Clinical Research Directory

Effect and Cost Effectiveness of a Dyadic Empowerment-based Heart Failure Management Program for Self-care

Global population aging has drastically increased healthcare spending worldwide, with the greatest portion going to hospital and community health services. Heart failure (HF), as the final form of many cardiovascular diseases resulting from insufficient myocardial pumping. Ineffective self-care is consistently identified as the major modifiable risk factor for HF decompensation requiring hospitalization. It refers to an active cognitive process that influence patients' engagement in self-care maintenance, symptom perception and self-care management. However, current studies pay much focus on interventions such as motivational interviewing and behavioural activation to enhance the HF-related self-care and health outcomes which only produces short-term benefits. In fact, the lack of a sustainable effect from the self-care supportive interventions might be related the use of patient-centric design in these studies, which totally ignores the fact that HF management takes place in a dyadic context. To advance, active strategies were adopted to mobilize collaborative effort of the dyad in actual disease management. This study aims to evaluate the effects and cost-effectiveness of a Dyadic empowerment-based Heart Failure Management Program (De-HF) for self-care, health outcomes, and health service utilization among HF patients who require family support after hospital discharge. The De-HF program is based on the Theory of Dyadic Illness Management to enhance the congruence in illness perception and active dyadic collaboration in managing HF via both face-to-face and online platforms.

Nurse Led Intervention on Self Care Adherence and Quality of Life

Background: Hemodialysis is the most common treatment modality in patients with chronic kidney disease. The majority of people with dialysis have a below-average quality of life. Adherence to diet and fluid intake, engagement in physical activity, and feeling blue and anxious will all affect quality of life. Nurses play a key role in patient education and behavioral support. Nurse-led interventions, especially educational programs (laptop-based), combined with reminders and educational materials, may improve patients' knowledge, adherence to treatment, and improvement in quality of life. Methodology The study will adopt the quantitative research design .The study will be conducted in a single private tertiary care center. First, the day and shift were randomized, and participants belonging to the particular day and shift will be considered as Group A and Group B. After this, the eligibility criteria will be assessed, and the baseline assessment will be done. A convenient sampling technique will be used to select the study sample. The sample will be a minimum of 56 in each arm. Therefore, altogether there will be at least 112 participants. One group will receive nurse-led interventions (Group A), and the control group (Group B) will receive usual routine care. Nurse-led intervention comprises 4 laptop-based educational and counseling sessions, 4-6 telephone reminders, and the distribution of the booklet on self-care. All four sessions will be conducted by the specialist nurse or nurse with at least one year of working experience in a dialysis unit. Each session will be conducted once every one to two weeks. The primary outcome will be self-care adherence. The self-care adherence will be measured by direct assessment of clinical parameters (interdialytic weight gain) of adherence and subjectively through face-to-face interviews. Patients' medical records will be reviewed. The secondary outcome will be the quality of life score. An independent assessor (enumerator) will measure the outcome at T1 and T2, which will be done at 2 months (T1) and 6 months (T2) from the baseline. Analysis will be done through the Stata software version 14. Descriptive statistics like frequency, percentage, mean±sd, median, inter quartile range are based on the nature of the data. Similarly, inferential statistics such t t-test and linear regression analysis will be used to find out the difference in mean score between two groups. The findings will be considered statistically significant at level p\<0.05 at 95% CI. The strength of this study will be the inclusion of both clinical and subjective parameters of adherence and assessment of quality of life. Use of a qualitative approach in explaining the factors, like appropriateness of the education and counselling session, along with the facilitators and barriers to adherence, will further help to modify the interventions. If the method is found to be effective, this will be an effective measure to improve quality of life cost-effectively. This can be continued on a regular basis in the same center and can be utilized in others, too.

Impact of Psychosocial Support Web-Based Toolkit

At times of crisis, early childhood development (ECD) workers, and schools/centers play an important role in the lives of children in the early childhood stage (less than 8 years old) and their parents; they are intended to act as the "great equalizer", offering not only curriculum teaching, but also additional social-emotional learning and educational opportunities for vulnerable children who are more likely to suffer in such situations. CD teachers, despite this responsibility, often lack tools and methods to promote their well-being, and to cope with vulnerable children and difficult situations. They are also rarely recognized as members of a workforce with specialized knowledge or competencies, and they hardly receive the support needed to uphold this great responsibility to young children, their families, and society.

Evaluation of Remote Motivational Interviewing for Disease Management in Heart Failure Patients and Their Carers

Heart failure (HF) is a chronic and progressive condition that significantly affects patients' quality of life and increases the burden on family caregivers. Many patients struggle with self-care, including medication adherence, diet, and symptom monitoring. The REMIND HF (REmote Motivational INterviewing for Disease Management in Heart Failure) study aims to evaluate the effectiveness of remote motivational interviewing (MI) as a behavioral intervention to improve disease management and self-care among heart failure patients and their informal caregivers. The intervention consists of a series of online motivational interviews conducted by trained nurses over a 12-month period, focusing on lifestyle modification, self-monitoring, and patient-caregiver cooperation. The study will be conducted at the Wroclaw Medical University and collaborating centers. It will enroll 300 patients with heart failure (The New York Heart Association Functional Classificaion - NYHA class: II-IV) and their primary caregivers. Outcomes will include self-care behaviors, quality of life, psychological well-being, and health service utilization. The results will contribute to developing accessible, patient-centered models of heart failure management based on telehealth and behavioral support.

Nursing Interventions to Enhance Positive Mental Health and Self Care in Women During the Climacteric

This study will test whether a nursing program using podcasts and videos can help women feel better and take better care of themselves during the climacteric (the stage leading up to and following menopause). Women between 42 and 58 years old who attend public sexual and reproductive health clinics in the Metropolitan South Health Region of Barcelona (Sant Boi, Sant Feliu, and Cornellà) will be invited to participate. Participants will be randomly assigned to one of two groups: Intervention Group: will receive access to podcasts and videos offering practical advice and strategies to improve emotional well-being and self-care. Control Group: will receive standard care. All participants will complete questionnaires before and after the program to assess symptoms, mental health, and satisfaction with self-care. Statistical methods will be used to compare the results between both groups and determine whether the program produces a significant difference. The aim of the study is to demonstrate that this digital nursing intervention is effective and could be implemented more broadly in healthcare settings.

Evaluation of the Psychometric Properties of the Turkish Version of the Hypoglycaemia Self-Care Behaviour Scale

The aim of this study is to validate the validity and reliability of the Hypoglycaemia Self-Care Behaviour Scale, developed to assess hypoglycaemia self-care behaviours in patients with type 2 diabetes, through a prospective cross-sectional study.

AI-Integrated Mobile Education and Self-Management in Hemodialysis

This randomized controlled trial aims to evaluate the effectiveness of an Artificial Intelligence-supported mobile education application designed to enhance self-care behaviors, arteriovenous fistula (AVF) care practices, and key biochemical parameters among adult hemodialysis (HD) patients. Chronic Kidney Disease (CKD) and its most common renal replacement therapy, hemodialysis, impose a substantial physical, psychological, and socioeconomic burden on patients. HD patients frequently experience fatigue, pain, cramping, sleep disturbances, thirst and fluid restriction challenges, dietary limitations, AVF-related complications, and emotional distress. These difficulties highlight the importance of strengthening patients' self-care abilities and promoting active involvement in disease management. Despite the prevalence of mobile health (mHealth) technologies in chronic disease management, existing applications for HD patients remain limited, and none have integrated personalized artificial intelligence-based educational support. The absence of AI-driven patient education represents a significant gap in nursing science and digital health innovation. This project addresses that gap by developing and testing a structured, evidence-based mobile education program supported by artificial intelligence, designed specifically for HD patients. The study will enroll 76 eligible hemodialysis patients from Bitlis State Hospital and Bitlis Tatvan State Hospital. Participants will be randomly assigned to either the intervention group or the control group using simple randomization. The intervention group will receive access to the AI-supported mobile application for six weeks, which includes modules on kidney function, CKD and treatment options, symptom management, dietary adherence, fluid management, treatment adherence, and AVF care. Each module incorporates written content, videos, visuals, voice-supported reading features, and an integrated "Ask a Question" function allowing patients to communicate directly with the research team. The control group will receive routine clinical care without additional intervention. The artificial intelligence component will assist with content personalization, monitoring of patient engagement, data storage, automated reminders for non-active users, and supportive feedback based on learning progress and biochemical trends. The development of the mobile application will be guided by expert opinions from nephrology specialists, dialysis nurses, academicians, and dietitians. Readability of educational materials will be assessed using the Ateşman Readability Formula. A pilot study will be conducted prior to the trial to evaluate usability using the Web Analysis and Measurement Inventory (WAMMI). Data collection will include a Patient Identification Form, the Hemodialysis Arteriovenous Fistula Self-Care Behavior Scale, the Hemodialysis Self-Management Scale, and a Biochemical Parameters Tracking Form. Pre-test data will be collected before the intervention; post-test data will be collected at the end of the six-week intervention period. Biochemical parameters will include BUN, creatinine, albumin, potassium, phosphorus, hemoglobin, uric acid levels, Kt/V, and dry weight, obtained from routine clinical records without additional blood sampling. The primary outcomes will assess changes in self-care and self-management behaviors based on validated scales. Secondary outcomes will examine changes in biochemical parameters between the intervention and control groups. Data analysis will be performed using SPSS, employing descriptive statistics, normality testing, and appropriate statistical comparison tests, with significance set at p \< 0.05. Ethical approval will be obtained from the appropriate institutional ethics committee, and written informed consent will be secured from all participants. Data confidentiality will be ensured using encrypted login systems and secure storage processes. This trial is expected to contribute significantly to the scientific literature by being the first AI-supported mobile education intervention tailored for hemodialysis patients. Anticipated benefits include improved self-care behaviors, increased patient autonomy, reduced AVF complications, better adherence to dietary and fluid restrictions, and improved biochemical outcomes. Broader impacts of the project include the potential reduction of hospitalization rates, decreased healthcare costs, increased quality of life for HD patients, and the establishment of a digital model that can be adapted for other chronic disease populations. Ultimately, this study aims to demonstrate that integrating artificial intelligence with mobile health education can create a transformative approach to patient empowerment, clinical care, and chronic disease management within the field of nephrology and nursing.

RCT to Evaluate the Efficacy of the NSSCEP in Reducing Burnout Among Jordanian Pediatric Oncology Nurses

The goal of this clinical trial is to learn if the Nurses' Stress Self-Care Educational Program (NSSCEP) can reduce burnout and occupational stress in Jordanian pediatric oncology nurses. The main questions it aims to answer are: 1. Does NSSCEP reduce symptoms of burnout in pediatric oncology nurses? 2. Does NSSCEP improve stress management skills among pediatric oncology nurses? Researchers will compare nurses participating in the NSSCEP to a control group receiving a general technical skills program to see if NSSCEP reduces burnout and improves stress management. Participants will: 1. Attend four educational sessions over one month, focusing on stress recognition, coping strategies, and resilience-building techniques 2. Complete weekly checklists to track their application of stress management skills 3. Participate in pre- and post-intervention surveys to assess burnout and stress levels

Assessing the Feasibility of Multimedia Interventions to Reduce Blood Pressure in Marginalized Hypertensive Communities of Karachi, Pakistan

This study utilizes the I-Change Model to empower individuals in literacy-limited settings, where the majority of the population is illiterate. By leveraging multimedia tools-such as an educational video and a pictorial infographic-we aim to promote self-care practices among individuals suffering from hypertension. Through these tailored interventions, we seek to enhance awareness, improve hypertension management, and encourage behavioral change, even in low-literacy communities

Association Between Sleep Quality and Self-Care in Heart Failure Patients

The research will be conducted as a prospective and relational study to longitudinally investigate the effect of sleep quality on self-care in patients with heart failure (HF) and to evaluate the relationship between self-care, sleep quality, and cognitive functions. The sample size was calculated using the multiple linear regression model with the G\*Power Version 3.1 program. Based on a medium effect size of 0.15, an alpha of 0.05, a power of 0.95, and 18 predictors, the sample size was determined to be 188. Considering a potential dropout rate of 10%, it was decided to complete the study with a minimum of 207 participants. Data will be collected from patients who apply to the Dokuz Eylül University Cardiology Outpatient Clinic and meet the inclusion criteria. After signing the informed consent form, participants will be followed up at baseline, the 1st month, the 3rd month, and the 6th month by telephone. The Statistical Package for Social Sciences (SPSS) 24.0 will be used to analyze the numerical data of the research. Descriptive statistics, including number, percentage, mean, and standard deviation, as well as inferential statistics such as the χ2 test, t-test for independent groups, and multiple linear regression, will be employed in the data analysis.

Effectiveness of Self-Physiotherapy in the Management of Lymphedema

Breast cancer-related lymphedema is a chronic condition adversely affecting physical, social, psychological and emotional well-being. The complex decongestive physiotherapy (CDP) programme is considered the gold standard in the management of lymphedema. The most important barriers affecting patient participation in the CDP programme are the lack of trained health personnel and the difficulty for patients to access treatment (peripheral location or financial difficulties). Therefore, self-administration of the CDP programme may contribute to the development of self-care strategies and the reduction of treatment costs.