- •Standardised symptom self-management support is insufficiently implemented.
- •The Symptom Navi© Programme showed excellent face validity, clarity and utility.
- •Nurse training facilitated the implementation of the program into daily routines.
- •Nurses' workload might be a barrier for applying the program in daily routines.
The Symptom Navi© Programme (SN©P) is a structured nurse-led intervention supporting symptom self-management in cancer patients. We describe the development and evaluation of the intervention, implementation strategy, and the evaluation of nurse training for the Symptom Navi© Pilot Study.
The intervention was developed using multiple methods (e.g. literature synthesis, focus groups) to produce SN©P information leaflets (SN©Flyers in French and German) and standardised training for nurses to deliver semi-structured consultations. We evaluated the SN©P using online surveys, focus groups, interviews, and the Item-Content Validity Index (I-CVI). Nurse training was evaluated in relation to content, acceptability, and confidence in implementing the SN©P. We examined the association between scored on the Work-related Sense of Coherence (Work-SoC) scale and nurses’ confidence in implementing the SN©P. Thematic analysis was used to analyse qualitative data. Quantitative data was descriptively analysed and the Kendall Tau test was employed for correlations.
Patients and health care professionals confirmed that SN©Flyers and semi-structured consultations facilitated symptom self-management. Nurses considered training content/format acceptable and appropriate and felt confident in implementing the SN©P. Overall Work-SoC scores were correlated with nurses’ confidence in implementing the SN©P (rπ = .47, p = .04).
Health care professionals and cancer patients perceived the SN©P as a useful support. Successful implementation of the SN©P depends on centre-specific factors including time, resources and workflow.
Clinical trial registry
NCT03649984 and SNCTP000002381.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Oncology Nursing
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Development and testing of the patient-reported chemotherapy indicators of symptoms and experience: patient-reported outcome and process indicators sensitive to the quality of nursing care in ambulatory chemotherapy settings.Cancer Nurs. 2014; 37: E52-E60
- Implementation of the Symptom Navi (c) Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi(c) Pilot Study).BMJ Open. 2019; 9e027942
- Work-SoC-Development and validation of a scale measuring work-related sense of coherence.Z. für Gesundheitspsychol. 2015; 23: 20-30
- Patient self-management of chronic disease in primary care.J. Am. Med. Assoc. 2002; 288: 2469-2475
- Using thematic analysis in psychology.Qual. Res. Psychol. 2006; 3: 77-101
- Framework for evaluating the impact of advanced practice nursing roles.J. Nurs. Scholarsh. 2016; 48: 201-209
- A scoping review of trials of interventions led or delivered by cancer nurses.Int. J. Nurs. Stud. 2018; 86: 36-43
- Self-management for men surviving prostate cancer: a review of behavioural and psychosocial interventions to understand what strategies can work, for whom and in what circumstances.Psycho Oncol. 2010; 19: 909-922
- Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer.Eur. J. Cancer Care. 2016; 25: 79-92
- Use of a symptom diary during chemotherapy: a mixed-methods evaluation of the patient perspective.Eur. J. Oncol. Nurs. 2017; 31: 37-45
- A nursing intervention for reducing symptom burden during chemotherapy.Oncol. Nurs. Forum. 2018; 45: 115-128
- Developing and evaluating complex interventions: the new Medical Research Council guidance.BMJ. 2008; 337: a1655
- Evidence: Helping People Help Themselves.Health Foundation, 2011
- Resilience and unmet supportive care needs in patients with cancer during early treatment: a descriptive study.Eur. J. Oncol. Nurs. 2015; 19: 582-588
- The EONS Cancer Nursing Education Framework.European Oncology Nursing Society, 2018 (online)
- The Institute of Medicine report on high-quality cancer care: implications for oncology nursing.Oncol. Nurs. Forum. 2013; 40: 603-609
- Supportive care framework.Can. Oncol. Nurs. J. 2008; 18: 6-24
- Oncology nurse generalist competencies: oncology nursing society's initiative to establish best practice.Clin. J. Oncol. Nurs. 2017; 21: 679-687
- Assessing quality of life on the day of chemotherapy administration underestimates patients' true symptom burden.BMC Canc. 2014; 14: 758
- Outcomes sensitive to nursing service quality in ambulatory cancer chemotherapy: systematic scoping review.Eur. J. Oncol. Nurs. 2012; 16: 238-246
- Self-management for adult patients with cancer an integrative review: an integrative review.Cancer Nurs. 2015; 38: E10-E26
- Kooperatives Lernen im Hochschulbereich.in: Bachmann H. Hochschullehre variantenreich gestalten, Kompetenzorientierte Hochschullehre - Ansätze, Methoden und Beispiele. hep verlag ag, Bern2013
- Enhancing self-efficacy for optimized patient outcomes through the theory of symptom self-management.Cancer Nurs. 2013; 36: E16-E26
- Self-management education interventions for patients with cancer: a systematic review.Support. Care Cancer. 2017; 25: 1323-1355
- Putting evidence into practice, A pocket guide to cancer symptom management.Oncol. Nurs. Soc. 2014; (ASIN: B00O18L286)
- Flyer Symptom Navi zur Unterstützung des Selbstmanagements von Symptomen bei Krebs: evaluation von Anwendbarkeit und Verständlichkeit.Pflege. 2017; 30: 151-160
- Symptom Navi program - entwicklung 2011 - 2015.Onkologische Pflege. 2017; 7: 21-27
- Evidence-based self-care guidelines for people receiving chemotherapy: do they reduce symptom burden and psychological distress?.Cancer Nurs. 2015; 38: E1-E8
- Self-management education: history, definition, outcomes, and mechanisms.Ann. Behav. Med. 2003; 26: 1-7
- Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care.J. Pain Symptom Manag. 2013; 46: 229-253
- Self-management: enabling and empowering patients living with cancer as a chronic illness.CA A Cancer J. Clin. 2011; 61: 50-62
- The Behaviour Change Wheel, A Guide to Designing Interventions.Silverback Publishing, Great Britain2014
- Specifying and reporting complex behaviour change interventions: the need for a scientific method.Implement. Sci. 2009; 4: 40
- The behaviour change wheel: a new method for characterising and designing behaviour change interventions.Implement. Sci. 2011; 6: 42
- CE: defining and understanding pilot and other feasibility studies.Am. J. Nurs. 2017; 117: 38-45
- The content validity index: are you sure you know what's being reported? Critique and recommendations.Res. Nurs. Health. 2006; 29: 489-497
- Recommended patient-reported core set of symptoms to measure in adult cancer treatment trials.J. Natl. Cancer Inst. 2014; 106
- Motivational Interviewing in Health Care, Helping Patients Change Behavior.The Guilford Press, New York2008
- Effective, clinically feasible and sustainable: key design features of psycho-educational and supportive care interventions to promote individualised self-management in cancer care.Acta Oncol. 2015; : 805-812
- Unmet supportive care needs of lung cancer patients during the chemotherapy phase: a descriptive study.Schweizer Krebsbulletin. 2012; : 118-122
- Organizational readiness for implementing change in acute care hospitals: an analysis of a cross-sectional, multicentre study.J. Adv. Nurs. 2018; 74: 2798-2808https://doi.org/10.1111/jan.13801
- Comprehensibility, Manageability and Meaningfulness at Work: Construct Validity of a Scale Measuring Work-Related Sense of Coherence.2013
- Treatment-related problems experienced by cancer patients undergoing chemotherapy: a scoping review.Eur. J. Cancer Care. 2015; 24: 605-617
- Supporting prostate cancer survivors in primary care: findings from a pilot trial of a nurse-led psycho-educational intervention (PROSPECTIV).Eur. J. Oncol. Nurs. 2018; 32: 73-81
Published online: January 15, 2020
Accepted: December 19, 2019
Received in revised form: December 11, 2019
Received: May 29, 2019
© 2019 Elsevier Ltd. All rights reserved.