Abstract：
OBJECTIVE: 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.
METHODS: A single-blinded, randomized controlled trial with a two-armed repeated measures design.
METHODS: 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.
CONCLUSIONS: 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.
CONCLUSIONS: 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.
BACKGROUND: NCT05765643 (ClinicalTrials.gov identifier).
UNASSIGNED: Parents of children with medical complexity contributed in mobile application development by giving comments on the usability of mobile application.
UNASSIGNED: 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.
METHODS: A single-blinded, randomized controlled trial with a two-armed repeated measures design.
METHODS: 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.
CONCLUSIONS: 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.
CONCLUSIONS: 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.
BACKGROUND: NCT05765643 (ClinicalTrials.gov identifier).
UNASSIGNED: Parents of children with medical complexity contributed in mobile application development by giving comments on the usability of mobile application.
UNASSIGNED: 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.
摘要：
目的：调查使用主动移动应用程序的护士支持在具有医疗复杂性的儿童的症状管理中提高父母自我效能的效果。
方法：单盲，采用双臂重复措施设计的随机对照试验。
方法：符合条件的父母和孩子将从特殊学校和非政府办公室招募。他们将被随机分配到干预组或对照组。研究组中的受试者将使用症状管理移动应用程序获得3个月的护士父母支持。对照组将接受社区中可用的常规护理。将在干预前(T1)收集数据，在干预后立即（T2），干预后3个月（T3）。主要结果是父母的自我效能感。次要结果包括儿童的症状负担和他们的卫生服务利用。主要结果将在T2和T3中与对照组进行比较，以确定父母自我效能感的预测试值。广义估计方程（GEE）将用于解决从T1到T3的次要目标，并具有适当的链接函数。
结论：由于这种护士主导的症状管理的成功实施，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率都将减少。这项研究的结果将有助于改善服务提供，因为它最大程度地提高了儿科健康服务对父母和当地社区儿童的可用性和可及性。
结论：本研究中产生的证据将扩大支持循证儿科家庭护理服务在症状管理中使用健康技术的知识库。这些证据也将有助于其他儿科患者群体的其他症状管理计划的发展。
背景：NCT05765643（ClinicalTrials.gov标识符）。
■具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。
■改善医疗服务的提供:家庭护理服务在香港长远来看可能无法持续,由于医疗保健系统近年来一直面临着严重的护理劳动力短缺。此外,这些服务在传染病社区爆发期间受到影响甚至暂停，就像最近的冠状病毒疾病大流行一样。使用主动移动健康应用程序为CMC提供症状管理的护士父母支持将有助于改善服务交付，因为它最大程度地提高了儿科健康服务对父母及其CMC在当地社区的可用性和可及性。改善父母及其CMC的身心健康：计划实施的成功将有助于提高父母在CMC症状管理中的自我效能，作为儿童症状负担减少的结果。改善知识库：本研究中产生的证据将（1）扩大支持与CMC症状管理相关的循证儿科社区护理服务的知识库。这些证据将有助于为其他儿科患者组制定其他症状管理计划。
方法：单盲，采用双臂重复措施设计的随机对照试验。
方法：符合条件的父母和孩子将从特殊学校和非政府办公室招募。他们将被随机分配到干预组或对照组。研究组中的受试者将使用症状管理移动应用程序获得3个月的护士父母支持。对照组将接受社区中可用的常规护理。将在干预前(T1)收集数据，在干预后立即（T2），干预后3个月（T3）。主要结果是父母的自我效能感。次要结果包括儿童的症状负担和他们的卫生服务利用。主要结果将在T2和T3中与对照组进行比较，以确定父母自我效能感的预测试值。广义估计方程（GEE）将用于解决从T1到T3的次要目标，并具有适当的链接函数。
结论：由于这种护士主导的症状管理的成功实施，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率都将减少。这项研究的结果将有助于改善服务提供，因为它最大程度地提高了儿科健康服务对父母和当地社区儿童的可用性和可及性。
结论：本研究中产生的证据将扩大支持循证儿科家庭护理服务在症状管理中使用健康技术的知识库。这些证据也将有助于其他儿科患者群体的其他症状管理计划的发展。
背景：NCT05765643（ClinicalTrials.gov标识符）。
■具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。
■改善医疗服务的提供:家庭护理服务在香港长远来看可能无法持续,由于医疗保健系统近年来一直面临着严重的护理劳动力短缺。此外,这些服务在传染病社区爆发期间受到影响甚至暂停，就像最近的冠状病毒疾病大流行一样。使用主动移动健康应用程序为CMC提供症状管理的护士父母支持将有助于改善服务交付，因为它最大程度地提高了儿科健康服务对父母及其CMC在当地社区的可用性和可及性。改善父母及其CMC的身心健康：计划实施的成功将有助于提高父母在CMC症状管理中的自我效能，作为儿童症状负担减少的结果。改善知识库：本研究中产生的证据将（1）扩大支持与CMC症状管理相关的循证儿科社区护理服务的知识库。这些证据将有助于为其他儿科患者组制定其他症状管理计划。
