Underserved, rural, and economically disadvantaged patients with cancer who are under the care of an oncology nurse navigator are better prepared to begin treatment and require fewer services than non-navigated peers, according to study findings published in the Oncology Nursing Forum (ONF). Authors Williams et al. said that their results indicate greater patient satisfaction.
The researchers conducted the study at the University of New Mexico Comprehensive Cancer Center (UNMCCC), which has a highly rural, lower socioeconomic, and largely people of color population, the researchers reported. In the 2020 census, New Mexico’s overall population was 47.7% Hispanic, the highest in the United States, and 8.9% Native American, second only to Alaska. To address the disparities associated with a higher risk of late-stage breast cancer diagnoses in UNMCCC’s patient population, the cancer center began a breast cancer nurse navigator (BCNN) program in 2017. In their published results, Williams et al. reported the program’s five-year outcomes.
Navigation Diminishes Disparities, Delays, Dissatisfaction, and Distress
The research team, which included ONS member Dianne R. Nielsen, RN, BSN, CNBN, CBCN®, cited previous studies conducted in settings similar to UNMCCC’s. Compared to their standard-care counterparts, patients under the care of a nurse navigator:
- Receive significantly better care coordination, psychosocial care, and patient education
- Have shorter delays between diagnosis and treatment initiation
- Feel satisfied and comfortable understanding their disease
- Have overall higher patient satisfaction and lower distress
Underserved Patients Have Better Understanding of and Engagement in Their Care With Navigation
For the current study, Williams et al. surveyed 54 patients under the care of UNMCCC’s BCNN and 32 patients receiving usual care about their: (a) experience with support from the BCNN (for navigated patients) or “office staff” (for non-navigated patients) and (b) usage of or desire for services such as educational information, emotional support, and assistance with appointment scheduling, transportation, and financial and insurance concerns.
They found that navigated patients:
- More strongly agreed that they were prepared for the beginning of treatment
- Had a decreased desire for an after-treatment summary
- Felt more strongly that their calls were returned promptly
The surveyed patients also reported that compared to office staff, the BCNN was more knowledgeable about their treatment plan, better helped them to understand their treatment plans, took their concerns more seriously, and better helped them to manage side effects.
They also found that navigated patients used fewer overall support services:
- Scheduling assistance (54% versus 78%)
- Educational information (54% versus 56%)
- Assistance with side effect management (54% versus 66%)
- Help with communication concerns (42% versus 47%)
- Emotional support and guidance (42% versus 47%)
- Referral to counseling (32% versus 44%)
- Referral to other providers (35% versus 38%)
- Referral for financial and insurance assistance (30% versus 41%)
- Referral for transportation assistance (19% versus 28%)
“The results of this study showed that patients in a diverse, underrepresented, rural, and economically disadvantaged population who received care from a BCNN desired fewer services than their non-navigated peers, indicating greater overall satisfaction with their cancer care,” the researchers concluded. “Understanding of and engagement with health care, as well as patient satisfaction, are all important aspects of patient care, particularly because underserved populations are at increased risk of poor outcomes. Therefore, these areas merit future research to mitigate health disparities and ensure equitable care for all patients.”