Purpose/Objectives: To summarize the current scientific literature pertaining to the role of the patient navigator in oncology using the concept analysis framework developed by Walker and Avant.
Data Sources: Published research articles, clinical articles, and Internet sources on patient navigator roles and programs. Literature was obtained from CINAHL®, PubMed, PsycINFO, the Cochrane Library, and Google Scholar™, incorporating reports in English from 1990-2008.
Data Synthesis: Patient navigation has received a plethora of attention as healthcare programs strive to streamline care and address current gaps in service delivery. The literature revealed that the role of the patient navigator remains context-specific and has been filled by a variety of individuals, including nurses, social workers, peer supporters, and lay individuals.
Conclusions: The role of a patient navigator includes removing barriers to care, improving patient outcomes, and ameliorating the overall quality of healthcare delivery.
Implications for Nursing: By examining the role of the patient navigator depicted in the scientific literature, nurses can gain insight into not only the features of navigation but also the current systematic gaps that call for navigation services. This article examines the numerous functions of a patient navigator and exemplifies the significance of the role in various domains.
References
Battaglia, T.A., Roloff, K., Posner, M.A., & Freund, K.M. (2007). Improving follow-up to abnormal breast cancer screening in an urban population: A patient navigation intervention. Cancer, 109(2, Suppl.), 359-367. doi: 10.1002/cncr.22354
Center to Reduce Cancer Health Disparities. (2003). Unpublished technical report prepared by NOVA Research Company.
Darnell, J.S. (2007). Patient navigation: A call to action. Social Work, 52, 81-84.
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
Doll, R., Stephen, J., Barroetavena, M.C., Linden, W., Poole, G., Ng, E., … Habra, M. (2003). Patient navigation in cancer care: Program delivery and research in British Columbia. Canadian Oncology Nursing Journal, 13, 193.
Ell, K., Vourlekis, B., Lee, P.J., & Xie, B. (2006). Patient navigation and case management following an abnormal mammogram: A randomized clinical trial. Preventive Medicine, 44, 26-33. doi: doi:10.1016/j.ypmed.2006.08.001
Ferrante, J.M., Chen, P.H., & Kim, S. (2007). The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: A randomized controlled trial. Journal of Urban Health, 85, 114-124. doi: 10.1007/s11524-007-9228-9
Fillion, L., de Serres, M., Lapointe-Goupil, R., Bairati, I., Gagnon, P., Deschamps, M., … Demers, G. (2006). Implementing the role of patient-navigator nurse at a university hospital centre. Canadian Oncology Nursing Journal, 16, 11-17.
Fowler, T., Steakley, C., Garcia, A.R., Kwok, J., & Bennett, L.M. (2006). Reducing disparities in the burden of cancer: The role of patient navigators. PLOS Medicine, 3, 974-976. doi: 10.1371/journal.pmed.0030193
Freeman, H.P. (2004). A model patient navigation program. Oncology Issues, 19, 44-46.
Freeman, H.P., Muth, B.J., & Kerner, J.F. (1995). Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Practice, 3, 19-30.
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, 113, 3391-3399. doi: 10.1002/cncr.23960
Gentry, S., & Sein, E. (2007). Taking the wheel. Oncology nurses help patients navigate the cancer journey. ONS Connect, 22(3), 8-11.
Giese-Davis, J., Bliss-Isberg, C., Carson, K., Star, P., Donaghy, J., Cordova, M.J., … Spiegel, D. (2006). The effect of peer counseling on quality of life following diagnosis of breast cancer: An observational study. Psycho-Oncology, 15, 1014-1022. doi: 10.1002/pon.1037
Hede, K. (2006). Agencies look to patient navigators to reduce cancer care disparities. Journal of the National Cancer Institute, 98, 157-159. doi: 10.1093/jnci/djj059
Jandorf, L., Gutierrez, Y., Lopez, J., Christie, J., & Itzkowitz, S.H. (2005). Use of a patient navigator to increase colorectal cancer screening in an urban neighborhood health clinic. Journal of Urban Health, 82, 216-224. doi: 10.1093/jurban/jti046
Psooy, B.J., Schreur, D., Borgaonkar, J., & Caines, J.S. (2004). Patient navigation: Improving timeliness in the diagnosis of breast abnormalities. Canadian Association of Radiologists Journal, 55, 145-150.
Rahm, A.K., Sukhanova, A., Ellis, J., & Mouchawar, J. (2007). Increasing utilization of cancer genetic counseling services using a patient navigator model. Journal of Genetic Counseling, 16, 171-177. doi: 10.1007/s10897-006-9051-6
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 Nursing, 11, 633-639. doi: 10.1188/07.CJON.633-639
Seek, A., & 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: Essential steps and initial challenges. Cancer, 107, 2669-2677. doi: 10.1002/cncr.22319
Vargas, R.B., Ryan, G.W., Jackson, C.A., Rodriguez, R., & Freeman, H.P. (2008). Characteristics of the original patient navigation programs to reduce disparities in the diagnosis and treatment of breast cancer. Cancer, 113, 426-433. doi: 10.1002/cncr.23547
Walker, L.O., & Avant, K.C. (2005). Strategies for theory construction in nursing (4th ed.). Upper Saddle River, NJ: Pearson/Prentice Hall.
Wells, K.J., Battaglia, T.A., Dudley, D.J., Garcia, R., Greene, A., Calhoun E., … Raich, P.C. (2008). Patient navigation: State of the art or is it science? Cancer, 113, 1999-2010. doi: 10.1002/cncr.23815