Funk Marjorie, Rose Leonie, Fennie Kristopher
Yale University School of Nursing, 100 Church St S, PO Box 9740, New Haven, CT 06536, USA.
AACN Adv Crit Care. 2010 Oct-Dec;21(4):376-9. doi: 10.1097/NCI.0b013e3181e6765d.
Randomized clinical trials (RCTs) are the gold standard for assessing causal relationships and the most rigorous design for evaluating interventions. Trials conducted by nurses are being performed with increasing frequency in critical care areas. Most of these RCTs focus on implementing new protocols of care. Internet-based interventions are being used in other settings, such as with patients and families in home and clinic settings. To our knowledge, however, there are no published reports of Internet-based interventions that target critical care nurses. The challenges of carrying out an RCT in critical care settings by using an Internet-based education intervention for nurses have not been addressed. The purpose of this column is to examine methodological issues associated with nonadherence to Internet-based interventions. We explore both the benefits and challenges of using an Internet-based education intervention in critical care, citing an example of our ongoing study in which an Internet-based education program is the primary intervention. We discuss strategies for assessing and promoting intervention fidelity in such a study and consider issues related to measuring outcomes online.
随机临床试验（RCTs）是评估因果关系的金标准，也是评估干预措施最严谨的设计。在重症监护领域，护士开展的试验越来越频繁。这些随机临床试验大多侧重于实施新的护理方案。基于互联网的干预措施正在其他环境中使用，比如在家庭和诊所环境中用于患者及其家属。然而，据我们所知，尚无针对重症监护护士的基于互联网干预措施的发表报告。在重症监护环境中，通过对护士使用基于互联网的教育干预措施来开展随机临床试验所面临的挑战尚未得到解决。本专栏的目的是探讨与不坚持基于互联网干预措施相关的方法学问题。我们以正在进行的一项研究为例，该研究以基于互联网的教育项目作为主要干预措施，探讨在重症监护中使用基于互联网的教育干预措施的益处和挑战。我们讨论在此类研究中评估和促进干预保真度的策略，并考虑在线测量结果的相关问题。
