IMPORTANCE OF NAVIGATION IN GYNECOLOGICAL CANCERS and NURSE'S ROLE AS NAVIGATOR

Abstract

Today, the incidence of gynaecological cancers is increasing. Therefore, early diagnosis and screening methods for gynaecological cancers are extremely important. However, as a result of delays in early diagnosis, screening and treatment of gynaecological cancers, patients may face with the progression of cancer. Patients diagnosed with gynaecological cancer and their families are adversely affected biopsychosocially and may experience shock. The patient and her family try to understand many treatment methods before they can get out of shock. At the same time, treatment methods in cancer are developing rapidly with the advancement of technology. This rapid change process can cause stress for the patient and family. In this process, the patient and family may need a navigation. This navigation need can be met through nurses. Because nurses can be the first people to whom the patient and his/her family apply for 24 hours in all kinds of problems within the health team. At the same time, due to these duties, nurses also provide communication within the health team. With the navigator role of the nurse; by playing an active role in the diagnosis and treatment processes of cancer patients, it provides an opportunity to increase the survival rates of patients and to support these patients psychologically, socially and economically. The aim of this review article is to draw attention to the importance of navigation in gynaecological cancers and the navigator role of the nurse.

Keywords

• Gynaecological cancer
• navigation
• navigator nurse

JİNEKOLOJİK KANSERLERDE NAVİGASYONUN ÖNEMİ ve HEMŞİRENİN NAVİGATÖR ROLÜ

Abstract

Günümüzde jinekolojik kanserlerin görülme sıklığı artmaktadır. Bu yüzden jinekolojik kanserler için erken tanı ve tarama yöntemleri son derece önemlidir. Ancak jinekolojik kanserlerin erken tanı, tarama ve tedavi aşamalarında yaşanan gecikmeler sonucunda hastalar kanserin ilerlemesi ile karşı karşıya kalabilmektedir. Jinekolojik kanser tanısı alan hasta ve ailesi biyopsikososyal yönden olumsuz etkilenmekte ve şok yaşayabilmektedir. Hasta ve ailesi şokun etkisinden çıkamadan birçok tedavi yöntemlerini anlamaya çalışmaktadır. Aynı zamanda kanserde tedavi yöntemleri teknolojinin ilerlemesi ile birlikte hızla gelişmektedir. Bu hızlı değişim sürecide hasta ve ailesi için stres oluşturabilmektedir. Bu süreçte hasta ve ailesi bir navigasyona ihtiyaç duyabilmektedir. Bu navigasyon ihtiyacı hemşireler aracılığıyla karşılanabilmektedir. Çünkü sağlık ekibi çerisinde hasta ve ailesinin her türlü problemlerinde 24 saat boyunca ilk başvurdukları kişiler hemşireler olabilmektedir. Aynı zamanda bu görevleri nedeniyle hemşireler sağlık ekibi içerisinde iletişimi de sağlamaktadır. Hemşirenin navigatör rolü ile; kanser hastalarının tanı ve tedavi süreçlerinde etkin rol oynayarak hastalarda sağ kalım oranlarının artmasına ve bu hastaların psikolojik, sosyal ve ekonomik yönden de desteklenmelerine fırsat sunmaktadır. Bu inceleme makalesinin amacı jinekolojik kanserlerde navigasyonun önemi ve hemşirenin navigatör rolüne dikkat çekmektir.

Keywords

• Jinekolojik kanser
• navigasyon
• navigatör hemşire

References

1. 1.Di Saia PJ, Creasman WT, Mannel RS, McMeekin DS, Mutch DG. Clinical gynecologic oncology. 9th ed. Philadelphia: Elsevier Inc; 2017.
2. 2.GLOBOCAN (Global Cancer Observator. International Agency for Research on Cancer) [Internet]. 2020 [cited 2024 March 1]. Available from: https://gco.iarc.fr/en
3. 3.T.C. Sağlık Bakanlığı. Halk Sağlığı Genel Müdürlüğü. Kanser Dairesi Başkanlığı. Türkiye Kanser İstatistikleri Yıllığı [Internet]. 2018 [cited 2024 March 1]. Available from: https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/Dokumanlar/Istatistikler/Kanser_Rapor_2018.pdf
4. 4.World Health Organization (WHO). World Cancer Report [Internet]. 2020 [cited 2024 March 1]. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death
5. 5. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2021; 71(3): 209-249. https://doi.org/10.3322/caac.21660
6. 6. Matthews T, Baken D, Ross K, Ogilvie E, Kent L. The experiences of patients and their family members when receiving bad news about cancer: A qualitative meta-synthesis. Psycho-oncology. 2019; 28(12): 2286–2294. https://doi.org/10.1002/pon.5241
7. 7.Hill EM, Frost A. Loneliness and psychological distress in women diagnosed with ovarian cancer: examining the role of self-perceived burden, social support seeking, and social network diversity. Journal of Clinical Psychology in Medical Settings. 2022; 29(1): 195–205. https://doi.org/10.1007/s10880-021-09789-x
8. 8. Bakhiet TE, Ali SM, Bakhiet AM. Prevalence of depression and anxiety among adult patients undergoing chemotherapy in Khartoum, Sudan: a cross-sectional study. Journal of Affective Disorders Reports. 2021; 6: 100218. https://doi.org/10.1016/j.jadr.2021.100218.

9. 9. Shirali E, Yarandi F, Ghaemi M, Montazeri A. Quality of life in patients with gynecological cancers: a web-based study. asian pacific journal of cancer prevention: APJCP. 2020; 21(7): 1969–1975. https://doi.org/10.31557/APJCP.2020.21.7.1969
10. 10.Faller H, Brähler E, Härter M, Keller M, Schulz H, Wegscheider K, et al. Unmet needs for information and psychosocial support in relation to quality of life and emotional distress: A comparison between gynecological and breast cancer patients. Patient Education and Counseling. 2017; 100(10): 1934–1942. https://doi.org/10.1016/j.pec.2017.05.031
11. 11.Shinan-Altman S, Levkovich I, Hamama-Raz Y. Cervical cancer survivors: The experiences of the journey. Palliative & Supportive Care. 2024; 22(3): 563-570. https://doi.org/10.1017/S1478951522000785
12. 12. Henson LA, Maddocks M, Evans C, Davidson M, Hicks S, Higginson IJ. Palliative care and the management of common distressing symptoms in advanced cancer: pain, breathlessness, nausea and vomiting, and fatigue. Journal of Clinical Oncology. 2020; 38(9): 905-914. https://doi.org/10.1200/JCO.19.00470
13. 13.Hsu HC, Tsai SY, Wu SL, Jeang SR, Ho MY, Liou WS, Chiang AJ, Chang TH. Longitudinal perceptions of the side effects of chemotherapy in patients with gynecological cancer. Supportive Care in Cancer: Official Journal of The Multinational Association of Supportive Care in Cancer. 2017; 25(11): 3457–3464. https://doi.org/10.1007/s00520-017-3768-7
14. 14. Nho JH, Reul Kim S, Nam JH. Symptom clustering and quality of life in patients with ovarian cancer undergoing chemotherapy. European Journal of Oncology Nursing: The Official Journal of European Oncology Nursing Society. 2017; 30: 8–14. https://doi.org/10.1016/j.ejon.2017.07.007
15. 15.Sharpe L, Curran L, Butow P, Thewes B. Fear of cancer recurrence and death anxiety. Psycho-Oncology. 2018; 27(11): 2559–2565. https://doi.org/10.1002/pon.4783
16. 16. Galica J, Giroux J, Francis JA, Maheu C. Coping with fear of cancer recurrence among ovarian cancer survivors living in small urban and rural settings: A qualitative descriptive study. European Journal of Oncology Nursing: The Official Journal of European Oncology Nursing Society. 2020; 44: 101705. https://doi.org/10.1016/j.ejon.2019.101705
17. 17. Walton LM, Reeve J, Brown PM, Farquhar CM. Gynaecologic cancer patients' needs and experiences of supportive health services in New Zealand. Psycho‐oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer. 2010; 19(2): 201-208. https://doi.org/10.1002/pon.1553
18. 18.Freeman HP, Muth BJ, Kerner JF. Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Practice. 1995; 3(1): 19–30.
19. 19. Hopkins J, Mumber MP. Patient navigation through the cancer care continuum: An overview. Journal of Oncology Practice. 2009; 5 (4): 150-152. https://doi.org/10.1200/JOP.0943501
20. 20.Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer. 2011; 117(S15): 3537-3542. https://doi.org/10.1002/cncr.26262
21. 21. Oncology Nursing Society, Association of Oncology Social Work, & National Association of Social Workers. Oncology Nursing Society, the Association of Oncology Social Work, and the National Association of Social Workers joint position on the role of oncology nursing and oncology social work in patient navigation. Oncology Nursing Forum. 2010; 37(3): 251–252. [Internet]. [cited 2024 March 1]. Available from: https://pubmed.ncbi.nlm.nih.gov/20439209/
22. 22. Percac-Lima S, Benner CS, Lui R, Aldrich LS, Oo SA, Regan N, et al. The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women. Journal of Women's Health (2002). 2013; 22(5), 426–431. https://doi.org/10.1089/jwh.2012.3900
23. 23. Paskett ED, Dudley D, Young GS, Bernardo BM, Wells KJ, Calhoun EA, PNRP Investigators. Impact of patient navigation interventions on timely diagnostic follow up for abnormal cervical screening. Journal of Women's Health. 2016; 25(1): 15-21. doi: 10.1089/jwh.2014.5094
24. 24. Wang X, Fang C, Tan Y, Liu A, Ma GX. (2010). Evidence-based intervention to reduce access barriers to cervical cancer screening among underserved Chinese American women. Journal of Women's Health (2002). 2010; 19(3): 463–469. https://doi.org/10.1089/jwh.2009.1422
25. 25. Burhansstipanov L, Shockney LD, Gentry S. History of oncology patient and nurse navigation. In: Shockney LD, ed. Team-based oncology care: The pivotal role of oncology navigation. 1st ed. Cham: Springer; 2018. p.13-42.
26. 26. Trevillion K, Carlson SS, Wong F, Sherriff C. An evaluation report of the nurse navigator services for the breast cancer support program. Canadian Oncology Nursing Journal. 2015; 25 (4): 409-414. https://doi.org/10.5737/23688076254409414
27. 27.Oncology Nursing Society (ONS). Oncology Nurse Navıgator Core Competencıes. [Internet]. 2013 [cited 2024 March 1]. Available from: https://www.ons.org/sites/default/files/ONNCompetencies_rev.pdf
28. 28. Wells KJ, Valverde P, Ustjanauskas AE, Calhoun EA, Risendal BC. What are patient navigators doing, for whom, and where? A national survey evaluating the types of services provided by patient navigators. Patient Education and Counseling. 2018; 101(2): 285–294. https://doi.org/10.1016/j.pec.2017.08.017
29. 29. Koh C, Nelson JM, Cook PF. Evaluation of a patient navigation program. Clinical Journal of Oncology Nursing. 2011;15(1): 41–48. https://doi.org/10.1188/11.CJON.41-48
30. 30. Brown CG, Cantril C, McMullen L, Barkley DL, Dietz M, Murphy CM, Fabrey LJ. Oncology nurse navigator role delineation study: an oncology nursing society report. Clinical Journal of Oncology Nursing. 2012; 16(6): 581–585. https://doi.org/10.1188/12.CJON.581-585
31. 31. Queesland Governmet. Navigate Your Health. [Internet]. 2020 [cited 2024 March 1]. Available from: https://www.qld.gov.au/youth/support-services/young-people-in-care/navigate-your-health
32. 32. Hohenadel J, Kaegi E, Laidlaw J, Kovacik G, Cortinois A, Kang R, Jadad AR. Leveling the playing field: the personal coach program as an innovative approach to assess and address the supportive care needs of underserved cancer patients. The Journal of Supportive Oncology. 2007;5(4): 185–193.
33. 33. Vargas RB, Ryan GW, Jackson CA, Rodriguez R, Freeman HP. Characteristics of the original patient navigation programs to reduce disparities in the diagnosis and treatment of breast cancer. Cancer. 2008; 113(2): 426–433. https://doi.org/10.1002/cncr.23547
34. 34. Liu JE, Mok E, Wong T. Perceptions of supportive communication in Chinese patients with cancer: experiences and expectations. Journal of Advanced Nursing, 2005; 52(3): 262–270. https://doi.org/10.1111/j.1365-2648.2005.03583.x
35. 35. Adler NE, Page AEK, Institute of medicine (us) committee on psychosocial services to cancer patients/families in a community setting (Eds.). Cancer care for the whole patient: Meeting psychosocial health needs. National Academies Press (US); 2008. p:23 49.
36. 36. Helseth S, Ulfsaet N. Having a parent with cancer: coping and quality of life of children during serious illness in the family. Cancer Nursing. 2003; 26(5), 355–362. https://doi.org/10.1097/00002820-200310000-00003
37. 37.Wilcox B, Bruce SD. Patient navigation: a "win-win" for all involved. Oncology Nursing Forum. 2010; 37(1): 21–25. https://doi.org/10.1188/10.ONF.21-25
38. 38. Hussain Rawther SC, Pai MS, Fernandes DJ. Oncology nurse navıgator programme ­ a narratıve revıew. Nitte University Journal of Health Science. 2015; 5 (1): 103-107.
39. 39. Salgia R, Boehmer LM, Celestin C, Yu H, Spigel DR. Improving care for patients with stage III or IV NSCLC: Learnings for multidisciplinary teams from the ACCC national quality survey. JCO Oncology Practice. 2021; 17(8): e1120–e1130. https://doi.org/10.1200/OP.20.00899
40. 40. McAllister KA, Schmitt ML. Impact of a nurse navigator on genomic testing and timely treatment decision making in patients with breast cancer. Clinical Journal of Oncology Nursing. 2015; 19(5): 510–512. https://doi.org/10.1188/15.CJON.510-512
41. 41. Taylor VM, Hislop TG, Jackson JC, Tu SP, Yasui Y, Schwartz SM, et al. A randomized controlled trial of interventions to promote cervical cancer screening among Chinese women in North America. Journal of the National Cancer Institute. 2002; 94(9): 670–677. https://doi.org/10.1093/jnci/94.9.670
42. 42. Rives TA, Pavlik H, Li N, Qasrawi L, Yan D, Pickarski J, Dietrich CS, et al. Implementation of nurse navigation ımproves rate of molecular tumor testing for ovarian cancer in a gynecologic oncology practice. Cancers. 2023;15(12): 3192. https://doi.org/10.3390/cancers15123192
43. 43.Thygesen MK, Pedersen BD, Kragstrup J, Wagner L, Mogensen O. Gynecological cancer patients’ differentiated use of help from a nurse navigator: a qualitative study. BMC Health Services Research. 2012;12(1): 1-11. https://doi.org/10.1186/1472-6963-12-168
44. 44.Hawighorst-Knapstein S, Fusshoeller C, Franz C, Trautmann K, Schmidt M, Pilch H, et al. The impact of treatment for genital cancer on quality of life and body image--results of a prospective longitudinal 10-year study. Gynecologic Oncology. 2004; 94(2): 398–403. https://doi.org/10.1016/j.ygyno.2004.04.025
45. 45.DeSanto-Madeya S, Bauer-Wu S, Gross A. Activities of daily living in women with advanced breast cancer. Oncology Nursing Forum. 2007; 34(4): 841–846. https://doi.org/10.1188/07.ONF.841-846
46. 46. Ersoy N. Onkoloji hemşireliğinde etik. Türk Onkoloji Dergisi. 2009; 24(4): 191-197.
47. 47. Çavdar İ. Kanserli hastanın terminal dönemdeki bakımı. Türk Onkoloji Dergisi. 2011; 26(3): 142-147.
48. 48. Hallaç S, Öz F. Genital kanser tanı sürecinde varoluşsal kaygı. Psikiyatride Güncel Yaklaşımlar. 2011; 3(4): 595-610.
49. 49. Baileys KA, MucMullen L, Lubejko B, Christensen D, Haylock PJ, Rose T, et al. Nurse navigator core competencies: an update to reflect the evolution of the role. navigation, Nurse Navigator, Care Coordination, Competencies. Clinical Journal of Oncology Nursing. 2018; 22(3): 272-281. https://doi.org/10.1188/18.CJON.272-281