Patient navigation moderates emotion and information demands of cancer treatment: a qualitative analysis

Rousseau, Sally; Humiston, Sharon G.; Yosha, Amy; Winters, Paul; Loader, Starlene; Luong, Vi; Schwartzbauer, Bonnie; Fiscella, Kevin

doi:10.1007/s00520-014-2295-z

Cited by 13 publications

(19 citation statements)

References 33 publications

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“…Preparation for medical appointments, which sometimes included "rehearsals" with the navigator, was perceived as helpful to patients. This result is consistent with several previous studies that showed a positive relationship between navigational services and communication between the patient and the medical team (11,26,27) . Our results also con rm those of other authors that communication support is a navigational service appreciated by patients (11,26,27) .…”

Section: Discussionsupporting

confidence: 93%

Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Piemeu

Loignon

Dionne

et al. 2020

Preprint

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Background: Primary healthcare is the main entry to the health care system for most of the population, even for specialized care. In 2014, it was estimated that about 25% of the population in Quebec (Canada) did not have a regular primary healthcare provider. In 2017, after the introduction of a centralized waiting list to enroll unattached patients with a family doctor, nearly 540,000 patients, many of whom were socially disadvantaged, remained on the list. Socially disadvantaged patients often have more health problems, more complex care needs, and more difficult to accommodate life situations (e.g. two or more jobs, no work accommodation, care responsibilities, low income, lack of social network). They can also lack the skills needed to navigate a constantly evolving and complex healthcare system and, consequently, misuse the system. To overcome this problem, a partnership of health system managers, family physician leaders, community agents, and researchers designed, implemented, and evaluated a navigational support initiative. This study aimed to describe and understand the expectations and needs of socially disadvantaged patients towards navigational support interventions to improve their access to healthcare. Methods: A descriptive qualitative study rooted in an international multi-site participatory study (IMPACT) was conducted with socially disadvantaged patients. Semi-structured individual face-to-face and telephone interviews were conducted with patients recruited at universal public primary health care clinics in Montérégie, some of whom received the evaluated navigational service. A thematic analysis was performed using NVivo 11 software. Results: Sixteen patients living in socially deprived contexts were recruited. Three main expectations of patients for navigational support were identified: communication expectations (support to understand providers and to be understood by them, provision of communication tips, and help to improve communication between providers); relational expectations (emotional or psychosocial support); and pragmatic expectations (information on available community resources, information about the clinic, tips and tools for medical appointments, and physical support to navigate the health care system).Conclusions: Our study contributes to the literature by identifying the many expectations socially disadvantaged patients have related to navigational services. This information can be used for navigational intervention design.

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Section: Discussionsupporting

confidence: 93%

Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Piemeu

Loignon

Dionne

et al. 2020

Preprint

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“…Similar to other research [18, 21], navigators in this study reported that financial burdens, work leave, insurance, and work-cancer fit were common concerns among their patients, with more nuanced findings highlighting the significant monetary burden cancer and its treatment places on patients [17]. Feedback from the navigators indicated a complex interplay of employment challenges that threaten the financial and overall wellbeing of patients.…”

Section: Discussionsupporting

confidence: 78%

Cancer and Employment Issues: Perspectives from Cancer Patient Navigators

2015

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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 U.S. 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 U.S., 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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“…Prior studies of care navigation in other diseases suggest ways that navigation programs have improved clinical health outcomes through decreased hospital readmissions among high-risk older adults in safety net settings, improved survival, and have addressed health disparities [1,10,33,34]. Many of these studies highlight the experience of navigation from the patient's perspective and focus primarily on the relationship between navigator and patient [35][36][37].…”

Section: Discussion and Conclusion Discussionmentioning

confidence: 99%

The Role of Care Navigators Working with People with Dementia and Their Caregivers

Bernstein

Harrison

Dulaney

et al. 2019

JAD

110

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Patient navigation moderates emotion and information demands of cancer treatment: a qualitative analysis

Cited by 13 publications

References 33 publications

Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Expectations and Needs of Socially Disadvantaged Patients for Navigational Support of Primary Health Care Services

Cancer and Employment Issues: Perspectives from Cancer Patient Navigators

The Role of Care Navigators Working with People with Dementia and Their Caregivers

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