Improving self-efficacy through nurse navigation in patients during treatment for colorectal cancer: a randomized controlled trial.

PURPOSE: We hypothesized that a nursing navigator intervention with needs assessment, distress evaluation, and emotional support from diagnosis to follow-up would improve self-efficacy compared with standard care in colorectal cancer. METHODS: Patients with a physician-verified suspicion of colorectal cancer following colonoscopy were assessed for eligibility. Those who fulfilled inclusion criteria and consented were randomized to either intervention (nurse navigation) or standard care during the following cancer treatment trajectory. Five special educated nurse navigators delivered the intervention. Self-efficacy was assessed using the short form of the Cancer Behavior Inventory questionnaire (CBI-B) at baseline before randomization and at treatment completion or within 1 year at the latest. The group difference between CBI-B changes from baseline to follow-up was assessed in a population-averaged linear regression model employing generalized estimating equations. RESULTS: Of 271 included participants, 222 were completed cases (115 in standard care, 107 in intervention). Based on 4888 observations, self-efficacy under standard care increased by a 2.06 score (CI -0.84; 4.97) and by 6.98 (CI 3.99; 9.97) under intervention. Estimated effect size was 4.92 (CI 0.75; 9.08), which was statistically significant (p = 0.021). CONCLUSIONS: Tailored nurse navigation across the course of colorectal cancer treatment significantly increased patients' self-efficacy.