Integrating the Fundamentals of Care Framework Into Italian Nursing Education

NCT ID: NCT05177627

Last Updated: 2022-01-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-31

Study Completion Date

2023-03-31

Brief Summary

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Research has shown a gap in what is important to patients and what is important to nurses when providing care. When the patient's fundamental needs are not recognized, such as hygiene, nutrition, mobilization, communication, he feels humiliated, ignored. The study aims to improve patient outcomes by educational interventions to integrate the Fundamental of Care (FoC) framework into nursing education.

A multi-centre randomized controlled trial will be conducted to evaluate the effectiveness of integrating the FoC framework into nursing education. Outcomes perceived by patients and their families relate to meeting the fundamental care needs.

Detailed Description

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Background and Significance: Since 2010, to fill the gap in what is essential when providing care in a complex and challenging environment, both for patients and nurses, a line of research has developed to study the fundamental of nursing care. The "Fundamentals of Care (FoC) Frameworks" defines FoC as fundamental activities for the patient, through which the patient feels at the centre of care and feels attention and respect around him. The framework outlines three dimensions necessary for delivering high-quality fundamental care: the nurse-patient relationship; addressing different fundamental needs; and a context that supports these goals. A positive and trusting nurse-patient relationship is the basis for delivering fundamental care and forms the core of the framework.

FOCs are often implicit or invisible in nursing education, taught as an introductory part in the first year of the course and rarely addressed in subsequent years. The study aims to improve patient outcomes by educational interventions to integrate the FUNDAMENTAL OF CARE FRAMEWORK into nursing education.

Objectives: The substantive objectives of the study are: 1) To describe how nurses, internship preceptors, students and patients and their families perceive fundamental care; 2) Assessing learning process in developing FOC skills of nursing students; 3) Assessing nursing students perception of the learning environment and the supervision related to learning of FOC skills during the clinical internship; 4) Assessing the perceived outcomes of patients and their families related to meet the fundamental care needs.

Design: multi-centre randomized controlled trial

Sample: Students of nursing degree enrolled in the first year of the course, internship preceptors nurses who work in the internship departments of students enrolled in the first year of nursing degree, and patients over the age of 18, cognitively intact, assisted in the internship departments, who have the following three needs: (1) nutrition; (2) elimination; (3) personal hygiene will be included.

Measures: All outcomes will be measured with established criteria and with instruments used in previous studies or developed by the investigators and found validated and reliable.

Analysis: In addition to descriptive statistics, statistical tests to analyze differences in the scores between groups will be used to address the objectives.

Conditions

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Nursing Students

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Students participating in the study will be randomly assigned to two groups:

1. experimental group with educational interventions of integration of the FoC framework (learning according to the FoC framework with the contents of the current curriculum);
2. control group without intervention (learning according to the current educational model and the contents of the current curriculum); A researcher not involved in the educational interventions and data collection of the study at the University of Genoa will randomly assign in a 1: 1 ratio the students to the two groups extracted from the lists of students provided by the universities based on a table of random numbers.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Fundamental of Care Framework implementation

Educational interventions related to introduction of FoC framework and taking charge of patients and their fundamental needs will be realized during theoretical, simulation and internship learning.

Group Type EXPERIMENTAL

Theoretical and classroom learning interventions

Intervention Type OTHER

aim of intervention: introduce students to the conceptual framework of fundamental of care, focus on three dimensions necessary for the delivery of high-quality fundamental care (the nurse-patient relationship; addressing different fundamental needs; and a context that supports these goals)

components and activities:

* educational interventions to understand how the communication and the relationship of trust between nurse and patient are the prerequisites for high quality nursing care;
* drawing attention to five essential relational elements for establishing the nurse-patient relationship (Trust; Focus; Anticipate; Know; Evaluate)

mode of delivery:

* classroom lessons on philosophies and theories on communication and trust
* small-group learning on realistic cases focused on fundamental needs to develop reflexivity, analytical skills, investigation

duration of the intervention: 12 hours of theoretical and classroom learning

Simulation interventions

Intervention Type OTHER

aim of intervention:

To develop active listening and use of non-verbal and verbal communication skills to establish a therapeutic relationship based on compassion, trust and respect; to apply the FoC conceptual framework, reflexivity and analytical skills to meet patient fundamental needs.

Students will express these goals during simulation activities with behaviours outlined by the FoC framework.

components and activities: - Implementation of communication simulation activities to develop interaction skills with patients; Implementation of simulation activities to apply the FoC conceptual framework and reflection to meet patient fundamental needs in realistic scenarios.

mode of delivery:

\- simulation activities on communication and trust Use ad hoc validated scenarios to apply the FoC conceptual framework to develop reflection and meet patient fundamental needs.

duration of the intervention: 25 hours

Internship interventions

Intervention Type OTHER

Aim of intervention: to apply active listening and non-verbal communication skills; to use the FoC conceptual framework, reflexivity, and analytical skills to meet patient fundamental needs.

Students will express these goals during simulation activities with behaviours outlined by the FoC framework.

components and activities:

\- to establish effective and trusting communication with patients to demonstrate compassion and respect and to enable patients to remain calm, involved and dignified; to apply the FoC conceptual framework to meet patient fundamental needs.

mode of delivery:

* attendance of clinical internship
* analysis and reflections guided by the clinical preceptor on real cases using elements of FoC conceptual framework.

duration of the intervention: 150 hours of internship.

No Fundamental of Care Framework implementation

the participants of no intervention group will receive the standard training as scheduled on the curriculum

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Theoretical and classroom learning interventions

aim of intervention: introduce students to the conceptual framework of fundamental of care, focus on three dimensions necessary for the delivery of high-quality fundamental care (the nurse-patient relationship; addressing different fundamental needs; and a context that supports these goals)

components and activities:

* educational interventions to understand how the communication and the relationship of trust between nurse and patient are the prerequisites for high quality nursing care;
* drawing attention to five essential relational elements for establishing the nurse-patient relationship (Trust; Focus; Anticipate; Know; Evaluate)

mode of delivery:

* classroom lessons on philosophies and theories on communication and trust
* small-group learning on realistic cases focused on fundamental needs to develop reflexivity, analytical skills, investigation

duration of the intervention: 12 hours of theoretical and classroom learning

Intervention Type OTHER

Simulation interventions

aim of intervention:

To develop active listening and use of non-verbal and verbal communication skills to establish a therapeutic relationship based on compassion, trust and respect; to apply the FoC conceptual framework, reflexivity and analytical skills to meet patient fundamental needs.

Students will express these goals during simulation activities with behaviours outlined by the FoC framework.

components and activities: - Implementation of communication simulation activities to develop interaction skills with patients; Implementation of simulation activities to apply the FoC conceptual framework and reflection to meet patient fundamental needs in realistic scenarios.

mode of delivery:

\- simulation activities on communication and trust Use ad hoc validated scenarios to apply the FoC conceptual framework to develop reflection and meet patient fundamental needs.

duration of the intervention: 25 hours

Intervention Type OTHER

Internship interventions

Aim of intervention: to apply active listening and non-verbal communication skills; to use the FoC conceptual framework, reflexivity, and analytical skills to meet patient fundamental needs.

Students will express these goals during simulation activities with behaviours outlined by the FoC framework.

components and activities:

\- to establish effective and trusting communication with patients to demonstrate compassion and respect and to enable patients to remain calm, involved and dignified; to apply the FoC conceptual framework to meet patient fundamental needs.

mode of delivery:

* attendance of clinical internship
* analysis and reflections guided by the clinical preceptor on real cases using elements of FoC conceptual framework.

duration of the intervention: 150 hours of internship.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All students of nursing degree enrolled in the first year of the course who will choose to participate in the study
* All internship preceptors nurses who work in the internship departments of students enrolled in the first year of nursing degree will choose to participate in the study.
* All patients over the age of 18 assisted in the internship departments who choose to participate in the study who have the following three needs: (1) nutrition; (2) elimination; (3) personal hygiene.

Exclusion Criteria

* Patients who are unable to answer the questionnaire independently, with altered mental status, with hospitalization of fewer than 24 hours
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Genova

OTHER

Sponsor Role lead

Responsible Party

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Milko Zanini

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Annamaria Bagnasco, Prof

Role: PRINCIPAL_INVESTIGATOR

Department of Health Sciences, University of Genoa

Central Contacts

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Gianluca Catania, Dr

Role: CONTACT

00390103538485

References

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Kitson A, Conroy T, Wengstrom Y, Profetto-McGrath J, Robertson-Malt S. Defining the fundamentals of care. Int J Nurs Pract. 2010 Aug;16(4):423-34. doi: 10.1111/j.1440-172X.2010.01861.x.

Reference Type BACKGROUND
PMID: 20649678 (View on PubMed)

Feo R, Kitson A. Promoting patient-centred fundamental care in acute healthcare systems. Int J Nurs Stud. 2016 May;57:1-11. doi: 10.1016/j.ijnurstu.2016.01.006. Epub 2016 Feb 1.

Reference Type BACKGROUND
PMID: 27045560 (View on PubMed)

Bagnasco A, Timmins F, de Vries JMA, Aleo G, Zanini M, Catania G, Sasso L. Understanding and addressing missed care in clinical placements - Implications for nursing students and nurse educators. Nurse Educ Today. 2017 Sep;56:1-5. doi: 10.1016/j.nedt.2017.05.015. Epub 2017 May 23.

Reference Type BACKGROUND
PMID: 28599196 (View on PubMed)

Feo R, Rasmussen P, Wiechula R, Conroy T, Kitson A. Developing effective and caring nurse-patient relationships. Nurs Stand. 2017 Mar 8;31(28):54-63. doi: 10.7748/ns.2017.e10735.

Reference Type BACKGROUND
PMID: 28271761 (View on PubMed)

Feo R, Conroy T, Alderman J, Kitson A. Implementing fundamental care in clinical practice. Nurs Stand. 2017 Apr 5;31(32):52-62. doi: 10.7748/ns.2017.e10765.

Reference Type BACKGROUND
PMID: 28378679 (View on PubMed)

Huisman-de Waal G, Feo R, Vermeulen H, Heinen M. Students' perspectives on basic nursing care education. J Clin Nurs. 2018 Jun;27(11-12):2450-2459. doi: 10.1111/jocn.14278.

Reference Type BACKGROUND
PMID: 29399907 (View on PubMed)

Voldbjerg SL, Laugesen B, Bahnsen IB, Jorgensen L, Sorensen IM, Gronkjaer M, Sorensen EE. Integrating the fundamentals of care framework in baccalaureate nursing education: An example from a nursing school in Denmark. J Clin Nurs. 2018 Jun;27(11-12):2506-2515. doi: 10.1111/jocn.14354.

Reference Type BACKGROUND
PMID: 29575165 (View on PubMed)

Saarikoski M, Warne T, Kaila P, Leino-Kilpi H. The role of the nurse teacher in clinical practice: an empirical study of Finnish student nurse experiences. Nurse Educ Today. 2009 Aug;29(6):595-600. doi: 10.1016/j.nedt.2009.01.005. Epub 2009 Feb 18.

Reference Type BACKGROUND
PMID: 19232789 (View on PubMed)

Bagnasco A, Lusignani M, Pagnucci N, Sallai T, Catania G, Napolitano F, Dal Molin A, Mazzoleni B, Cosmai S, Cattani D, Mansi L, Montani D, Zavaglio A, Sanvito P, Cartabia C, Consolo L, Giuseppe L, Zanini M, Sasso L. Italian Version of the Fundamentals of Care Framework and the Fundamentals of Care Practice Process: A Comprehensive Validation Study. J Adv Nurs. 2025 Jul 28. doi: 10.1111/jan.70099. Online ahead of print.

Reference Type DERIVED
PMID: 40726058 (View on PubMed)

Other Identifiers

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FoC-FORM 2021

Identifier Type: -

Identifier Source: org_study_id

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