Rabi Sarah, Santana Maria, Dimitropoulos Gina, McBrien Kerry, Benterud Eleanor, Wigston Lorraine, Tang Karen
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
Health Expect. 2025 Aug;28(4):e70383. doi: 10.1111/hex.70383.
Patient navigation was first envisioned to assist marginalized cancer patients access timely healthcare services by identifying and addressing social barriers to care. While this understanding of patient navigation may still hold for a subgroup of programs today, its expansion over the past 30 years has resulted in a diverse set of interventions with distinct care settings, patient eligibility criteria, navigator training requirements and program goals. This study aimed to explore patients' understanding of patient navigation programs to identify program features that are of particular value and importance to them.
In this qualitative study, we conducted one-on-one semi-structured interviews from November 2023 to February 2024 with patients involved in five distinct hospital-, clinic- and community-based patient navigation programs across Alberta. Inductive thematic analysis and interpretive exercises were performed to construct a coherent narrative relevant to the research objective. Study participants were adult patients with patient navigation program exposure for at least 1 month (range: 2 months to 11 years).
Twenty-three patient experiences were captured in the study (12 [52%] women; median [IQR] age, 59 [48-67] years), with approximately half receiving support from a nurse navigator (11/23, 48%). Regardless of navigation type, the patients' stories were tethered by their navigators' provision of personalized, seamless and humanized care. These perceived navigator functions were accomplished through patient-identified navigator characteristics, including navigator approachability, accessibility and comprehensive systems knowledge. While the identified functions and characteristics of navigators were consistent across patients, the operationalization of these components varied based on the program's setting and the particular needs of each patient.
The commonalities in patient perceptions of patient navigation indicate continued points of overlap across programs despite their increasing heterogeneity. Additionally, our findings provide insight into the functions and characteristics of patient navigation most valued by patients, which may inform future program development and implementation efforts.
Continued collaboration with two patient partners was maintained throughout the study to ensure responsiveness to patient priorities.
患者导航最初的设想是通过识别和消除医疗保健的社会障碍，帮助边缘化癌症患者及时获得医疗服务。虽然如今对患者导航的这种理解可能仍适用于一部分项目，但在过去30年里它不断扩展，产生了一系列不同的干预措施，这些措施在护理环境、患者资格标准、导航员培训要求和项目目标方面都有所不同。本研究旨在探索患者对患者导航项目的理解，以确定对他们特别有价值和重要性的项目特征。
在这项定性研究中，我们于2023年11月至2024年2月对参与艾伯塔省五个不同的基于医院、诊所和社区的患者导航项目的患者进行了一对一的半结构化访谈。进行了归纳主题分析和解释性练习，以构建与研究目标相关的连贯叙述。研究参与者为成年患者，他们接触患者导航项目至少1个月（范围：2个月至11年）。
该研究收集了23例患者的经历（12例[52%]为女性；年龄中位数[四分位间距]为59[48 - 67]岁），约一半患者得到了护士导航员的支持（11/23，48%）。无论导航类型如何，患者的故事都与导航员提供的个性化、无缝且人性化的护理紧密相连。这些被感知到的导航员功能是通过患者确定的导航员特征实现的，包括导航员的平易近人、易于接触以及全面的系统知识。虽然所确定的导航员功能和特征在患者中是一致的，但这些组成部分的实施方式因项目设置和每个患者的特定需求而异。
患者对患者导航的看法中的共性表明，尽管项目日益多样化，但各项目之间仍存在持续的重叠点。此外，我们的研究结果深入了解了患者最看重的患者导航的功能和特征，这可能为未来的项目开发和实施工作提供参考。
在整个研究过程中，与两名患者合作伙伴保持了持续合作，以确保对患者优先事项做出响应。
