Palliative Care Clinical Trial
— SPARKOfficial title:
Strengthening Palliative Care in Primary Health Care Through Knowledge Enhancement (SPARK) for Nurses in Yogyakarta: A Randomized Control Trial
The implementation of palliative care has been started in Indonesia since 2007. This was declared by Ministry of health regulation (SK Menkes no 812/Menkes/SK/2007). However, there has been a slow development in palliative care compared to other Asian countries. One of the reasons is the lack of knowledge and skills among health care professionals in Indonesia. Primary Heath Center (PHC) is at the frontline in the health care system in Indonesia to provide care for patients. Its function is especially important in the Universal Health Coverage era. Studies have shown that PHC's nurses' knowledge on palliative care is still limited since the integration of palliative care into the nursing curriculum just started 2-3 years ago. Also, this curriculum integration is still limited in some Universities. Continuing nursing education (CNE) is one of the ways to enhance nurses' knowledge and skills. CNE for palliative care in Indonesian training programs has not been structurally established yet. It is fragmented in its application into some areas and has not been applied for the majority of areas in Indonesia. Investigators aim to develop a palliative care training for PHC nurses using an online format. It will be done in several steps. Firstly, investigators are starting by conducting a review to collect information on what topics are suitable for PHC nurses. Secondly, investigators are developing modules and other educational tools (a virtual education package). Thirdly, those educational packages will be then evaluated by experts. Next, the education package will be integrated into eLOK (e-learning: open for knowledge sharing) at Universitas Gadjah Mada. After that, training for PHC nurses in Yogyakarta using eLOK will be conducted under the acronym: SPARK or Strengthening PAlliative caRe in the community by enhancing nurses' Knowledge (Sinau PAliatif Rame-rame karo eLOK). The effectiveness of SPARK will be measured with a Randomized Control Trial. Investigators will also collect more information on the feasibility of this program using qualitative data collection since investigators expect to refine this program to be applied in a larger area in Indonesia.
Status | Not yet recruiting |
Enrollment | 44 |
Est. completion date | September 30, 2021 |
Est. primary completion date | August 1, 2021 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - - Nurses who currently work in Primary Health Center (PHC) in Yogyakarta, Indonesia, at least for one year; - Able to access the Internet; and - Willing to be part of the study. Exclusion Criteria: - Nurses working in PHC Yogyakarta but unable to provide consent due to some limitations (on leave, do not have enough time, do not have Internet access, temporary leaving job due to study commitment, etc.) |
Country | Name | City | State |
---|---|---|---|
Indonesia | Primary Health Center | Yogyakarta | Daerah Istimewa Yogyakarta |
Lead Sponsor | Collaborator |
---|---|
Gadjah Mada University |
Indonesia,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | PHC nurse' knowledge | Primary outcome of the current study is to measure the changes of the level of knowledge of PHC nurses. Investigators are using Palliative Care Quiz for Nursing Indonesian version (PCQN-i) from baseline to after intervention and to 4 and 8 weeks post intervention. This instrument (N=20 items) measures nurses' knowledge on palliative care which consists of 3 domains: philosophy and principles (4 items); pain and symptom management (13 items); and psychosocial and spiritual care (3 items). Items are responded to by 'true', 'false' and 'don't know' and each correct answer will score 1. The higher score will indicate the greater palliative care knowledge. | Week 0 (baseline), Week 5 (after intervention), Week 10 (follow up), Week 14 (follow up) | |
Secondary | PHC nurse's difficulty in palliative care | Secondary aims are to measure the changes of perception of PHC nurses in the implementation of palliative care in the community using Palliative Care Difficulty Scale (PCDC). It is a validated tool to quantify the levels of difficulty when health professionals provide palliative care. This instrument (N=18 items) includes five subscales: expert support, alleviating symptoms, community coordination, communication in multidisciplinary teams and communication with patients and families. Each subscale has three items graded on a 5 point Likert-type scale from 1 = never to 5 = very much. A higher value means more perceived difficulties, with a possible score range from 1 to 5. | Week 0 (baseline), Week 5 (after intervention), Week 10 (follow up), Week 14 (follow up) | |
Secondary | PHC nurse's practice report | Another secondary aim is to measure the changes of reporting implementation of palliative care in the community using the Palliative Care Self-Reported Practice Scale. It is a validated tool to quantify the levels of adherence to recommended practices in palliative care (N=15 items). This scale is comprised of six sub scales graded on a 5 point Likert-type scale from never to very much. A higher value means closer adherence to recommended practices in palliative care, with possible score range from 1 to 5. | Week 0 (baseline), Week 5 (after intervention), Week 10 (follow up), Week 14 (follow up) |
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