Patient navigators' reflections on the navigator-patient relationship.
Patient navigation emerged as a strategy to reduce cancer disparities among low-income and minority patients and has demonstrated efficacy in improving clinical outcomes. Observational studies have contributed valuable evaluations of navigation processes and tasks; however, few have offered in-depth reflections about the relationship between patient and navigator from the navigators' perspective. These approaches have addressed the emotional and relational components of patient navigation through the lens of process factors, relegating the navigator-patient relationship to a siloed, compartmentalized functionality. To expand upon existing task-oriented definitions of navigation, we conducted qualitative interviews among community-based patient navigators who coordinated care for uninsured, predominantly Hispanic, women receiving cancer screening and follow-up care in a county outside Chicago. Interviews were recorded, transcribed, and analyzed for themes within the navigator-patient relationship domain. The main themes that emerged centered on relational roles, relational boundaries, and ideal navigator relational qualities. While patient navigators described engaging with patients in a manner similar to a friend, they stressed the importance of maintaining professional boundaries. Navigators' support assisted patients in bridging their hospital and community lives, a result of navigators' investment in both hemispheres. We conclude that the navigator-patient relationship is not a self-contained utility, but rather the medium through which all other navigator functions are enabled. These insights further characterize the navigator-patient relationship, which will help shape the development of future navigation programs and support the need for further research on the impact of relationship factors on clinical and psychosocial outcome measures.
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 633 N St. Clair Street, Suite 1800, Chicago, IL, 60611, USA.
Sara
S
Phillips
Narissa
N
Nonzee
Laura
L
Tom
Kara
K
Murphy
Nadia
N
Hajjar
Charito
C
Bularzik
Xinqi
X
Dong
Melissa A
MA
Simon
D001943:Breast Neoplasms / Q000517:prevention & control*; D003142:Communication; D055812:Community-Based Participatory Research; D003695:Delivery of Health Care; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D017063:Outcome Assessment, Health Care; D010344:Patient Advocacy; D062526:Patient Navigation / Q000379:methods* / Q000458:organization & administration; D011369:Professional-Patient Relations; D036301:Qualitative Research; D014594:Uterine Neoplasms / Q000517:prevention & control*