Using Normalization Process Theory to Evaluate Providing Pediatric Palliative Care at End-of-Life as Web-Based Training Intervention for Nurses: Study Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Moustafa Ali Al-Shammari ◽  
Amean Yasir ◽  
Nuhad Aldoori ◽  
Hussein Mohammad
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Normalization Process Theory ◽  
Process Theory ◽  
Pediatric Palliative Care ◽  
Web Based ◽  
Critical Care Units ◽  
Training Course ◽  
And Training ◽  
Normalization Process

BACKGROUND Palliative care is a rather concept that new in Iraq, there is no training intended for both health care specialists and the overall public. The lack of education and training programs is the most important barrier. Intermediate training is needed for individuals regularly at work with patients with life-threatening diseases. The End-of-Life Nursing Education Consortium-Pediatric Palliative Care, meant for nurses with an interest in provide care for those children with a life-limiting disease or in the event of accidents/and unexpected passing. OBJECTIVE The present paper is intended to evaluate the effect of a web-based course using the Normalization Process Theory, which focuses attention on how complex interventions become routinely embedded in practice and training of the sample academic nurses’ staff in the application of the pediatric palliative care in routine daily practice. It hypothesizes that nurses’ specialists will help after passing the training in providing palliative care for the pediatric population. METHODS In a Multicenter, parallel, Pragmatic trial, five health care settings spread over a single city of Babylon Province. Participants will be recruited and stratified to two strata (critical care units and non-critical care units). In the experimental condition, the (n = 86 academic nursing staff) will be trained in the application of the pediatric palliative care, for two weeks as web-based training course powered by Relais platform through inviting the nurses to participate via email, or instant messaging instruct WhatsApp, telegram, Viber account of participants to provide End of life care in addition to usual care to children and adolescents with life-limiting conditions. In the control condition (n=86), continue usual care. The program's effectiveness will be assessed at the level of nurses only. The statistical analyses will compare the baseline assessment for each participant (before the intervention) with a post-intervention assessment (after passing the training course). Moreover, a continuation assessment will occur three months after the course end. As around numerous unidentified factors influencing the effect of the course training, a progress evaluation to evaluate selection sample, application, and intervention value besides difficulties and organizers to implementation will as well be present comprised in the study analysis. The staff of nursing might not be the intervention blinded, nonetheless were blinded for the results. RESULTS The study trial recruitment opened in July 2020. The first outcomes are predicted to be available in December 2020. CONCLUSIONS Study object to determine the training effect of the academic nurse staff of multicenter departments\ units with a training course in the application of new pediatric palliative care. The study strengths are the usual practice setting, the staff training, the readiness of staff to participate in the study, and the random allocation to the intervention. Possible drawbacks may drop out because of staff of nursing may well transfer to another department throughout the study period. CLINICALTRIAL Trial Registration: NCT04461561

scholarly journals Combining Realist approaches and Normalization Process Theory to understand implementation: a systematic review

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Sonia Michelle Dalkin ◽  
Rebecca J. L. Hardwick ◽  
Catherine A. Haighton ◽  
Tracy L. Finch
Keyword(s):  
Systematic Review ◽  
Health Management ◽  
Explanatory Power ◽  
Family Health ◽  
Realist Evaluation ◽  
Normalization Process Theory ◽  
Process Theory ◽  
Scientific Realist ◽  
Health Database ◽  
Normalization Process

Abstract Background Realist approaches and Normalization Process Theory (NPT) have both gained significant traction in implementation research over the past 10 years. The aim of this study was therefore to explore how the approaches are combined to understand problems of implementation, to determine the degree of complementarity of the two approaches and to provide practical approaches for using them together. Methods Systematic review of research studies combining Realist and NPT approaches. Realist methodology is concerned with understanding and explaining causation, that is, how and why policies, programmes and interventions achieve their effects. NPT is a theory of implementation that explains how practices become normalised. Databases searched (January 2020) were ASSIA, CINAHL, Health Research Premium Collection via Proquest (Family Health Database, Health & Medical Collection, Health Management Database, MEDLINE, Nursing & Allied Health Database, Psychology Database, Public Health Database) and PsycARTICLES. Studies were included if the author(s) stated they used both approaches: a scientific Realist perspective applying the principles of Pawson and Tilley’s Realist Evaluation or Pawson’s Realist Synthesis and Normalization Process Theory either solely or in addition to other theories. Two authors screened records; discrepancies were reviewed by a third screener. Data was extracted by three members of the team and a narrative synthesis was undertaken. Results Of 245 total records identified, 223 unique records were screened and 39 full-text papers were reviewed, identifying twelve papers for inclusion in the review. These papers represented eight different studies. Extent and methods of integration of the approaches varied. In most studies (6/8), Realist approaches were the main driver. NPT was mostly used to enhance the explanatory power of Realist analyses, informing development of elements of Contexts, Mechanisms and Outcomes (a common heuristic in realist work). Authors’ reflections on the integration of NPT and Realist approaches were limited. Conclusions Using Realist and NPT approaches in combination can add explanatory power for understanding the implementation of interventions and programmes. Attention to detailed reporting on methods and analytical process when combining approaches, and appraisal of theoretical and practical utility is advised for advancing knowledge of applying these approaches in research. Systematic review registration Not registered.

scholarly journals The Swedish version of the Normalization Process Theory Measure S-NoMAD: translation, adaptation, and pilot testing

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Marie Elf ◽  
Sofi Nordmark ◽  
Johan Lyhagen ◽  
Inger Lindberg ◽  
Tracy Finch ◽  
...  
Keyword(s):  
Normalization Process Theory ◽  
Process Theory ◽  
Swedish Version ◽  
Pilot Testing ◽  
Normalization Process

scholarly journals A Novel Narrative E-Writing Intervention for Parents of Children With Chronic Life-Threatening Illnesses: Protocol for a Pilot, Open-Label Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Andy Hau Yan Ho ◽  
Oindrila Dutta ◽  
Geraldine Tan-Ho ◽  
Toh Hsiang Benny Tan ◽  
Casuarine Xinyi Low ◽  
...  
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Well Being ◽  
Mobile App ◽  
Pediatric Palliative Care ◽  
Writing Intervention ◽  
Open Label ◽  
Web Based ◽  
Randomized Controlled ◽  
Life Threatening

BACKGROUND A novel evidence-based Narrative e-Writing Intervention (NeW-I) has been developed and tested in Singapore to advance psychosociospiritual support for parents of children with chronic life-threatening illnesses. NeW-I is informed by an international systematic review and a Singapore-based qualitative inquiry on the lived experience of parental bereavement and supported by literature on anticipatory grief interventions for improving the holistic well-being of parent caregivers of seriously ill children. OBJECTIVE This study's aim was to provide an accessible platform, NeW-I—which is a strengths- and meaning-focused and therapist-facilitated mobile app and web-based counseling platform—that aims to enhance quality of life, spiritual well-being, hope, and perceived social support and reduce depressive symptoms, caregiver burden, and risk of complicated grief among parents of children with chronic life-threatening illnesses. METHODS The NeW-I therapist-facilitated web-based platform comprises a mobile app and a website (both of which have the same content and functionality). NeW-I has been implemented in Singapore as a pilot open-label randomized controlled trial comprising intervention and control groups. Both primary and secondary outcomes will be self-reported by participants through questionnaires. In collaboration with leading pediatric palliative care providers in Singapore, the trial aims to enroll 36 participants in each group (N=72), so that when allowing for 30% attrition at follow-up, the sample size will be adequate to detect a small effect size of 0.2 in the primary outcome measure, with 90% power and two-sided significance level of at least .05. The potential effectiveness of NeW-I and the accessibility and feasibility of implementing and delivering the intervention will be assessed. RESULTS Funding support and institutional review board approval for this study have been secured. Data collection started in January 2019 and is ongoing. CONCLUSIONS NeW-I aspires to enhance holistic pediatric palliative care services through a structured web-based counseling platform that is sensitive to the unique cultural needs of Asian family caregivers who are uncomfortable with expressing emotion even during times of loss and separation. The findings of this pilot study will inform the development of a full-scale NeW-I protocol and further research to evaluate the efficacy of NeW-I in Singapore and in other Asian communities around the world. CLINICALTRIAL ClinicalTrials.gov NCT03684382; https://clinicaltrials.gov/ct2/show/NCT03684382 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17561

scholarly journals Impact of a health literacy intervention combining general practitioner training and a consumer facing intervention to improve colorectal cancer screening in underserved areas: protocol for a multicentric cluster randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie-Anne Durand ◽  
Aurore Lamouroux ◽  
Niamh M. Redmond ◽  
Michel Rotily ◽  
Aurélie Bourmaud ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Literacy ◽  
Normalization Process Theory ◽  
Trial Registration ◽  
Process Theory ◽  
Crc Screening ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
The Impact ◽  
Normalization Process

Abstract Background Colorectal cancer (CRC) is a leading cause of cancer burden worldwide. In France, it is the second most common cause of cancer death after lung cancer. Systematic uptake of CRC screening can improve survival rates. However, people with limited health literacy (HL) and lower socioeconomic position rarely participate. Our aim is to assess the impact of an intervention combining HL and CRC screening training for general practitioners (GPs) with a pictorial brochure and video targeting eligible patients, to increase CRC screening and other secondary outcomes, after 1 year, in several underserved geographic areas in France. Methods We will use a two-arm multicentric randomized controlled cluster trial with 32 GPs primarily serving underserved populations across four regions in France with 1024 patients recruited. GPs practicing in underserved areas (identified using the European Deprivation Index) will be block-randomized to: 1) a combined intervention (HL and CRC training + brochure and video for eligible patients), or 2) usual care. Patients will be included if they are between 50 and 74 years old, eligible for CRC screening, and present to recruited GPs. The primary outcome is CRC screening uptake after 1 year. Secondary outcomes include increasing knowledge and patient activation. After trial recruitment, we will conduct semi-structured interviews with up to 24 GPs (up to 8 in each region) and up to 48 patients (6 to 12 per region) based on data saturation. We will explore strategies that promote the intervention’s sustained use and rapid implementation using Normalization Process Theory. We will follow a community-based participatory research approach throughout the trial. For the analyses, we will adopt a regression framework for all quantitative data. We will also use exploratory mediation analyses. We will analyze all qualitative data using a framework analysis guided by Normalization Process Theory. Discussion Limited HL and its impact on the general population is a growing public health and policy challenge worldwide. It has received limited attention in France. A combined HL intervention could reduce disparities in CRC screening, increase screening rates among the most vulnerable populations, and increase knowledge and activation (beneficial in the context of repeated screening). Trial registration Registry: ClinicalTrials.gov. Trial registration number: 2020-A01687-32. Date of registration: 17th November 2020.

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