Short summary

Cancer patients face a host of challenges, including reduced self-efficacy of cancer and loneliness which are associated with lower levels of cognitive capacity and possible burn-out. Post treatment psychological problems are experienced by up to 60 % of cancer patients. In a randomized controlled trial we investigate whether nurse navigation, as a specifically defined concept of coherent help throughout the cancer trajectory will prove superior to the existing Danish department specific navigation practice with regard to primarily 1) self-evaluated self-efficacy for cancer.

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Rationale

In Denmark, more than 35,000 new cases of cancer are diagnosed each year, and GP's suspect cancer in many more cases. Cancer patients face a host of challenges, including reduced self-efficacy of cancer and loneliness, which are associated with lower levels of cognitive capacity and possible burn-out. Post treatment psychological problems are experienced by up to 60 % of cancer patients. They receive investigations and treatment from many different healthcare professionals and at many different places, and can lack information or even feel lost during transitions. A yet unpublished follow-up study has found that cancer patients' self-efficacy for cancer decreases as early as in the diagnosing phase. All of which add to a state of uncertainty.  Further, relatives of cancer patients can experience challenges like loneliness and fear, and they can be unsure about what to do to help. All such challenges call for a supportive intervention.

Patients desire a single or few persons to follow them through a cancer trajectory and we will test an upskilled coherent combined bio-psycho-social-practical navigation initiative in comparison with an existing department-specific navigation, where patients get a new navigator each time they change department.

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Description of the cohort

Sites and recruitment

The colorectal cancer examination and surgery departments in Nyborg, Svendborg, Odense and Slagelse as well as the oncologic departments in Odense and Næstved will participate.

• Inclusion criteria: Patients suspected for colon cancer after colposcopy at the hospitals Nyborg, Svendborg, Odense, and Slagelse and a minimum of 18 years of age.
• Exclusion criteria: Patients not able to speak or understands Danish or with dementia or untreated severe psychological disease.

Data and biological material

Questionnaire data:

1. self-evaluated self-efficacy for cancer
2. continuity of care
3. fulfilled needs
4. health-related quality of life

.. and sociodemographics.

Collaborating researchers and departments

Department of Surgery, Odense University Hospital

Clinical Institute, Faculty of Health Sciences, University of Southern Denmark

• Clinical researcher and Assistent professor Marianne K. Thygesen

The Nursing Faculty, Laval University and Psycho-Oncology Service, CHU de Quebec, Canada

• Professor and Clinical phychologist Lise Fillion

The Research Unit for General Practice, University of Southern Denmark

• Associate professor and Statistician René DePont Christensen
• Leading Professor and General practitioner Jens Soendergaard

Department of Oncology, Odense University Hospital

• Postdoc Karin Diepering

Department of Surgery, Slagelse Hospital

• Head surgeon Sharaf Karim Perdawood

The Surgical Research Unit at Clinical Institute, University of Southern Denmark

Clinical Institute, Faculty of Health Sciences, University of Southern Denmark

• Leading Surgeon and Leading Professor Niels Qvist