Development of a Nurse Navigator Programme for the Care of Breast Cancer Patients

Abstract

Background: Breast cancer incidences in India are rapidly rising, amounting to a significant percentage of all cancers in women. The diagnosis and expenses for treatment make the patient to thrust on a journey that disorganizes their daily function and family roles with much fear and uncertainty. The care of the patients requires a comprehensive individualized care from a pivotal nurse to meet their informational and educational needs, support, and care coordination throughout their illness trajectory. Limited studies have been reported from developing countries on specific nursing roles in cancer care. Therefore, the researcher felt the need for developing a nurse navigation program for the care of breast cancer patients. Aim: The aim of the study was to develop, validate and assess the usefulness of the program in women with breast cancer. Methods: The content of Nurse Navigator Program was prepared by reviewing literature pertaining to nurse/patient navigation programs. The program has been validated by an expert committee consisting of experts from various fields. The program consists of preoperative education on surgery and postmastectomy care, progressive muscle relaxation training, information booklets on post mastectomy care, chemotherapy and radiation therapy, telephonic follow-up sessions and ONN visits. Readability testing of the information booklets was checked online by Flesch reading ease and Flesch Kincaid-Grade level. The educational program and information booklets were translated into Kannada and retranslated into English with help of 2 experts. Researcher had undergone training in progressive muscle relaxation. Finally the usefulness and acceptability of the program was tested in 60 breast cancer patients undergoing surgery followed by chemo/radiation therapy in surgery, chemo and radiotherapy wards of a tertiary care hospital in Karnataka. After obtaining ethical permission from institutional ethical committee written informed consent was obtained from participants before conducting study. Results: The mean ICVI, SCVI/UA and mean expert proportion of the Nurse Navigator Program was found to be −1.00 for each. Flesch reading ease was 77.3 and Flesch Kincaid-Grade level achieved was 4.8. 83.3% of women strongly agreed that information booklets were useful, 80% strongly agreed the user friendliness of this program & 70% of people reported that their emotional needs were taken care seriously and got additional emotional support. 90% strongly agreed navigation services are necessary and would recommend navigation service. Conclusion: The validated Nurse Navigator Program was found acceptable and useful for patients. The whole program may give evidence on the effectiveness of a nurse navigator program for the care of women with breast cancer. If significant effects are detected this program could be implemented in the hospital setting to improve cancer care.