ABSTRACT
In this study, we investigated the prevalence of mental health problems among patients with cancer and whether oncology nurse navigation improved their mental health outcomes and medical experience. In this randomized controlled clinical trial, we recruited 128 outpatients with cancer via purposive sampling from a teaching hospital in northern Taiwan. Participants were randomly assigned to the navigation group (N = 61) or the usual care group (N = 67). Data were collected from January 2019 to July 2020 using questionnaires, including the self-reported Distress Thermometer, Hospital Anxiety and Depression Scale, Demoralization Scale, and Patient Assessment of Chronic Illness Care. Data were collected at baseline and after three and six months of the intervention. Descriptive and analytical statistical analyses were performed. The prevalence rates of anxiety, depression, distress, and demoralization were 17.9%, 15.7%, 29.7%, and 29.7%, respectively. After three months, the participants in the navigation group exhibited significantly reduced levels of anxiety, demoralization, and emotional distress (reduced by 92%, 75%, and 58%, respectively) and reported a better medical experience (odds ratio = 1.40) than those in the usual care group.
Subject(s)
Neoplasms , Oncology Nursing , Humans , Female , Male , Taiwan , Neoplasms/psychology , Middle Aged , Oncology Nursing/methods , Mental Health , Anxiety , Patient Navigation , Adult , Aged , DepressionABSTRACT
Oncology Nurse Navigation is a professional service that integrates complex medical care procedures and promotes patient awareness of the major nursing problems. Using pre-assessment strategies and the integration of medical care information, Nurse Navigators help patients and their families gain comprehensive medical information and nursing care guidance from their initial post-diagnosis visit to their follow-up visits after remission. This article describes the author's experience with a 53-year-old married overseas Chinese woman who had been diagnosed with a rare tumor, PEComa, and who had traveled to Taiwan for treatment. During the outpatient care period with tumor progression, in addition to disease-related psychological and physical discomfort and pain, the prolonged uncertainty regarding treatment had induced adjustment difficulties and psychological symptoms in the patient. The patient's husband continued to work at his job in order to support the family's finances and was not able to maintain a close understanding of his wife's situation. He developed emotional stress when he saw his wife's disease relapse. The authors used Oncology Nurse Navigation approaches to actively assess the needs of the patient and her spouse, to explore their psychological state using emotional assessment scales, to understand the impact of recurrence on the family, to provide available resources and information, to help the couple learn to cope with psychological adjustment symptoms, to enhance their cognitive understanding of the disease, and to learn useful measures that helped them regain physical control, control over the treatment process, and effectively adapt to the disease and its effects. The authors' experience using Oncology Nurse Navigation with this patient may serve as a reference for healthcare professionals to facilitate the proactive assessment of patient needs at different stages of outpatient care, to remove barriers to seeking medical care through early interventions, and to implement a comprehensive and patient-centered approach to cancer treatment that may improve cancer treatment efficacy and quality of care.