Clinical trial NCT06263296: Smartphone Assisted Self-management Education for Adult Burn Patient At Aftercare
Official title: The Impact on Quality of Life in Individual with Burn Injury: Utilizing Smartphone Assisted Self-management Education At Aftercare
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Burns
Self Efficacy
Burn Second Degree
Burns Third Degree
Quality of Life
Adherence, Treatment
Burn Injury
Lead sponsor: Queen Mary Hospital, Hong Kong
Sponsor class: OTHER
First posted: 2024-02-16
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Pilot Randomized Controlled Trial
Primary purpose: TREATMENT

Brief summary: Burn rehabilitation management is dependent on the patients themselves, non-treatment adherence may delay the optimal timing of burn rehabilitation and it may not be regained easily. The inevitable sequelae of increasing joint stiffness and tethered soft-tissue glide become more devastating over time. It has a major impact on clinical outcomes such as scarring, deformity and dysfunction, which result in lower quality of life compared to general population

There is a growing body of research on patient-centered interventions including the concept of self-management. Such phenomenon is consistent with burn patients' needs at aftercare. The proposed smartphone self-management program is to change the paradigm from paternalistic to collaborative relationship. Self-management is to build up patient equipping ability in problem solving, decision making, and appropriate use of resources and has led to improved patient engagement, adherence, and better quality of care.

The investigators hypothesize that, upon intervention completion and compared with the control group, burn patients in the intervention group will report:

1. Higher level of health-related quality of life,
2. Higher level of self-efficacy
3. Higher level of score in Burn Rehabilitation Knowledge
4. Lower pain level, as measured by Numeric Pain Rating Scale; and
5. Lower level of itchiness

The desired smart phone assisted self-management intervention will be carried out by principal investigator to selected adult burn patients before discharge and post discharge period. Before discharge, ward nurses will provide discharge pamphlet and individual face to face education to both groups as usual care. After discharge, instant messaging supportive enquiry service will be provided to both groups via smartphone apps.

For intervention group, principal investigator will assess subject health care needs prior to intervention. Two extra sessions, 20 minutes, face to face, individual self-management education with aid of computer, track log sheet will be provided to intervention group. Concept of motivational interviewing will be incorporated as complement teaching strategy to facilitate self-management learning. Principal investigator will be responsible to deliver burn self-management education upon discharge. Intervention group will receive "Rehabilitation Booklet for Burn Patients" upon discharge. After discharge, only intervention group subject receives two sessions, 10 minutes, telephone follow up calls and five personalized chat-based messaging follow up will be provided. Besides that, self-management education information will be delivered to intervention group via instant messaging service as well. Ad-hoc instant messaging support will be provided to both groups if required.

Detailed description: Due to the advancement of medical treatment, burn-related mortality has been reduced especially in developed countries . Long-term undesirable impacts such as wound problems, skin care, exercise training, scar management, psychological and social problems have been detected in both major and non-major burns (less than 20% total body surface area (TBSA). The focus of burn care is shifted not only acute care but also rehabilitation.

Burn rehabilitation management is dependent on the patients themselves, non-treatment adherence may delay the optimal timing of burn rehabilitation and it may not be regained easily. The inevitable sequelae of increasing joint stiffness and tethered soft-tissue glide become more devastating over time. It has a major impact on clinical outcomes such as scarring, deformity and dysfunction, which result in lower quality of life compared to general population

There is a growing body of research on patient-centered interventions including the concept of self-management. Such phenomenon is consistent with burn patients' needs at aftercare. The proposed smartphone self-management program is to change the paradigm from paternalistic to collaborative relationship. Self-management is to build up patient equipping ability in problem solving, decision making, and appropriate use of resources and has led to improved patient engagement, adherence, and better quality of care.

The investigators hypothesize that, upon intervention completion and compared with the control group, burn patients in the intervention group will report:

1. Higher level of health-related quality of life,
2. Higher level of self-efficacy
3. Higher level of score in Burn Rehabilitation Knowledge
4. Lower pain level, as measured by Numeric Pain Rating Scale; and
5. Lower level of itchiness

The desired smart phone assisted self-management intervention will be carried out by principal investigator to selected adult burn patients before discharge and post discharge period.

Before discharge, ward nurses will provide discharge pamphlet and individual face to face education to both groups as usual care.

After discharge, instant messaging supportive enquiry service will be provided to both groups via smartphone apps.

For intervention group, principal investigator will assess subject health care needs prior to intervention. Two extra sessions, 20 minutes, face to face, individual self-management education with aid of computer, track log sheet will be provided to intervention group. Concept of motivational interviewing will be incorporated as complement teaching strategy to facilitate self-management learning.

Principal investigator will be responsible to deliver burn self-management education upon discharge. Intervention group will receive "Rehabilitation Booklet for Burn Patients" upon discharge.

After discharge, only intervention group subject receives two sessions, 10 minutes, telephone follow up calls and five personalized chat-based messaging follow up will be provided. Besides that, self-management education information will be delivered to intervention group via instant messaging service as well. Ad-hoc instant messaging support will be provided to both groups if required.

Eligibility criteria: Inclusion Criteria:

* Chinese adult aged above 18 years old
* Hospitalized burn patient
* Adult who can understand Cantonese
* Superficial partial thickness burn: TBSA \>10%
* Deep partial thickness burn or full thickness burn: TBSA \> 5%

Exclusion Criteria:

* Inhalation injury solely
* Sustained burn injury due to self-injury
* Diagnosed psychiatric illness with or without medication
* Client who is unable to communicate via instant messaging apps

Primary outcomes:
measure: Change from Baseline in the Disease Specific Quality of life at Week 4 & Week 12
timeFrame: Baseline and Week 4; Week 12
measure: Change from Baseline in the Generic Quality of life at Week 4 & Week 12
timeFrame: Baseline and Week 4; Week 12
measure: Change from Baseline in the Burn Rehabilitation Knowledge Questionnaire
timeFrame: Baseline and Week 4
Secondary outcomes:
measure: Change from Baseline in the Self efficacy at Week 4 & Week 12
timeFrame: Baseline and Week 4; Week 12
measure: Change from Baseline in the Itchiness of life at Week 4 & Week 12
timeFrame: Baseline and Week 4; Week 12
measure: Change from Baseline in the Pain level at Week 4 & Week 12
timeFrame: Baseline and Week 4; Week 12
Other outcomes:
measure: Percentage in the Burn related out-patient clinic attendance
timeFrame: Week 4; Week 12
Locations:
city: Hong Kong
country: China
facility: LIU Siu Kwong
Study officials:
References:
citation: Procter F. Rehabilitation of the burn patient. Indian J Plast Surg. 2010 Sep;43(Suppl):S101-13. doi: 10.4103/0970-0358.70730.
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citation: Esselman PC. Burn rehabilitation: an overview. Arch Phys Med Rehabil. 2007 Dec;88(12 Suppl 2):S3-6. doi: 10.1016/j.apmr.2007.09.020.
citation: Smolle C, Cambiaso-Daniel J, Forbes AA, Wurzer P, Hundeshagen G, Branski LK, Huss F, Kamolz LP. Recent trends in burn epidemiology worldwide: A systematic review. Burns. 2017 Mar;43(2):249-257. doi: 10.1016/j.burns.2016.08.013. Epub 2016 Sep 3.
citation: Barrett LW, Fear VS, Waithman JC, Wood FM, Fear MW. Understanding acute burn injury as a chronic disease. Burns Trauma. 2019 Sep 16;7:23. doi: 10.1186/s41038-019-0163-2. eCollection 2019.