Effectiveness of an Online Interactive E-book in Enhancing Home Care Nurses' Knowledge, Perceived Barriers, and Self-efficacy in Home Pressure Injury Care

March 13, 2026 updated by: Hsiao-Ching Lin, Kaohsiung Medical University

The goal of this study is to learn if an interactive e-book helps home care nurses improve their skills in managing pressure injuries at home. It will also learn if digital learning can overcome the challenges of traditional training. The main questions it aims to answer are:

  1. Does the e-book increase home care nurses' knowledge about pressure injury prevention and treatment?
  2. Does it improve their confidence and reduce the barriers they face when providing wound care?
  3. How long do the learning benefits last after completing the program?

Researchers will compare an interactive e-book to standard PDF training materials from the Ministry of Health and Welfare (MOHW) to see which is more effective for nursing education.

Participants will:

  1. Use an online interactive e-book covering 11 units of wound care for 1 month
  2. Use standard PDF training materials from the MOHW Long-term Care section
  3. Complete surveys about their knowledge and skills before the study, immediately after the program, and 1 month later

Expected Outcomes and Contributions:

This study aims to solve the problem of nursing shortages and training difficulties in rural areas. The researchers expect that home care nurses will become more competent in wound management, leading to better patient health and fewer hospital readmissions. These results will support Taiwan's "Long-term Care 3.0" policy by driving innovation in digital education.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The goal of this study is to learn if an interactive e-book helps home care nurses improve their skills in managing pressure injuries at home. It will also learn if this digital tool can overcome barriers to traditional training.

The main questions it aims to answer are:

  1. Does the e-book increase home care nurses' knowledge about pressure injury prevention and treatment?
  2. Does it improve their confidence and reduce the barriers they face when providing wound care?
  3. How long do these learning benefits last after the program ends? Researchers will compare an interactive e-book to standard PDF training materials from the Ministry of Health and Welfare (MOHW) to see which is more effective for nursing education.

Participants will:

  1. Use an online interactive e-book on wound care for 1 month (Experimental Group)
  2. Read standard PDF training materials from the MOHW Long-term Care section (Control Group)

Complete surveys about their knowledge and skills before the study, immediately after the program, and 1 month later

Study Type

Interventional

Enrollment (Estimated)

132

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Taiwan
    • Kaohsiung
      • Kaohsiung City, Kaohsiung, Taiwan, 807
        • Recruiting
        • Home Care Agency of Kaohsiung Medical University Chung-Ho Memorial Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Registered nurses aged 18 years or older.
  • Currently employed full-time as a home care nurse in a hospital-affiliated home care agency, private home care agency, or public health center.
  • Have at least six months of clinical experience in home care nursing.
  • Willing to participate in this study and sign the informed consent form.

Exclusion Criteria:

  • Home care nurses who hold specialized certifications related to advanced wound care (due to their existing high level of expertise in pressure injury management).
  • Nurses practicing in community nursing homes or residential care facilities.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Interactive E-book on Pressure Injury Care
Participants in this group will access an online interactive e-book focused on home-based pressure injury prevention and wound care for one month. The e-book consists of 11 interactive learning units.
Other: Interactive E-book on Pressure Injury Care
An online interactive digital e-book containing 11 units on pressure injury prevention and wound care management for home care nurses.
Active Comparator: MOHW Standard PDF Educational Materials
Participants in this group will be provided with standard PDF educational materials on pressure injuries from the Ministry of Health and Welfare (MOHW) Long-term Care section for one month.
Other: MOHW Standard PDF Educational Materials
Standardized PDF educational documents regarding pressure injuries provided by the Ministry of Health and Welfare (MOHW) Long-term Care section.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pressure Injury Knowledge Assessment Score (PUKAT 2.0)
Time Frame: Baseline (Pre-intervention), 1 month (immediately post-intervention), and 2 months (1-month follow-up).
Pressure Injury Knowledge Assessment Score as measured by the Pressure Ulcer Knowledge Assessment Tool version 2.0 (PUKAT 2.0). The PUKAT 2.0 consists of 28 multiple-choice items across six themes: etiology, classification, risk assessment, nutrition, prevention (pressure), and prevention (shear/friction). Each correct answer is awarded 1 point, while incorrect or "I do not know" answers receive 0 points. Possible scores range from 0 to 28, with higher scores indicating a greater level of knowledge and competency in the prevention and management of pressure injuries. An overall score of 17 or higher (≥60%) is typically considered the threshold for satisfactory knowledge.
Baseline (Pre-intervention), 1 month (immediately post-intervention), and 2 months (1-month follow-up).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived Barriers to Wound Care (WCBS)
Time Frame: Baseline (Pre-intervention), 1 month (immediately post-intervention), and 2 months (1-month follow-up).
Measured by the Wound Care Perceived Barriers Scale (WCBS), consisting of 16 items. Each item is rated on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Total scores range from 16 to 80 points. A higher score indicates that the participant perceives significantly greater barriers to performing wound care.
Baseline (Pre-intervention), 1 month (immediately post-intervention), and 2 months (1-month follow-up).
Pressure Ulcer Management Self-Efficacy (PUM-SES)
Time Frame: Baseline (Pre-intervention), 1 month (immediately post-intervention), and 2 months (1-month follow-up).
Measured by the Pressure Ulcer Management Self-Efficacy Scale (PUM-SES). Each item is rated on a 5-point Likert scale from 1 (Totally Incapable) to 5 (Totally Capable). Total scores range from 10 to 50 points. A higher score indicates stronger self-efficacy in the prevention and management of pressure injuries.
Baseline (Pre-intervention), 1 month (immediately post-intervention), and 2 months (1-month follow-up).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kaohsiung Medical University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 1, 2026

Primary Completion (Estimated)

July 31, 2027

Study Completion (Estimated)

July 31, 2027

Study Registration Dates

First Submitted

January 6, 2026

First Submitted That Met QC Criteria

January 6, 2026

First Posted (Actual)

January 14, 2026

Study Record Updates

Last Update Posted (Actual)

March 17, 2026

Last Update Submitted That Met QC Criteria

March 13, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KMUHIRB-F(I)-20250035

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared to protect participant privacy and maintain data confidentiality as per the institutional review board requirements.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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