Purpose/Objectives: To determine whether patient navigation in a comprehensive community cancer center affects patient and staff perceptions of patient preparation for treatment, access to care, and overall satisfaction.
Design: Program evaluation with patient and staff surveys.
Setting: Comprehensive community cancer center accredited by the American College of Surgeons in the southeastern United States with 1,037 analytic cases of cancer in 2007; population of the main county served is about 177,963.
Sample: 48 patients (28 navigator and 20 non-navigator) and 26 employees, including physicians, nurses, and other support staff.
Methods: A 10-item survey with Likert scale format was sent to a stratified sample of 100 newly diagnosed patients with cancer. A five-item survey with the same format was sent to 40 staff working with the patients.
Main Research Variable: Patient navigation.
Findings: Patients who received navigation services responded more positively to survey statements. Statistical significance (p > 0.05) was identified in 7 of 10 statements when patient groups were compared. Provider responses indicated agreement with all five statements included in the survey.
Conclusions: Patients with cancer and oncology staff reported that patient navigation is effective in increasing patient satisfaction and decreasing barriers to care.
Implications for Nursing: Patient navigation is an emerging trend in cancer care. Patient navigators can play a significant role in assisting patients with coordinating services across the continuum of care. Continued research is essential in refining the role and eminence of patient navigators.
References
American Cancer Society. (2009). Cancer facts and figures 2009. Atlanta, GA: Author.
Costich, T.D., & Lee, F.C. (2003). Improving cancer care in a Kentucky managed care plan: A case study of cancer disease management. Disease Management, 6, 9-20. doi: 10.1089/109350703321530837
Deshler, A.M., Fee-Schroeder, K.C., Dowdy, J.L., Mettler, T.A., Novotny, P., Zhao, X., & Frost, M.H. (2006). A patient orientation program at a comprehensive cancer center. Oncology Nursing Forum, 33, 569-578. doi: 10.1188/06.ONF.569-578
Dohan, D., & Schrag, D. (2005). Using navigators to improve care of underserved patients: Current practices and approaches. Cancer, 104, 848-855. doi: 10.1002/cncr.21214
Ell, K., Vourlekis, B., Lee, P.J., & Xie, B. (2007). Patient navigation and case management following an abnormal mammogram: A randomized clinical trial. Preventive Medicine, 44, 26-33. doi: 10.1016/j.ypmed.2006.08.001
Ford, M.E., Randolph, V., Hopkins-Johnson, L., Eason, S.L., Havstad, S., Jankowski, M., … Vernon, S.W. (2004). Design of a case management approach to enhance cancer screening trial retention among older African American men. Journal of Aging and Health, 16(5, Suppl.), 39S-57S. doi: 10.1177/0898264304268148
Freeman, H.P., & Chu, K.C. (2005). Determinants of cancer disparities: Barriers to cancer screening, diagnosis, and treatment. Surgical Oncology Clinics of North America, 14, 655-669. doi: 10.1016/j.soc.2005.06.002
Freund, K.M., Battaglia, T.A., Calhoun, E., Dudley, D.J., Fiscella, K., Paskett, E., … Roetzheim, R.G. (2008). National Cancer Institute Patient Navigation Research Program: Methods, protocol, and measures. Cancer, 1113, 3391-3399. doi: 10.1002/cncr.23960
Goodwin, J.S., Satish, S., Anderson, E.T., Nattinger, A.B., & Freeman, J.L. (2003). Effect of nurse case management on the treatment of older women with breast cancer. Journal of the American Geriatrics Society, 51, 1252-1259. doi: 10.1046/j.1532-5415.2003.51409.x
Hede, K. (2006). Agencies look to patient navigators to reduce cancer care disparities. Journal of the National Cancer Institute, 98, 157-159.
Jennings-Sanders, A., Kuo, Y.F., Anderson, E.T., Freeman, J.L., & Goodwin, J.S. (2005). How do case managers care for older women with breast cancer? Oncology Nursing Forum, 32, 625-632. doi: 10.1188/05.ONF.625-632
Lenhart, C. (2005). Relative dose intensity: Improving cancer treatment outcomes. Oncology Nursing Forum, 32, 757-764. doi: 10.1188/05.ONF.757-764
Mills, M.E., & Sullivan, K. (1999). The importance of information giving for patients newly diagnosed with cancer: A review of the literature. Journal of Clinical Nursing, 8, 631-642. doi:10.1046/j.1365-2702.1999.00296.x
Schwaderer, K.A., & Itano, J.K. (2007). Bridging the healthcare divide with patient navigation: Development of a research program to address disparities. Clinical Journal of Oncology, 11, 633-639.
Seek, A.J., & Hogle, W.P. (2007). Modeling a better way: Navigating the healthcare system for patients with lung cancer. Clinical Journal of Oncology Nursing, 11, 81-85. doi: 10.1188/07.CJON.81-85
Steinberg, M.L., Fremont, A., Khan, D.C., Huang, D., Knapp, H., Karaman, D., … Streeter, O.E., Jr. (2006). Lay patient navigator program implementation for equal access to cancer care and clinical trials. Cancer, 107, 2669-2677. doi: 10.1002/cncr.22319
Sweeney, L., Halpert, A., & Waranoff, J. (2007). Patient-centered management of complex patients can reduce costs without shortening life. American Journal of Managed Care, 13, 84-92.
Vourlekis, B., Ell, K., & Padgett, D. (2005). Evidence-based assessment in case management to improve abnormal cancer screen follow-up. Health and Social Work, 30, 98-106.
Wells, K.J., Battaglia, T.A., Dudley, D.J., Garcia, R., Greene, A., Calhoun, E., … Patient Navigation Research Program. (2008). Patient navigation: State of the art or is it science? Cancer, 113, 1999-2010. doi: 10.1002/cncr.23815