Carroll Jennifer Kate, Winters Paul C, Purnell Jason Q, Devine Katie, Fiscella Kevin
University of Rochester Medical Center, Department of Family Medicine, Rochester, NY 14620, USA.
J Cancer Educ. 2011 Dec;26(4):761-6. doi: 10.1007/s13187-011-0234-y.
Patient navigation requires that patient load be equitably distributed. We examined whether navigators could predict the relative amount of time needed by different patients for navigation. Analysis of 139 breast and colorectal cancer patients randomized to the navigation arm of a trial evaluating the effectiveness of navigation. Navigators completed a one-item scale estimating how much navigation time patients were likely to require. Participants were mostly females (89.2%) with breast cancer (83.4%); barriers to cancer care were insurance difficulties (26.6%), social support (18.0%), and transportation (14.4%). Navigator baseline estimates of navigation intensity predicted total navigation time, independent of patient characteristics. The total number of barriers, rather than any specific type of barrier, predicted increased navigator time, with a 16% increase for each barrier. Navigators' estimate of intensity independently predicts navigation time for cancer patients. Findings have implications for assigning navigator case loads.
患者导航需要公平分配患者负担。我们研究了导航员是否能够预测不同患者进行导航所需的相对时间量。对139名乳腺癌和结直肠癌患者进行了分析，这些患者被随机分配到一项评估导航有效性试验的导航组。导航员完成了一项单项量表，估计患者可能需要多少导航时间。参与者大多为女性（89.2%），患有乳腺癌（83.4%）；癌症护理的障碍包括保险困难（26.6%）、社会支持（18.0%）和交通（14.4%）。导航员对导航强度的基线估计预测了总导航时间，与患者特征无关。障碍的总数而非任何特定类型的障碍预测了导航员时间的增加，每增加一个障碍，时间增加16%。导航员对强度的估计独立预测癌症患者的导航时间。研究结果对分配导航员的病例量具有启示意义。
