Oncological navigation and the assessment of barriers in the continuum of the oncological journey

Keywords

patient navigation - oncology - nursing

Introduction: Oncology patients undergo significant changes in their routines, impacting access to and management of their treatment journey. The nurse navigator (NN) plays a crucial role in identifying and overcoming barriers, particularly during the initial nursing consultation.

Objective: To analyze the barriers faced by oncology patients during the initial consultation with the NN in a navigation program (NP) at a Cancer Center.

Method: A retrospective cross-sectional study, approved by the Research Ethics Committee (CAAE: 47748821.7.0000.5432). Data collected between October 2021 and March 2024 were analyzed in absolute numbers, percentages, and through the cross-referencing of sociodemographic variables and barriers.

Results: A total of 9,083 patients were analyzed, with 58% being female and most aged between 50-69 years. Although most patients did not present significant communication, diagnosis understanding, or transportation barriers, patients over 70 years old (26%) showed greater difficulty in understanding their diagnosis and treatment (p<0.0001). Additionally, 44.4% of patients reside outside the city of São Paulo, facing geographical barriers to treatment access. Low education (8.8%) was a relevant factor, impacting treatment comprehension. In terms of support, 17% of patients have a friend or family member as their primary caregiver, suggesting possible dependence on others for treatment management. Approximately 17.4% use public or private transportation to access the hospital, and 11.1% reported little or no family support. Women have less family support compared to men. Referrals to the multidisciplinary team included nutrition (7.4%), physiotherapy (3.9%), nursing (6.9%), and psychology (1.9%), highlighting the need for comprehensive and personalized care.

Conclusion: The study reinforces the role of the NN in proactively identifying barriers to healthcare access, enabling targeted interventions and promoting equity. Identifying these barriers during the initial consultation is crucial to improving patient experience, reducing disparities in access to care, and enhancing clinical outcomes.

Corresponding author: Claudia Cristina Klumpp (e-mail: [e-mail]).