Patient Navigation Needs and Quality of Life Among Women with Gynecological Cancer in Indonesia: A Cross-Sectional...

Background: Patient navigation has been recognized as a promising strategy to address fragmented cancer care; however, evidence from low- and middle-income countries (LMICs) remains limited, particularly regarding how navigation-related needs are associated with patient-reported outcomes. Objective: This study aimed to examine the association between multidimensional patient navigation needs and quality of life (QoL) among women with gynecological cancer in Indonesia. Methods: A cross-sectional study was conducted among 128 women diagnosed with gynecological cancer at a referral hospital in Indonesia. Patient navigation needs were assessed using a 37-item multidimensional instrument developed based on international frameworks, while QoL was measured using the EORTC QLQ-C30. Data were analyzed using Pearson correlation and multiple linear regression to evaluate the relationships and relative contributions of navigation need domains to QoL. Results: The mean global health status score indicated relatively low QoL (Mean = 41.7, SD = 31.0). Most domains of patient navigation needs were significantly and negatively associated with QoL (p < 0.001), with the strongest correlation observed for total navigation needs (r = -0.657). Multivariable analysis showed that administrative and financial needs showed the strongest association with poorer QoL (β = -0.373, p < 0.001), followed by psychosocial, cultural, and family support needs (β = -0.356, p < 0.001). In contrast, late-stage clinical needs were positively associated with QoL (β = 0.206, p = 0.005). The model explained 59.5% of the variance in QoL. Conclusions: Patient navigation needs are strongly associated with QoL among women with gynecological cancer, highlighting the critical role of system-level and psychosocial factors in shaping patient outcomes. Addressing administrative complexity, financial burden, and psychosocial support gaps is essential for improving QoL in LMIC settings. These findings provide novel evidence for developing context-specific, integrated patient navigation models to enhance cancer care delivery.