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William J. Gradishar, MD, FACP, FASCO


Can Nurse-Led Treatment Navigation Reduce Psychological Distress in Patients With Breast Cancer?

By: Chris Schimpf, BS
Posted: Tuesday, August 1, 2023

A Danish study conducted by Pernille Envold Bidstrup, MA, PhD, of the Psychological Aspects of Cancer Group, Danish Cancer Society Research Center, Copenhagen, and colleagues, examined the effects of a nurse-led treatment navigation program on symptoms of psychological distress in patients with breast cancer. Although their findings, published in JAMA Network Open, did not indicate significant reductions in psychological distress, they suggested improvements in other psychological symptoms and supported additional research to refine the nurse navigation framework and further explore its clinical potential.

The team developed a two-component manualized intervention. It consisted of systematic screening for patient-reported psychological and physical symptoms and personalized nurse navigation of care and resources to collaboratively address patients’ needs. Patients were screened at 6, 12, and 18 weeks after baseline, and nurse navigation occurred over the course of approximately six individual sessions within the first 8 months.

“To our knowledge, this is the first trial to show the feasibility (through a simple triage approach) of systematically selecting patients with breast cancer who had psychological symptoms of distress and to offer them more comprehensive supportive care, with the nurse navigator actively supporting the patient in accessing health care services that are available within the health-care system,” the researchers noted.

A total of 309 adult female patients were included in the study, of whom 156 were randomly assigned to the intervention group and 153 of whom received standard care. Patients who received the intervention demonstrated reduced (although not significant) psychological distress versus those who received standard care, especially at the 12-month follow-up. The researchers also observed significant effects on symptoms of depression at 6 months and health-related quality of life at 12 months. And although the effect sizes were small, the investigators noted that effects were especially pronounced in subgroups with social vulnerabilities and that patient satisfaction was high.

Disclosure: Dr. Bidstrup reported no conflicts of interest. For full disclosures of the other study authors, visit

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