One-stop navigation for cancer support: Assisting unmet needs according to own initiatives.

[[abstract]]Background: Cancer support needs are with complexity, individual specific and access demanding. That how to bridge unmet needs to appropriate supports and to solve issues in a prompt and individualized manner is challenging. Cancer is the leading cause of death in Taiwan and cancer survivors are increasing. Patient navigation program is a national initiative; and one-stop cancer navigation programs in ambulatory settings led by trained oncology nurses or social workers were piloted in 5 hospitals aiming to address unmet cancer needs. The purpose of this study was to explore the programs and describe the unmet needs and navigation activities. Methods: All navigation programs were at outpatient settings where the patients can easily access. Trained lay persons or volunteers were accompanied the professional navigators to assist in the program. The sites were equipped with educational materials and necessities for cancer support. A retrospective analysis was conducted based on the professional navigators’ records of each encounter from 2008 to 2009. Data included characteristics of the patients/family, reported unmet needs, type of activities provided, length of the encounter. Results: A total of 4620 encounters was recorded. They were for the patients with mean age of 48.3 and with the mean length of 20 minutes. A majority of them were made for female patients (56.9%), by the patients’ own initiatives (74.4%) and for the issues related to follow-up treatment. The breast (29.0%) and oral (17.0%) cancer diagnoses were accounted as the top two. Greater than 1/3 were unmet needs of psychosocial, disease issues, care or nutrition issues. The top 3 activities provided by navigators were education, counseling and providing information/booklets. Around 1/3 included subsequent bridges to other resources or providing rehabilitation necessities, such as wits, bra. The length of encounters was significantly longer if the unmet needs were emotional support, patient education for newly diagnosis and bridging to other resources. Conclusions: One-stop cancer navigation programs in ambulatory settings provided an alternative way to fulfill cancer patients’ unmet needs based on their own initiatives