Patient navigation is increasingly employed to guide patients through cancer treatment. We assessed the elements of navigation that promoted patients’ involvement in treatment among patients with breast and colorectal cancer that participated in a navigation study.
We conducted qualitative analysis of 28 audiotaped and transcribed semi-structured interviews of navigated and unnavigated cancer patients.
Themes included feeling emotionally and cognitively overwhelmed and desire for a strong patient-navigator partnership. Both participants who were navigated and those who were not felt that navigation did or could help address their emotional, informational, and communicational needs. The benefits of logistical support were cited less often.
Findings underscore the salience of personal relationships between patients and navigators in meeting patients’ emotional and informational needs.
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Jemal A et al (2009) Cancer statistics, 2009. CA Cancer J Clin 59(4):225–249
Shepherd HL, Tattersall MH, Butow PN (2008) Physician-identified factors affecting patient participation in reaching treatment decisions. J Clin Oncol 26(10):1724–1731
Jean-Pierre P et al (2010) Race/ethnicity-based concerns over understanding cancer diagnosis and treatment plan. J Natl Med Assoc 102(3):184–189
Wells KJ et al (2008) Patient navigation: state of the art or is it science? Cancer 113(8):1999–2010
Robinson-White S et al (2010) Patient navigation in breast cancer: a systematic review. Cancer Nurs 33(2):127–140. doi:10.1097/NCC.0b013e3181c40401
Freeman HP, Rodriguez RL (2011) History and principles of patient navigation. Cancer 117(S15):3537–3540
Basu M et al (2013) The effect of nurse navigation on timeliness of breast cancer care at an academic comprehensive cancer center. Cancer 119(14):2524–2531
Freund KM et al (2008) National Cancer Institute Patient Navigation Research Program: methods, protocol, and measures. Cancer 113(12):3391–3399
Fiscella K et al (2012) Patient navigation for breast and colorectal cancer treatment: a randomized trial. Cancer Epidemiol Biomark Prev 21(10):1673–1681
Hendren S et al (2010) Study protocol: a randomized controlled trial of patient navigation-activation to reduce cancer health disparities. BMC Cancer 10:551
Hibbard JH et al (2004) Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res 39(4 Pt 1):1005–1026
Greene J, Hibbard JH (2012) Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med 27(5):520–526
Calhoun EA et al (2010) A national patient navigator training program. Health Promot Pract 11(2):205–215
Family development credential. Available from: http://www.familydevelopmentcredential.org/Plugs/default.aspx
Sandelowski M, Barroso J (2003) Classifying the findings in qualitative studies. Qual Health Res 13(7):905–923
Freeman HP (2006) Patient navigation: a community based strategy to reduce cancer disparities. J Urban Health 83(2):139–141
van’t Spijker A, Trijsburg RW, Duivenvoorden HJ (1997) Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980. Psychosom Med 59(3):280–293
Sultan S et al (2004) Impact of functional support on health-related quality of life in patients with colorectal cancer. Cancer 101(12):2737–2743
Kang SH, Bloom JR (1993) Social support and cancer screening among older black Americans. J Natl Cancer Inst 85(9):737–742
Bloom JR (2008) Improving the health and well-being of cancer survivors: past as prologue. Psycho-Oncology 17(6):525–532
Love RR et al (1989) Side effects and emotional distress during cancer chemotherapy. Cancer 63(3):604–612
Mazor KM et al (2013) Patients’ and family members’ views on patient-centered communication during cancer care. Psycho-Oncology 22(11):2487–2495
Schwabe L et al (2012) Stress effects on memory: an update and integration. Neurosci Biobehav Rev 36(7):1740–1749
Jim HSL et al (2012) Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. J Clin Oncol 30(29):3578–3587
Woodard GR, Edouard L (1992) Reaching out: a community initiative for disadvantaged pregnant women. Can J Public Health 83(3):188–190
Eng E, Smith J (1995) Natural helping functions of lay health advisors in breast cancer education. Breast Cancer Res Treat 35(1):23–29
Brownstein JN et al (1992) Breast and cervical cancer screening in minority populations: a model for using lay health educators. J Cancer Educ 7(4):321–326
Nguyen TU et al (2011) A qualitative assessment of community-based breast health navigation services for Southeast Asian women in southern California: recommendations for developing a navigator training curriculum. Am J Public Health 101(1):87–93
Heisler M et al (2009) Participants’ assessments of the effects of a community health worker intervention on their diabetes self-management and interactions with healthcare providers. Am J Prev Med 37(6 Suppl 1):S270–S279
Madore S et al (2014) Feasibility of a psychosocial and patient navigation intervention to improve access to treatment among underserved breast cancer patients. Support Care Cancer
Wagner EH et al (2013) Nurse navigators in early cancer care: a randomized, controlled trial. J Clin Oncol 32:12–18
Bickell NA et al (2014) Do community-based patient assistance programs affect the treatment and well-being of patients with breast cancer? J Oncol Pract 10(1):48–54
Matsuda A et al (2014) Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Qual Life Res 23(1):21–30
Murty VP et al (2010) fMRI studies of successful emotional memory encoding: a quantitative meta-analysis. Neuropsychologia 48(12):3459–3469
We extend our thanks to the patients who participated in our patient navigation research program for sharing their insights, thoughts, and reflections with us. We also deeply appreciate the dedication, commitment, and hard work of the entire navigation staff in our program. We also acknowledge Carol Moulthroup for her assistance in preparing this manuscript for submission. The National Cancer Institute funded this project: U01CA116924-5.
Conflict of interest
There is no financial relationship between the authors and the organization that sponsored the research. The authors also state that they have full control of all primary data and that they agree to allow the journal to review their data if requested.
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Rousseau, S.J., Humiston, S.G., Yosha, A. et al. Patient navigation moderates emotion and information demands of cancer treatment: a qualitative analysis. Support Care Cancer 22, 3143–3151 (2014). https://doi.org/10.1007/s00520-014-2295-z
- Patient navigation
- Cancer treatment
- Breast cancer
- Colorectal cancer