Describing a nurse case manager intervention to empower low-income men with prostate cancer

Describe and categorize nurse case manager (NCM) interventions for low-income, uninsured men with prostate cancer.

Descriptive, retrospective record review.

Statewide free prostate cancer treatment program in which each patient is assigned an NCM.

7 NCMs who developed interventions based on empowerment through increasing self-efficacy.

NCM entries were extracted and coded from 10 electronic patient records, line by line, to reveal initial themes. Themes were grouped under categories. Investigators then reviewed and expanded these categories and their descriptions and postulated linkages. Linkages and relationships among categories were empirically verified with the original data. NCM entries from another 20 records were prepared in the same manner as the original records. Modifications were made until the categories contained all of the data and no new categories emerged. Categories were verified for content validity with the NCMs and reviewed for completeness and representation.

NCM interventions.

Categories of NCM interventions emerged as assessment, coordination, advocacy, facilitation, teaching, support, collaborative problem solving, and keeping track. Categories overlapped and supported each other. NCMs tailored interventions by combining categories for each patient.

The skillful tailoring and execution of intervention strategies depended on the knowledge, experience, and skill that each NCM brought to the clinical situation. NCM categories were consistent with the tenets of the self-efficacy theory.

The model, based on NCM interventions, provides a guide for the care of underserved men with prostate cancer. Components of the model need to be tested.