Table 1.

Overview of the Included Articles

Authors & Date	Methodology	Purpose	Populations and Province	Roles and Responsibilities of the Oncology Nurse Navigator (ONN)
Baliski et al. (2014)	Quantitative study	To determine the impact that the Interior Breast Rapid Investigation Diagnose program (IB-RAPiD) (i.e., organized by the nurse navigator) had on wait times for the centre, and to identify areas where improvements could be made in the care path.	Breast cancer patients in British Columbia	The program was organized by the navigator. The navigator held several roles, such as facilitating all relevant imaging tests and image-guided biopsies and obtaining pathology reports expediting surgical referrals (coordinated care). They also provided information and support to patients and the family, in the form of one-on-one meetings, along with group educational events involving other healthcare providers.
Blais (2008)	Theoretical paper	To investigate and highlight the importance of the nurse navigator in supporting patients and their families through the health care system.	Varied cancer patients in Alberta	ONNs acted as patient liaisons, providing specialized nursing care using a broad knowledge base. They provided access to resources and services, and empowered patients to make informed decisions. This was achieved through providing education, information, guidance, emotional support, and psychological assistance.
Blais et al. (2014)	Qualitative study	To document the characteristics of patients in terms of the prevalence of distress/problems/symptoms they reported, in addition to the support they wanted versus the support they were offered at the time of their first meeting with nurse navigators, 2) to identify the factors that are the most strongly associated with distress 3) to verify whether the cutoff score on the tool used to orient patients (on the basis of their reported distress) was optimal.	Varied cancer patients in Quebec	Identifying and acknowledging patients’ needs/concerns was an intervention in itself, and a central responsibility of the navigator. Actively listening to and supporting patients in solving their identified problems was a key role of the ONN. Therefore, ONNs were identified as needing to establish dialogue and an open relationship with patients. Navigators required basic communication skills to establish the therapeutic relationship and provide psychosocial care.
Campbell (2016)	Theoretical paper	Outlined a proposal to create a cancer therapy nurse navigator role.	Oral cancer patients in Ontario	The authors investigated a registered nurse model of care to provide education, coaching, support, and navigation for patients and their caregivers. Several responsibilities outlined for the ONN included meeting with patients/caregivers to identify barriers to care, referring patients to supportive teams (e.g., social worker, dietician), providing education to patients/ caregivers, communicating and verifying treatments with patients on the start day of therapy, assess for side effects and provide therapeutic advice, scheduling exams or consultations, arrange for follow-ups based on assessments, participate in monthly visits with oncologists, triage for symptoms, help patients navigate the healthcare system, and provide outreach education to retail pharmacies.
Cha et al. (2020)	Quantitative study	To monitor the impact of the centralized intake for surgical referral and triaging on wait times for definitive surgery for patients with breast cancer using navigators.	Breast cancer patients in British Columbia	Patient navigators reviewed all referrals and investigations to triage patients and referred patients to breast physicians for assessment and surgeons for tumour excision.
Common et al. (2018)	Quantitative study	To determine if the Thoracic Triage Panel (TTP) reduced wait times for lung cancer diagnosis and treatment, and if it led to more appropriate specialist consultations than the traditional, primary care provider-led referral process.	Lung cancer patients in Newfoundland	The nurse navigator developed personal relationships with patients and communicated the team’s plans at weekly meetings. Therefore, the nurse navigator coordinated patient care and acted as the contact person for patients and clinicians involved in the program.
Cook et al. (2013)	Theoretical paper	To identify the core areas of practice and associated competencies for professional cancer navigators that were considered integral to optimizing patient and family empowerment and facilitating continuity of care.	Varied cancer patients across Canada	Based on a synthesis of evidence, the ONN operated within three core areas of practice. One, providing information and education, and two, providing emotional and supportive care. This role included the ability to identify problems and issues causing distress, and offer clinical interventions to help manage issues (i.e., engaging in conversations, using tools to explore fears and anxieties about disease progression). And three, coordinating services and continuity of care within the context of an interdisciplinary team approach. Screening, treatments, and supportive care were all provided by different providers and in different settings. Therefore, the navigator supported patients throughout the continuum and created continuity at key points, including diagnosis, transition into active treatment, to survivorship and palliative care. They served as the link between patient/care team/hospital/care services.
Crawford et al. (2013)	Theoretical paper	To describe the design, development, and evaluation of the “Patient Navigation in Oncology Nursing Practice” course.	Varied cancer patients across Canada	The ONN program taught knowledge and skills in seven key domains of the role, including supportive care (i.e., assessing the needs of patients and families), care planning, communication, attending to patient’s emotional states, addressing patients’ concerns, patient education, valuing culture and diversity, assessing available social supports, community resources, and services.
Duthie et al. (2017)	Qualitative study	To explore cancer patients’ experiences with multimodal treatments, as well as issues related to navigating the care system.	Colorectal, breast, B cell lymphoma, endometrial, prostate, multiple myeloma, and chronic lymphocytic leukemia patients in Quebec	The ONN accompanied and supported patients and families throughout the trajectory of the cancer experience. The ONN accompanied patients with complex needs throughout their cancer journey (i.e., accessing and managing physical needs, providing information and education, providing support, and coordinating care). They were described as facilitators of communications among providers, acting as the point of focus at the centre of the healthcare wheel.
Etchegary et al. (2022)	Qualitative study	To understand the experiences and preferences of cancer predisposition syndromes (CPS) carriers, as this would inform how a nurse-led navigation program is best suited to meet their individualized needs.	Patients living in Newfoundland with a history of any molecularly confirmed hereditary cancer syndrome or a combination of any hereditary cancer genes	ONN programs were identified as patient centred, aimed at reducing fragmentation and barriers patients face within the cancer care system. The authors identified the key responsibilities of ONNs were to communicate among team members, provide supportive care, and coordinate care. Navigators were also involved in providing education to patients on health promotion activities (e.g., screening for genetic mutations). The authors also highlighted that the scope of navigators varied across care models, but their primary function of increasing access to care was common across all.
Fillion et al. (2006)	Qualitative study	To propose a profile for the role and function of an oncology patient navigator nurse (OPN) and to assess its implementation in a specialized team within a university hospital centre with a supraregional model for oncology. Specific objectives were to describe 1) the role and functions of an OPN, 2) role outcomes on the process of adaption to illness for individuals with cancer and their families, 3) role outcomes on continuity of care and services delivered by the interdisciplinary team and crew network.	Head and neck cancer patients in Quebec	Four functions were linked to the role of the OPN for individuals with cancer and their families. One, to assess the needs and follow up on the interventions implemented throughout the initial assessment, two to inform and teach, three to provide special support and attention and four, to coordinate and promote continuity of care, services, information, and therapeutic relationships. All functions and scopes of the role were flexible to encourage respect for the culture and service model in the setting, and to avoid duplication of services and roles of various caregivers.
Fillion et al. (2010)	Qualitative study	To assess the implementation of oncology nurse navigators within two local joint teams. The study’s objective was to describe the implementation process from the perspectives of the stakeholders involved.	Varied cancer patients in Quebec	The authors described the role of the ONN was vague in relation to its clinical and organizational components. However, the authors particularly highlighted the empowerment role and that patient navigators improved care coordination and the patient’s understanding of the healthcare system and the care trajectory.
Fillion et al. (2011)	Qualitative study	To describe the perceptions of implementing the Screening for Distress tool within professional cancer navigators from the perspective of key actors before and after it’s implementation in the Quebec and Nova Scotia provinces.	Varied cancer patients in Nova Scotia and Quebec	The ONN was described as a professional role, used to facilitate continuity of care and promote patient empowerment. Navigators offered patients/families/caregivers assistance through the maze of services to promote the best possible outcomes and quality of life, through all phases of the cancer experience. The authors identified medical and biopsychosocial care coordination as central to the role.
Fillion et al. (2012a)	Qualitative study	To elaborate, refine, and validate the content of the bidimensional framework for patient navigation in a Canadian context.	Varied cancer patients in Nova Scotia and Quebec	Professional cancer navigators aimed to ease and expedite patients’ access to services and resources, improve continuity and coordination of care throughout the cancer continuum, and serve as a patient advocate. The patient navigator role was illustrated in two dimensions, including firstly promoting continuity of care (i.e., responding to patient needs and tailoring interventions). The second dimension was empowerment. This involved promoting active coping, cancer self management (i.e., supporting patient’s ability to accept the illness and regain control), and supportive care (i.e., meeting physical, emotional, psychological, social, and spiritual needs).
Gilbert et al. (2011)	Qualitative study	To explore the phenomena of patient navigation in depth. Specifically, the definition of patient navigation, how navigation benefits patient care, the role of nurses in patient navigation in the diagnostic period, the education/training needed to develop the knowledge and skills to navigate, and the role of other members of the healthcare team in patient navigation.	Varied cancer patients in Ontario, Nova Scotia, and Manitoba	Four roles of the patient navigator were highlighted, including primarily coordination of care (i.e., providing information and coordination during the care journey), improving patient outcomes (i.e., decreasing anxiety and increasing satisfaction in areas of greatest impact on the patient), and creating partnerships. Patient navigators collaborated with various clinicians involved in cancer diagnosis and treatment to create system improvements. Patient navigators facilitated patient navigation along the patient pathway. Some navigators improved the pathway by pre-booking appointments and expediting diagnostic procedures.
Haase et al. (2020)	Theoretical paper	To provide a historical analysis of the development of the Canadian Association of Nurses in Oncology position statement on Cancer Patient Navigation.	Evaluated the Cancer Patient Navigation (CPN) role across Canada	ONNs created care that was personalized, coordinative, enabling, and person-centred (i.e., promoting dignity, compassion, and respect). Care was described as tailored, coordinated across time, supportive of patients’ changing needs, enabled self management, supportive, and involved in treating patients with dignity, respect, and compassion.
Hebert & Fillion (2011a)	Qualitative study	To better understand the oncology nurse navigators’ support function, first from the perspective of the individuals living with cancer, and second from the perspective of the ONNs themselves. The objective was to understand the perspectives of people living with cancer, the nature of their needs, and the support provided by the oncology nurse navigator along the disease trajectory.	Varied cancer patients in Quebec	The patient navigator assesed the patient’s needs and provided support through targeted interventions. The patient navigator was identified as being present along the care trajectory to meet the emotional needs and form trusting relationships with patients. The navigator must also provide information (information support) continuously along the care journeys.
Hebert & Fillion (2011b)	Qualitative study	To explore and describe from the perspective of the oncology nurse navigator the support interventions provided to those living with cancer and their families throughout the care trajectory.	Varied cancer patients in Quebec	The functions of the ONN were assessing, teaching and informing, supporting, and coordinating. The authors described the nature of the support function required clarification. The navigator created support interventions to meet practical needs (i.e., coordinated activities for appointments/exams, services), information needs (i.e., facilitate decision making, promote development of skills such as coping), emotional needs (i.e., crafting a sense of belonging, reassurance, feeling emotionally sound), physical needs (i.e., management of physical symptoms and discomforts), psychosocial needs (i.e., consolidate coping strategies), and spiritual needs (i.e., meeting needs related to personal values, priorities, and hopes).
Jeyathevan et al. (2017)	Qualitative study	To explore the role of oncology nurse navigators in enhancing patient empowerment for adult patients with lung cancer during the diagnostic phase of cancer care.	Varied cancer patients in Ontario	The clinical functions of the ONN roles were determined based on patients’ perceptions of how the ONN impacted patients and the family’s level of empowerment, in relation to their use of active coping, supporting self-management, and supportive care. Promoting active coping in patients was a central strategy used by ONNs to remove stressors from the patients during the diagnostic phase. This was achieved through acting as a patient advocate and providing educational supports.
Kammili et al. (2023)	Quantitative study	To examine the impact of a corridor of care between rural and urban areas on gastric cancer outcomes by comparing rural versus urban patients treated at a centralized referral centre.	Gastric cancer patients in Montreal	Pivot nurses (navigators) were assigned to all cancer patients and coordinated care among multidisciplinary teams. They acted as the interface between the patient, care team, family, and other health services. Select responsibilities included coordinating blood work, consultations, therapies, and follow-up appointments throughout the care trajectory. Care was described as individualized and met the patient’s preferences, expectations, and needs. The pivot nurse achieved this by communicating with all care providers a consistent vision for the care plan.
Kuzmarov et al. (2011)	Theoretical paper	To analyze the development of a multidisciplinary anti-cancer model, for a hospital and it’s network in the province of Quebec, focusing on the evolving ONN’s roles among the geriatric population faced with cancer.	Varied cancer patients in Quebec	Trained nurse navigators played a ‘central role’ in providing supportive care and expert guidance, assisting the patient/family in navigating the healthcare system and providing information and education.
Lavoie et al. (2016)	Qualitative study	To explore how the context of First Nations people’s lives intersect with structural barriers to shape their access to care and expectations of cancer care.	Breast cancer patients in Manitoba	The patient navigator role was used to support continuity of care. Patient navigation programs had significant positive impacts on continuity of care where barriers prevent patients from navigating an existing and functioning system.
Loiselle et al. (2020)	Quantitative study	To report on participants’ cancer care experiences and satisfaction according to their perceptions of being assigned to a nurse navigator (NN) and to compare NN/non NN groups across the six cancer care domains: emotional support, coordination and continuity of care, respect for patient preferences, physical comfort, information, communication and education, access to care, as well as four main nursing functions (i.e., assessment, education, support, coordination).	Varied cancer patients in Ontario	Nurse navigators were considered essential members of the oncology multidisciplinary team in Quebec to support patient-centred care. The role included four main functions including assessing patient needs, providing education and information, supporting patients and family members, and coordinating care.
Marchand (2010)	Theoretical paper	To explore the application and the growth of the concept navigation within the Canadian health care system. The author also aimed to outline the challenges and successes of the nurse navigator role in the development of a formal provincial breast assessment program.	Breast cancer patients in Quebec	Identified the role of the navigator must fluidly assume the competencies of the clinical nurse specialist, including clinical, research, leadership, and consultant/collaboration. The central roles/responsibilities of the nurse navigator role were to enhance and bridge interdisciplinary interactions and communication, guide patients proactively through diagnostics (i.e., with adherence to targeted timelines), provide education on the patient’s health care and disease process, facilitate referral to allied health members such as social work, and review data and facilitate knowledge transfer to all parties.
Melhelm & Daneault (2017)	Qualitative study	To explore the needs of cancer patients in palliative care and to determine how care providers could meet these needs more fully.	Varied cancer patients in Quebec	Six roles of the ONN were outlined, including ensuring the patient understood their diagnosis, being present after they heard the diagnosis, consulting with the oncologist or family physician, following the patient (i.e., from the moment of the diagnosis of cancer), providing the patient with emotional support (i.e., validating their feelings, referring patients to professionals), listening attentively (i.e., being present), ensuring the patient was comfortable, and being proactive in cooperating and communicating with other providers.
Miller et al. (2021)	Qualitative study	To identify patient factors associated with a greater need for navigation, according to the views of nurse navigators in Nova Scotia.	Varied cancer patients in Nova Scotia	Cancer patient navigators (CPNs) had three primary roles: psychosocial and practical, informational and coordination of care. The psychosocial and practical roles included providing emotional support and helping patients arrange the practical aspects of accessing cancer care (i.e., travel, lodging for cancer treatments, applying for low-income assistance programs, and paying for some treatments and prostheses). The informational role included activities such as reviewing diagnostic and treatment information with patients. The coordination of care role involved communicating with the health care team regularly, and following up on healthcare decisions on behalf of/ assistance to the patient.
Park et al. (2018)	Quantitative study	To investigate of individuals diagnosed with cancer who died in Nova Scotia during 2011 to 2014, how do adult descendants who were navigation enrollees differ from those who were not.	End of life cancer patients in Nova Scotia	The goal of navigation was to ensure timely, up-to-date, coordinated patient-centred care. They also were involved in meeting advanced care planning and palliative end-of-care needs. The role contained three domains, including patient education, psychosocial and practical support, and coordination of care.
Pedersen & Hack (2011)	Theoretical paper	To answer three questions to facilitate refinement of the British Columbian model of navigation. 1) What are the stakeholders needs and perspectives, 2) What are the core functions and best practices of current navigators, and 3) What models and theories should guide and inform navigation practice and evaluation?	Varied cancer patients in British Columbia	One key assumption of the BCPNM (British Columbian navigator framework) was that patients and families required information and emotional support to feel prepared. This was classified as one of the main goals of navigation. Four central roles were identified based on this goal, including facilitating linkage to health care resources, facilitating decision-making of patients, improving access to practical assistance, and identifying/developing community supports.
Pedersen et al. (2014)	Qualitative study	To delineate the role of the oncology nurse navigator, drawing from the experiences and descriptions of younger women with breast cancer.	Breast cancer patients in Manitoba	Supporting patients during times of uncertainty (i.e., having someone assisting them through the oncology treatment process and providing direction related to other aspects of care throughout the entire illness trajectory) was identified as a key role of the NN. Navigators were identified as someone who must know the cancer system, patient resources, and understand the medical side of breast cancer.
Plante & Joannette (2009a)	Theoretical paper	To explain why nurses were selected as patient navigators and to describe how the role was integrated in the Monteregie region.	Varied cancer patients in Quebec	ONNs offered and facilitated social supports, decision supports, active coping, and fostered patients’ self-efficacy. ONNS used a holistic approach when engaging with both the patient and their family (i.e., empowering patients), managing system issues, and developing a care team. The nurse navigator-initiated changes in the care philosophy and structured changes within the organization by evaluating and supporting patients’ needs.
Plante & Joannette (2009b)	Theoretical paper	To describe the role of IPOs (Quebec’s Oncology nurse navigators) in practice, the problems encountered in various care contexts, and the solutions brought forward to facilitate their implementation.	Varied cancer patients in Quebec	Identified the ONN’s role was understood by the cancer team. The role involved evaluating the needs of patients with cancer and their families, presenting new cases to the team at interdisciplinary meetings, and engaging the team in developing a plan for interdisciplinary interventions. NNs also acted as agents of change to address existing clinical and organizational problems (e.g., changes to the organization of care).
Richard et al. (2010)	Quantitative study	To add understanding to the measurement of patient satisfaction in a comprehensive cancer care centre (CCC) and to provide data to inform quality improvement initiatives that would result in greater satisfaction with care for cancer patients.	Varied cancer patients in Quebec	ONN interventions focused on providing patient-centred care, which led to increased patient satisfaction. The navigator guided the patient through the illness trajectory. Roles of the ONN included assessment and management of needs and symptoms, patient education, support to patients and their families, and ensuring continuity of care.
Ritvo et al. (2015)	Quantitative study	To analyze how much of an increase in screening rates could be accomplished with a personal navigation intervention.	Bowel and colorectal cancer patients in Ontario	The authors used a primary care outreach approach to arrange nurse navigation to increase colorectal cancer screening uptake. Each tailored nurse navigation intervention involved providing general information regarding colorectal cancer screening, reviewing colorectal screenings, and elucidating the participant’s preferred screening tests.
Roberts et al. (2020)	Theoretical paper	To describe the author’s experience as a First Nations, Inuit, and Metis (FNIM) nurse navigator.	Varied cancer patients in Ontario	The NN is a diverse, land-based, and patient-centred role. The position is generally non-clinical. It is not solely a case management role. The principle objective of the navigator was to establish trust with patients, act as the ‘link’ between the patient and the health care team, and as their advocate.
Srikanthan et al. (2016)	Quantitative study	To determine if the presence of a dedicated program for young breast cancer patients and a nurse navigator would be associated with an increased frequency of fertility discussions prior to the initiation of adjuvant or neoadjuvant systemic therapy.	Breast cancer patients in Ontario	The OCC program included the ONN; the ONN’s major role was to implement coordinative care management for patients. The nurse navigator screened referrals to the cancer center, contacted patients post-appointment, and followed women through diagnosis, treatment, and beyond. In addition to expediting tests/consultations, and providing ongoing support, the NN also raised and discussed age-related issues such as fertility, genetics, and sexual health.
Trevillion et al. (2015)	Qualitative study	To evaluate the effectiveness of breast cancer care support provided by breast cancer care navigators (BCCN) for women attending the breast health clinic.	Breast cancer patients in British Columbia	The BCCN (navigator) program aimed to provide appropriate information, education, and emotional support for patients who were newly diagnosed, undergoing treatments, or engaging in follow-up care. Their primary objective was to serve as liaison between the patient and their treatment providers. The second was to provide timely delivery of diagnostic, treatment, and follow-up services.
Watson et al. (2016a)	Theoretical paper	To develop an educational framework that guided the competency development and orientation for registered nurses hired into cancer patient navigation roles and how the framework evolved to support navigators from novices to experts.	Varied cancer patients in Alberta	The role of the NN involved facilitating continuity of care (i.e., informational continuity, management continuity, relational continuity), and promoting patient and family empowerment (i.e., active coping, cancer self-management, supportive care). The navigator role acted as a single point of contact for patients and families living with cancer, the community-based provider, and the cancer care system, aiming to integrate care across systems.
Watson et al. (2016b)	Qualitative study	To integrate the cancer patient navigator role into the existing clinical environment at each setting (15 sites across Alberta) and to evaluate its impact.	Varied cancer patients in Alberta	The navigator role provided meaningful support, as the navigator was able to focus their supportive interventions on what was an issue for the patient/family. The navigators identified their general roles were to enhance continuity of care, improve access to information, and provide person-centred care.
Zibrik et al. (2016)	Quantitative study	To improve referral practices, timelines, and availability of molecular testing for patients with advanced non-small cell lung cancer.	Lung cancer patients in British Columbia	The role of the nurse navigator was to streamline the triaging process for patients with lung cancer by ensuring all appropriate interventions were initiated at the time of referral (e.g., radiologic and molecular tests), and arranging consultations.