Effects of a Navigation Program for Patients with Newly Diagnosed Gastric Cancer: A Randomized Controlled Trial

Yeon Seo Hong; Jeong Yun Park; So Hee Kim; Sun A Kim; Yeon Hee Kim

doi:10.5388/aon.2016.16.3.132

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Hong, Park, Kim, Kim, and Kim: Effects of a Navigation Program for Patients with Newly Diagnosed Gastric Cancer: A Randomized Controlled Trial

Original Article

Asian Oncology Nursing 2016; 16(3): 132-138.

Published online: 30 September 2016

DOI: https://doi.org/10.5388/aon.2016.16.3.132

Effects of a Navigation Program for Patients with Newly Diagnosed Gastric Cancer: A Randomized Controlled Trial

Yeon Seo Hong¹, Jeong Yun Park², So Hee Kim¹, Sun A Kim¹, Yeon Hee Kim¹

¹Department of Nursing, Asan Medical Center, Seoul, Korea.

²Department of Clinical Nursing, University of Ulsan, Seoul, Korea.

Address reprint requests to: Park, Jeong Yun. Department of Clinical Nursing, University of Ulsan 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. Tel: +82-2-3010-5333, Fax: +82-2-3010-5332, pjyun@ulsan.ac.kr

Received 4 August 2016 Revised 28 September 2016 Accepted 28 September 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was to identify how a navigation program would affect resilience, uncertainty and anxiety in patients with newly diagnosed gastric cancer.

Methods

A randomized controlled design was used with 103 participants recruited and randomly allocated in two groups. The experimental group (n=50) received the navigation program, which consisted of information provisions and psychological support, prior to treatment. The control group (n=53) received standard care with general educational intervention only prior to treatment. Collected data were analyzed using SPSS for Windows.

Results

Compared with the control group, patients in the navigation program group showed signicant reduction in scores for anxiety (F=5.86, p<.017). However uncertainty (F=0.22, p=.642) and resilience (F=1.06, p=.503) were not signicantly different.

Conclusion

These results suggest that the navigation program has positive effects on anxiety in patients with newly diagnosed gastric cancer. We suggest that further studies be conducted to investigate other strategies for increasing the resilience and reducing the uncertainty of these patients.

Keywords: Stomach Neoplasms, Navigation Program, Anxiety, Uncertainty, Resilience

Figures and Tables

Fig. 1

Study Design.

Table 1

Navigation Program for Patients with Newly Diagnosed Gastric Cancer

Session	Time (min)	Method	Activity
Session 1 (1st visit)	30	Face to face	Introduction
			Introduction to navigation program
			Encourage participation
			Giving pamphlet & personal counseling
			Closing
Session 2 (2nd week)	30	Face to face/telephone	Overview of treatment using CD & pamphlet
			Providing information about complication of operation and diet
			Strengthen of self-efficacy promotion through counseling
			Closing
Session 3 (3rd week)	30	Face to face	Stress management
			Q&A
			Closing

CD= Compact disc; Q&A= Questions and answers.

Table 2

Homogeneity Test of Characteristics between Groups (N=103)

Characteristics	Categories	Exp. (n=50)	Cont. (n=53)	χ² or t	p
Characteristics	Categories	n (%) or M ± SD	n (%) or M ± SD	χ² or t	p
Age (year)	<40	5 (10.0)	5 (9.4)	1.08	.897
	40~49	6 (12.0)	9 (17.0)
	50~59	23 (46.0)	20 (37.8)
	60~69	11 (22.0)	14 (26.4)
	≥70	5 (10.0)	5 (9.4)
		55.1 ± 10.8	55.3 ± 11.1	-0.10	.919
Gender	Male	37 (74.0)	38 (71.7)	0.07	.793
Gender	Female	13 (26.0)	15 (28.3)	0.07	.793
Marital status	Single	3 (6.0)	1 (1.9)	1.17	.280
Marital status	Married	47 (94.0)	52 (98.1)	1.17	.280
Family member	Yes	46 (92.0)	49 (92.5)	0.01	.932
Family member	No	4 (8.0)	4 (7.5)	0.01	.932
Education level	≤Middle school	14 (28.0)	15 (28.3)	0.85	.655
	High school	17 (34.0)	22 (41.5)
	≥College	19 (38.0)	16 (30.2)
Religion	Yes	19 (38.0)	33 (62.3)	6.06	0.014
Religion	No	31 (62.0)	20 (37.7)	6.06	0.014
Employment	Employed	39 (76.0)	40 (75.5)	0.00	.950
Employment	Unemployed	12 (24.0)	13 (24.5)	0.00	.950
Monthly income (10,000 won)	<100	10 (20.0)	6 (11.3)	1.71	.636
	100~300	19 (38.0)	22 (41.5)
	301~500	12 (24.0)	16 (30.2)
	>500	9 (18.0)	9 (17.0)
Caregiver	Spouse	35 (70.0)	37 (69.8)	1.78	.411
	Offspring	11 (22.0)	8 (15.1)
	Others	4 (8.0)	8 (15.1)
Diagnosis	EGC	43 (86.0)	42 (79.2)	0.81	.367
Diagnosis	AGC	7 (14.0)	11 (20.8)	0.81	.367
Treatment	OP	30 (60.0)	32 (60.4)	0.00	.969
Treatment	ESD	20 (40.0)	21 (39.6)	0.00	.969
Waiting days		21.66 ± 12.47	25.74 ± 16.56	-1.42	.160

Exp.= Experimental group; Cont.= Control group; EGC= Early gastric cancer; AGC= Advanced gastric cancer; OP= Operation; ESD= Endoscopic submucosal dissection; Waiting days= from first cancer center visit day to first treatment day.

Table 3

Homogeneity Test of Dependent Variables between Groups at the Baseline (N=103)

Variables	Range of scale	Exp. (n=50)	Cont. (n=53)	t	p
Variables	Range of scale	M±SD	M±SD	t	p
Anxiety	20~80	50.50±7.69	45.30±13.21	2.46	.016
Uncertainty	32~160	84.68±11.42	83.23±14.38	0.57	.573
Resilience	0~100	72.64±13.68	74.15±14.55	-0.54	.589

Exp.= Experimental Group; Cont.= Control group.

Table 4

Effects of a Navigation Program on Resilience, Uncertainty, Anxiety (N=103)

Variables	Categories	Exp. (n=50)	Cont. (n=53)	Source	F^*	p
Variables	Categories	M±SD	M±SD	Source	F^*	p
Anxiety	Pretest	50.50±7.69	45.30±13.21	G	2.47	.119
	Posttest	43.34±10.58	42.72±9.80	T	26.60	<.001
				G*T	5.86	.017
Uncertainty	Pretest	84.68±11.42	83.23±14.38	G	1.50	.223
	Posttest	76.80±13.63	77.60±14.68	T	0.30	.586
				G*T	0.22	.642
Resilience	Pretest	72.64±13.68	74.15±14.55	G	0.30	.308
	Posttest	74.18±9.80	73.38±12.11	T	0.12	.191
				G*T	1.06	.503

^*ANCOVA: Pre-anxiety level as covariate; Exp.= Experimental group; Cont.= Control group; G= Group; T= Time; G^*T= Group^*Time.

Notes

This article is a revision of the first author's master's thesis from Ulsan University.

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