Cancer Patient Navigation by Nurses in Brazil: History, Concepts, and Models

Maia, Gleyce Kelly Cordeiro; Ramos, Raquel de Souza; Pautasso, Fernanda Felipe; Santos, Carla Maria Castro dos

doi:10.32635/2176-9745.RBC.2025v71n4.5255

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Original Article • Rev. Bras. Cancerol. 71 (4) • 2025 • https://doi.org/10.32635/2176-9745.RBC.2025v71n4.5255EN linkcopy

Cancer Patient Navigation by Nurses in Brazil: History, Concepts, and Models

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction: Cancer patient navigation aims to eliminate barriers in cancer treatment by offering support and facilitating access to therapeutic care. It originated with Harold Freeman's theory and has spread to other countries, including Brazil, where it has been adapted to the local context.

Objective: To identify the theoretical conceptualization and navigation models adopted by nurse navigators of cancer patients in Brazil, to compare theory and practice based on COFEN resolution 735/2024, and to verify the perception of nurses about the repercussions of theory on daily practice.

Method: Qualitative research, with interviews conducted with 27 nurse navigators, selected by snowball sampling. Data collection included semi-structured interviews, and the data was analyzed using Bardin's content analysis technique.

Results: Freeman's principles are the basis for navigation programs in Brazil. However, the theoretical models are not well described in the practice of nurses, who often confuse the structure of the program with the navigation model. The personalization of action, according to institutional and patient needs, is frequently mentioned.

Conclusion: The study confirms the application of Freeman's principles but highlights the lack of standardization and knowledge about theoretical models. The navigation of cancer patients in Brazil is constantly evolving and is moving towards complying with COFEN regulations, with the need for greater integration with the SUS to reduce disparities in access to healthcare.

Key words:
Patient Navigation/trends; Nursing; Oncology Nursing; Practice Patterns, Nurses’; Oncology Service, Hospital

Patient navigation model	Description
Lay	Performed by lay navigators, who work as journey facilitators with no specific clinical knowledge or attributions. More aimed at information reproduction, expansion, and recruiting for health care
Academic	Performed by navigator students in the health field, who function as journey guides and facilitators
Professional	The navigator has professional training in the field they intend to work. Some eligibility criteria for this work, in addition to training, are familiarity with the public, the chosen field, and competencies for each navigation level. In this model, nurses and social workers can excel
Full journey	Involves the navigator's work throughout the journey stages from the moment of admission to the navigation program. It can start at the time of disease detection and follow up with the disease already identified, up to rehabilitation, survival, or death
Per journey phase	Involves the work of a navigator at a certain stage, either for a patient who has just identified the disease or who is following up from a previously diagnosed disease. Guides the patient through prevention, screening, diagnosis, treatment, rehabilitation, or survival
Per patient profile	Considers the type of vulnerability found and the required assistance for each public. Aims for better resourcefulness to overcome the barriers found
Clinic	Care targeted at needs and symptoms, health education, information, help with decision-making, emotional support, and coordination of care throughout the journey. For this model, nurses are preferred
Non-clinic	Targeted at social, logistical, and organizational barriers. Usually done by lay navigators or social workers
Community	Classified by location of practice, usually in community groups, therapeutic communities, or clinics with an established coverage territory
Culturally concordant/bilingual	Considers the cultural and logistical competency essential to the role, to achieve better accessibility, understanding, and adherence results

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Instituto Nacional de Câncer Rua Marquês de Pombal, 125 - 2º andar, Centro , CEP 20230-240, Tel.: +55 21 3207-6132 - Rio de Janeiro - RJ - Brazil
E-mail: rbc@inca.gov.br

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