Impact of a Telenursing service on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized trial study protocol

Abstract

BackgroundPediatric rheumatic diseases have a significant impact on children’s quality of life and family functioning. Disease control and management of the symptoms are important to minimize disability and pain. Specialist clinical nurses play a key role in supporting medical teams, recognizing poor disease control and the need for treatment changes, providing a resource to patients on treatment options and access to additional support and advice, and identifying best practices to achieve optimal outcomes for patients and their families. This highlights the importance of investigating follow-up telenursing (TN) consultations with experienced, specialist clinical nurses in rheumatology to provide this support to children and their families.Methods/DesignThis randomized crossover, experimental longitudinal study will compare the effects of standard care against a novel telenursing consultation on children’s and family outcomes. It will examine children below 16 years old, recently diagnosed with inflammatory rheumatic diseases, who attend the pediatric rheumatology outpatient clinic of a tertiary referral hospital in western Switzerland, and one of their parents. The telenursing consultation, at least once a month, by a qualified, experienced, specialist nurse in pediatric rheumatology will consist of providing affective support, health information, and aid to decision-making. Cox’s Interaction Model of Client Health Behavior serves as the theoretical framework for this study. The primary outcome measure is satisfaction and this will be assessed using mixed methods (quantitative and qualitative data). Secondary outcome measures include disease activity, quality of life, adherence to treatment, use of the telenursing service, and cost. We plan to enroll 56 children.DiscussionThe telenursing consultation is designed to support parents and children/adolescents during the course of the disease with regular follow-up. This project is novel because it is based on a theoretical standardized intervention, yet it allows for individualized care. We expect this trial to confirm the importance of support by a clinical specialist nurse in improving outcomes for children and adolescents with inflammatory rheumatisms.Trial registrationClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012).

Práticas de enfermagem ao paciente com dor crônica: revisão integrativa

“…(20,22) Studies have shown that the recommended interventions are effective for pain and symptom management without causing costly side effects, as well as having a holistic approach that facilitates assessment of quality of life, (20,22) that is, they increase their efficiency in meeting patients' needs and include a wide range of activities, including screening in emergencies, patient safety through nursing counseling and teaching. (22) The systematized care of the nurse produces autonomy in the management of pain and its interventions were able to overcome the existing inadequacies through pain evaluation, nursing prescription and adequate recording, resulting in comfort, better understanding of the patient and organization of the work process. (21,25,27) Regarding comfort and integrated approach, non-pharmacological complementary treatments have been proven as great contributors to pain relief.…”

“…(21,25,27) Regarding comfort and integrated approach, non-pharmacological complementary treatments have been proven as great contributors to pain relief. (12,22,25) Thus, these therapeutic resources show, in the last decades, as potent adjuvants in the global rebalancing and not only symptomatic treatment, adding to the drug therapies previously had as the only and priority in the control of pain. (14,15,24,28) Multiprofessional programs offering chronic pain nursing practices, with patient-centered care, low complexity psychological approaches (cognitive behavioral therapy), combined with lifestyle reorientation, are interventions that have stood out in the studies, with potential emphasis on rehabilitation, promotion of self-care, ability to promote comfort, minimization of suffering and promotion of quality of life, as well as meditation.…”

“…(13,27) Systematized activities, with good communication and evaluation of the behaviors established to the patient, as well as satisfaction regarding the care, guide improvements and benefits both the team and the patient. (13,18,21,22,27) The Educational Practices allow direct positive interference both in the care plan and in the daily life of the same as in the greater response to the treatment due to the information provided that causes understanding the lived situation. (13,15,24)…”

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

“…A randomized crossover, experimental longitudinal design was used in this study (see protocol published elsewhere) [ 20 ]. This article presents the quantitative component of this study.…”

Acompanhamento por telefone no pós alta hospitalar de idosos

“…Contudo, a intermediação no processo educacional pelo uso das Tecnologias da Informação e Comunicação (TIC), aumentou as possibilidades de comunicação e aquisição de informações, o que alterou a forma de viver, trabalhar, organizar-se socialmente e também de aprender na atualidade [3][4] .…”