Abstract
BackgroundFragmentation in healthcare can present challenges for patients with suspected cancer. It can add to existing anxiety, fear, despair and confusion during disease trajectory. In some circumstances patients are offered help from an extra contact person, a Nurse Navigator (NN). Scientific studies showing who will benefit from the extra help offered are missing. This study aims to explore who could benefit from the help on offer from a nurse appointed as NN in the early part of a cancer trajectory, and what would be meaningful experiences in this context.MethodsA longitudinal study with a basis in phenomenology and hermeneutics was performed among Danish women with gynecological cancer. Semi-structured interviews provided data for the analysis, and comprehensive understanding was arrived at by first adopting an open-minded approach to the transcripts and by working at three analytical levels.ResultsPrior experience of trust, guarded trust or distrust of physicians in advance of encountering the NN was of importance in determining whether or not to accept help from the NN. For those lacking trust in physicians and without a close relationship to a healthcare professional, the NN offered a new trusting relationship and they felt reassured by her help.ConclusionsNot everyone could use the help offered by the NN. This knowledge is vital both to healthcare practitioners and to administrators, who want to do their best for cancer patients but who are obliged to consider financial consequences. Moreover patients’ guarded trust or distrust in physicians established prior to meeting the NN showed possible importance for choosing extra help from the NN. These findings suggest increased focus on patients’ trust in healthcare professionals. How to find the most reliable method to identify those who can use the help is still a question for further debate and research.
Highlights
Fragmentation in healthcare can present challenges for patients with suspected cancer
This study aims to explore who could make use of the help offered from a nurse appointed as an Nurse Navigator (NN) in the early part of a cancer trajectory, and what patients experienced to be meaningful in this connection
A naive reading and structural analysis of the data pointed at trust or guarded trust of healthcare professionals as a reason that contributed to whether the patient could use additional help from the NN
Summary
Fragmentation in healthcare can present challenges for patients with suspected cancer. In some circumstances patients are offered help from an extra contact person, a Nurse Navigator (NN). Research in the Nordic countries has proposed that the offer of support should be aimed at all patients with cancer [1,18], and in Denmark a healthcare professional contact person is required by law [19,20]. Navigators in cancer care have been proposed to embrace this extra help They help the cancer patient “ travel the healthcare maze in a more timely fashion, but [the patient’s] psychosocial well-being and quality of life may be enhanced” [25] p. A comprehensive understanding and discussion were carried out In this process literature relevant for the topics, as well as parts of the narratives, was included to widen the interpretation further.
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