The Effect of Decision Support System on Symptom Self-Management in Non-Hodgkin Lymphoma Patients
NCT ID: NCT05443165
Last Updated: 2025-01-28
Study Results
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Basic Information
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COMPLETED
NA
56 participants
INTERVENTIONAL
2024-01-31
2024-06-30
Brief Summary
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Detailed Description
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In the study, a web-based decision support system for symptom self-management in NHL patients will be developed. The website content and decision support system will be prepared in line with current literature, national and international websites, and guidelines, evaluated with expert opinions and readability index, and will be finalized by testing with preliminary application. The study was designed as a randomized study with a single-blind and active control group. This study will be carried out with an NHL patient who is followed up and treated in the Hematology Outpatient Clinic and Daytime Chemotherapy Unit and meets the inclusion criteria of the sample. It will be prepared in line with the Consolidated Standard of Reporting Trials - CONSORT 2018 guidelines.
In the study, the sample size was calculated based on 80% power and 5% confidence interval on the G\*POWER software package. The study will be conducted with cancer patients (n=52), 26 in the intervention group and 26 in the control group. Patients with NHL diagnosis (Diffuse Large B-Cell Lymphoma and Follicular Lymphoma), over 18 years of age, who received at least two cycles of chemotherapy, had an ECOG performance score of 0-1-2, were treated with chemotherapy for the first time due to NHL diagnosis and had no verbal communication disorder. Literate patients, have internet access, and use the internet will be included.
As a randomization method, the "block randomization method" will be chosen so that the participants in the intervention and control groups have similar characteristics. An independent researcher who was not involved in the research will be assigned to the intervention and control groups with the mobile application program. Randomization will be done in a computer environment using the http://www.r-bloggers.com/example-2014-2-block-/randomization/ website and put in opaque envelopes. After obtaining informed consent from patients who meet the inclusion criteria, pre-tests will be performed by the researcher. After the pre-tests are applied, the participants will be assigned to the groups with opaque envelopes prepared by an independent researcher. Thus, assignment bias will be prevented in the randomization process. As the participants do not know the hypothesis of the research and in which group they are, it will be ensured that the participants are blinded. For the patients in the control group not to understand the application to the intervention group, the link of the website prepared for the intervention group, which contains only information on the evaluation of symptom frequency and severity, will be opened to the patients in the control group with a password. Algorithms in the decision support system intervention protocol developed for symptom self-management to be tested in the intervention group will not be included in the website shared with the control group. Blinding the patients will be ensured by having a website that will be applied to both the intervention and control groups. Since the attempt is made by the researcher, the researcher cannot be blinded.
The decision support system designed for symptom self-management will be evaluated by experts, researchers by calculating the readability formula, and patients with NHL who will be included in the preliminary application. Pre-application will be made with NHL patients who meet the inclusion criteria and consent to participate in the study. It is aimed to make a preliminary application to 10% (n=5) of the sample. Patients who were taken into pre-application will not be included in the study.
A website for symptom self-management strategies of NHL patients will be developed. On the website, patients will be asked to evaluate the frequency and severity of symptoms with a visual analog scale. The severity of symptoms was categorized as mild, moderate, or severe in line with evidence-based guidelines; In line with the algorithms created according to the severity of the symptoms, the patients in the intervention group will be provided to use the decision support systems developed for symptom self-management. It is planned that the patients in the intervention group will use the decision support system for the evaluation of symptom frequency and severity and symptom self-management on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy courses. In addition, a short SMS message will be sent to the patients on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy cycles to remind the user of the decision support system developed for self-management. Three repeated SMS will be sent to patients who do not use the decision support system, and if the system is still not used, patients will be contacted by phone. Patients in the control group will benefit from routine hospital services for three months, and only the link of the website developed for symptom self-management strategies of NHL patients to evaluate symptom frequency and severity with a visual analog scale will be shared with patients. On the 3rd, 7th, and 10th days of the chemotherapy course, they will be asked to evaluate their symptom experience and severity. To remind the patients in the control group to evaluate the frequency and severity of symptoms, a short SMS message will be sent to the patients on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy cycles. In addition, the link to the "Lymphoma Patient Guide" on the Turkish Society of Hematology page for the symptom management system will be sent to the control group via SMS.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
In the control group, SMS will be sent to the control group on the 3rd, 7th, and 10th days after each chemotherapy to remind them about the frequency and severity of symptoms during the three-month follow-up. The "Lymphoma Patient Guide" link on the Turkish Society of Hematology page for the symptom management system will be sent to the patients via SMS.
SUPPORTIVE_CARE
SINGLE
Study Groups
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Symptom self-management with an online decision support system
Symptom frequency and severity level of NHL patients will be evaluated with an online web-based application. NHL patients, who will be applying symptom self-management with an online decision support system, will be expected to additionally manage their symptom self-management using with this system. Participants in the intervention group will be asked to evaluate the frequency and severity of symptoms through the online symptom evaluation system on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy courses, and to use the decision support system for symptom self-management according to symptom severity. During the follow-up period, a short SMS message will be sent to the patients on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy cycles. In the third month, after the follow-up phase of the study is completed, the patients in the intervention group who come to the hospital for follow-up or treatment will receive post-tests.
The effectiveness of the online decision support system developed for symptom self-management
The online decision support system will appear with mild, moderate, or high severity according to symptom severity. If the patient's symptom is of mild category severity, a green area will appear on the screen and patients will see information on self-management strategies in this area. If patient's symptom is of moderate category severity, a yellow area will appear on the screen and patients will see information on self-management strategies and symptom monitoring at home in this area. In moderate symptom severity, when a yellow area occurs, patients should be asked, "Is your fever above 38℃?" according to their needs. Information about the treatment steps to be followed will be given. If the patient's symptom is in a severe category, a red area will appear on the screen and the patients will be warned to apply to the healthcare institution within this area.
Symptom self-management with an education booklet
Symptom frequency and severity level of NHL patients will be evaluated with an online web-based application. NHL patients, who will be treated with the symptom self-management with education booklet. Participants will be asked to evaluate the frequency and severity of symptoms through the online symptom evaluation system on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy courses for three months. They will be able to do symptom self-management within the scope of the patient education booklet sent to them via SMS. During the follow-up period, a short SMS message will be sent to the patients on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy cycles. In the third month, after the follow-up phase of the study is completed, the patients in the intervention group who come to the hospital for follow-up or treatment will receive post-tests.
Symptom self-management with an education booklet
Symptom frequency and severity level of NHL patients will be evaluated with an online web-based application. NHL patients, who will be treated with the symptom self-management with education booklet. Participants will be asked to evaluate the frequency and severity of symptoms through the online symptom evaluation system on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy courses for three months. They will be able to do symptom self-management within the scope of the patient education booklet sent to them via SMS.
Interventions
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The effectiveness of the online decision support system developed for symptom self-management
The online decision support system will appear with mild, moderate, or high severity according to symptom severity. If the patient's symptom is of mild category severity, a green area will appear on the screen and patients will see information on self-management strategies in this area. If patient's symptom is of moderate category severity, a yellow area will appear on the screen and patients will see information on self-management strategies and symptom monitoring at home in this area. In moderate symptom severity, when a yellow area occurs, patients should be asked, "Is your fever above 38℃?" according to their needs. Information about the treatment steps to be followed will be given. If the patient's symptom is in a severe category, a red area will appear on the screen and the patients will be warned to apply to the healthcare institution within this area.
Symptom self-management with an education booklet
Symptom frequency and severity level of NHL patients will be evaluated with an online web-based application. NHL patients, who will be treated with the symptom self-management with education booklet. Participants will be asked to evaluate the frequency and severity of symptoms through the online symptom evaluation system on the 3rd, 7th, and 10th days of the 3rd, 4th, and 5th chemotherapy courses for three months. They will be able to do symptom self-management within the scope of the patient education booklet sent to them via SMS.
Eligibility Criteria
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Inclusion Criteria
* Diagnosed with NHL (Diffuse Large B Cell Lymphoma and Follicular Lymphoma)
* Chemotherapy for the first time due to the diagnosis of NHL
* Have received at least two cycles of chemotherapy
* ECOG performance score of 0-1-2
* Had no verbal communication disorder
* Literate
* Having internet access at home, having a device such as a tablet, computer, or phone, and being able to use these tools
Exclusion Criteria
* Undergoing major surgery
* With terminal disease
* ECOG performance score of 3 and above
18 Years
ALL
Yes
Sponsors
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Akdeniz University
OTHER
Responsible Party
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Merve Gözde SEZGİN
Principal Investigator
Locations
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Akdeniz Üniversitesi
Antalya, , Turkey (Türkiye)
Countries
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Other Identifiers
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3890
Identifier Type: -
Identifier Source: org_study_id
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