Effect of patient navigation on stress and depression in women with a breast cancer screening abnormality.

摘要

Previous research exploring the psychological effects of abnormal screening tests for breast cancer in women has shown long-lasting distress, even after the abnormality is determined to be benign. Women in underserved, minority patients are likely to face more barriers when trying to obtain healthcare and may experience more distress when presented with an abnormal screening test. Limited research has examined the effectiveness of interventions at reducing distress after an abnormal screening test. Patient navigation (PN) is an intervention model designed to assist patients in underserved, minority populations in identifying and reducing barriers to healthcare.;The current study explored data from a cluster-randomized study evaluating the efficacy of PN in improving the quality and timeliness of cancer diagnostic care. Seventy women from underserved, minority populations were included for analysis. This study aimed to explore: 1) whether time to diagnosis was associated with stress and depression; 2) whether the number of barriers moderated this effect; 3) several moderated mediation models examining the relationship between the number of in-person encounters and its association with stress and depression; 4) whether this relationship was mediated by coping styles; and 5) whether these mediated relationships were moderated by the number or types of barriers.;Findings suggested that time to diagnosis alone was not associated with stress [F(1,66)=.06, p=.807] or depression [F(1,66)=.472, p=.495]; nor did the number of in-person encounters affect stress or depression (all p≥.05). Though none of the primary hypotheses were supported, results did suggest: a strong association of emotion-focused coping to both stress and depression (p<.001); and the presence of two crossover interactions suggesting moderating effects of problem-focused barriers and system-level barriers (p=.026). These findings suggest the importance of patient navigators to develop techniques for acknowledging and altering coping styles in their patients, with consideration of the barriers they experience. Limitations of the current study included the lack of control group, limited sample size, and the low presence of distress. Future research should continue to explore all the elements of PN and its effect on distress, while considering the contributing effects of specific barriers and barrier types.