Refining the Patient Navigation Role in a Colorectal Cancer Screening Program: Results From an Intervention Study
Refining the Patient Navigation Role in a Colorectal Cancer Screening Program: Results From an Intervention Study
复制标题
DOI：
10.6004/jnccn.2016.0147
复制
发表时间：
2016-11-01
影响因子：
13.4
通讯作者：
Schroy, Paul
中科院分区：
文献类型：
--
作者：
Rohan, Elizabeth A.;Slotman, Beth;Schroy, Paul
背景：肿瘤患者导航员帮助个体克服障碍，增加获得癌症筛查、诊断和及时治疗的机会。本研究是一项随机干预试验的一部分，该试验调查了患者导航在提高结肠镜检查完成率方面的功效，研究了导航员在改善医学劣势人群结肠镜筛查障碍方面的活动。方法：本研究于2012年至2014年在波士顿医疗中心进行。我们分析了420名参与者的导航服务交付和调查数据，这些参与者在随机分配到该干预措施后被导航进行结肠镜检查。调查的关键变量包括结肠镜检查的障碍、导航员为减少障碍而进行的活动、导航员在每次活动和每次接触上花费的时间以及患者对导航员服务的满意度。描述性分析评估了导航员如何花费他们的时间，并检查了患者最重视患者导航的哪些方面。结果：导航员花费了最多的时间来评估患者的障碍/需求；方便预约安排；提醒病人预约；教育患者结肠直肠癌，筛查的重要性，结肠镜检查的准备和程序；安排交通。导航员在每位患者身上平均花费44分钟。患者重视导航员，特别是他们提供情感/同伴支持，并清楚地解释筛查程序和肠道准备。结论：我们的研究结果有助于阐明导航员在医学弱势群体结肠镜筛查中的作用。这些发现可能有助于进一步完善导航员在癌症筛查和治疗计划中的作用，因为设施努力将导航有效地整合到他们的服务中。
Background: Oncology patient navigators help individuals overcome barriers to increase access to cancer screening, diagnosis, and timely treatment. This study, part of a randomized intervention trial investigating the efficacy of patient navigation in increasing colonoscopy completion, examined navigators' activities to ameliorate barriers to colonoscopy screening in a medically disadvantaged population. Methods: This study was conducted from 2012 through 2014 at Boston Medical Center. We analyzed navigator service delivery and survey data collected on 420 participants who were navigated for colonoscopy screening after randomization to this intervention. Key variables under investigation included barriers to colonoscopy, activities navigators undertook to reduce barriers, time navigators spent on each activity and per contact, and patient satisfaction with navigation services. Descriptive analysis assessed how navigators spent their time and examined what aspects of patient navigation were most valued by patients. Results: Navigators spent the most time assessing patient barriers/needs; facilitating appointment scheduling; reminding patients of appointments; educating patients about colorectal cancer, the importance of screening, and the colonoscopy preparation and procedures; and arranging transportation. Navigators spent an average of 44 minutes per patient. Patients valued the navigators, especially for providing emotional/peer support and explaining screening procedures and bowel preparation clearly. Conclusions: Our findings help clarify the role of the navigator in colonoscopy screening within a medically disadvantaged community. These findings may help further refine the navigator role in cancer screening and treatment programs as facilities strive to effectively and efficiently integrate navigation into their services.