On twitter I learned of an EU project @CANCERLESS_EU and an initial paper:
Phrases like 'navigation', 'architecture', 'maps' are a trigger so after some tweets, I was kindly directed to the above paper.
Here, I'm mapping patient navigation and related concepts I have added, to Hodges' model.
"Patient navigation is a community-based and person-centered
intervention, whereby a named worker – the navigator – supports and
guides individuals to overcome the barriers they face in accessing
healthcare services and works to facilitate timely and appropriate
access to care for the individual as well as their relatives, and
caregivers, when needed (Freeman, 2012; Wang et al., 2015)."
INDIVIDUAL |
INTERPERSONAL : SCIENCES
HUMANISTIC -------------------------------------- MECHANISTIC
SOCIOLOGY : POLITICAL
|
GROUP
psycho-
depression, anxiety, distress, trauma (psyche) serious mental health substance misuse dual diagnosis
vulnerability isolated
difficult to engage, missing appointments, no designated point of access - Address
Personally reliant on welfare/benefits for finance - phone contact sporadic.
providing emotional support, phone, transport Hit by energy costs/rent (pre-payment) if finding a place. hopelessness, lack of trust - let down many times? Stigmatized attitudes towards treatment? tailored health education
asocial (due to lived experience, trauma..?)
| -geography
low-income areas, or areas with a high proportion of ethnic minorities or migrants USA - other nations - terminology?
method: scoping review, literature search, inc. exc criteria interventions tailored to age and gender
respiratory conditions, trauma (physical) excess winter mortality
"homeless population having an average age at death of just 47, 30 years lower than that for the general population"
exposure to activities known to increase risk of cancer HIV patients data - inc. no-show rates in-person / phone
Timeliness of screening, intervention
|
Navigators - lay persons, or clinical professionals
Lived experience, "near peer" family
Training for Navigators organizing and attending appointments and facilitating self-care/self-management
clinical and community settings, parks, pavements, and homeless encampments, home visits, walking and
support groups
*risk of stigmatization
and experienced discrimination
navigation less successful with certain groups?
|
Underserved, marginalized people Homelessness High-risk of poor health-related outcomes reported barriers
access to appropriate healthcare for this population are also often
compounded by lack of insurance, legal problems*...
...the PN model has been associated with a reduction in hospital costs, and even in some cases, increased revenue
histories of offending and/or care women in rural areas non-specific vulnerable populations
reduce incarceration, vocational and volunteering activities, access to housing
|