Impact of a nurse led telephone intervention on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized clinical trial

Anne-Sylvie Ramelet, Béatrice Fonjallaz, Laura Rio, Sandra Zoni, Pierluigi Ballabeni, Joachim Rapin, Christophe Gueniat, Michaël Hofer, Anne-Sylvie Ramelet, Béatrice Fonjallaz, Laura Rio, Sandra Zoni, Pierluigi Ballabeni, Joachim Rapin, Christophe Gueniat, Michaël Hofer

Abstract

Background: Children suffering from rheumatic disease are faced with multidimensional challenges that affect their quality of life and family dynamics. Symptom management and monitoring of the course of the disease over time are important to minimize disability and pain. Poor disease control and anticipation of the need for treatment changes may be prompted by specialist medical follow-up and regular nurse-led consultations with the patient and families, in which information and support is provided. The purpose of this study was to evaluate the impact of a nurse-led telephone intervention or Telenursing (TN) compared to standard care (SC) on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their parents.

Methods: A multicentered, randomized, longitudinal, crossover trial was conducted with pediatrics outpatients newly diagnosed with inflammatory rheumatic diseases. Participants were randomly assigned to two groups TN and SC for 12 months and crossed-over for the following 12 months. TN consisted of providing individualized affective support, health information and aid to decision making. Satisfaction (primary outcome) and health outcomes were assessed with the Client Satisfaction Questionnaire-8 and the Juvenile Arthritis Multidimensional Assessment Report, respectively. A mixed effect model, including a group x time interaction, was performed for each outcome.

Results: Satisfaction was significantly higher when receiving TN (OR = 7.7, 95% CI: 1.8-33.6). Morning stiffness (OR = 3.2, 95% CI: 0.97-7.15) and pain (OR = 2.64, 95% CI: 0.97-7.15) were lower in the TN group. For both outcomes a carry-over effect was observed with a higher impact of TN during the 12 first months of the study. The other outcomes did not show any significant improvements between groups.

Conclusion: TN had a positive impact on satisfaction and on morning stiffness and pain of children with inflammatory rheumatic diseases and their families. This highlights the importance of support by specialist nurses in improving satisfaction and symptom management for children with inflammatory rheumatisms and their families.

Trial registration: ClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012).

Keywords: Patient satisfaction; Pediatrics; Rheumatology; Symptom management; Telehealth; Telenursing.

Conflict of interest statement

Ethics approval and consent to participate

The study and its amendment were approved by the Human Research Ethics Committee of the Canton de Vaud (CER-VD) on January 17, 2011 and March 28, 2011, respectively. Following ethics approval, parents and patients who attended the pediatric rheumatology outpatient clinic between January 2010 and August 2012, were invited to participate in our study. A written informed consent to participate form and questionnaires were mailed to patients and their parents prior their medical consultations. They were then approached by a researcher (SZ) for consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study enrollment and flow

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