Al-Shammari Moustafa A, Yasir Amean, Aldoori Nuhad, Mohammad Hussein
Nursing Department, Al-Mustaqbal University College, Hillah, Iraq.
College of Nursing, University of Babylon, Babil, Iraq.
JMIR Res Protoc. 2022 Nov 11;11(11):e23783. doi: 10.2196/23783.
Palliative care (PC) is a new concept in Iraq, and there is no training for health care specialists or the public. The lack of education and training programs is the most important barrier for PC. Intermediate training is needed for nurses who regularly manage patients with life-threatening diseases. The End-of-Life Nursing Education Consortium for pediatric palliative care (PPC) program is intended for nurses who are interested in providing care to children with life-limiting diseases or providing support in the event of an accident or unexpected death.
Our trial aims to evaluate the effect of a web-based training course, using the Normalization Process Theory. It focuses on how complex interventions become routinely embedded in practice and on training of a sample of academic nurses in the application of PPC in routine daily practice. It hypothesizes that nurses will be able to provide PC for the pediatric population after completing the training.
This is a multicenter, parallel, pragmatic trial in 5 health care settings spread across a single city in Babylon Province, Iraq. Participants will be recruited and stratified into 2 categories (critical care units and noncritical care units). In the experimental condition, 86 nurses will be trained in the application of PPC for 2 weeks through a web-based training course powered by the Relais Platform. The nurses will be invited to participate via email or instant messaging (WhatsApp, Telegram, or Viber). They will provide end-of-life care in addition to usual care to children and adolescents with life-limiting conditions. In the control condition, 86 nurses will continue usual care. The program's effectiveness will be assessed at the level of nurses only. We will compare baseline findings (before the intervention) with postintervention findings (after completing the training course). A further assessment will be performed 3 months after the course. As numerous unidentified factors can influence the effect of the training, we will perform a progressive evaluation to assess sample selection, application, and intervention value, as well as implementation difficulties. The nursing staff will not be blinded to the intervention, but will be blinded to the results.
The study trial recruitment opened in July 2020. The first outcomes became available in December 2020.
The trial attempts to clarify the delivery of PC at the end of life through the implementation of a web-based training course among Iraqi nurses in the pediatric field. The study strengths include the usual practice setting, staff training, readiness of staff to participate in the study, and random allocation to the intervention. However, participants may drop out after being transferred to another department during the study period.
ClinicalTrials.gov NCT04461561; https://clinicaltrials.gov/ct2/show/NCT04461561.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/23783.
姑息治疗（PC）在伊拉克是一个新概念，医疗保健专业人员或公众都没有接受过相关培训。缺乏教育和培训项目是姑息治疗面临的最重要障碍。对于经常护理危及生命疾病患者的护士来说，需要进行中级培训。儿科姑息治疗（PPC）项目的临终护理教育联盟计划面向那些有兴趣为患有危及生命疾病的儿童提供护理或在事故或意外死亡情况下提供支持的护士。
我们的试验旨在使用规范化过程理论评估基于网络的培训课程的效果。它关注复杂干预措施如何在实践中常规化嵌入，以及对一批学术护士进行PPC在日常实践中应用的培训。它假设护士在完成培训后将能够为儿科人群提供姑息治疗。
这是一项在伊拉克巴比伦省一个城市的5个医疗保健机构中进行的多中心、平行、务实试验。参与者将被招募并分为两类（重症监护病房和非重症监护病房）。在实验条件下，86名护士将通过由Relais平台提供支持的基于网络的培训课程接受为期2周的PPC应用培训。护士将通过电子邮件或即时通讯工具（WhatsApp、Telegram或Viber）被邀请参与。他们将在为患有危及生命疾病的儿童和青少年提供常规护理的同时提供临终护理。在对照条件下，86名护士将继续提供常规护理。该项目的有效性将仅在护士层面进行评估。我们将比较干预前（基线结果）和干预后（完成培训课程后）的结果。在课程结束3个月后将进行进一步评估。由于许多未知因素会影响培训效果，我们将进行逐步评估，以评估样本选择、应用和干预价值以及实施困难。护理人员不会对干预措施不知情，但会对结果不知情。
研究试验招募于2020年7月开始。首批结果于2020年12月可得。
该试验试图通过在伊拉克儿科领域的护士中实施基于网络的培训课程来阐明临终时姑息治疗的提供情况。该研究的优势包括常规实践环境、工作人员培训、工作人员参与研究的意愿以及随机分配到干预组。然而，在研究期间，参与者可能会在被调至另一个部门后退出。
ClinicalTrials.gov NCT04461561；https://clinicaltrials.gov/ct2/show/NCT04461561。
国际注册报告识别码（IRRID）：PRR1-10.2196/23783。
