The Nurse Navigator Model and the Roles of Nurse Navigators in the Management of Polycystic Ovary Syndrome: A Traditional Review

Abstract

Polycystic ovary syndrome (PCOS) is a common and heterogeneous endocrine disorder affecting women of reproductive age, characterized by hyperverogenism, menstrual irregularities, and polycystic ovarian morphology. Although its etiology remains incompletely understood, hyperverogenism and ovulatory dysfunction are widely recognized as the primary pathophysiological mechanisms. Depending on the diagnostic criteria applied, the prevalence of PCOS ranges from 6% to 20%, affecting approximately one in fifteen premenopausal women worldwide. Given its chronic course and multisystem involvement, PCOS requires a comprehensive and multidisciplinary approach to care. In this context, the nurse navigator model has gained increasing importance. Nurse navigators establish continuous and close communication with patients, playing an active role in managing treatment-related side effects, promoting adherence to therapy, and facilitating early identification of potential complications. They also monitor clinical responses, support the correct and timely use of medications, and coordinate care processes across healthcare settings. This study was designed as a traditional narrative review. The literature search was conducted between January 2010 and December 2025 using PubMed/MEDLINE, Scopus, Web of Science, and CINAHL databases. Within PCOS management, nurse navigators undertake educational, coordinative, advocacy, counseling, monitoring and evaluation, care planning, and research roles. Through these functions, women receive comprehensive support in symptom management, lifestyle modification, psychosocial care, and evidence-based practice. Evidence from chronic disease management suggests that the nurse navigator model improves patient satisfaction and self-efficacy, strengthens treatment adherence, enhances quality of life, and contributes to better clinical outcomes. In the context of PCOS, this model represents an empowering and sustainable care approach.

Keywords

• nursing
• models
• nurse navigators
• polycystic ovary syndrome
• roles

Polikistik Over Sendromunda Navigatör Hemşirelik Modeli ve Navigatör Hemşirenin Rolleri: Geleneksel Derleme

Abstract

Polikistik over sendromu (PKOS), üreme çağındaki kadınları etkileyen yaygın ve heterojen bir endokrin bozukluk olup hiperverojenizm, adet düzensizlikleri ve polikistik over morfolojisi ile karakterizedir. Etiyolojisi tam olarak aydınlatılamamış olmakla birlikte, hiperverojenizm ve ovulatuvar disfonksiyon temel patofizyolojik mekanizmalar olarak kabul edilmektedir. Kullanılan tanı kriterlerine bağlı olarak PKOS prevalansı %6-20 arasında değişmekte olup dünya genelinde premenopozal dönemdeki yaklaşık her on beş kadından birini etkilemektedir. Kronik seyri ve çoklu sistemleri etkileyen yapısı nedeniyle PKOS, kapsamlı ve multidisipliner bir bakım yaklaşımı gerektirir. Bu bağlamda hemşire navigatör modeli giderek daha fazla önem kazanmaktadır. Hemşire navigatörler hastalarla sürekli ve yakın iletişim kurarak tedaviye bağlı yan etkilerin yönetiminde aktif rol almakta, tedaviye uyumu artırmakta ve olası komplikasyonların erken tanılanmasını kolaylaştırmaktadır. Ayrıca klinik yanıtları izlemekte, ilaçların doğru ve zamanında kullanımını desteklemekte ve sağlık sistemi içindeki bakım süreçlerini koordine etmektedirler. Bu çalışma geleneksel bir derleme olarak tasarlanmıştır. Literatür taraması Ocak 2010 ile Aralık 2025 tarihleri arasında PubMed/MEDLINE, Scopus, Web of Science ve CINAHL veri tabanları kullanılarak gerçekleştirilmiştir. PKOS yönetiminde hemşire navigatörlerin rolleri; eğitim, koordinasyon, savunuculuk, danışmanlık, izlem ve değerlendirme, bakım planlama ve araştırma rolleri olarak tanımlanmaktadır. Bu roller aracılığıyla kadınlara semptom yönetimi, yaşam tarzı değişikliği, psikososyal bakım ve kanıta dayalı uygulamalar konusunda kapsamlı destek sağlanmaktadır. Kronik hastalık yönetimine ilişkin kanıtlar, hemşire navigatör modelinin hasta memnuniyetini ve öz yeterliliği artırdığını, tedaviye uyumu güçlendirdiğini, yaşam kalitesini iyileştirdiğini ve daha iyi klinik sonuçlara katkı sağladığını göstermektedir. PKOS bağlamında bu model, kadınları güçlendiren ve sürdürülebilir davranış değişimini destekleyen etkili bir bakım yaklaşımıdır.

Keywords

• hemşirelik
• model
• navigatör hemşirelik
• polikistik over sendromu
• rol

References

1. Alqntash, N., AlZabin, A., Almajed, E., Alotaibi, K., Alhindi, G., Ali, S. I., & Bakhsh, H. (2024). Polycystic Ovary Syndrome: A Comprehensive Exploration of Diagnosis Experience in Saudi Women. Journal of Clinical Medicine, 13(17), 5305.
2. Anderson, M. K., Bettencourt, E. V., & LeFebvre, K. B. (2024). Defining the role ve responsibilities of the oral anticancer medication nurse navigator. Seminars in Oncology Nursing, 40(2), 151582.
3. Bai, H., Ding, H., & Wang, M. (2024). Polycystic ovary syndrome (PCOS): Symptoms, causes, and treatment. Clinical ve Experimental Obstetrics & Gynecology, 51(5), 126.
4. Balogh, Z., Csehely, S., Orosz, M., Bhattoa, H. P., Krasznai, Z. T., Deli, T., & Jakab, A. (2025). Relations of insulin resistance, body weight, vitamin D deficiency, SHBG, ve verogen levels in PCOS patients. Biomedicines, 13(8), 1803.
5. Budde, H., Williams, G. A., Winkelmann, J., Pfirter, L., & Maier, C. B. (2021). The role of patient navigators in ambulatory care: overview of systematic reviews. BMC Health Services Research, 21(1), 1166.
6. Burhansstipanov, L., Shockney, L.D., Gentry, S. (2026). History of Oncology Patient and Nurse Navigation. In: Shockney, L.D. (eds) Team-Based Oncology Care: The Pivotal Role of Oncology Navigation. Springer, Cham.
7. Byrne, A. L., Baldwin, A., & Harvey, C. (2020). Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLOS ONE, 15(3), e0229923.
8. Byrne, A. L., Hegney, D., Harvey, C., Baldwin, A., Willis, E., Heard, D., ... & Ferguson, B. (2020). Exploring the nurse navigator role: A thematic analysis. Journal of Nursing Management, 28(4), 814-821.

9. Carmina, E., Azziz, R., Bergfeld, W., Escobar-Morreale, H. F., Futterweit, W., Huddleston, H., ... & Olsen, E. (2019). Female pattern hair loss ve verogen excess: A report from the multidisciplinary verogen excess ve PCOS committee. The Journal of Clinical Endocrinology & Metabolism, 104(7), 2875–2891.
10. Carter, N., Valaitis, R. K., Lam, A., Feather, J., Nicholl, J., & Cleghorn, L. (2018). Navigation delivery models ve roles of navigators in primary care: a scoping literature review. BMC Health Services Research, 18(1), 96.
11. Chan, R. J., Milch, V. E., Crawford-Williams, F., Agbejule, O. A., Joseph, R., Johal, J., & Hart, N. H. (2023). Patient navigation across the cancer care continuum: An overview of systematic reviews ve emerging literature. CA: A Cancer Journal for Clinicians, 73(6), 565–589.
12. Chen, M., Wu, V. S., Falk, D., Cheatham, C., Cullen, J., & Hoehn, R. (2024). Patient navigation in cancer treatment: A systematic review. Current Oncology Reports, 26(5), 504–537.
13. Cooney, L. G., & Dokras, A. (2018). Beyond fertility: Polycystic ovary syndrome ve long-term health. Fertility ve Sterility, 110(5), 794–809.
14. Copp, T., Hersch, J., Muscat, D. M., McCaffery, K. J., Doust, J., Dokras, A., Mol, B. W., & Jansen, J. (2019). The benefits ve harms of receiving a diagnosis of polycystic ovary syndrome: A qualitative study. Human Reproduction Open, 2019(4), hoz026.
15. Correia, J. C., Waqas, A., Huat, T. S., Gariani, K., Jornayvaz, F. R., Golay, A., & Pataky, Z. (2022). Effectiveness of therapeutic patient education interventions in obesity and diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutrients, 14(18), 3807.
16. Çınar, D. (2022). Navigation ve roles of navigator nurse in geriatric hematology. Ege University Faculty of Nursing Journal, 38(3), 257–265.
17. Dikmen, R., İlkin Aydın, E., & Şahin, S. (2024). Jinekolojik kanserlerde navigasyonun önemi ve hemşirenin navigatör rolü. Türkiye Sağlık Araştırmaları Dergisi, 5(3), 50–56.
18. Dilmen, S., & Tuğut, N. (2025). jinekolojik onkolojide navigatör hemşire ve telenavigasyon uygulamaları. Sağlık Bilimlerinde Teknoloji ve İnovasyon Disiplinlerarası Yaklaşım, 37.
19. Dokras, A., Saini, S., Gibson-Helm, M., Schulkin, J., Cooney, L., & Teede, H. (2017). Gaps in knowledge among physicians regarding diagnostic criteria ve management of polycystic ovary syndrome. Fertility ve Sterility, 107(6), 1380–1386.
20. Freeman, H. P. (2006). Patient navigation: a community based strategy to reduce cancer disparities. Journal of Urban Health, 83(2), 139-141.
21. Freeman, H. P., & Rodriguez, R. L. (2011). The history and principles of patient navigation. Cancer, 117(Suppl 15), 3539–3542.
22. Gao, X., Zhao, S., Du, Y., Yang, Z., Tian, Y., Zhao, J., ... & Chen, Z. J. (2025). Data-driven subtypes of polycystic ovary syndrome ve their association with clinical outcomes. Nature Medicine, 31, 4214–4224.
23. Gibson-Helm, M. E., Lucas, I. M., Boyle, J. A., & Teede, H. J. (2014). Women’s experiences of polycystic ovary syndrome diagnosis. Family Practice, 31(5), 545–549.
24. Gibson-Helm, M., Teede, H., Dunaif, A., & Dokras, A. (2017). Delayed diagnosis ve lack of information associated with dissatisfaction in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 102(2), 604–612.
25. Gilbert, J. E., Green, E., Lankshear, S., Hughes, E., Burkoski, V., & Sawka, C. (2011). Nurses as patient navigators in cancer diagnosis: Review, consultation, ve model design. European Journal of Cancer Care, 20(2), 228–236.
26. Huddleston, H. G., & Dokras, A. (2022). Diagnosis ve treatment of polycystic ovary syndrome. JAMA, 327(3), 274-275.
27. Im, E. O., & Meleis, A. I. (2021). Situation-specific theories: philosophical roots, properties, ve approach. In Situation Specific Theories: Development, Utilization, ve Evaluation in Nursing (pp. 13-27). Springer.
28. International PCOS Network. (2018). International evidence-based guideline for the assessment ve management of polycystic ovary syndrome.
29. Kubat, B. (2023). Hemşirelikte Yeni Bir Rol: Navigasyon Programı/Navigatör Hemşireliği. USCEH Dergisi, 3(1), 16-26.
30. McMurray, A., & Cooper, H. (2017). The nurse navigator: An evolving model of care. Collegian, 24(2), 205–212.
31. McMurray, A., Ward, L., Johnston, K., Yang, L., & Connor, M. (2018). The primary health care nurse of the future: Preliminary evaluation of the nurse navigator role in integrated care. Collegian, 25(5), 517–524.
32. Mohamed, R. A., Taref, N. N., Osman, N. E., Keshta, N. H. A., Alboghdady, M. A., Marzouk, M. M., ... & Fadel, E. A. (2024). Effect of web-based health education on nursing students’ knowledge... BMC Nursing, 23(1), 479.
33. Mosquera, I., Todd, A., Balaj, M., Zhang, L., Benitez Majano, S., Mensah, K., & Carvalho, A. L. (2023). Components ve effectiveness of patient navigation programmes... Cancer Medicine, 12(13), 14584–14611.
34. Muzio, K., Hiemstra, J., Morton-Ninomiya, M., Toameh, D., Nicholson, E., & Isaac, K. V. (2025). The value of the nurse navigator in complex cancer care: A scoping review. Healthcare, 13(13), 1585.
35. Nemchikova, O., & Frontoni, S. (2022). The role of dietitian in the multidisciplinary treatment of PCOS. Nutrition, Metabolism ve Cardiovascular Diseases, 32(4), 827-832.
36. Oh, J., & Ahn, S. (2021). Effects of nurse navigators during the transition... Asian Nursing Research, 15(5), 291-302.
37. Ou, Y., Wu, L., Liu, L., Ye, X., Chen, Y., & Yuan, H. (2023). Effects of an “internet+” multidisciplinary model... Clinical ve Experimental Obstetrics & Gynecology, 50(6), 125.
38. Patil, A. D., Vaidya, R. A., Begum, S., Chauhan, S. L., Mukherjee, S., Kokate, P. P., et al. (2022). An integrated multidisciplinary model... Indian Journal of Medical Research, 156(3), 449–458.
39. Phimphasone-Brady, P., Palmer, B., Vela, A., Johnson, R. L., Harnke, B., Hoffecker, L., … Epperson, C. N. (2022). Psychosocial interventions for women with PCOS... F&S Reviews, 3(1), 42–56.
40. Ramezani Tehrani, F., Behboudi-Gharveevani, S., Bidhendi Yarvei, R., Saei Ghare Naz, M., & Carmina, E. (2021). Prevalence of acne vulgaris... Gynecological Endocrinology, 37(5), 392–405.
41. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus... Human Reproduction, 19, 41–47.
42. Sabbatini, A. K., Merck, L. H., Froemming, A. T., Vaughan, W., Brown, M. D., Hess, E. P., & Comfere, N. I. (2015). Optimizing patient-centered communication... Academic Emergency Medicine, 22(12), 1427–1434.
43. Sakashita, C., Endo, E., Ota, E., & Oku, H. (2025). Effectiveness of nurse-led transitional care interventions... BMC Nursing, 24(1), 379.
44. Siddiqui, S., Mateen, S., Ahmad, R., & Moin, S. (2022). A brief insight into the etiology... Journal of Assisted Reproduction ve Genetics, 39(11), 2439–2473.
45. Simon, S. L., Phimphasone-Brady, P., McKenney, K. M., Gulley, L. D., Bonny, A. E., Moore, J. M., … Cree, M. G. (2024). Comprehensive transition of care... The Lancet Child & Adolescent Health, 8(6), 443–455.
46. Soni, R., & Laddad, M. M. (2024). Psychological ve physical health profile... Frontiers in Health Informatics, 13(3).
47. Spritzer, P. M., Marchesan, L. B., Santos, B. R., & Fighera, T. M. (2022). Hirsutism, normal verogens... Diagnostics, 12(8), 1922.
48. Stener-Victorin, E., Teede, H., Norman, R. J., Legro, R., Goodarzi, M. O., Dokras, A., & Piltonen, T. T. (2024). Polycystic ovary syndrome. Nature Reviews Disease Primers, 10(1), 27.
49. Stev, C. H. (2025). Analysis of the influence of psychosocial support... International Journal of Nursing ve Midwifery Research, 3(2), 76–85.
50. Sydora, B. C., Wilke, M. S., McPherson, M., Chambers, S., Ghosh, M., & Vine, D. F. (2023). Challenges in diagnosis... BMC Women’s Health, 23(1), 569.
51. Teede, H. J., Tay, C. T., Laven, J. J. E., Dokras, A., Moran, L. J., Piltonen, T. T., … Joham, A. E. (2023). Recommendations from the 2023 guideline... The Journal of Clinical Endocrinology & Metabolism, 108(10), 2447–2469.
52. Türk Dil Kurumu. (2026). Güncel Türkçe Sözlük Navigatör.
53. Ver Hoeve, E. S., Calhoun, E., Hernandez, M., High, E., Armin, J. S., Ali-Akbarian, L., … Hamann, H. A. (2024). Evaluating implementation... BMC Health Services Research, 24(1), 550.
54. Witchel, S. F., Oberfield, S. E., & Peña, A. S. (2019). Polycystic ovary syndrome... Journal of the Endocrine Society, 3(8), 1545–1573.
55. Zehravi, M., Maqbool, M., & Ara, I. (2022). Polycystic ovary syndrome ve infertility: an update. International Journal of Adolescent Medicine and Health, 34(2), 1-9.