Nurse navigator. A concept analysis according to the Walker and Avant model
DOI:
https://doi.org/10.17533/udea.iee.v44n1e06Keywords:
nurse-patient relationships, patient navigation, nursing care, continuity of patient care, health servicesAbstract
Objective. To analyze the concept of nurse navigator in light of the Walker and Avant model.
Methods. This is a concept analysis, based on the Walker and Avant model, operationalized through a scope review according to the JBI and PRISMA-ScR guidelines. The investigation follows other methodological stages for the construction and understanding of the “nurse navigator” concept.
Results. The attributes that prevailed were care management, health literacy, overcoming barriers, assertive communication, bonding, specialized knowledge, continued care, quality of care and patient integration into health systems. Regarding the most frequent antecedents, the following stand out: vulnerable populations, health disparities, communication gaps, delays and fragmentation of care, and low therapeutic adherence. The main consequences were the reduction of costs and mortality, reduction of hospitalizations and time spent in hospital, improvements in access to healthcare, adherence to treatment, quality of life and satisfaction with care.
Conclusion. The study defined the nurse navigator as the professional who manages care in a continuous way, capable of integrating it into the health system and strengthening the nurse-patient bond, reducing barriers and disparities, in addition to guaranteeing continuity and adherence to treatment.
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References
1. Organização Mundial da Saúde. Noncommunicable diseases progress monitor 2020 [Internet]. Geneva: WHO; 2020 [cited 2024 oct 12]. Available from: https://www.who.int/publications-detail/ncd-progress-monitor-2020.
2. Venancio DBR, Marques DS, Neto RAV, Moura ED, Silva EC, Lira MC et al. Doenças crônicas não transmissíveis (DCNT): problemas resultantes desses agravos. Research, Society and Development. 2022; 11(14):e526111436630.
3. Simões TC, Meira KC, Santos J, Câmara DCP. Prevalências de doenças crônicas e acesso aos serviços de saúde no Brasil: evidências de três inquéritos domiciliares. Ciência & Saúde Coletiva. 2021; 26:3991–4006.
4. Szwarcwald CL, Stopa SR, Malta DC. Situação das principais doenças crônicas não transmissíveis e dos estilos de vida da população brasileira: Pesquisa Nacional de Saúde, 2013 e 2019. Cadernos de Saúde Pública. 2022; 38:e00276021.
5. Wehrmeister FC, Wendt AT, Sardinha L. Iniquidades e doenças crônicas não transmissíveis no Brasil. Epidemiologia e Serviços de Saúde. 2022; 31:e20211065.
6. Rodrigues RL, Schneider F, Kalinke LP, Kempfer SS, Backes VMS. Clinical outcomes of patient navigation performed by nurses in the oncology setting: an integrative review. Revista Brasileira de Enfermagem. 2021; 74(2):e20190804.
7. Domenico EBL, Kalinke LP. Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage. Revista Brasileira de Enfermagem. 2024; 77:e770201.
8. Jones CMH, Mitchell GK, Mutch AJ. The nurse navigator: Broker, boundary spanner and problem solver. Collegian. 2021; 28(6):622-7.
9. Souza DB, Sangoi KCM. The importance of the navigator nurse in cancer patient care: an integrative literature review. Research, Society and Development. 2022; 11(5):e25511528024.
10. Roque AC, Gonçalves IR, Popim RC. Experience of care nurses: approaches to the principles of navigation of cancer patients. Texto & Contexto Enfermagem. 2023; 32:e20230020.
11. Mosquera I, Todd A, Balaj M, Zhang L, Majano SB, Mensah K, et al. Components and effectiveness of patient navigation programmes to increase participation to breast, cervical and colorectal cancer screening: A systematic review. Cancer Medicine. 2023; 12(13):14584-611.
12. Siqueira SWA, Fialho IR, Jaime M, Pautasso FF, Caregnato RCA. Atuação do enfermeiro navegador em diferentes áreas da saúde: revisão integrativa. Brazilian Journal of Health Review. 2022; 5(5):20755-70.
13. Araújo JS, Abreu WO, Santos DA, Santos AG, Paizão WHP, Silva JLL. Navegação em oncologia: atuação do enfermeiro navegador na assistência ao paciente com câncer. Revista Pró-UniverSUS. 2024; 15(1):39-47.
14. Souza I, Fernandes W, Vieir S. Atuação e competências do enfermeiro navegador: revisão integrativa. Revista Científica E-Locucao. 2021; 1(20):25.
15. Pautasso FF, Lobo TC, Flores CD, Caregnato RCA. Nurse Navigator: development of a program for Brazil. Revista Latino-Americana de Enfermagem. 2020; 28:e3275.
16. Roque AC, Gonçalves IR, Popim CR. Benefícios do programa de navegação de pacientes e assistência de enfermagem em oncologia: revisão integrativa. Nursing. 2022; 25(285):7235-50.
17. Walker L, Avant KC. Strategies for theory construction in nursing. Boston: Pearson, Prentice Hall; 2019.
18. Peters MDJ, Godfrey C, McInerney P, Khalil H, Larsen P, Marnie C, et al. Best practice guidance and reporting items for the development of scoping review protocols. JBI Evidence Synthesis. 2022 ;20(4):953-68.
19. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372(71):1-9.
20. Araújo DAS, Moreira MMC, Martins QCS. Enfermeiro Navegador: uma análise de conceito segundo modelo de Walker e Avant [Internet]. 2024 [cited 2025 feb 12]. Available from: https://osf.io/6ab7k.
21. Aromataris E, Munn Z. JBI Manual for Evidence Synthesis. JBI; 2020. doi: https://doi.org/10.46658/JBIMES-20-01.
22. Sullivan KA, Schultz K, Ramaiya M, Berger M, Parnell H, Quinlivan EB. Experiences of women of color with a nurse patient navigation program for linkage and engagement in HIV care. AIDS Patient Care STDs. 2015; 29:S49–54.
23. Thygesen MK, Pedersen BD, Kragstrup J, Wagner L, Mogensen O. Gynecological cancer patients' differentiated use of help from a nurse navigator: a qualitative study. BMC Health Services Research. 2012; 21;12:168.
24. Horner K, Ludman EJ, McCorkle R, Canfield E, Flaherty L, Min J, et al. An oncology nurse navigator program designed to eliminate gaps in early cancer care. Clinical Journal of Oncology Nursing. 2013; 17(1):43–8.
25. Newton JC, O'Connor M, Saunders C, Ali S, Nowak AK, Halkett GKB. "Who can I ring? Where can I go?" Living with advanced cancer whilst navigating the health system: a qualitative study. Support Care Cancer. 2022; 30(8):6817–26.
26. Soin A, Barrall D, Chen J, Patel A, Pollack A, Wangombe A. An observational study on the use of a patient navigator to help improve outcomes in patients on chronic opioids. Pain Physician. 2022; 25(5):381–6.
27. Manderson B, McMurray J, Piraino E, Stolee P. Navigation roles support chronically ill older adults through healthcare transitions: a systematic review of the literature. Health and Social Care Community. 2012; 20(2):113–27.
28. McBrien KA, Ivers N, Barnieh L, Bailey JJ, Lorenzetti DL, Nicholas D, et al. Patient navigators for people with chronic disease: a systematic review. PLoS One. 2018; 13(2):e0191980.
29. Chan RJ, Milch VE, Crawford-Williams F, Agbejule OA, Joseph R, Johal J, et al. Patient navigation across the cancer care continuum: an overview of systematic reviews and emerging literature. CA: A Cancer Journal for Clinicians. 2023; 73(6):565–89.
30. Katerenchuk J, Salas AS. An integrative review on the oncology nurse navigator role in the Canadian context. Canadian Oncology Nursing Journal. 2023; 33(4):385–99.
31. Baileys K, McMullen L, Lubejko B, Christensen D, Haylock PJ, Rose T, et al. Nurse navigator core competencies: an update to reflect the evolution of the role. Clinical Journal of Oncology Nursing. 2018; 22(3):272–81.
32. Gordils-Perez J, Schneider SM, Gabel M, Trotter KJ. Oncology nurse navigation: development and implementation of a program at a comprehensive cancer center. Clinical Journal of Oncology Nursing. 2017; 21(5):581–8.
33. Lubejko BG, Cantril C, Hogg LH, Kennedy Sheldon L. Novice Oncology Nurse Navigator: Core Elements in Establishing Training Needs and Building on Competencies. Clinical Journal of Oncology Nursing. 2019; 23(4):387-94.
34. Lim HN, Lee JH, Lee T, Choi MN, Kim S, Lee JH, et al. Development of Nurse-led Navigation Program for Gastric Cancer Patients with Gastrectomy: Exploring the Effectiveness. Medico-legal Update. 2021; 21(3):360-71.
35. Pautasso FF, Zelmanowicz AM, Flores CD, Caregnato RCA. Atuação do Nurse Navigator: revisão integrativa. Revista Gaúcha de Enfermagem. 2018; 39:e2017-0102.
36. Guha C, Khalid R, Zwieten AV, Francis A, Hawley CM, Jauré A, et al. Baseline characteristics of participants in the NAVKIDS2 trial: a patient navigator program in children with chronic kidney disease. Pediatric Nephrology. 2023; 38(5):1577–90.
37. Duzova US, Can G. The effect of navigation programme on the management of symptoms related to head and neck radiotherapy. Transplant Immunology. 2021; 69:101488.
38. Lima MERF, Santos CTS, Santos ASL, Leite RR, Santos EC, Viturino MGSC, et al. Atuação do enfermeiro navegador no acolhimento ao paciente oncológico. RECIMA21 Revista Científica Multidisciplinar. 2021; 2(10):e210815.
39. Anjos TR. Enfermeiro navegador em oncologia: scoping review [monografia]. Fortaleza: Universidad Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem; 2023 [cited 2025 Apr 05]. 40 p. Available from: http://www.repositorio.ufc.br/handle/riufc/74054.
40. Lima FC, Sagica TP, Júnior AJSC, Santana ME. Navegación de pacientes por enfermeros en el contexto de las neoplasias de cabeza y cuello: una revisión integradora. Aquichan. 2025; 25(1):e2512.
41. Doerfler-Evans RE. Shifting paradigms continued—the emergence and the role of nurse navigator. Journal of Thoracic Disease. 2016; 8(Suppl 6):S498–500.
42. Shockney LD, Dean M, Allard BL. Chronic disease and complex care navigators: a scoping review [Internet]. Journal of Oncology Navigation & Survivorship. 2021; 12(7):206.
43. Pinheiro DO, Azevedo TMT, Silva ER. O enfermeiro navegador no contexto assistencial ao paciente oncológico - revisão integrativa de literatura. Revista Ibero-Americana De Humanidades, Ciências E Educação. 2023; 9(10):6759–74.
44. Borchartt DB, Sangoi KCM. The importance of the navigator nurse in cancer patient care: an integrative literature review. Research, Society and Development. 2022; 11(5):e25511528024.
45. Adler G, Kaufman G, Simon-Tuval T. Healthcare utilization of breast cancer patients following telephone-based consultations of oncology nurse navigator via telemedical care. PLoS One. 2019; 14(5):e0216365.
46. De La Cruz II, Freund KM, Battaglia TA, Chen CA, Bak S, Kalish R, Lottero B, Egan P, Heeren T, Kronman AC. Impact of depression on the intensity of patient navigation for women with abnormal cancer screenings. Journal of Health Care for the Poor and Underserved. 2014; 25(1):383-95.
47. Slind LM, Keating TM, Fisher AG, Rose TG. A patient navigation model for veterans traveling for cancer care. Federal Practitioner. 2016; 33(Suppl 1):40S-45S.
48. Collier S, Semeere A, Byakwaga H, Laker-Oketta M, Chemtai L, Wagner AD, et al. A type III effectiveness-implementation hybrid evaluation of a multicomponent patient navigation strategy for advanced-stage Kaposi's sarcoma: protocol. Implementation Science Communications. 2022; 3(1):50.
49. Bush ML, Kaufman MR, Shackleford T. Adherence in the cancer care setting: a systematic review of patient navigation to traverse barriers. Journal of Cancer Education. 2018; 33(6):1222-9.
50. Yatim F, Cristofalo P, Ferrua M, Girault A, Lacase M, Dipalma M, et al. Analysis of nurse navigators’ activities for hospital discharge coordination: a mixed method study for the case of cancer patients. Support Care Cancer. 2017; 25(5):1569-1576. doi: 10.1007/s00520-016-3474-x.
51. Gervès-Pinquié C, Daumas-Yatim F, Lalloué B, Girault A, Ferrua M, Fourcade A, et al. Impacts of a navigation program based on health information technology for patients receiving oral anticancer therapy: the CAPRI randomized controlled trial. BMC Health Services Research. 2017;1 7(1):133. doi: 10.1186/s12913-017-2066-x.
52. Budde H, Williams GA, Winkelmann J, Pfirter L, Maier CB. The role of patient navigators in ambulatory care: overview of systematic reviews. BMC Health Services Research. 2021;21(1):1166.
53. Heritage B, Harvey C, Brown J, Hegney D, Willis E, Baldwin A, et al. The use of telephone communication between nurse navigators and their patients. PLoS One. 2020; 15(1):e0227925.
54. Wong CL, Chan CWH, Zhang M, Cheung YT, Chow KM, Li CK, et al. Care coordination models for transition and long-term follow-up among childhood cancer survivors: a scoping review. BMJ Open. 2024; 14(8):e087343.
55. Howitt L, Jacob G, Zucal G, Smith J, Crocker Ellacott R, Sharkey S. Navigation Support during Transitions in Care for Persons with Complex Care Needs: A Systematic Review. Healthcare (Basel). 2024; 12(18):1814.
56. Jesus TS, Stern BZ, Lee D, Zhang M, Struhar J, Heinemann AW, et al. Systematic review of contemporary interventions for improving discharge support and transitions of care from the patient experience perspective. PLoS One. 2024; 19(5):e0299176.
57. Pratt-Chapman M, Simon MA, Patterson AK, Risendal BC, Patierno S. Survivorship navigation outcome measures: a report from the ACS patient navigation working group on survivorship navigation. Cancer. 2011; 117(15 Suppl):3575-84.
58. Lopez D, Pratt-Chapman ML, Rohan EA, Sheldon LK, Basen-Engquist K, Kline R, Shulman LN, Flores EJ. Establishing effective patient navigation programs in oncology. Support Care Cancer. 2019; 27(6):1985-96.
59. Pires JM, Rodrigues AB, Alencar MMSC, Barbosa RCM. Navegação de pacientes oncológicos por enfermeiros: revisão de escopo. Revista Rene. 2024; 25:e94027.
60. Kokorelias KM, Shiers-Hanley JE, Rios J, Knoepfli A, Hitzig SL. Factors influencing the implementation of patient navigation programs for adults with complex needs: a scoping review of the literature. Health Services Insights. 2021; 14:11786329211033267.
61. Tang KL, Ghali WA. Patient navigation—exploring the undefined. JAMA Health Forum. 2021; 2(11):e213706.
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