Strengthening Palliative Care in Primary Health Care Through Knowledge Enhancement

NCT04862169 | Completed DMC

• 1 other identifier: SPARK project 2021
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Palliative Care; Nurse; Community Health Services

Keywords

Palliative care; Nurses; Indonesia; Primary Health Center; SPARK Indonesia

Outcome Measures

Primary Outcomes (1)

• 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 Outcomes (2)

• PHC nurse's difficulty in palliative care

  Week 0 (baseline), Week 5 (after intervention), Week 10 (follow up), Week 14 (follow up)

• PHC nurse's practice report

  Week 0 (baseline), Week 5 (after intervention), Week 10 (follow up), Week 14 (follow up)

Study Arms (2)

Control group

PLACEBO COMPARATOR

In the control group, they will only receive electronic version of the modules. They are able to access the module on their own devices. The observation arm will receive the link of eLOK at the end of data collection and follow-ups (week 14). With this link, then they are able to access modules, videos and case studies provide in SPARK.

Other: electronic version of the modules

Intervention group

EXPERIMENTAL

The intervention on this RCT is an educational training program: SPARK (Strengthening PAlliative caRe in the community by enhancing nurses' Knowledge). This is an educational intervention using an online method with learning method system (LMS) eLOK hosted by Universitas Gadjah Mada Yogyakarta (Affiliation of authors' team). The intervention includes online discussions and access to eLOK for study materials (modules and videos) and some synchronous meetings.

Other: educational intervention (SPARK)

Interventions

educational intervention (SPARK) OTHER

There are 3 modules with 11 chapters. These topics were considered as the most relevant topics for implementation of palliative care for PHC nurses. Also, topics were selected based on our previous literature review of the previous study on the content of PHC nurses training program. The first module is the introduction. This consists of three chapters: introduction, support system and effective communication. Total reading time is estimated to be one hour. The second module is about the nursing approach in palliative care. It is estimated to be completed in around 2 hours and 15 minutes. The last module is about end of life care. The participants are expected to access this module before the scheduled synchronous mode. Modules will be provided in the electronic version, so that participants are able to download and read them on their own devices. We are also providing video as trigger for case study discussion

Intervention group

electronic version of the modules OTHER

electronic version of the modules

Control group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \- 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.

You may not qualify if:

• 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.)

Sponsors & Collaborators

• Gadjah Mada University: lead

Study Sites (1)

Primary Health Center

Yogyakarta, Special Region of Yogyakarta, 55581, Indonesia

Location

Study Officials

• Martina Sinta Kristanti, PhD

  Gadjah Mada University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: Allocation concealment will use sealed envelopes. Randomization will be done by concealing a piece of paper that has the phrase "Intervention (SPARK)" or "Control (MODULE only)" which will be placed inside a thick envelope. The outside of the envelopes will be labelled with the sequence number. After a participant has been enrolled into the study and consented, the next sequence numbered envelope on the stack will be opened to determine the study group that the subject will enter.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator, Assistant Professor

Model Details: The intervention on this RCT is SPARK (Sinau PAlliative Rame-rame bareng eLOK) OR Strengthening PAlliative caRe in the community by enhancing nurses' Knowledge). This is an educational intervention using an online method with learning method system (LMS) eLOK hosted by Universitas Gadjah Mada Yogyakarta (Affiliation of authors' team). The intervention includes online discussions and access to eLOK for study materials (modules and videos).

Study Record Dates

• First Submitted: April 22, 2021
• First Posted: April 27, 2021
• Study Start: July 25, 2021
• Primary Completion: November 1, 2021
• Study Completion: December 30, 2021
• Last Updated: July 11, 2024

Record last verified: 2024-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: in 2022

Locations

ID (1)