MedTrace Logo

Nurses' Competence and Role in Survival Prediction and Prognostic Communication

NCT06962553 · Status: NOT_YET_RECRUITING · Type: OBSERVATIONAL · Enrollment: 152

Last updated 2025-05-08

No results posted yet for this study

Summary

\[Background\] Nurses' roles in survival prediction and prognostic communication have historically been limited due to role delineation, lack of formal training, and cultural norms. In Taiwan and other cultural contexts, prognostic discussions have traditionally been the purview of physicians. However, evolving paradigms in health communication, practical realities in nursing practice, and the expanded responsibilities of advanced practice nurses have highlighted the importance of nurses in this domain. Nurses frequently engage in "foreseeing" prognostic indicators through daily patient care, and emerging evidence suggests their prognostic accuracy is often comparable to or exceeds that of physicians. Despite this, the exact scope of nurses' roles in prognostication remains unclear, creating gaps in understanding the contributions, benefits, and associating factors of nurses' involvement of prognostication process.

\[Aim\] This mixed-methods study aims to examine hospice nurses' competencies and roles in prognostication, with a focus on their survival prediction accuracy, confidence, influencing factors, and self-perceived responsibilities.

\[Method\] This three-year, cross-national study adopts an explanatory sequential mixed-methods design. First, the quantitative phase utilizes a prospective cohort design, recruiting palliative nurses and physicians from ten palliative care sites across three countries. Eligible clinicians include nurses and physicians who provide care for patients with advanced cancer in palliative care settings or oncologic wards. Participating clinicians will provide weekly prognostic predictions for targeted patients and rate their confidence levels. Patients' demographic and disease-related information will also be collected to estimate survival using prediction tools. Data collection will conclude upon the patient's death or discharge. Based on the results of the quantitative phase, a descriptive qualitative study will be conducted to purposefully recruit nurses with varying levels of prediction accuracy and confidence from the quantitative phase. Semi-structured interviews will be carried out to gather qualitative data on their perspectives regarding prognostication, with a particular focus on their roles. The estimated sample size for quantitative phase is 152 nurse-physician dyads (based on 152 patients), while 20-30 nurses are expected to participate in the qualitative phase.

\[Data Analysis\] Descriptive statistics, area under the receiver operating characteristic (ROC) curve (AUC), Cohen's kappa, weighted kappa, McNemar's test, and ordinal logistic regression will be used to analyze quantitative data. Qualitative data will be analyzed using conventional content analysis. Nurses' Competence and Role in Survival Prediction and Prognostic Communication.

\[Expecting Outcomes and Conclusion\] This project uniquely highlights nurses' contributions to prognostication, aiming to generate evidence that informs future research, clinical practice, and policy development. The findings will shed light on nurses' roles, functions, potential benefits, and the barriers the face in prognostication.

Conditions

Sponsors & Collaborators

  • National Taiwan University Hospital

    lead OTHER

Eligibility

Sex
ALL
Healthy Volunteers
Yes

Timeline & Regulatory

Start
2025-05-08
Primary Completion
2025-12-31
Completion
2027-12-31

More Related Trials

Entities

Diseases

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06962553 on ClinicalTrials.gov