6 clinics), Connecticut (n = 1), and Pennsylvania (n = 2). The trial measures diagnostic interval (number of days from positive screen to diagnostic determination) and time to receipt of evidence-based ASD services/recommended services (number of days from date of diagnosis to receipt of services) in those with PN compared to and activated control -Conventional Care Management - which is similar to care management received in a high quality medical home. At the same time, a mixed-method implementation evaluation is being carried out. DISCUSSION This study will examine the effectiveness of PN to reduce the time to and receipt of evidence-based services for vulnerable children with ASD, as well as factors that influence implementation. Findings will tell us both if PN is an effective approach for improving access to evidence-based care for children with ASD, and inform future strategies for dissemination. TRIAL REGISTRATION NCT02359084 Registered February 1, 2015.
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Affiliation(s)
- Sarabeth Broder-Fingert
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, 02114, USA. .,Division of General Pediatrics, Boston University School of Medicine, 850 Harrison Ave, Room 310A, Boston, MA, 02118, USA.
| | - Morgan Walls
- 0000 0004 0367 5222grid.475010.7Department of Pediatrics, Boston University School of Medicine, Boston, MA 02114 USA
| | - Marilyn Augustyn
- 0000 0004 0367 5222grid.475010.7Division of Developmental and Behavioral Pediatrics, Boston University School of Medicine, Boston, MA 02114 USA
| | - Rinad Beidas
- 0000 0004 1936 8972grid.25879.31Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - David Mandell
- 0000 0004 1936 8972grid.25879.31Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | | | - Michael Silverstein
- 0000 0004 0367 5222grid.475010.7Department of Pediatrics, Boston University School of Medicine, Boston, MA 02114 USA
| | - Emily Feinberg
- 0000 0004 0367 5222grid.475010.7Department of Pediatrics, Boston University School of Medicine, Boston, MA 02114 USA ,0000 0004 1936 7558grid.189504.1Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02114 USA
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Wells KJ, Valverde P, Ustjanauskas AE, Calhoun EA, Risendal BC. What are patient navigators doing, for whom, and where? A national survey evaluating the types of services provided by patient navigators. PATIENT EDUCATION AND COUNSELING 2018; 101:285-294. [PMID: 28935442 PMCID: PMC5808907 DOI: 10.1016/j.pec.2017.08.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 08/01/2017] [Accepted: 08/28/2017] [Indexed: 05/12/2023]
Abstract
OBJECTIVE A nationwide cross-sectional study was conducted to assess patient navigator, patient population, and work setting characteristics associated with performance of various patient navigation (PN) tasks. METHODS Using respondent-driven sampling, 819 navigators completed a survey assessing frequency of providing 83 PN services, along with information about themselves, populations they serve, and setting in which they worked. Analyses of variance and Pearson correlations were conducted to determine differences and associations in frequency of PN services provided by various patient, navigator, and work setting characteristics. RESULTS Nurse navigators and navigators with lower education provide basic navigation; social workers typically made arrangements and referrals; and individuals with higher education, social workers, and nurses provide treatment support and clinical trials/peer support. Treatment support and clinical trials/peer support are provided to individuals with private insurance. Basic navigation, arrangements and referrals, and care coordination are provided to individuals with Medicaid or no insurance. CONCLUSION Providing basic navigation is a core competency for patient navigators. There may be two different specialties of PN, one which seeks to reduce health disparities and a second which focuses on treatment and emotional support. PRACTICE IMPLICATIONS The selection and training of patient navigators should reflect the specialization required for a position.
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Affiliation(s)
- Kristen J Wells
- Department of Psychology, San Diego State University, San Diego, USA; University of California, San Diego Moores Cancer Center, La Jolla, USA.
| | - Patricia Valverde
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, USA
| | - Amy E Ustjanauskas
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, USA
| | - Elizabeth A Calhoun
- Department of Public Health Policy and Management, University of Arizona Health Sciences, Tucson, USA
| | - Betsy C Risendal
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, USA
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Duggleby W, Pesut B, Cottrell L, Friesen L, Sullivan K, Warner G. Development, Implementation, and Evaluation of a Curriculum to Prepare Volunteer Navigators to Support Older Persons Living With Serious Illness. Am J Hosp Palliat Care 2017; 35:780-787. [PMID: 29129107 DOI: 10.1177/1049909117740122] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this article is to report the development, implementation, and evaluation of a curriculum designed to prepare volunteer navigators to support community-dwelling older persons with serious chronic illness. The role of the volunteer navigator was to facilitate independence and quality of life through building social connections, improving access to resources, and fostering engagement. A curriculum was constructed from evidence-based competencies, piloted and revised, and then implemented in 7 subsequent workshops. Workshop participants were 51 volunteers and health-care providers recruited through local hospice societies and health regions. Curriculum was evaluated through satisfaction and self-efficacy questionnaires completed at workshop conclusion. Postworkshop evaluation indicated a high degree of satisfaction with the training. One workshop cohort of 7 participants was followed for 1 year to provide longitudinal evaluation data. Participants followed longitudinally reported improved self-efficacy over 12 months and some challenges with role transition. Future improvements will include further structured learning opportunities offered by telephone postworkshop, focusing on advocacy, communication, and conflict management. Overall, volunteers were satisfied with the curriculum and reported good self-perceived efficacy in their new role as navigators.
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Affiliation(s)
- Wendy Duggleby
- 1 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Barbara Pesut
- 2 Faculty of Health and Social Development, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Laura Cottrell
- 1 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Lynnelle Friesen
- 3 School of Nursing, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Kelli Sullivan
- 3 School of Nursing, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Grace Warner
- 4 School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
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Spencer JC, Samuel CA, Rosenstein DL, Reeder-Hayes KE, Manning ML, Sellers JB, Wheeler SB. Oncology navigators' perceptions of cancer-related financial burden and financial assistance resources. Support Care Cancer 2017; 26:1315-1321. [PMID: 29124417 DOI: 10.1007/s00520-017-3958-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/03/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION As the cost of cancer treatment continues to rise, many patients are faced with significant emotional and financial burden. Oncology navigators guide patients through many aspects of care and therefore may be especially aware of patients' financial distress. Our objective was to explore navigators' perception of their patients' financial burden and their role in addressing financial needs. MATERIALS AND METHODS We conducted a real-time online survey of attendees at an oncology navigators' association conference. Participants included lay navigators, oncology nurse navigators, community health workers, and social workers. Questions assessed perceived burden in their patient population and their role in helping navigate patients through financial resources. Answers to open-ended questions are reported using identified themes. RESULTS Seventy-eight respondents participated in the survey, reporting that on average 75% of their patients experienced some degree of financial toxicity related to their cancer. Only 45% of navigators felt the majority of these patients were able to get some financial assistance, most often through assistance with medical costs (73%), subsidized insurance (36%), or non-medical expenses (31%). Commonly identified barriers for patients obtaining assistance included lack of resources (50%), lack of knowledge about resources (46%), and complex/duplicative paperwork (20%). CONCLUSION Oncology navigators reported a high burden of financial toxicity among their patients but insufficient knowledge or resources to address this need. This study underscores the importance of improved training and coordination for addressing financial burden, and the need to address community and system-level barriers.
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Affiliation(s)
- Jennifer C Spencer
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7411, Chapel Hill, NC, 27599-7570, USA.
| | - Cleo A Samuel
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7411, Chapel Hill, NC, 27599-7570, USA
| | - Donald L Rosenstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine E Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michelle L Manning
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jean B Sellers
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie B Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7411, Chapel Hill, NC, 27599-7570, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Vanderpool RC, Nichols H, Hoffler EF, Swanberg JE. Cancer and Employment Issues: Perspectives from Cancer Patient Navigators. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:460-466. [PMID: 26627904 PMCID: PMC4889558 DOI: 10.1007/s13187-015-0956-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Among individuals diagnosed with cancer, 40 % are working-age adults who will face numerous challenges in returning to work, yet oncology providers report limited guidance and uncoordinated communication processes in addressing patients' work-related issues. Cancer patient navigators are uniquely positioned to fill this care and communication gap due to their focus on both practical matters and clinical care. This cross-sectional study utilized survey methodology to collect quantitative and qualitative data from 58 cancer patient navigators to (1) identify patients' cancer and employment issues that commonly challenge navigators and (2) identify the necessary training navigators felt would allow them to more effectively help patients deal with cancer and employment issues. Participants from the southeast USA were invited to complete a paper survey while in attendance at a statewide cancer patient navigator conference or online via the state comprehensive cancer coalition's cancer patient navigator listserv. Results suggest financial burdens, work and treatment conflicts, taking unpaid leave for cancer care, and working through treatment were common concerns among their patients. Navigators also identified employment, legal, government programs, and financial resources as important training and education topics that would help them address their clients' employment and cancer conflicts. Given the fact that employment issues remain one of the most common unmet need of survivors and the increasing presence of navigators across the USA, it is important to address the role of navigators in meeting patients' needs regarding cancer and employment and ensure they are provide with adequate training and resources.
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Affiliation(s)
- Robin C Vanderpool
- Department of Health Behavior, University of Kentucky College of Public Health, 2365 Harrodsburg Road, Suite A230, Lexington, KY, 40504, USA.
| | - Helen Nichols
- University of Maryland School of Social Work, Baltimore, MD, USA
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Jeyathevan G, Lemonde M, Brathwaite AC. The role of oncology nurse navigators in enhancing patient empowerment within the diagnostic phase for adult patients with lung cancer. Can Oncol Nurs J 2017; 27:164-170. [PMID: 31148626 PMCID: PMC6516234 DOI: 10.5737/23688076272164170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The objective of this study was to explore the role of oncology nurse navigators (ONN) in enhancing patient empowerment for adult patients with lung cancer during the diagnostic phase of cancer care. DESIGN A qualitative descriptive design was used. Data were gathered through individual patient interviews and a focus group with the ONNs. RESULTS Eight individuals participated: four adult patients with lung cancer and four oncology nurse navigators. Themes regarding the clinical functions of the ONN role in enhancing patient empowerment were identified: patient advocate, educational support, personalized symptom management, and resource navigation. CONCLUSION ONNs are in a key position to adapt their practice to the emotional and supportive care needs required to promote patient and family empowerment.
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Affiliation(s)
- Gaya Jeyathevan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6
| | - Manon Lemonde
- University of Ontario Institute of Technology, Oshawa, ON L1H 7K4
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Jeyathevan G, Lemonde M, Brathwaite AC. The role of oncology nurse navigators in facilitating continuity of care within the diagnostic phase for adult patients with lung cancer. Can Oncol Nurs J 2017; 27:74-80. [PMID: 31148689 DOI: 10.5737/236880762717480] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective The objective of this study was to explore the role of oncology nurse navigators (ONN) in facilitating continuity of care for adult lung cancer patients during the diagnostic phase of cancer care. Design A phenomenological approach was used and involved semi-structured patient interviews and an oncology nurse navigators' focus group. Results Eight individuals participated, including four adult patients with lung cancer and four oncology nurse navigators. Themes regarding the organizational functions of the ONN role in facilitating continuity of care were identified: patient-focused care, needs assessments, shared decision-making, accessibility, and eliminating barriers. Conclusion Awareness of the organizational functions of the ONN role could be used to create core areas of practice within nursing training modules to provide consistent and patient-centred continuity of care.
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Affiliation(s)
- Gaya Jeyathevan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6,
| | - Manon Lemonde
- University of Ontario Institute of Technology, Oshawa, ON L1H 7K4,
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van Ee I, Hagedoorn M, Slaets J, Smits C. Patient navigation and activation interventions for elderly patients with cancer: A systematic review. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12621] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2016] [Indexed: 11/27/2022]
Affiliation(s)
- I.B. van Ee
- Research Group Innovating with Older Adults; Centre of Expertise in Health Care and Social Work; Windesheim University of Applied Sciences; Zwolle The Netherlands
| | - M. Hagedoorn
- Health Sciences/Health Psychology; University Medical Center Groningen; Groningen The Netherlands
| | - J.P.J. Slaets
- Leyden Academy on Vitality and Ageing, Leiden/Department of Geriatrics; University Medical Center Groningen; Groningen The Netherlands
| | - C.H.M. Smits
- Research Group Innovating with Older Adults; Centre of Expertise in Health Care and Social Work; Windesheim University of Applied Sciences; Zwolle The Netherlands
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Watson LC, Anderson J, Champ S, Vimy K, Delure A. Developing a provincial cancer patient navigation program utilizing a quality improvement approach Part two: Developing a Navigation Education Framework. Can Oncol Nurs J 2016; 26:186-193. [PMID: 31148745 PMCID: PMC6516310 DOI: 10.5737/23688076263186193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In 2012, the provincial cancer agency in Alberta initiated a provincial quality improvement project to develop, implement, and evaluate a provincial cancer navigation program spanning 15 sites across more than 600,000 square kilometres. This project was selected for two years of funding (April 2012-March 2014) by the Alberta Cancer Foundation (ACF) through an Enhanced Care Grant process (ACF, 2015). A series of articles has been created to capture the essence of this quality improvement (QI) project, the processes that were undertaken, the standards developed, the education framework that guided the orientation of new navigator staff, and the outcomes that were measured. The first article in this series focused on establishing the knowledge base that guided the development of this provincial navigation program and described the methodology undertaken to implement the program across 15 rural and isolated urban cancer care delivery sites (Anderson et al., 2016). This article, the second in the series, delves into the education framework that was developed to guide the competency development and orientation process for the registered nurses who were hired into cancer patient navigator roles and how this framework has evolved to support navigators, as they move from novice to expert practice. The third and final article will explore the outcomes that were achieved through this quality improvement project culminating with a discussion section highlighting key learnings, adaptations made, and next steps underway to broaden the scope and impact of the provincial navigation program.
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Affiliation(s)
- Linda C Watson
- CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | | | - Sarah Champ
- CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | - Kristina Vimy
- Faculty of Nursing, University of Calgary, Alberta, Canada
| | - Andrea Delure
- CancerControl Alberta, Alberta Health Services, Alberta, Canada
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Anderson J, Champ S, Vimy K, Delure A, Watson LC. Developing a provincial cancer patient navigation program utilizing a quality improvement approach Part one: Designing and implementing. Can Oncol Nurs J 2016; 26:122-128. [PMID: 31148695 PMCID: PMC6516289 DOI: 10.5737/23688076262122128] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In 2012, the provincial cancer agency in Alberta initiated a provincial quality improvement project to develop, implement, and evaluate a provincial navigation program spanning 15 sites across over 600,000 square kilometres. This project was selected for two years of funding (April, 2012-March 31, 2014) by the Alberta Cancer Foundation (ACF) through an Enhanced Care Grant process. A series of articles has been created to capture the essence of this quality improvement project, the processes that were undertaken, the standards developed, the educational framework that guided the orientation of new navigator staff, and the outcomes that were measured. This first article in the series focuses on establishing the knowledge base that guided the development of this provincial navigation program and describing the methodology undertaken to implement the program across 15 rural and isolated urban cancer care delivery sites. The second article in this series will delve into the educational framework that was developed to guide the competency development and orientation process for the registered nurses who were hired into the newly developed cancer patient navigator roles. The third and final article will explore the outcomes that were achieved through this quality improvement project culminating with a discussion section highlighting key learnings, adaptations made, and next steps underway to broaden the scope and impact of the provincial navigation program.
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Affiliation(s)
| | - Sarah Champ
- Cancer Control Alberta, Alberta Health Services, AB
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Lithner M, Klefsgard R, Johansson J, Andersson E. The significance of information after discharge for colorectal cancer surgery-a qualitative study. BMC Nurs 2015; 14:36. [PMID: 26045695 PMCID: PMC4456055 DOI: 10.1186/s12912-015-0086-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 05/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim was to explore patients' experiences of information and their information needs after discharge for colorectal cancer surgery. METHODS Thirty one interviews were performed with sixteen patients during the first seven weeks at home after discharge. Patients were included from three hospitals in the south of Sweden, two of which used an enhanced recovery programme. RESULTS Trying to regain control in life by using information was the overall theme emerging from the interviews. Patients experienced the bodily changes after surgery and the emotional impact of the cancer disease, and these combined experiences seriou/sly affected their ability to manage their daily lives. They both needed, and were in search of, information to increase participation in their own cancer trajectory and to facilitate the regaining of some measure of control in their lives. Waiting for different kinds of information increased the anguish and fear in the face of an unknown future. CONCLUSIONS This study showed that receiving information was vital when patients tried to regain control in life after colorectal cancer surgery. The information was necessary in order to facilitate and manage the transition from hospital to home, and the need varied between different transitions. Patients needed more information to manage the daily life at home, but also to understand what the cancer disease really meant to them. This suggests a need for patients to participate more actively in the information and the discharge planning.
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Affiliation(s)
- Maria Lithner
- />Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00 Lund, Sweden
| | | | - Jan Johansson
- />Department of Surgery, Skåne University Hospital, SUS Lund, 221 85 Lund, Sweden
| | - Edith Andersson
- />Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00 Lund, Sweden
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A national system approach to oncology patient population management across the continuum of care: how we standardized navigation. Nurs Adm Q 2014; 38:138-46. [PMID: 24569760 DOI: 10.1097/naq.0000000000000019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The increasing complexity of cancer care has the potential to result in care fragmentation and suboptimal coordination and timeliness to care. In managing the oncology patient population, navigators have the opportunity to provide patient-centered care throughout the cancer care trajectory and to positively impact patient's outcomes. The role of the navigator benefits both the patient and the cancer care team by fostering continuity of care and improved communication. As cancer programs find themselves struggling with the global challenges that surround the evolution of patient's navigation and seeking to provide evidence-based care, Catholic Health Initiatives' National Oncology Service Line developed a system-wide approach to identifying and deploying best practices for navigation across their cancer programs.
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Crawford J, Brudnoy L, Soong T, Graham T. Patient Navigation in Oncology Nursing: An Innovative Blended Learning Model. J Contin Educ Nurs 2013; 44:461-9. [DOI: 10.3928/00220124-20130903-88] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 07/26/2013] [Indexed: 11/20/2022]
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