Gunn Christine, Battaglia Tracy A, Parker Victoria A, Clark Jack A, Paskett Electra D, Calhoun Elizabeth, Snyder Frederick R, Bergling Emily, Freund Karen M
J Health Care Poor Underserved. 2017;28(2):663-676. doi: 10.1353/hpu.2017.0066.
Given the momentum in adopting patient navigation into cancer care, there is a need to understand the contribution of specific navigator activities to improved clinical outcomes. A mixed-methods study combined direct observations of patient navigators within the Patient Navigation Research Program and outcome data from the trial. We correlated the frequency of navigator tasks with the outcome of rate of diagnostic resolution within 365 days among patients who received the intervention relative to controls. A focused content analysis examined those tasks with the strongest correlations between navigator tasks and patient outcomes. Navigating directly with specific patients (r = 0.679), working with clinical providers to facilitate patient care (r = 0.643), and performing tasks not directly related to their diagnostic evaluation for patients were positively associated with more timely diagnosis (r = 0.714). Using medical records for non-navigation tasks had a negative association (r = -0.643). Content analysis revealed service provision directed at specific patients improved care while systems-focused activities did not.
鉴于将患者导航纳入癌症护理的发展态势，有必要了解特定导航活动对改善临床结果的贡献。一项混合方法研究结合了患者导航研究项目中对患者导航员的直接观察以及试验的结果数据。我们将导航员任务的频率与接受干预的患者相对于对照组在365天内的诊断解决率结果进行了关联。一项重点内容分析考察了导航员任务与患者结果之间相关性最强的那些任务。与特定患者直接导航（r = 0.679）、与临床提供者合作以促进患者护理（r = 0.643）以及为患者执行与其诊断评估无直接关系的任务与更及时的诊断呈正相关（r = 0.714）。将医疗记录用于非导航任务呈负相关（r = -0.643）。内容分析表明，针对特定患者的服务提供改善了护理，而以系统为重点的活动则没有。
