The Patient Navigation Project for Socially Vulnerable Cancer Patients Improves Quality of Life and Health Literacy

Abstract

Background: Social inequality in cancer survival and rehabilitation is a major problem. Patient navigation has shown to empower cancer patients to take part in their health care and help them navigate through an increasingly complex health care system. These promising results makes it relevant to explore whether patient navigation can improve the lives of vulnerable cancer patients. Aim: The aim of this study is to examine whether the Danish Cancer Society's nation-wide Patient Navigation Project improves quality of life and health literacy among socially vulnerable cancer patients. Methods: Socially vulnerable cancer patients were included in the project and matched with a navigator (volunteer). The navigators, who had a background in social welfare or health care, supported the patients during a 6-month period. The navigators participated in health care visits, helped the patients to keep track of their disease and treatment, and gave the patients emotional support. The support was based on the patients' needs and the navigators focused on empowering the patients. The patients completed a baseline questionnaire and a 6-month follow-up questionnaire. The questionnaires focused on quality of life (WHO-5 Well-being Index and distress thermometer) and health literacy. Results: Of the 268 participants enrolled in the project, 45 were still enrolled when data were collected and 110 did not complete the 6-month navigation period, due to death or disease worsening. Of the 113 participants who completed the 6-month navigation period, 97 participants filled out the 6-month follow-up questionnaire (86%). The participants were predominantly on retirement benefit (61%), 19% were unemployed and 56% had no or a short education. At baseline, the mean distress level was 8.1, and 64% had a low well-being score and were therefore at risk for depression/long term stress. 6 month after enrolment, the distress level had decreased to 6.7 ( P < 0.001) and 28% had a low well-being score ( P < 0.001). When it comes to health literacy, 60% of the participants stated that they had become better at finding information about their disease 6 month after enrolment, and 74% had become better at asking questions at meetings at the hospital. Conclusion: The socially vulnerable cancer patients enrolled in the Patient Navigation Project experienced increased well-being, a lower distress level and improved health literacy 6 months after enrollment. The findings of the study suggests that patient navigation can improve quality of life and health literacy for socially vulnerable cancer patients.