Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC, 20037, USA.
Support Care Cancer. 2019 May;27(5):1655-1662. doi: 10.1007/s00520-018-4407-7. Epub 2018 Aug 14.
Patient navigation has emerged as a promising strategy in reducing disparities among diverse cancer patients. However, little is known about navigators' own perspectives on their roles in providing culturally competent care. The purpose of the present study is to describe these self-identified roles.
Data were collected from an online survey with a convenience sample of cancer patient navigators. Using NVivo 10, qualitative content analysis was conducted on free text responses to the question: "In your opinion, what is the role of a patient navigator or nurse navigator in the provision of culturally sensitive care to patients?" Frequencies of each navigator-identified role mentioned were tabulated.
Of 294 respondents, 50.7% (n = 149) provided a response to the question of interest. Respondents described the following 11 interrelated navigator roles in the provision of culturally competent care: (1) assess and understand patient needs, (2) tailor care to patient, (3) build rapport/open communication, (4) facilitate communication between patient and health care team, (5) educate/provide resources to the patient, (6) advocate, (7) self-motivated learning, (8) address barriers to care, (9) involve/meet the needs of family or support people, (10) educate/support health care team, and (11) support patient empowerment in care.
Patient navigators are uniquely well-positioned to improve cultural competence of cancer care given their role as liaison to patients and providers. Cancer care settings should use navigators with direct knowledge of patient culture whenever possible; however, communication and cultural competence training is highly recommended for all navigators given the diversity of patient needs.
患者导航员已成为减少不同癌症患者之间差异的一种很有前途的策略。然而,对于导航员在提供文化上胜任的护理方面自身角色的看法知之甚少。本研究的目的是描述这些自我认同的角色。
从一项在线调查中收集数据,该调查使用便利样本的癌症患者导航员。使用 NVivo 10 对关于问题的自由文本回复进行定性内容分析:“在您看来,患者导航员或护士导航员在为患者提供敏感文化的护理方面的角色是什么?”列出了每位导航员识别的角色出现的频率。
在 294 名受访者中,有 50.7%(n=149)回答了感兴趣的问题。受访者在提供文化能力护理方面描述了以下 11 个相互关联的导航员角色:(1)评估和了解患者需求,(2)根据患者需求调整护理,(3)建立融洽/开放的沟通,(4)促进患者与医疗保健团队之间的沟通,(5)教育/向患者提供资源,(6)倡导,(7)自我激励学习,(8)解决护理障碍,(9)参与/满足家庭或支持人员的需求,(10)教育/支持医疗保健团队,以及(11)支持患者在护理中赋权。
鉴于患者导航员作为患者和提供者之间的联络人,他们在提高癌症护理的文化能力方面具有独特的优势。癌症护理机构应尽可能使用具有患者文化直接知识的导航员;然而,鉴于患者需求的多样性,强烈建议所有导航员进行沟通和文化能力培训。