Nurse Navigation Versus Current Care Coordination During Colorectal Cancer Trajectories (NaviCan)
Primary Purpose
Self Efficacy, Continuity of Care, Quality of Life
Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Nurse navigation
Current care coordination
Sponsored by
About this trial
This is an interventional supportive care trial for Self Efficacy focused on measuring Nurse navigation, Family, Self Efficacy, Needs assessment, Quality of Life, Colorectal Neoplasms, Case Management
Eligibility Criteria
Inclusion Criteria:
- Lesions suspected for cancer in the colon or rectum recognized through colonoscopy or sigmoidoscopy found at scopy centres in Odense, Nyborg, Svendborg or Slagelse, all in Denmark
- Can speak and understand Danish.
Exclusion Criteria:
- Life-threatening disease: score 4 in the American Society of Anaesthesiologists status classification system.
- Dementia ( Diagnosed or in a diagnostic phase).
- Severe psychiatric disease ( Diagnosed or in a diagnostic phase).
- Mentally retarded ( Diagnosed or in a diagnostic phase).
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Nurse navigation
Current care coordination
Arm Description
Coherent navigation and support from a family-centred viewpoint throughout the cancer trajectory, despite the individual patient's affiliation to any department.
Department-specific coordination and answers to questions from a patient-centred viewpoint.
Outcomes
Primary Outcome Measures
Self evaluated Self Efficacy for Cancer
Cancer Behaviour Inventory - Brief
Secondary Outcome Measures
Self evaluated Self Efficacy for Cancer
Cancer Behaviour Inventory - Brief
Self evaluated Self Efficacy for Cancer
Cancer Behaviour Inventory - Brief
Self evaluated Self Efficacy for Cancer
Cancer Behaviour Inventory - Brief
Self evaluated Self Efficacy for Cancer
Cancer Behaviour Inventory - Brief
Self evaluated Self Efficacy for Cancer
Cancer Behaviour Inventory - Brief
Continuity of care
Qualitatively validated questions answered by participants
Continuity of care
Qualitatively validated questions answered by participants
Continuity of care
Qualitatively validated questions answered by participants
Continuity of care
Qualitatively validated questions answered by participants
Continuity of care
Qualitatively validated questions answered by participants
Continuity of care
Qualitatively validated questions
Unmet needs
Patients experienced needs and degree of fulfilled support
Unmet needs
Patients experienced needs and degree of fulfilled support
Unmet needs
Patients experienced needs and degree of fulfilled support
Health-related Quality of Life
European Organisation for Research and Treatment of Cancer Quality of life questionnaire with 30 questions (EORCT QLQ-c30).
Full Information
NCT ID
NCT03281447
First Posted
September 11, 2017
Last Updated
April 2, 2019
Sponsor
Odense University Hospital
Collaborators
University of Southern Denmark, Laval University, Slagelse Hospital, Region of Southern Denmark, Region Zealand, Danish Cancer Society, Odense Patient Data Explorative Network
1. Study Identification
Unique Protocol Identification Number
NCT03281447
Brief Title
Nurse Navigation Versus Current Care Coordination During Colorectal Cancer Trajectories
Acronym
NaviCan
Official Title
NaviCan. Navigation and Support to Cancer Patients - A Randomized Controlled Trial.
Study Type
Interventional
2. Study Status
Record Verification Date
April 2019
Overall Recruitment Status
Completed
Study Start Date
February 26, 2016 (Actual)
Primary Completion Date
October 23, 2017 (Actual)
Study Completion Date
December 31, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Odense University Hospital
Collaborators
University of Southern Denmark, Laval University, Slagelse Hospital, Region of Southern Denmark, Region Zealand, Danish Cancer Society, Odense Patient Data Explorative Network
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
In western countries, the number of cancer survivors increases, and current cancer care seems insufficient with both patients' experiences of lack of help in transitions and up to 60 % of the patients having psychological problems after treatment. Further, Denmark shall have new hospitals, where researchers and healthcare professionals are expected to merge tasks and reach a higher patient experienced quality of care, without additional costs, so a better way to provide cancer care, which benefits the patients and supports the ideas within the new hospitals in Denmark, is needed.
In a randomized controlled trial, the organizational structure of the healthcare system is challenged and the impact of a coherent nurse navigation practice compared to the currently existing department-specific care coordination is tested. The primary data are changes in patients' self-reported cancer-related self-efficacy from inclusion till one week after receipt of the information that they have reached the end of treatment, or in case of prolonged treatment, till not later than one year after inclusion.
Patients can participate if they are 18 years of age or older, speak and understand Danish, and have a proven lesion suspected of cancer in the colon or rectum after colonoscopy or sigmoidoscopy at the Danish endoscopy centers at Odense University Hospital (the cities: Nyborg, Svendborg and Odense) or at Slagelse Hospital. Furthermore, participants must not be mentally retarded, they must not suffer from a constant life-threatening disease, and they must not suffer from, or be in the diagnostic phase of, dementia or severe psychiatric disease.
Participants are allocated to support from nurse navigation or to current care coordination, and fill in four questionnaires during their cancer trajectory: 1) At inclusion, 2) Three days before treatment start, 3) One week after receipt of information about treatment end or not later than one year after inclusion, and 4) Six weeks after measure point 3. Data is analyzed using suitable statistical models.
With positive results, participants in nurse navigation are better helped during their cancer trajectory and have a better psychological start on the rest of their lives after cancer treatment. Focus will be on colon and rectum cancer care, but the results will be transferable to similar settings. Furthermore, positive results will support changes in the onset of rehabilitation initiatives.
Detailed Description
The primary hypothesis in this study is:
Nurse navigation, as a specific, defined concept of coherent help through cancer trajectories, will prove superior to current care coordination with regard to patients' self-evaluated self-efficacy for cancer from inclusion to one week after receipt of information about treatment end or not later than one year after inclusion.
Allocation The randomization will be stratified by age and gender. The rational is that age and gender is differently associated with benefit by a given care.
Data collection Participants fill in questionnaires at four measurements, and supplements to sociodemographic information as well as information for an economic evaluation is collected from provider side.
The questionnaires for participants are available in paper and electronically, and participants are allowed to discuss the individual questions with a person whom they trust before filling in their answers. If a participant is blind or dyslexic and has no one to help them fill in the questionnaires, a trained study nurse will read out loud the questions and fill in the participant's answers, and eventually in this process, listen to the participant's pros and cons, acknowledge that they are heard, ask for an answer and read out loud the question again. All data are stored in Research Electronic Data Capture (RedCap).
Blinding The trial is not blinded but all participants are told, there is no favorite group. The statistician is blinded to randomization group and this blinding will be unveiled after the data is analyzed.
Statistics Data are analyzed following the modified intention-to-treat principle, which is carried out by a senior statistician in close collaboration with the research group. Usual descriptive statistics will be used to summarize baseline and subject characteristics. The analyses of the primary endpoint, i.e. change in self-evaluated self-efficacy for cancer from inclusion (measurement 1) to end of treatment (measurement 3), and the secondary outcomes are done using analysis of covariance of the measure at measurement 3 with randomization group as a factor and measure at measurement 1 as covariate. In secondary analyses for all endpoints (measurement 1-4), the change over time will be investigated by mixed effects repeated measures analysis with randomization group as factor and random effects for subjects. These analyses are repeated within the subgroup of all cancer patients and the subgroup of cancer patients treated with curative aim. In the subgroup analyses, the influence of relevant subject-level confounders such as age, disease-stage, treatment, etc. will be explored, and appropriate adjustment will be performed. An economic evaluation will be performed for each randomized group and compared.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Self Efficacy, Continuity of Care, Quality of Life, Colorectal Neoplasms, Case Management
Keywords
Nurse navigation, Family, Self Efficacy, Needs assessment, Quality of Life, Colorectal Neoplasms, Case Management
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
280 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Nurse navigation
Arm Type
Experimental
Arm Description
Coherent navigation and support from a family-centred viewpoint throughout the cancer trajectory, despite the individual patient's affiliation to any department.
Arm Title
Current care coordination
Arm Type
Active Comparator
Arm Description
Department-specific coordination and answers to questions from a patient-centred viewpoint.
Intervention Type
Other
Intervention Name(s)
Nurse navigation
Intervention Type
Other
Intervention Name(s)
Current care coordination
Primary Outcome Measure Information:
Title
Self evaluated Self Efficacy for Cancer
Description
Cancer Behaviour Inventory - Brief
Time Frame
Change in "Cancer Behaviour Inventory - Brief" from inclusion to measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion.
Secondary Outcome Measure Information:
Title
Self evaluated Self Efficacy for Cancer
Description
Cancer Behaviour Inventory - Brief
Time Frame
Change in "Cancer Behaviour Inventory - Brief" from inclusion to three days before treatment start.
Title
Self evaluated Self Efficacy for Cancer
Description
Cancer Behaviour Inventory - Brief
Time Frame
Change in "Cancer Behaviour Inventory - Brief" from inclusion to six weeks after measurement 3.
Title
Self evaluated Self Efficacy for Cancer
Description
Cancer Behaviour Inventory - Brief
Time Frame
Change in "Cancer Behaviour Inventory - Brief" from three days before treatment start to measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion.
Title
Self evaluated Self Efficacy for Cancer
Description
Cancer Behaviour Inventory - Brief
Time Frame
Change in "Cancer Behaviour Inventory - Brief" from three days before treatment start to six weeks after measurement 3.
Title
Self evaluated Self Efficacy for Cancer
Description
Cancer Behaviour Inventory - Brief
Time Frame
Change in "Cancer Behaviour Inventory - Brief" from one week after measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion to six weeks after measure point 3.
Title
Continuity of care
Description
Qualitatively validated questions answered by participants
Time Frame
Change in "Continuity of care" from inclusion to measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion.
Title
Continuity of care
Description
Qualitatively validated questions answered by participants
Time Frame
Change in "Continuity of care" from inclusion to three days before treatment start.
Title
Continuity of care
Description
Qualitatively validated questions answered by participants
Time Frame
Change in "Continuity of care" from inclusion to six weeks after measurement 3.
Title
Continuity of care
Description
Qualitatively validated questions answered by participants
Time Frame
Change in "Continuity of care" from three days before treatment start to measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion.
Title
Continuity of care
Description
Qualitatively validated questions answered by participants
Time Frame
Change in "Continuity of care" from three days before treatment start to six weeks after measurement 3.
Title
Continuity of care
Description
Qualitatively validated questions
Time Frame
Change in "Continuity of care" from one week after measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion to six weeks after measure point 3.
Title
Unmet needs
Description
Patients experienced needs and degree of fulfilled support
Time Frame
Change in "Unmet needs" from three days before treatment start to measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion.
Title
Unmet needs
Description
Patients experienced needs and degree of fulfilled support
Time Frame
Change in "Unmet needs" from three days before treatment start to six weeks after measurement 3.
Title
Unmet needs
Description
Patients experienced needs and degree of fulfilled support
Time Frame
Change in "Cancer Behaviour Inventory - Brief" from one week after measurement 3: one week after receipt of information about treatment end or not later than one year after inclusion to six weeks after measure point 3.
Title
Health-related Quality of Life
Description
European Organisation for Research and Treatment of Cancer Quality of life questionnaire with 30 questions (EORCT QLQ-c30).
Time Frame
Change in "Health-related Quality of Life" from three days before treatment start to six weeks after measurement 3.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Lesions suspected for cancer in the colon or rectum recognized through colonoscopy or sigmoidoscopy found at scopy centres in Odense, Nyborg, Svendborg or Slagelse, all in Denmark
Can speak and understand Danish.
Exclusion Criteria:
Life-threatening disease: score 4 in the American Society of Anaesthesiologists status classification system.
Dementia ( Diagnosed or in a diagnostic phase).
Severe psychiatric disease ( Diagnosed or in a diagnostic phase).
Mentally retarded ( Diagnosed or in a diagnostic phase).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lise Fillion, PhD
Organizational Affiliation
Nursing Faculty, Laval University
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Jens Søndergaard, PhD
Organizational Affiliation
Research Unit of General Practice, Faculty of Health Sciences, University of Southern Denmark
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Marianne K Thygesen, PhD
Organizational Affiliation
Surgery department A, Clinical Institute, Faculty of Health Sciences, University of Southern Denmark and OPEN at Region of Southern Denmark
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Niels Qvist, DMSc
Organizational Affiliation
Surgery department A, Clinical Institute, Faculty of Health Sciences, University of Southern Denmark
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Nurse Navigation Versus Current Care Coordination During Colorectal Cancer Trajectories
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