Nurse Navigators Help Cancer Patients Cope Early in Care

Cancer patients who received support from a nurse navigator or advocate soon after being diagnosed had better experiences and fewer problems with their care, particularly in the areas of health information, care coordination and psychological and social care, according to a study from the Group Health Research Institute.

Patients reported feeling better emotionally, more involved in their own care, and better informed and more prepared for the future. They also felt that the healthcare team had gone out of their way to make them feel better emotionally. The extra help is especially welcome with new cancer patients, given that they and their caregivers need help translating medical jargon and navigating the healthcare maze, researchers say.

Oncology nurse navigator programs are proliferating across the country, but they are highly variable because there hasn’t been much rigorous evidence, researchers added.

In this randomized controlled trial, half of the 251 adult patients newly diagnosed with cancer were assigned to an oncology nurse navigator to help them for four months. Starting two weeks after the diagnosis, the nurse navigator initiated weekly phone calls and contacted each patient an average of 18 times, including meeting in person at least once with each patient: for instance, accompanying them to a doctor’s appointment.

The other group of patients received enhanced usual care consisting of educational material designed by a patient advisory committee. Most (190) of the patients had breast cancer, but 30 had lung and 31 had colon or rectal cancer. Patient-reported outcomes were measured at baseline, four months, and one year.

Some of the differences between the groups persisted for eight months after patients’ last contact with a nurse navigator. Overall costs of healthcare, including the costs of the intervention, didn’t rise at all with the nurse navigator intervention, and they might have declined in lung cancer patients. No overall changes were detected in patients’ quality of life or depression.

The oncology nurse navigators had experience with cancer patients, received special training to deal with psychosocial distress, and were familiar with the Group Health system. Group Health was so impressed with this work that it has already incorporated an oncology nurse navigator into usual care for women newly diagnosed with breast cancer at its Capitol Hill campus, even before the research was published.

Source: Group Health Research Institute , November 25, 2013

Essentials of Embedded Case Management: Hiring, Training, Caseloads and Technology for Practice-Based Care Coordinators

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