Health navigation for people experiencing newly acquired long-term physical disability: A realist-informed integrative review

Abstract

Navigating healthcare complexities can be challenging for disabled people, leading to challenges accessing services when required, and contributing to inequitable outcomes for disabled people and their families. Physiotherapists may be key health providers for people with newly acquired physical disabilities and may experience these navigational complexities themselves. Health navigators have been postulated as one solution and are well established in services for other health conditions such as cancer and mental health. However, navigation services for disabled people are less well developed and implemented. This realist-informed integrative review aimed to articulate and clarify underlying causal processes of health navigation programmes for people with newly acquired long-term physical disability, particularly within the New Zealand context. A two-phase literature search was conducted using integrative review methods. Two primary foci emerged for navigation programmes – a targeted health focus, directed towards reducing secondary complications and better service use and flow, or holistic health focus, directed towards more aspirational outcomes. Nine mechanisms of effect were identified across the spectrum of navigational programmes, with empowerment and self-determination overarching. Our findings are important for synthesising knowledge about existing navigation programmes and clarifying the aims and outcomes of future programmes addressing the navigational needs of disabled people.