Catalyzing Navigation for Breast Cancer Survivorship (CaNBCS) in Safety-Net Settings: A Mixed Methods Study.
Catalyzing Navigation for Breast Cancer Survivorship (CaNBCS) in Safety-Net Settings: A Mixed Methods Study.
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DOI：
10.1177/10732748211038734
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Burke N
中科院分区：
文献类型：
--
作者：
Dixit N;Sarkar U;Trejo E;Couey P;Rivadeneira NA;Ciccarelli B;Burke N
目前，美国乳腺癌幸存者（BCS）的数量约为380万，随着治疗方法的改进，这一数字有望进一步增加。幸存者护理计划（scp）是以患者为中心的工具，旨在满足癌症幸存者对其治疗史、推荐的医疗保健和健康维护的信息需求。然而，关于SCP益处的数据仍然不确定，特别是在低收入和种族和少数民族癌症幸存者中。患者导航是一种有效的干预措施，以提高患者的依从性和经验的跨学科乳腺癌治疗。本研究旨在了解非专业患者导航员（LPN）在安全网设置中BCS生存护理计划中的作用。本研究是一项混合方法试点随机临床试验，旨在了解患者导航在公立医院癌症生存护理计划中的作用。我们邀请在5年内完成积极乳腺癌治疗的BCS。lpn在6个月的干预期内讨论BCS的生存护理计划和生存护理相关问题，并陪同患者进行初级保健预约。lpn还鼓励幸存者与肿瘤学和初级保健提供者讨论保健问题。主要目的是评估BCS的健康相关生活质量（HRQOL）。次要目标是自我效能和实施。我们通过从干预组招募的15名BCS进行45 - 60分钟的半结构化访谈，以及与肿瘤学家和lpn单独进行60分钟的焦点小组访谈来评估实施情况。我们招募了40名患者，20名随机接受常规治疗，20名随机接受LPN导航。我们没有发现两组在HRQOL上有统计学上的显著差异。两组之间的自我效能感也没有差异。定性分析确定了干预措施的实施障碍，这些障碍可能导致干预措施效果不佳。未来的幸存者护理计划干预措施需要考虑：癌症幸存者的需求和偏好，对专用资源的需求，以及电子健康记录在幸存者护理计划交付中的作用。
The current number of breast cancer survivors (BCS) in the United States is approximately 3.8 million, and this number is further expected to increase with improvement in treatments. Survivorship care plans (SCPs) are patient-centered tools that are designed to meet cancer survivors' informational needs about their treatment history, recommended health care, and health maintenance. However, the data on SCP benefits remain uncertain, especially in low-income and racial and ethnic minority cancer survivors. Patient navigation is an effective intervention to improve patient adherence and experience of interdisciplinary breast cancer treatment. This study sought to understand the role of lay patient navigators (LPN) in survivorship care planning for BCS in safety-net settings. This study is a mixed methods pilot randomized clinical trial to understand the role of patient navigation in cancer survivorship care planning in a public hospital. We invited BCS who had completed active breast cancer treatment within 5 years. LPNs discussed survivorship care planning and survivorship care-related issues with BCS in the intervention arm over a 6-month intervention period and accompanied patients to their primary care appointment. LPNs also encouraged survivors to discuss health care issues with oncology and primary care providers. The primary objective was to assess BCS’ health-related quality of life (HRQOL). The secondary objectives were self-efficacy and implementation. We assessed implementation with 45–60-min semi-structured interviews with 15 BCS recruited from the intervention arm and 60-min focus groups with the oncologists and separately with LPNs. We enrolled 40 patients, 20 randomized to usual care and 20 randomized to LPN navigation. We did not find a statistically significant difference between the two arms in HRQOL. There was also no difference in self-efficacy between the two arms. Qualitative analysis identified implementation barriers to intervention that may have contributed to less effective intervention. Future survivorship care planning interventions need to consider: Cancer survivors’ needs and preferences, the need for dedicated resources, and the role of electronic health records in survivorship care plan delivery.
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DOI：
10.1037/hea0000263
发表时间：
2016-01
期刊：
Health psychology : official journal of the Division of Health Psychology, American Psychological Association
影响因子：
--
作者：
Gonzalez P;Nuñez A;Wang-Letzkus M;Lim JW;Flores KF;Nápoles AM
通讯作者：
Nápoles AM
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
--
作者：
Birken, Sarah A.;Clary, Alecia S.;Jacobs, Sara R.
通讯作者：
Jacobs, Sara R.
影响因子：
3.7
作者：
Burke, Nancy J.;Napoles, Tessa M.;Joseph, Galen
通讯作者：
Joseph, Galen
影响因子：
1.9
作者：
Campbell, Cheryl;Craig, Janet;Bailey-Dorton, Chasse
通讯作者：
Bailey-Dorton, Chasse