NCT05765643

Brief Summary

Parents of children with medical complexity (CMC) are suffering from high level of stress. These CMC get multisystem diseases, including severe neurologic conditions or cancer, resulting in potential premature death. They experience one or more physical and psychological symptoms at one time, which seriously affect their quality of life and increase their health services utilization. Parents may lack confidence in their abilities when managing their child's symptoms. Literature suggested that increasing parental self-efficacy in managing their child's symptoms could improve child's health status. Home-based nursing services for the CMC and parents are available in Hong Kong. However, the service faces challenges because of serious nursing workforce shortage and the recent coronavirus pandemic. Nurse parental support in symptom management using a proactive mobile health App is an alternative method considered more feasible to continue home-based support for the CMC and parents. This proposed RCT will test the effects of a nurse-led mobile App for enhancing parental self-efficacy in symptom management for CMC. A repeated-measures, two-group design will be used to evaluate the effects between intervention and wait-listed control groups by comparing the study group receiving nurse support using a mobile App, and the wait-listed control group receiving usual community care for 96 randomly selected parents over a three-month follow-up. Primary outcome is parental self-efficacy. Secondary outcomes include children's symptom burden and health services utilization. These factors will be measured before intervention, immediately after intervention and three-month after intervention. The effectiveness of the intervention will be evaluated by comparing the primary outcome at three-month after intervention across the two study groups using ANCOVA with control for the pre-test value of parental self-efficacy. Generalized estimating equation will be used to address secondary objectives regarding the effectiveness of the mobile App as compared to the control on secondary outcomes from T1 to T3 with appropriate link function. It is hypothesized that nurse support using the mobile App is more effective than usual community care in enhancing parental self-efficacy in symptom management for their CMC at three-month after intervention.

Trial Health

57
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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
96

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Aug 2023

Typical duration for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 28, 2023

Completed
13 days until next milestone

First Posted

Study publicly available on registry

March 13, 2023

Completed
5 months until next milestone

Study Start

First participant enrolled

August 15, 2023

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 30, 2024

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2025

Completed
Last Updated

August 8, 2025

Status Verified

June 1, 2025

Enrollment Period

1.4 years

First QC Date

February 28, 2023

Last Update Submit

August 7, 2025

Conditions

Keywords

Child with medical complexityChild with cancerparental self-efficacymobile health applicationsymptom management

Outcome Measures

Primary Outcomes (1)

  • Change of caregiver self-efficacy

    The CaSES (Chinese version) is a 18-item scale. It is rated on a 9-point scale, with 1= no confidence, to 9 =full confidence.

    0, week 12, week 24

Secondary Outcomes (2)

  • Change of children health service utilization

    0, week 12, week 24

  • Change of children's symptom burden

    0, week 12, week 24

Study Arms (2)

Nurse parental support in symptom management using a mobile health App over 3 months

EXPERIMENTAL
Other: Nurse parental support in symptom management using a mobile health App

Wait-listed control

NO INTERVENTION

Parents in this group can join the usual community social or health care services as usual.

Interventions

Parents in this group will receive a mobile App that includes health assessment, monitoring, health education and nurse support using phone calls over a 3-month period

Nurse parental support in symptom management using a mobile health App over 3 months

Eligibility Criteria

Age2 Years - 18 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • The eligible criteria for parents are:
  • parent of a child with medical complexity aged 2-18
  • having a Smartphone
  • able to communicate in Chinese and read Chinese
  • living with his/her child at home.

You may not qualify if:

  • a reported mental health disorder
  • engaging in other structured programs related to symptom management 3) living in an area with no internet coverage.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

School of Nursing The Hong Kong Polytechnic University

Kowloon, Kowloon, 852, Hong Kong

COMPLETED

School of Nursing

Hong Kong, 852, Hong Kong

RECRUITING

Related Publications (1)

  • Lam W, Zhao Z, Law QP, Ngai VW, Wong FK, Fowler C. Nurse-led proactive mobile application in symptom management for children with medical complexity: Study protocol for a randomized controlled trial. J Adv Nurs. 2024 Sep;80(9):3856-3865. doi: 10.1111/jan.16294.

MeSH Terms

Conditions

Muscular Atrophy

Condition Hierarchy (Ancestors)

Neuromuscular ManifestationsNeurologic ManifestationsNervous System DiseasesAtrophyPathological Conditions, AnatomicalPathological Conditions, Signs and SymptomsSigns and Symptoms

Study Officials

  • Lam Winsome, PhD

    The Hong Kong Polytechnic University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Lam Winsome, PhD

CONTACT

Sze Wan Man

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Model Details: This is a single-blinded, randomized controlled trial with two-armed repeated measures
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

February 28, 2023

First Posted

March 13, 2023

Study Start

August 15, 2023

Primary Completion

December 30, 2024

Study Completion

December 31, 2025

Last Updated

August 8, 2025

Record last verified: 2025-06

Data Sharing

IPD Sharing
Will not share

Locations