School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
J Adv Nurs. 2024 Sep;80(9):3856-3865. doi: 10.1111/jan.16294.
To investigate the effect of a nurse support using a proactive mobile app to enhance parental self-efficacy in symptom management for children with medical complexity.
A single-blinded, randomized controlled trial with a two-armed repeated measures design.
Eligible parents and the children will be recruited from the special schools and non-government offices. They will be randomly assigned either to the intervention or control groups. Subjects in the study group will receive nurse parental support using a symptom management mobile app for 3 months. The control group will receive the usual care that is available in the community. Data will be collected pre-intervention (T1), immediately after the intervention (T2), and three-month after intervention (T3). The primary outcome is parental self-efficacy. The secondary outcomes include child's symptom burden and their health service utilization. Primary outcome will be compared across two groups in T2 and T3 using with control for the pre-test value of parental self-efficacy. Generalized estimating equation (GEE) will be used to address secondary objectives from T1 to T3 with appropriate link function.
As a result of the successful implementation of this nurse-led symptom management, parental self-efficacy will be enhanced. Both the symptoms reported by the children and their health service utilization will be reduced. Findings of this study will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and the children in local communities.
The evidence produced in this study will enlarge the knowledge base that supports evidence-based paediatric home nursing service with the use of health technology in symptom management. This evidence will also contribute to the development of other symptom management programs for other paediatric patient groups.
NCT05765643 (ClinicalTrials.gov identifier).
Parents of children with medical complexity contributed in mobile application development by giving comments on the usability of mobile application.
Improve health service delivery: Home nursing service may not be sustainable in a long run in Hong Kong, as the health care system has been facing a serious nursing workforce shortage in recent years. Besides, these services are affected or even suspended during the community outbreak of infectious disease, like recent coronavirus disease pandemic. Nurse parental support in symptom management for the CMC using a proactive mobile health application will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and their CMC in local communities. Improve physical and psychological health of parents and their CMC: The success of program implementation will help to increase parental self-efficacy in symptom management for their CMC, as a result of decrease of children's symptom burden. Improve knowledge base: The evidence produced in this study will (1) enlarge the knowledge base that supports evidence-based paediatric community nursing service related to symptom management for the CMC. This evidence will contribute to the development of other symptom management programs for other paediatric patient groups.
研究护士使用主动式移动应用程序支持对有医疗复杂性的儿童进行症状管理，以增强父母自我效能感的效果。
一项单盲、随机对照试验，采用双臂重复测量设计。
从特殊学校和非政府机构招募合格的父母和儿童。他们将被随机分配到干预组或对照组。研究组的受试者将在 3 个月内接受使用症状管理移动应用程序的护士父母支持。对照组将接受社区内提供的常规护理。在干预前（T1）、干预后立即（T2）和干预后 3 个月（T3）收集数据。主要结局是父母自我效能感。次要结局包括儿童的症状负担和他们的卫生服务利用情况。使用父母自我效能感的预测试值进行控制，在 T2 和 T3 时比较两组的主要结局。使用适当的链接函数，广义估计方程（GEE）将用于 T1 至 T3 的次要目标。
由于成功实施了这种由护士主导的症状管理，父母的自我效能感将得到增强。儿童报告的症状和他们的卫生服务利用情况都将减少。本研究的结果将有助于改善服务提供，因为它最大限度地提高了当地社区父母和儿童获得儿科卫生服务的可及性和可及性。
这项研究产生的证据将扩大支持基于证据的儿科家庭护理服务的知识库，该服务使用健康技术进行症状管理。这一证据还将有助于为其他儿科患者群体开发其他症状管理计划。
NCT05765643（ClinicalTrials.gov 标识符）。
有医疗复杂性的儿童的父母通过对移动应用程序的可用性发表评论，为移动应用程序的开发做出了贡献。
改善卫生服务提供：在香港，家庭护理服务可能无法长期持续，因为近年来医疗保健系统一直面临严重的护理人员短缺问题。此外，在传染病社区爆发期间，这些服务甚至会受到影响甚至暂停，例如最近的冠状病毒病大流行。使用主动式移动健康应用程序对 CMC 进行护士父母支持的症状管理，将有助于改善服务提供，因为它最大限度地提高了当地社区父母和 CMC 获得儿科卫生服务的可及性和可及性。改善父母及其 CMC 的身心健康：计划实施的成功将有助于增加父母对 CMC 症状管理的自我效能感，因为儿童的症状负担减轻了。
这项研究产生的证据将（1）扩大支持基于证据的儿科社区护理服务的知识库，该服务与 CMC 的症状管理有关。这一证据将有助于为其他儿科患者群体开发其他症状管理计划。
