A support nurse may strengthen the participation of patients with low socio-economic status in treatment pathways of head and neck cancer: A theory-based evaluation

AIM: To test and evaluate a support nurse intervention within the head and neck cancer (HNC) pathway.

BACKGROUND: Even though interventions aiming to support patients with a low socio-economic status have been a focus for development and implementation in several countries, research still shows that these patients often have unmet needs and encounter challenges in communicating with health professionals during their treatment pathways. Furthermore, support interventions are few in Denmark and none of the existing interventions target patients with HNC receiving radiation therapy of whom the majority have a low socio-economic status and therefore potentially carry a high risk of being challenged during their treatment pathways.

DESIGN: A theory-based evaluation was used as framework. A support nurse intervention was designed to offer patients with a low socio-economic status help and support in the initial part of the HNC pathway. Eleven patients were included in the trial period.

METHODS: The evaluation of the intervention was based on interviews, a questionnaire survey and field notes.

RESULTS: The expected outputs were achieved, thus: (1) the patients felt supported and assisted, (2) the support nurse was capable of supporting, helping and accompanying the patients, (3) the patients were informed as relevant and understood the information provided. Unexpected outputs were that the support nurse was capable of co-ordinating the pathway in line with the patient's needs and that she facilitated the interaction between patients and health professionals.

CONCLUSIONS: Support for patients with a low socio-economic status improves their ability to engage in their cancer treatment pathway. This, in turn, increases their preparedness for participation and, hence, strengthens their choice of treatment.

REPORTING METHOD: This study is reported using consolidated guideline for reporting interventions Template for intervention description and replication (TIDieR checklist). We used theory-based evaluation as described by Peter Dahler-Larsen.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.