USING PATIENT-REPORTED OUTCOMES IN A WORK INTERVENTION OF ONCOLOGY NURSE NAVIGATORS
Nearly two-thirds of cancer survivors return to work after their diagnosis, experiencing unique challenges as they strive to maintain health and career goals. Dedicated supportive interventions and programs for those individuals are few. Interventions using oncology nurse navigation can be a significant resource in optimizing work ability, employment, and social reintegration. Because this is an innovative approach to nursing care coordination, particularly in the workplace, there is a dearth of research to guide clinical evaluation and quality improvement efforts.
The purpose was to find valid and relevant outcomes measurement instruments to evaluate and improve the nurse navigation intervention of cancer survivors and work.
A search of the literature published from 2004 to 2016 was completed. Databases including CINAHL, PsychInfo, Scopus, and PubMed were searched using the keywords cancer, cancer survivor, employment, nursing, navigation, patient-reported outcomes, and return to work. A conceptual model linking navigation to patient-reported outcomes (PROs) (Fiscella, 2011) and the Cancer Survivorship and Work Model (Mehnert, deBoer, & Feuerstein, 2013) summarizing the multitude of factors that affect employment were identified. Validated PROs that aligned with the conceptual models and intervention goals were chosen for program evaluation and improvement.
PROs serve to understand the impact of navigation in an intervention supporting cancer survivors and work. Key PROs related to nurse navigation, and criteria for selecting measures in this domain were identified. The model linking navigation to PROs demonstrates that navigators provide services in two broad categories: Informational support (i) technical competence in referral to resources and addressing instrumental needs and barriers, and Emotional support and coping self-efficacy; Patient satisfaction with navigator relationship (ii) relational alliance in providing emotional support, education and coaching, and acting as an advocate. The outcome measure proffered from these two broad categories will determine if the navigation program makes a difference for the participants.
PROs may be selected and used to assess individual and interpersonal perceptions of cancer survivors, while also providing valuable information to develop a workplace program based on navigation.