Collaborative cOMMUNIty Care for Metastatic breAsT cancEr Patients in inDonesia (Communicated)

NCT ID: NCT06517992

Last Updated: 2024-07-24

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-01

Study Completion Date

2025-09-01

Brief Summary

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The current study aims to empower local cadres in providing care for metastatic breast cancer (mBC) patients in 2 provinces in Indonesia (Bali and Yogyakarta).

Detailed Description

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Most mBC patients in Indonesia stay at home until they have heavy physical symptoms and need hospitalizations. In this country, even in hospitalization, support from the family caregivers is greatly needed \[1\]. Family caregivers and the community have a significant role for patients with mBC.

In Indonesia, the support system from local neighbours and community has been implemented for some decades through the involvement of cadres. Health cadres are people from the village who are appointed by their community to train and enhance the community participation in order to empower community health in Indonesia \[2\]. Most of them are housewives who have enough capability (mentally and physically) to learn, have enough time, and willing to provide support for their community. This role is informal and voluntary-based \[3\].

-Community support through the existence of cadre in Indonesia- Cadres in Indonesia are initiated by community health services (hereafter Pusat Kesehatan Masyarakat/Puskesmas) around the area. The selection and development of cadres involve the lowest level of local government in the area. Cadres need to have some essential characteristics to undertake their role. They should have empathy as well as good communication skills since one of their tasks is to deliver important health information and message to the community. They need to be able to connect with the community to develop a mutual understanding and be accepted \[4\]. Funding received from national and local government is allocated for cadres to subsidize the transportation and logistics expenses, but this does not cover the monthly wages \[2\].

Cadres play a fundamental role in tackling health care problems especially those that are related to psychosocial and cultural factors since they have enough information and knowledge about people and situations in their area. Health care professionals who work in Puskesmas usually cooperate with cadres to gather information related to health conditions in the area or to support local activities. Several roles of cadre have been identified. First, health cadres are responsible for educating and motivating patients and their family to access health care system. They are responsible for assisting patients to access health care facilities for early diagnosis or treatment. On a daily basis, cadres are expected to monitor patients' condition as well as do home visit. At last, it is expected that cadres are able to advocate for patients and their family in the relation to health care professionals \[5, 6\].

Cadres are initiated and developed by Puskesmas and working closely with integrated health service posts (hereafter Posyandu). Posyandu is a local health unit, under the coordination of Puskesmas, that aims to provide care for baby and infant. Their activities include baby weighting, providing vitamin and enhancing the nutritional status of babies and infants. During Posyandu, health care teams from Puskesmas and cadres are working together. To be able to be classified as active, a Posyandu needs to have at least five health cadres \[2\]. Currently, there are around 395.495 health cadres in Indonesia.

-Challenges of cadre in Indonesia- In Indonesia, some challenges faced by cadres have been identified. The first is that the role of cadres in Indonesia is still limited. Mostly, their role is merely to provide care for infants and children. Since the number of mBC patients who stay at home is high, health cadres are frequently requested to provide care for this specific group. There have been several initiatives in Indonesia focused on expanding cadres' roles; however, most of the initiatives are focusing on screening and early detection of cancer \[7-9\]. Until now, there is no single adequate intervention in Indonesia to prepare cadres in Indonesia to support mBC patients and their family caregivers.

The second issue is that although cadres have some connections with Puskesmas, the breadth and depth of the connections are still limited and have an unclear structure. There is a need to open communication channels so that cadres are able to connect with health care professionals from Puskesmas and their role can be recognized by local health authorities. When needed, cadres would be better positioned to request for help or provide important information to Puskesmas in regards to mBC patients problems and needs.

Given the important role of cadres, the COMMUNICATED project aims to empower local cadres to provide care for metastatic breast cancer (mBC) patients in in Indonesia.

Conditions

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Metastatic Breast Cancer Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Quasi experiment
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Health education for cadre

Health education for cadre (Health Community Volunteer) to support metastatic breast cancer patients and their family caregivers

Group Type EXPERIMENTAL

Health education for cadre (communicated project)

Intervention Type OTHER

The investigators perform health education to cadre in order to support their role in providing care for metastatic breast cancer living in the community using a module. The module consists of text (written information) and some videos as education medias.

Interventions

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Health education for cadre (communicated project)

The investigators perform health education to cadre in order to support their role in providing care for metastatic breast cancer living in the community using a module. The module consists of text (written information) and some videos as education medias.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Diagnosed for having breast cancer at least in stage 3B or confirm to have metastatic breast cancer
* Live at home
* Considered as adult (Eighteen years of age or older)


The local cadre in Yogyakarta and Bali who self-identified as local cadre in the community and willing to involve for assisting mBC patients. The local cadre will be excluded when they are not providing consent to involve in the current study.

Exclusion Criteria

\- mBC patients will be exclude when their physical condition is deteriorating or when they need hospitalization.

The following criteria will be applied for family caregivers:

1. Appointed by mBC patients or self-identified as family caregiver of mBC patients for at least 3 months
2. Live/not live together with mBC patients but providing care to mBC patient
3. Considered as adult (Eighteen years of age or older)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Pfizer

INDUSTRY

Sponsor Role collaborator

Queensland University of Technology

OTHER

Sponsor Role collaborator

Gadjah Mada University

OTHER

Sponsor Role lead

Responsible Party

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Martina Sinta Kristanti

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Syahirul Alim, PhD

Role: STUDY_CHAIR

Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada

Locations

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Primary Health Center

Yogyakarta, Special Region of Yogyakarta, Indonesia

Site Status

Primary Health center

Bali, , Indonesia

Site Status

Countries

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Indonesia

Central Contacts

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Martina Sinta Kristanti, PhD

Role: CONTACT

+6281227811976

Lalitya Paramarta, BSN

Role: CONTACT

+6285647152142

Facility Contacts

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I Made Cahyadi, MSN

Role: primary

+6285792100989

References

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Kristanti MS, Effendy C, Utarini A, Vernooij-Dassen M, Engels Y. The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach. Palliat Med. 2019 Jun;33(6):676-684. doi: 10.1177/0269216319833260. Epub 2019 Mar 27.

Reference Type RESULT
PMID: 30916614 (View on PubMed)

Kristanti MS, Setiyarini S, Effendy C. Enhancing the quality of life for palliative care cancer patients in Indonesia through family caregivers: a pilot study of basic skills training. BMC Palliat Care. 2017 Jan 17;16(1):4. doi: 10.1186/s12904-016-0178-4.

Reference Type RESULT
PMID: 28095837 (View on PubMed)

Related Links

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https://doi.org/10.1016/j.enfcli.2020.06.056

Sapar, Salju, Risal M, et al. The influence of TB care community cadre's roles on the treatment adherence of tuberculosis (TB) sufferers. Enfermería Clínica 2020; 30: 244-248.

https://peraturan.bpk.go.id/Details/111722/permenkes-no-8-tahun-2019

Permenkes. Peraturan Menteri Kesehatan Republik Indonesia Nomor 8 Tahun 2019 Tentang Pemberdayaan Masyarakat Bidang Kesehatan. 2019.

https://jurnal.stikespantiwaluya.ac.id/index.php/JPW/article/view/63

Sunarti. peran kader kesehatan dalam pelayanan posyandu UPTD puskesmas kecamatan sananwetan kota Blitar. Jurnal Keperawatan Malang 2019; 3: 94-100.

Other Identifiers

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Communicated UGM

Identifier Type: -

Identifier Source: org_study_id

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