Nurse-led Integrated Home Service to Support Parents in Symptom Management for Children Requiring Respiratory Support
Nurse-led Integrated Home Health Service to Support Parents in Symptom Management for Children With Respiratory Support: an Effectiveness-implementation Hybrid 2 Study
The aims of this study are to test the effectiveness of a nurse-led integrated home health service to enhance parental self-efficacy in symptom management for children requiring respiratory support, and alongside identify factors facilitating or deterring the program implementation.
A single group pre-post quasi-experimental study on parents of CMC requiring respiratory support.
Parents will be recruited from non-government organizations, with an estimated sample size of 80 parents. Self-administrated questionnaire, and semi-structured interview guide will be used for data collection.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Parents of children required respiratory support are at risk of high stress levels because these children have multisystem diseases, including severe neurologic conditions, resulting in potential premature death. Literature suggested that increasing parental self-efficacy in managing their child's symptoms could improve the child's health.
Nurse-led integrated home health service in symptom management is an alternative method considered more comprehensive and health-parent interactivity to continue home-based support for these parents and their children.
Self-administrated questionnaire, and semi-structured interview guide will be used for data collection. Descriptive statistics, including proportions for categorical variables, mean, and SD for normally distributed continuous variables, and median and inter-quartile range for non-normally distributed variables, will be reported. Generalized estimating equation will be used to address the objectives with appropriate link function. Qualitative data will be analyzed using thematic analysis to identify the facilitator, and barriers of program implementation.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Winsome Lam, PhD
- Phone Number: 4291 852-2766
- Email: winsome.lam@polyu.edu.hk
Study Locations
-
-
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Hong Kong, China, 852
- School of Nursing The Hong Kong Polytechnic University
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Contact:
- winsome Yorke, PhD
- Phone Number: 4291 852-2766
- Email: winsome.lam@polyu.edu.hk
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- parent of a child with respiratory support aged 6-month to 22 years old
- having a Smartphone
- able to communicate in Chinese or in English
- living with his/her child at home.
Exclusion Criteria:
- a reported mental health disorder
- engaging in other structured programs related to symptom management
- living in an area with no internet coverage
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Nurse-led integrated home service
Nurse-led integrated home service to support parents in Symptom Management for Children With Respiratory Support for a 3-month period.
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Nurse-led integrated home service to support parents in Symptom Management for Children With Respiratory Support for a 3-month period.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Caregiving Self-efficacy
Time Frame: Time Frame: Day 0, Month 3, Month 6
|
The scale consists of 18 items to measure the self-efficacy of Chinese caregivers.
It is rated on a 9-point scale, with 1= no confidence, to 9 =full confidence.
|
Time Frame: Day 0, Month 3, Month 6
|
|
Implementation evaluation
Time Frame: Time Frame: month 6
|
Semi-structured interviews will be conducted to the related community stakeholders to evaluate the quality of service provided. Semi-structured interview guide will be used to collect qualitative data in four perspectives including:
|
Time Frame: month 6
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Modified Memorial Symptom Assessment Scale
Time Frame: Time Frame: Day 0, Month 3, Month 6
|
This is a modified 40-item Memorial Symptom Assessment Scale (MSAS in Chinese version).
The items for measuring the frequency and severity of symptoms are rated on a 4-point Likert scale from one (almost never) to four (always).
The items for measuring distress are rated on a 5-point Likert scale from one (not at all) to five (very).
|
Time Frame: Day 0, Month 3, Month 6
|
|
Children health service utilization
Time Frame: Time Frame: Day 0, Month 3, Month 6
|
This is a record used to summarize a child's visits to outpatient clinic and emergency room, and the child's admission history.
|
Time Frame: Day 0, Month 3, Month 6
|
|
Depression Anxiety Stress Scale (DASS) (Chinese version)
Time Frame: Time Frame: Day 0, Month 3, Month 6
|
DASS is a self-report instrument consisting of 21 items used to assess the states of depression, anxiety and stress in parents.
It is rated on a 4-point scale from 0 (does not apply to me at all) to 3 (applies to me very much, or most of the time).
A higher score on each subscale indicates more severe symptoms of depression, anxiety and stress.
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Time Frame: Day 0, Month 3, Month 6
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- 1. Cohen, E., et al., Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics, 2011. 127(3): p. 529-538. 2. Chan, K.S., Palliative care: the need of the modern era. Hong Kong Med J, 2018. 24(4): p. 391-399. 3. Chung, W.W., et al., Improving Children's cancer pain management in the home setting: Development and formative evaluation of a web-based program for parents. Comput Biol Med, 2018. 101: p. 146-152. 4. Kun SS, Davidson-Ward SL, Hulse LM, Keens TG. How much do primary care givers know about tracheostomy and home ventilator emergency care? Pediatr Pulmonol. 2010 Mar;45(3):270-4. doi: 10.1002/ppul.21169. PMID: 20146395. 5. Truitt BA, Ghosh RN, Price EW, Du C, Bai S, Greene D, Simon DM, Reeder W, Kasi AS. Family Caregiver Knowledge in the Outpatient Management of Pediatric Tracheostomy-Related Emergencies. Clin Pediatr (Phila). 2025 Jul;64(7):936-943. doi: 10.1177/00099228241304480. Epub 2024 Dec 20. PMID: 39707594. 6. Wang, J., et al., Supporting Caregivers of Children With Acute Lymphoblastic Leukemia via a Smartphone App: A Pilot Study of Usability and Effectiveness. Comput Inform Nurs, 2016. 34(11): p. 520-527. 7. Bandura, A., Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev, 1977. 84(2): p. 191-215. 8. Kwok and Wong, Mental health of parents with young children in Hong Kong: The roles of parenting stress and parenting self-efficacy. Child & Family Social Work, 2000. 5(1): p. 57-65. 9. Streisand, R., et al., Pediatric parenting stress among parents of children with type 1 diabetes: the role of self-efficacy, responsibility, and fear. J Pediatr Psychol, 2005. 30(6): p. 513-21. 10. World Health Organization mHealth: new horizons for health through mobile technologies 2011. 11. Crable, E.L., et al., Standardizing an approach to the evaluation of implementation science proposals. Implement Sci, 2018. 13(1): p. 71. 12. Curran, G.M., et al., Effectiveness-implementation hybrid designs: combi
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- DonationHongKongPolyU
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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