Patients facing colorectal cancer often experience distress and challenges managing symptoms and treatment. The investigators hypothesized that a structured nurse navigation intervention that included needs assessment, distress evaluation, and emotional support from diagnosis through follow-up would improve patient self-efficacy compared with standard care.
This research was conducted as a randomized controlled trial and reported in Support Care Cancer. The trial compared a nurse navigation intervention against usual care across the cancer treatment trajectory for individuals with a physician-verified suspicion of colorectal cancer following colonoscopy.
Adults who had a physician-verified suspicion of colorectal cancer after colonoscopy were screened for eligibility. Those meeting inclusion criteria who consented were randomized to either the intervention or standard care. A total of 271 participants were included in the trial; 222 participants completed follow-up and were treated as completed cases (115 in the standard care arm and 107 in the intervention arm).
Five specially educated nurse navigators delivered the intervention. The intervention components described in the abstract included individualized needs assessment, routine distress evaluation, and provision of emotional support across the treatment course from diagnosis to follow-up. The abstract does not provide further operational details such as session frequency, duration per contact, or specific training curriculum for the nurse navigators.
The primary outcome reported was self-efficacy, measured with the short form of the Cancer Behavior Inventory (CBI-B). Measurements were taken at baseline before randomization and again at treatment completion or within 1 year at the latest. The abstract does not report additional secondary outcomes, quality-of-life measures, or longer-term follow-up beyond the stated timing.
Group differences in change from baseline to follow-up for the CBI-B were analyzed using a population-averaged linear regression model employing generalized estimating equations (GEE). Analyses were based on a total of 4,888 observations, as reported in the abstract. The model produced estimates of mean change within each group and the between-group effect size with corresponding confidence intervals and p values.
Of the 271 randomized participants, 222 were completed cases for analysis: 115 in standard care and 107 in the nurse navigation intervention. The abstract does not provide further demographic breakdowns, baseline CBI-B scores, reasons for loss to follow-up, or per-protocol versus intention-to-treat analyses beyond the count of completed cases.
Based on the GEE analysis, self-efficacy increased under standard care by 2.06 CBI-B score points (95% CI −0.84 to 4.97). In the nurse navigation intervention arm, self-efficacy increased by 6.98 points (95% CI 3.99 to 9.97).
The estimated between-group effect size (difference in change from baseline to follow-up) was 4.92 points with a 95% CI of 0.75 to 9.08. This difference reached statistical significance (p = 0.021), favoring the nurse navigation intervention.
The authors conclude that a tailored nurse navigation program delivered throughout the colorectal cancer treatment course significantly increased patients' self-efficacy as measured by the CBI-B compared with standard care. The abstract frames nurse navigation as an effective supportive-care strategy to enhance patients' confidence in coping with cancer-related challenges during treatment.
The authors declared no competing interests. The abstract does not report certain operational details needed to appraise implementation and generalizability fully: specifics of the nurse navigator training, exact intervention schedule or intensity, eligibility inclusion/exclusion criteria beyond clinician-verified suspicion after colonoscopy, baseline characteristics of randomized groups, and any secondary outcomes or adverse events were not reported in the source abstract.