{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:52:08Z","timestamp":1780109528815,"version":"3.54.0"},"reference-count":72,"publisher":"BMJ","issue":"7","funder":[{"name":"Swiss Cancer League, Bern, Switzerland"},{"name":"Lindenhofgruppe, Bern, Switzerland"},{"name":"CHUV, Departement of Oncology, Lausanne, Switzerland"},{"name":"Heds-FR, School of Health Sciences, Fribourg, Switzerland"},{"name":"Dr. Hans Altsch\u00fcler Stiftung, St. Gallen, Switzerland"},{"name":"Institute of Higher Education and Research in Health Care, Faculty of Biology and Medicine, University of Lausanne, Switzerland"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,9]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Self-management interventions show promising results on symptom outcomes and self-management behaviours. The Symptom Navi\u00a9 Programme (SN\u00a9P) is a nurse-led intervention supporting patients\u2019 symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi\u00a9 Flyers (SN\u00a9Flyers)), semistructured consultations and a training manual for nurses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This pilot study will evaluate the implementation of the SN\u00a9P based on the Reach Effectiveness\u2014Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN\u00a9Flyers. Outcomes include patients\u2019 accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses\u2019 fidelity of providing the intervention as intended, and patients\u2019 safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The Symptom Navi\u00a9 Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017\u201300020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT03649984\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\">NCT03649984<\/jats:ext-link>\n                      ; Pre-results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-027942","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T12:24:56Z","timestamp":1562675096000},"page":"e027942","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Implementation of the Symptom Navi \u00a9 Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi\u00a9 Pilot Study)"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03649984","registry":"10.18810\/clinical-trials-gov","type":"preResults"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9988-6299","authenticated-orcid":false,"given":"Marika","family":"Bana","sequence":"first","affiliation":[{"name":"HedS-FR School of Health Sciences, University of Applied Science and Arts Western Switzerland, Fribourg, Switzerland"},{"name":"IUFRS Institut de formation et de recherche en soins, Universit\u00e9 de Lausanne Facult\u00e9 de biologie et m\u00e9decine, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4724-1197","authenticated-orcid":false,"given":"Karin","family":"Ribi","sequence":"additional","affiliation":[{"name":"IUFRS Institut de formation et de recherche en soins, Universit\u00e9 de Lausanne Facult\u00e9 de biologie et m\u00e9decine, Lausanne, Switzerland"},{"name":"Quality ofLife Office, International Breast Cancer Study Group, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Kropf-Staub","sequence":"additional","affiliation":[{"name":"Fachentwicklung Pflege, Lindenhofgruppe, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabin","family":"Z\u00fcrcher-Florin","sequence":"additional","affiliation":[{"name":"Fachentwicklung Pflege, Lindenhofgruppe, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernst","family":"N\u00e4f","sequence":"additional","affiliation":[{"name":"Department of Practice Development in Nursing, Solothurner Spitaler AG, Solothurn, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Manser","sequence":"additional","affiliation":[{"name":"FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"B\u00fctikofer","sequence":"additional","affiliation":[{"name":"CTU, Universit\u00e4t Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Rintelen","sequence":"additional","affiliation":[{"name":"CTU, Universit\u00e4t Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solange","family":"Peters","sequence":"additional","affiliation":[{"name":"Departement of Oncology, CHUV, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Eicher","sequence":"additional","affiliation":[{"name":"IUFRS Institut de formation et de recherche en soins, Universit\u00e9 de Lausanne Facult\u00e9 de biologie et m\u00e9decine, Lausanne, Switzerland"},{"name":"Departement of Oncology, CHUV, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,7,9]]},"reference":[{"key":"2025121402351407000_9.7.e027942.1","unstructured":"Arndt V , Feller A , Hauri D , et al . 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