Cobran Ewan K, Merino Yesenia, Roach Beth, Bigelow Sharon M, Godley Paul A
University of Georgia, College of Pharmacy, Department of Pharmaceutical Health Services, Outcomes, and Policy, Athens, GA.
University of North Carolina at Chapel Hill, Gillings School of Public Health, Department of Health Behavior, Chapel Hill, NC.
J Oncol Navig Surviv. 2017 Oct;8(10):454-462.
Navigation programs are generally characterized as providing patient-centered support and guidance intended to help patients and family members overcome barriers such as timely diagnosis resolution, patient satisfaction, coping with primary and adjuvant treatment, management of side effects, and patient engagement in the healthcare process. The aim of this study was to examine the associations between the Independent Specialty Medical Advocate (ISMA) model of patient navigation and intermediate patient health outcomes for newly diagnosed cancer patients.
A pre-post intervention study was conducted in 26 newly diagnosed cancer patients recruited from a national partnership between the LIVE Cancer Navigation Service Program and the NavigateCancer Foundation between April 2013 and December 2015. Participants received a 1-hour initial telephone consultation, and then a navigation care plan was developed for the 6-week study period. A paired test was conducted to assess changes in intermediate health outcomes at baseline and 6 weeks after study intervention.
The majority of study participants were males (62%), married (50%), and Caucasian (69%). Overall, there was a statistically significant reduction in anxiety at 6 weeks postintervention (mean, 2.48; SD, 0.62; <.05) compared with baseline (mean, 2.92; SD, 0.82) and in depression at 6 weeks postintervention (mean, 2.00; SD, 0.81; <.05) compared with baseline (mean, 2.45; SD, 0.19).
The ISMA model of patient navigation appears to be associated with significant reduction in anxiety and depression. Further studies are needed to evaluate the ISMA model of patient navigation on long-term patient outcomes.
导航项目的一般特点是提供以患者为中心的支持和指导，旨在帮助患者及其家庭成员克服障碍，如及时诊断、患者满意度、应对主要和辅助治疗、管理副作用以及患者参与医疗过程等。本研究的目的是探讨独立专科医疗倡导者（ISMA）患者导航模式与新诊断癌症患者的中期健康结局之间的关联。
2013年4月至2015年12月期间，在从LIVE癌症导航服务项目与导航癌症基金会的全国合作项目中招募的26名新诊断癌症患者中进行了一项干预前后研究。参与者接受了1小时的初始电话咨询，然后为为期6周的研究期制定了导航护理计划。进行配对t检验以评估研究干预前和干预后6周时中期健康结局的变化。
大多数研究参与者为男性（62%）、已婚（50%）且为白种人（69%）。总体而言，与基线相比，干预后6周时焦虑水平有统计学意义的降低（均值为2.48；标准差为0.62；P<0.05），基线时均值为2.92；标准差为0.82），干预后6周时抑郁水平也有统计学意义的降低（均值为2.00；标准差为0.81；P<0.05），基线时均值为2.45；标准差为0.19）。
ISMA患者导航模式似乎与焦虑和抑郁的显著降低有关。需要进一步研究来评估ISMA患者导航模式对患者长期结局的影响。
