Harding, M. (2015). Effect of nurse navigation on patient care satisfaction and distress associated with breast biopsy. Clinical Journal of Oncology Nursing, 19, E15–E20. 

DOI Link

Study Purpose

To evaluate how nurse navigation affected care satisfaction and distress among women who were undergoing breast biopsy. Specifically, were there significant differences in women undergoing breast biopsy with and without nurse navigators?

Intervention Characteristics/Basic Study Process

Nurse navigation was compared to non-navigation for women presenting for core needle breast biopsy at two different outpatient radiology clinics: one that provided nurse navigation and one that provided coordination of care by radiologic technicians and support staff (not nurse-navigation). 

Sample Characteristics

  • N = 137  
  • AGE: Range = 18-89 years. Thirty-two percent were aged 50 years or younger; 68% older than age 50
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Non-pregnant women aged 18 years or older undergoing core needle breast biopsy procedure

Setting

  • SITE: Multi-site    
  • SETTING TYPE: Outpatient    
  • LOCATION: Northern Appalachia

Phase of Care and Clinical Applications

  • PHASE OF CARE: Diagnostic

Study Design

  • Descriptive, cross-sectional survey

Measurement Instruments/Methods

  • Demographics were collected via a questionnaire.
  • Distress was measured with the Hospital Anxiety and Depression Scale (HADS-A, HADS-D) and the State Trait Anxiety Inventory, State (STAI-S) scale.
  • Satisfaction was recorded with the Patient Satisfaction Questionnaire (PSQ-18).

Results

No significant between-group differences were noted in depression. Lower scores were shown for anxiety (significance p < 0.05) among patients who had navigation. There was no difference in overall satisfaction with care though there was an association between satisfaction and distress: that is, women with more satisfaction reported less distress. The population with nurse navigators shows stronger relationship-based characteristics. Significant differences were shown in five categories (accessibility, communication, finances, interpersonal manner, and time) for the navigated population and in two categories (accessibility, general satisfaction) for the non-navigated or usual care population.

Conclusions

Nurse navigation increased satisfaction with care. General satisfaction measured significantly higher in the non-navigated sample when compared to the navigated group. Distress screening followed by interventions of emotional support, education, and facilitating communication between and among providers are roles nurses can fulfill to improve satisfaction outcomes and lower distress levels.

Nursing Implications

Train nurse navigators in addressing key areas of patient-center interface: accessibility to care, communication among providers, financial support, interpersonal manner, time with care provider, and technical quality. Nurse navigators have knowledge and skill to manage care of women undergoing needle biopsy and, thereby, improve general satisfaction in specific areas.