KOLOREKTAL KANSERLİ HASTALARDA HEMŞİRE LİDERLİĞİNDEKİ TELENAVİGASYON PROGRAMININ ETKİNLİĞİ: RANDOMİZE KONTROLLÜ BİR ÇALIŞMA
Abstract
Amaç: Telenavigasyon, onkoloji hemşireleri için yeni ve yenilikçi bir kanser takip yöntemidir. COVID-19 salgınının ardından, teletıp hizmetleri onkolojide giderek artan bir gereksinim haline gelmiş ve hasta navigasyon hizmetlerininde dahil olduğu teletıp uygulamalarının bu alanda kullanımı artmıştır. Ancak bu konu üzerine çalışmalar literatürde halen sınırlıdır. Bu çalışma, hemşire liderliğindeki telenavigasyon programının kolorektal kanserli (KRK) hastalarda semptom yönetimi ve psikososyal uyum üzerindeki etkisini değerlendirmeyi amaçlamaktadır.
Yöntem: Bu randomize kontrollü çalışmada, İstanbul'daki bir kanser merkezine başvuran 60 kolorektal kanser hastası rastgele atama yöntemi kullanılarak navigasyon uygulanan ve navigasyon uygulanmayan olmak üzere iki gruba ayrıldı. Hemşire Liderliğindeki Telenavigasyon Programı (HLTP) kapsamında WhatsApp uygulaması aracılığıyla 3 seans görüşme yapıldı. Araştırma kapsamında semptom yönetimi ve psikososyal uyum ölçümleri değerlendirildi. Bulgular, istatistiksel yöntemler kullanılarak analiz edildi.
Bulgular Hemşire liderliğindeki telenavigasyon programının KRK'li hastalar üzerindeki etkisini araştıran çalışmada, müdahale (navigasyon uygulanan) ve kontrol (navigasyon uygulanmayan) gruplarının her ikisinde de N-SAS ölçeğinin fiziksel ve psikolojik iyilik hâli alt ölçekleri ile toplam puanlarında anlamlı düşüşler gözlemlendi (p<.05). Ancak gruplar arasında N-SAS alt ölçekleri ve toplam puanları açısından anlamlı bir fark bulunmadı (p>.05). Öte yandan navigasyon uygulanan grupta zamanla PAIS-SR toplam puanlarında anlamlı bir azalma görülürken (p<.05), navigasyon uygulanmayan grupta anlamlı bir değişiklik saptanmadı (p>.05). Bu bulgular, HLTP'nin KRK hastalarında psiko-sosyal uyumu anlamlı düzeyde artırdığını (p<.05), ancak fiziksel semptomların yönetimindeki etkilerinin yetersiz olduğunu göstermektedir (p>.05).
Sonuç: Hemşire liderliğinde telenavigasyon programlarının kanser hastalarına göre uyarlanmış engellilik odaklı müdahaleler olduğu gerçeği göz önünde bulundurulduğunda, mevcut çalışma kolorektal kanser hastalarının psikososyal refahını iyileştirmeyi amaçlayan onkoloji hemşireleri için değerli bir rehberlik sağlamaktadır. Bu çalışmanın sonucunda, hemşire liderliğindeki telenavigasyon programının daha çeşitli popülasyonları ve daha büyük örneklem gruplarını içeren ek çalışmalar yoluyla değerlendirilmesi önerilmektedir.
Keywords
References
- World Health Organization. (WHO). GLOBOCAN 2020. Accessed December 16, 2021. https://gco.iarc.fr/
- Lim CYS, Laidsaar-Powell RC, Young JM, et.al. Healthcare experiences of people with advanced colorectal cancer: A qualitative study. Eur J Oncol Nurs. 2023;63:102265.
- Taghadosi, M., Tajamoli, Z., & Aghajani, M. Psychosocial adjustment to cancer and its associated factors in patients undergoing chemotherapy: A cross-sectional study. Biomed Res Ther. 2017;4(12),1853-1866.
- Uğur Ö. Symptom management of cancer patients. Turk J Oncol. 2014;29(3):125-135.
- Ülger E, Alacacıoğlu A, Gülseren AŞ, et al. Psychosocial problems in cancer and the importance of psychosocial oncology. J DEU Med. 2014;28(2):85-92.
- Witzig Brändli V, Lange C, Kobleder A, Kohler M. Effectiveness and content components of nursing counselling interventions on self- and symptom management of patients in oncology rehabilitation-A systematic review. Nurs Open. 2023;10(5):2757-2769.
- El-Shami K, Oeffinger KC, Erb NL, et al. American Cancer Society colorectal cancer survivorship care guidelines. CA Cancer J Clin. 2015;65(6):428-455.
- Röhrl K, Guren MG, Småstuen MC, Rustøen T. Symptoms during chemotherapy in colorectal cancer patients. Support Care Cancer. 2019;27(8):3007-3017.
- Charalambous A, Wells M, Campbell P, et al. A scoping review of trials of interventions led or delivered by cancer nurses. Int J Nurs Stud. 2018;86:36-43.
- Kelly D, Campbell P, Torrens C, et al. The effectiveness of nurse-led interventions for cancer symptom management 2000-2018: A systematic review and meta-analysis. Health Sci Rev. 2022;100052.
- Kwok C, Degen C, Moradi N, Stacey D. Nurse-led telehealth interventions for symptom management in patients with cancer receiving systemic or radiation therapy: A systematic review and meta-analysis. Support Care Cancer. 2022;30(9):7119-7132.
- Ream E, Hughes AE, Cox A, et al. Telephone interventions for symptom management in adults with cancer. Cochrane Database Syst Rev. 2020;6(6):CD007568.
- Shum N, Lui T, Law WL, Fong DY. A nurse-led psycho-education programme for Chinese carers of patients with colorectal cancer: Nga Fan Shum and colleagues report on a randomised controlled trial of the effectiveness of telephone support in Hong Kong. Cancer Nurs Prac. 2014;13:31-39.
- Dülger Z, Dönmez E. The COVID-19 and cancer care. Health Care Acad J. 2021;8(3):227-232.
- González-Montero J, Valenzuela G, Ahumada M, Barajas O, Villanueva L. Management of cancer patients during COVID-19 pandemic at developing countries. World J Clin Cases. 2020;26;8(16):3390-3404.
- Steingass SK, Maloney-Newton S. Telehealth triage and oncology nursing practice. Semin Oncol Nurs. 2020;36(3):151019.
- Rising KL, Ward MM, Goldwater JC, Bhagianadh D, Hollander JE. Framework to advance oncology-related telehealth. JCO Clin Cancer Inform. 2018;2:1-11.
- Zon RT, Kennedy EB, Adelson K, et al. Telehealth in oncology: ASCO standards and practice recommendations. JCO Oncol Pract. 2021;17(9):546-564.
- Freeman HP. The origin, evolution, and principles of patient navigation. Cancer Epidemiol Biomarkers Prev. 2012;21(10):1614-1617.
- Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer. 2011;117(15 Suppl):3539-3542.
- Gordils-Perez J, Schneider SM, Gabel M, Trotter KJ. Oncology nurse navigation: Development and implementation of a program at a comprehensive cancer center. Clin J Oncol Nurs. 2017;21(5):581-588.
- Muñoz R, Farshidpour L, Chaudhary UB, Fathi AH. Multidisciplinary cancer care model: A positive association between oncology nurse navigation and improved outcomes for patients with cancer. Clin J Oncol Nurs. 2018;22(5):E141-E145.
- Temucin E, Nahcivan NO. The effects of the nurse navigation program in promoting colorectal cancer screening behaviors: A randomized controlled trial. J Cancer Educ. 2020;35(1):112-124.
- Emfield Rowett K, Christensen D. Oncology nurse navigation: Expansion of the navigator role through telehealth. Clin J Oncol Nurs. 2020;24(3):24-31.
- Hoon LS, Chi Sally CW, Hong-Gu H. Effect of psychosocial interventions on outcomes of patients with colorectal cancer: A review of the literature. Eur J Oncol Nurs. 2013;17(6):883-891.
- Lai XB, Ching SSY, Wong FKY, et al. A nurse-led care program for breast cancer patients in a chemotherapy day center: A randomized controlled trial. Cancer Nurs. 2019;42(1):20-34.
- Mooney KH, Beck SL, Wong B, et al. Automated home monitoring and management of patient-reported symptoms during chemotherapy: Results of the symptom care at home RCT. Cancer Med. 2017;6(3):537-546.
- Nam KH, Kim HY, Kim JH, Kang KN, Na SY, Han BH. Effects of social support and self-efficacy on the psychosocial adjustment of Korean ostomy patients. Int Wound J. 2019;16(1):13-20.
- Butcher NJ, Monsour A, Mew EJ, et al. Guidelines for reporting outcomes in trial reports: The CONSORT-outcomes 2022 extension. JAMA. 2022;328(22):2252-2264.
- Ritvo PG, Myers RE, Paszat LF, et al. Personal navigation increases colorectal cancer screening uptake. Cancer Epidemiol Biomarkers Prev. 2015;24(3):506-511.
- Sussman J, Bainbridge D, Whelan TJ, et al. Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: A cluster randomized trial. Support Care Cancer. 2018;26(5):1533-1541.
- Can G, Aydiner A. Development and validation of the Nightingale Symptom Assessment Scale (N-SAS) and predictors of the quality of life of the cancer patients in Turkey. Eur J Oncol Nurs. 2011;15(1):3-11.
- Derogatis LR. The Psychosocial Adjustment To Illness Scale (PAIS). J Psychosom Res. 1986;30(1):77-91.
- Mooney KH, Beck SL, Friedman RH, Farzanfar R, Wong B. Automated monitoring of symptoms during ambulatory chemotherapy and oncology providers' use of the information: A randomized controlled clinical trial. Support Care Cancer. 2014;22(9):2343-2350.
- Traeger L, McDonnell TM, McCarty CE, Greer JA, El-Jawahri A, Temel JS. Nursing intervention to enhance outpatient chemotherapy symptom management: Patient-reported outcomes of a randomized controlled trial. Cancer. 2015;121(21):3905-3913.
- Loiselle CG, Edgar L, Batist G, Lu J, Lauzier S. The impact of a multimedia informational intervention on psychosocial adjustment among individuals with newly diagnosed breast or prostate cancer: A feasibility study. Patient Educ Couns. 2010;80(1):48-55.
- Lichiello S, Rainwater L, Russell GB, et al. Cancer during a pandemic: A psychosocial telehealth intervention for young adults. Curr Probl Cancer. 2022;46(4):100865.
- Chen YY, Guan BS, Li ZK, Li XY. Effect of telehealth intervention on breast cancer patients' quality of life and psychological outcomes: A meta-analysis. J Telemed Telecare. 2018;24(3):157-167.
THE EFFECTIVENESS OF NURSE-LED TELENAVIGATION PROGRAM FOR PATIENTS WITH COLORECTAL CANCER: A RANDOMISED CONTROLLED TRIAL
Abstract
Objective: Telenavigation is a new and innovative cancer follow-up method for oncology nurses. Since the COVID-19 pandemic, the need for telemedicine in oncology has grown, alongside the integration of patient navigation services into telemedicine. However, studies on this topic remain limited. This study aims to evaluate the effect of a nurse-led telenavigation program on symptom management and psychosocial adjustment in colorectal cancer (CRC) patients.
Method: This randomized controlled study included 60 CRC patients divided into navigated and non-navigated groups through random allocation at a cancer center in Istanbul. The navigated group received a Nurse-led Telenavigation Program (NTP) through three sessions on WhatsApp, focusing on symptom management and psychosocial adjustment. Data were analyzed using statistical methods.
Results: The study examining the effects of a nurse-led telenavigation program (NTP) on patients with colorectal cancer (CRC) found that both the intervention (navigated) and control (non-navigated) groups experienced significant reductions in the physical and psychological well-being subscales, as well as the total scores of the N-SAS (p<.05). However, no significant differences were observed between the two groups in terms of N-SAS subscales or total scores (p>.05). In contrast, the navigated group showed a significant decrease in total PAIS-SR scores over time (p<.05), whereas the non-navigated group showed no significant change (p>.05). These findings suggest that the NTP significantly improved psychosocial adjustment in CRC patients (p<.05), although it had limited effectiveness in alleviating physical symptoms (p>.05).
Conclusion: In consideration of the fact that nurse navigation programs are disability-focused interventions tailored to cancer patients, the present study provides valuable guidance for oncology nurses aiming to improve the psychosocial well-being of colorectal cancer patients. Consequently, it is recommended that the nurse-led telenavigation program be further evaluated through additional studies involving more diverse populations and larger sample sizes.
References
- World Health Organization. (WHO). GLOBOCAN 2020. Accessed December 16, 2021. https://gco.iarc.fr/
- Lim CYS, Laidsaar-Powell RC, Young JM, et.al. Healthcare experiences of people with advanced colorectal cancer: A qualitative study. Eur J Oncol Nurs. 2023;63:102265.
- Taghadosi, M., Tajamoli, Z., & Aghajani, M. Psychosocial adjustment to cancer and its associated factors in patients undergoing chemotherapy: A cross-sectional study. Biomed Res Ther. 2017;4(12),1853-1866.
- Uğur Ö. Symptom management of cancer patients. Turk J Oncol. 2014;29(3):125-135.
- Ülger E, Alacacıoğlu A, Gülseren AŞ, et al. Psychosocial problems in cancer and the importance of psychosocial oncology. J DEU Med. 2014;28(2):85-92.
- Witzig Brändli V, Lange C, Kobleder A, Kohler M. Effectiveness and content components of nursing counselling interventions on self- and symptom management of patients in oncology rehabilitation-A systematic review. Nurs Open. 2023;10(5):2757-2769.
- El-Shami K, Oeffinger KC, Erb NL, et al. American Cancer Society colorectal cancer survivorship care guidelines. CA Cancer J Clin. 2015;65(6):428-455.
- Röhrl K, Guren MG, Småstuen MC, Rustøen T. Symptoms during chemotherapy in colorectal cancer patients. Support Care Cancer. 2019;27(8):3007-3017.
- Charalambous A, Wells M, Campbell P, et al. A scoping review of trials of interventions led or delivered by cancer nurses. Int J Nurs Stud. 2018;86:36-43.
- Kelly D, Campbell P, Torrens C, et al. The effectiveness of nurse-led interventions for cancer symptom management 2000-2018: A systematic review and meta-analysis. Health Sci Rev. 2022;100052.
- Kwok C, Degen C, Moradi N, Stacey D. Nurse-led telehealth interventions for symptom management in patients with cancer receiving systemic or radiation therapy: A systematic review and meta-analysis. Support Care Cancer. 2022;30(9):7119-7132.
- Ream E, Hughes AE, Cox A, et al. Telephone interventions for symptom management in adults with cancer. Cochrane Database Syst Rev. 2020;6(6):CD007568.
- Shum N, Lui T, Law WL, Fong DY. A nurse-led psycho-education programme for Chinese carers of patients with colorectal cancer: Nga Fan Shum and colleagues report on a randomised controlled trial of the effectiveness of telephone support in Hong Kong. Cancer Nurs Prac. 2014;13:31-39.
- Dülger Z, Dönmez E. The COVID-19 and cancer care. Health Care Acad J. 2021;8(3):227-232.
- González-Montero J, Valenzuela G, Ahumada M, Barajas O, Villanueva L. Management of cancer patients during COVID-19 pandemic at developing countries. World J Clin Cases. 2020;26;8(16):3390-3404.
- Steingass SK, Maloney-Newton S. Telehealth triage and oncology nursing practice. Semin Oncol Nurs. 2020;36(3):151019.
- Rising KL, Ward MM, Goldwater JC, Bhagianadh D, Hollander JE. Framework to advance oncology-related telehealth. JCO Clin Cancer Inform. 2018;2:1-11.
- Zon RT, Kennedy EB, Adelson K, et al. Telehealth in oncology: ASCO standards and practice recommendations. JCO Oncol Pract. 2021;17(9):546-564.
- Freeman HP. The origin, evolution, and principles of patient navigation. Cancer Epidemiol Biomarkers Prev. 2012;21(10):1614-1617.
- Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer. 2011;117(15 Suppl):3539-3542.
- Gordils-Perez J, Schneider SM, Gabel M, Trotter KJ. Oncology nurse navigation: Development and implementation of a program at a comprehensive cancer center. Clin J Oncol Nurs. 2017;21(5):581-588.
- Muñoz R, Farshidpour L, Chaudhary UB, Fathi AH. Multidisciplinary cancer care model: A positive association between oncology nurse navigation and improved outcomes for patients with cancer. Clin J Oncol Nurs. 2018;22(5):E141-E145.
- Temucin E, Nahcivan NO. The effects of the nurse navigation program in promoting colorectal cancer screening behaviors: A randomized controlled trial. J Cancer Educ. 2020;35(1):112-124.
- Emfield Rowett K, Christensen D. Oncology nurse navigation: Expansion of the navigator role through telehealth. Clin J Oncol Nurs. 2020;24(3):24-31.
- Hoon LS, Chi Sally CW, Hong-Gu H. Effect of psychosocial interventions on outcomes of patients with colorectal cancer: A review of the literature. Eur J Oncol Nurs. 2013;17(6):883-891.
- Lai XB, Ching SSY, Wong FKY, et al. A nurse-led care program for breast cancer patients in a chemotherapy day center: A randomized controlled trial. Cancer Nurs. 2019;42(1):20-34.
- Mooney KH, Beck SL, Wong B, et al. Automated home monitoring and management of patient-reported symptoms during chemotherapy: Results of the symptom care at home RCT. Cancer Med. 2017;6(3):537-546.
- Nam KH, Kim HY, Kim JH, Kang KN, Na SY, Han BH. Effects of social support and self-efficacy on the psychosocial adjustment of Korean ostomy patients. Int Wound J. 2019;16(1):13-20.
- Butcher NJ, Monsour A, Mew EJ, et al. Guidelines for reporting outcomes in trial reports: The CONSORT-outcomes 2022 extension. JAMA. 2022;328(22):2252-2264.
- Ritvo PG, Myers RE, Paszat LF, et al. Personal navigation increases colorectal cancer screening uptake. Cancer Epidemiol Biomarkers Prev. 2015;24(3):506-511.
- Sussman J, Bainbridge D, Whelan TJ, et al. Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: A cluster randomized trial. Support Care Cancer. 2018;26(5):1533-1541.
- Can G, Aydiner A. Development and validation of the Nightingale Symptom Assessment Scale (N-SAS) and predictors of the quality of life of the cancer patients in Turkey. Eur J Oncol Nurs. 2011;15(1):3-11.
- Derogatis LR. The Psychosocial Adjustment To Illness Scale (PAIS). J Psychosom Res. 1986;30(1):77-91.
- Mooney KH, Beck SL, Friedman RH, Farzanfar R, Wong B. Automated monitoring of symptoms during ambulatory chemotherapy and oncology providers' use of the information: A randomized controlled clinical trial. Support Care Cancer. 2014;22(9):2343-2350.
- Traeger L, McDonnell TM, McCarty CE, Greer JA, El-Jawahri A, Temel JS. Nursing intervention to enhance outpatient chemotherapy symptom management: Patient-reported outcomes of a randomized controlled trial. Cancer. 2015;121(21):3905-3913.
- Loiselle CG, Edgar L, Batist G, Lu J, Lauzier S. The impact of a multimedia informational intervention on psychosocial adjustment among individuals with newly diagnosed breast or prostate cancer: A feasibility study. Patient Educ Couns. 2010;80(1):48-55.
- Lichiello S, Rainwater L, Russell GB, et al. Cancer during a pandemic: A psychosocial telehealth intervention for young adults. Curr Probl Cancer. 2022;46(4):100865.
- Chen YY, Guan BS, Li ZK, Li XY. Effect of telehealth intervention on breast cancer patients' quality of life and psychological outcomes: A meta-analysis. J Telemed Telecare. 2018;24(3):157-167.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases Nursing |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 28, 2025 |
| Submission Date | September 26, 2024 |
| Acceptance Date | January 22, 2025 |
| Published in Issue | Year 2025 Volume: 6 Issue: 1 |
This material is licensed by Creative Commons Attribution-NonCommercial-No Derivative 4.0 International License.