Conclusions
reduced distress, depression, anxiety, breast cancer
BREAST CANCER
We believe the REBECCA intervention fills an important gap in the existing literature regarding providing patient-centered care to patients with breast cancer and social and psychological vulnerabilities. In this RCT, we observed reduced distress in patients who received the REBECCA intervention, especially after 12 months, although the effect was not significant. The intervention resulted in significant improvement in symptoms of depression and breast cancer–specific HRQOL, especially at the 6- and 12-month follow-up, and nonsignificant improvement in symptoms of anxiety and patient activation. The effect sizes were small, but effects were especially pronounced in subgroups with social vulnerabilities, and patient satisfaction was high. To our knowledge, this is the first trial to show the feasibility (through a simple triage approach) of systematically selecting patients with breast cancer who had psychological symptoms of distress and to offer them more comprehensive supportive care, with the nurse navigator actively supporting the patient in accessing health care services that are available within the health care system. These findings warrant further research to develop the nurse navigation framework and to explore the potential translation of this intervention into clinical practice.