Challenges of an Internet-based education intervention in a randomized clinical trial in critical care.
Challenges of an Internet-based education intervention in a randomized clinical trial in critical care.
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DOI：
10.1097/nci.0b013e3181e6765d
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发表时间：
2010-10
影响因子：
2.2
通讯作者：
Fennie K
中科院分区：
文献类型：
--
作者：
Funk M;Rose L;Fennie K
随机临床试验（RCT）是评估因果关系的黄金标准，也是评估干预措施的最严格设计。由护士进行的试验在重症监护领域越来越频繁地进行。大多数随机对照试验侧重于实施新的护理方案。基于互联网的干预措施正在其他环境中使用，例如在家庭和诊所环境中与患者和家庭一起使用。然而，据我们所知，目前还没有针对重症监护护士的基于互联网的干预措施的公开报道。通过对护士进行基于互联网的教育干预，在重症监护环境中开展RCT的挑战尚未得到解决。本专栏的目的是研究与不遵守基于互联网的干预措施相关的方法学问题。我们探讨了在重症监护中使用基于互联网的教育干预的好处和挑战，引用了我们正在进行的研究的一个例子，其中基于互联网的教育计划是主要的干预措施。我们讨论了在这样的研究中评估和促进干预保真度的策略，并考虑了与在线测量结果相关的问题。
Randomized clinical trials (RCTs) are the gold standard for assessing causal relationships and the most rigorous design for evaluating interventions. Trials conducted by nurses are being performed with increasing frequency in critical care areas. Most of these RCTs focus on implementing new protocols of care. Internet-based interventions are being used in other settings, such as with patients and families in home and clinic settings. To our knowledge, however, there are no published reports of Internet-based interventions that target critical care nurses. The challenges of carrying out an RCT in critical care settings by using an Internet-based education intervention for nurses have not been addressed. The purpose of this column is to examine methodological issues associated with nonadherence to Internet-based interventions. We explore both the benefits and challenges of using an Internet-based education intervention in critical care, citing an example of our ongoing study in which an Internet-based education program is the primary intervention. We discuss strategies for assessing and promoting intervention fidelity in such a study and consider issues related to measuring outcomes online.