AzTrials
AzTrials

Congenital MicrotiaNCT06569927

Application and Effectiveness of the Perioperative Position Management Based on the ADDIE Model in Patients With Congenital Microtia

A study testing Utilization of a perioperative position management protocol for congenital microtia patients based on the ADDIE model. in people with Congenital Microtia, run by Eye & ENT Hospital of Fudan University at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Aims and objectives: To evaluate the clinical application and effectiveness of a perioperative position management program constructed using the ADDIE model for patients with congenital microtia. Read more about this study

Who is it for?
Ages 6 to 40 yearsHealthy volunteers can take part
Conditions the study is for
Congenital Microtia
What is being tested?
Utilization of a perioperative position management protocol for congenital microtia patients based on the ADDIE model.
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
196 participants
Where
1 siteChina
Study dates
1 May 2023to 31 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 to 40 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Diagnosis of congenital microtia according to the "Chinese Plastic Surgery" criteria, and undergoing ear reconstruction.
  • No other severe comorbidities.

Who cannot join

  • Abnormal coagulation function.
  • Presence of eczema or infection on the affected side.
  • Severe cognitive impairment or mental illness.
  • Patient or family disagrees with the study.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Eye & ENT Hospital, Fudan University

    Shanghai, Shanghai Municipality, 200031

Other trials in China

About this study

Aims and objectives: To evaluate the clinical application and effectiveness of a perioperative position management program constructed using the ADDIE model for patients with congenital microtia.

Background: The primary challenge in auricular reconstruction is the fragility of the reconstructed ear structure, necessitating strict avoidance of postoperative pressure to ensure the surgery's effect. Clinically, this has been found to cause anxiety in patients and their families. Some patients maintain a fixed position to avoid pressure on the reconstructed ear, which may lead to restricted neck movement and a high risk of pressure-related injuries. Therefore, a systematic perioperative position management program for patients with congenital microtia is necessary.

Methods: A quasi-trial design with non-randomized grouping was adopted. Using convenience sampling, 98 patients with congenital microtia admitted to a tertiary specialized hospital in Shanghai from May to August 2023 were included in the control group and received routine care. From September to December 2023, another 98 patients were included in the intervention group, receiving a perioperative position management program in addition to routine care. Effectiveness was evaluated using the Ear Reconstruction Effectiveness Scale, SCARED, Quality of Life Scale for Congenital External and Middle Ear Malformation Patients, SAS, Northwick Park Neck Pain Questionnaire, and Position Execution Checklist.

Read the detailed description

Auricular reconstruction remains one of the most challenging surgeries due to its delicate structures and potential complications. The reconstructed auricle is too fragile to withstand excessive pressure that will cause blood circulation disturbances or even necrosis. Clinical observations have noted that patients and their families often experience anxiety due to concerns over complications and the impact on recovery, affecting their quality of life. Furthermore, patients frequently hold their heads in a fixed position to prevent pressure on the reconstructed auricle, which results in neck stiffness, asymmetry, and limited mobility. Therefore, effective perioperative position management is crucial for improving surgical outcomes and patient prognosis and alleviating negative emotions in patients and their families.

In our study, we evaluated the clinical usefulness of a perioperative position management program designed using the ADDIE model for patients with microtia. The patients were divided into the experimental group(98 cases)and control group (98 cases)in a quasi-experimental design that used non-randomized grouping. The experimental group received the perioperative position management program in addition to routine care. Key elements included perioperative postural management, preoperative sleeping posture adaptability training, neck movement training, standardization of head position angles and head suspension time during surgery, use of protective headrests, attention to transfer and handover procedures, and specially designed pillows.

Being tested
Utilization of a perioperative position management protocol for congenital microtia patients based on the ADDIE model.
Keywords
Congenital microtia, Position management
Medical subject headings
Congenital Microtia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Utilization of a perioperative position management protocol for congenital microtia patients based on the ADDIE model.Procedure or surgery

    Key elements included formation of a multidisciplinary team,perioperative postural management, preoperative sleeping posture adaptability training, neck movement training, standardization of head position angles and head suspension time during surgery, use of protective headrests, attention to transfer and handover procedures, and specially designed pillows.

Study groups in NCT06569927
Study groupRoleWhat they receive
Intervention groupExperimentalThe intervention group implemented a perioperative position management program for congenital microtia based on the ADDIE model, in addition to routine position care.
Receives: Procedure: Utilization of a perioperative position management protocol for congenital microtia patients based on the ADDIE model.
Control GroupNo interventionThe control group received routine position care, which included perioperative verbal emphasis on the importance of position by nurses, intraoperative use of hydrocolloid positioning pads to prevent pressure injuries, postoperative nurse monitoring and encouragement of proper positioning, assistance with bed mobility, and guidance on safe ambulation techniques.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ear Reconstruction Effectiveness Scale

    Evaluation was conducted using the surgical outcome scoring system developed by Wei Lü. The scale includes five aspects: (1) The size, position, and realism of the reconstructed ear compared to the healthy side (total score 24 points). (2) The angle size and stability of the cranioauricular angle of the reconstructed ear (total score 12 points). (3) The color of the skin of the reconstructed ear and its coordination with the surrounding skin (total score 10 points). (4) The condition of the local scars at the incision behind the ear (total score 9 points). (5) The presentation of the subunit structure of the reconstructed ear (total score 45 points). A total score greater than 85 is rated as excellent; 75-84 is rated as good; 65-74 is rated as fair; and less than 65 is rated as poor. The specific method of use involves plastic surgeons scoring based on the structure of the child's healthy side or the structure of a normal person's auricle.

    Measured: 3 months postoperatively.

  2. Incidence of skin and flap-related complications after ear reconstruction

    The researchers independently designed the position execution checklist based on a review of relevant literature. The checklist consists of two parts: (1) Demographic Information: This includes gender, age, education level, and caregivers. (2)Disease-Related Information: This includes the duration of surgery, the side of the surgery, the name of the surgery, instances of reconstructed ear compression, the time period during which the compression occurred, the occurrence of complications, and medication usage.

    Measured: 3 months postoperatively.

Secondary outcomes (4)
  1. Quality of Life Scale for Congenital External and Middle Ear Malformation Patients

    This scale is used to assess the quality of life of patients with congenital middle and outer ear deformities, encompassing three dimensions: physical function, psychological state, and social relationships, with a total of 18 items. Each item is rated on a five-point scale from 0 to 4, with a total score ranging from 0 to 80. The higher the score, the poorer the quality of life.

    Measured: Within 24 hours prior to discharge.

  2. Northwick Park Neck Pain Questionnaire (NPQ)

    This scale is used to assess the function of clinical neck pain patients and consists of 9 items, including pain severity, duration of symptoms, nighttime prickling or numbness, the impact of pain on sleep, social activities, reading, work or household tasks, and driving. If the subject has no driving experience, this item is not scored. Each item is rated on a five-point scale from 0 to 4, with a total score ranging from 0 to 36. The higher the score, the more severe the neck pain.

    Measured: Within 24 hours prior to discharge.

  3. Screen for Child Anxiety Related Emotional Disorders (SCARED)

    This scale is used for self-assessment of anxiety disorders in children and adolescents aged 8-16. It includes five factors: somatization/panic, generalized anxiety, separation anxiety, social phobia, and school phobia, with a total of 41 items. Each item is scored on a three-point scale from 0 to 2. 0: no problem; 1: sometimes; 2: often. The higher the score, the more severe the anxiety.

    Measured: Within 24 hours prior to discharge.

  4. Self-Rating Anxiety Scale (SAS)

    This scale is used to assess subjective feelings of anxiety and consists of 20 items. Each item is scored on a four-point scale. Five items (items 5, 9, 13, 17, 19) are positively worded, while the remaining 15 items are negatively worded. Patients' families use the Self-Rating Anxiety Scale (SAS) for evaluation, with scores interpreted as follows: less than 50 indicates no anxiety, 50-59 indicates mild anxiety, 60-69 indicates moderate anxiety, and greater than 69 indicates severe anxiety. Higher scores reflect more severe anxiety.

    Measured: Within 24 hours prior to discharge.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Aug 2024
  2. Study start1 May 2023
  3. Primary completion31 Dec 2023
  4. Study completion31 Dec 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
Subjects were grouped based on admission time to avoid contamination between groups, with data collection for the intervention group conducted after the control group.
Masking
Single blind
Who is masked
Participant
Enrolment
196 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06569927
Sponsor's protocol ID
FNF202312
Status last verified
Aug 2024
First submitted
20 Aug 2024
Last updated
26 Aug 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Abuhassna, H., Alnawajha, S., Awae, F., Adnan, M., & Edwards, B. (2024). Synthesizing technology integration within the Addie model for instructional design: A comprehensive systematic literature review. Journal of Autonomous Intelligence, 7(5), 1-28. https://doi.org/https://doi.org/10.32629/jai.v7i5.1546

  • Ayhan H, Tastan S, Iyigun E, Ozturk E, Yildiz R, Gorgulu S. The Effectiveness of Neck Stretching Exercises Following Total Thyroidectomy on Reducing Neck Pain and Disability: A Randomized Controlled Trial. Worldviews Evid Based Nurs. 2016 Jun;13(3):224-31. doi: 10.1111/wvn.12136. Epub 2016 Jan 15.

    PubMed 26773539
  • Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, Sparks C, Robertson EK. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017 Jul;47(7):A1-A83. doi: 10.2519/jospt.2017.0302.

    PubMed 28666405
  • Chen X, Ma J, Zhang T. Genetics and Epigenetics in the Genesis and Development of Microtia. J Craniofac Surg. 2024 Feb 12;35(3):e261-6. doi: 10.1097/SCS.0000000000010004. Online ahead of print.

    PubMed 38345940
  • Chen X, Zhang R, Zhang Q, Xu Z, Xu F, Li D, Li Y. Microtia Part II: Post-Operation and Complications Management Lessons from 1012 Ear Reconstruction Operations. Aesthetic Plast Surg. 2022 Dec;46(6):2790-2796. doi: 10.1007/s00266-022-03010-6. Epub 2022 Jul 14.

    PubMed 35835875
  • Deng K, Dai L, Yi L, Deng C, Li X, Zhu J. Epidemiologic characteristics and time trend in the prevalence of anotia and microtia in China. Birth Defects Res A Clin Mol Teratol. 2016 Feb;106(2):88-94. doi: 10.1002/bdra.23462. Epub 2015 Dec 17.

    PubMed 26681129
  • Fan Y, Liu W, Fan X, Niu X, Chen X. Psychosocial status of patients with unilateral and bilateral microtia before auricular reconstruction surgery. Int J Pediatr Otorhinolaryngol. 2021 Dec;151:110928. doi: 10.1016/j.ijporl.2021.110928. Epub 2021 Sep 25.

    PubMed 34607045
  • Han SE, Oh KS. Satisfactory surgical option for cartilage graft absorption in microtia reconstruction. J Craniomaxillofac Surg. 2016 Apr;44(4):471-8. doi: 10.1016/j.jcms.2015.12.015. Epub 2016 Jan 6.

    PubMed 26857756
  • Li H, Wang Y, Qian J, Wang B, Liu T, Zhang Q. A Two-Stage Method for Adult Congenital Microtia: The Essentials of 15-Year Experience. Laryngoscope. 2023 Sep;133(9):2148-2153. doi: 10.1002/lary.30531. Epub 2022 Dec 20.

    PubMed 36537375
  • Li Q, Zhou X, Wang Y, Qian J, Zhang Q. Auricular reconstruction of congenital microtia by using the modified Nagata method: Personal 10-Year experience with 1350 cases. J Plast Reconstr Aesthet Surg. 2018 Oct;71(10):1462-1468. doi: 10.1016/j.bjps.2018.05.036. Epub 2018 Jun 19.

    PubMed 30097399
  • Nuyen BA, Kandathil CK, Saltychev M, Firmin F, Most SP, Truong MT. The Social Perception of Microtia and Auricular Reconstruction. Laryngoscope. 2021 Jan;131(1):195-200. doi: 10.1002/lary.28619. Epub 2020 Apr 10.

    PubMed 32275329
  • Patel KR, Benchetrit L, Ronner EA, Occhiogrosso J, Hadlock T, Shaye D, Quesnel AM, Cohen MS. Development of an interdisciplinary microtia-atresia care model: A single-center 20-year experience. Laryngoscope Investig Otolaryngol. 2022 Nov 16;7(6):2103-2111. doi: 10.1002/lio2.896. eCollection 2022 Dec.

    PubMed 36544952
  • Sevillano-Jimenez A, Romero-Saldana M, Molina-Recio G. Nursing role on rapid recovery programmes fast-track. Enferm Clin (Engl Ed). 2017 Jul 27:S1130-8621(17)30098-0. doi: 10.1016/j.enfcli.2017.06.002. Online ahead of print. English, Spanish.

    PubMed 28757097
  • Turhan Damar H, Ogce Aktas F. Anxiety, Depression, Stress, and Self-Esteem in Turkish Parents of Children with Microtia. Cleft Palate Craniofac J. 2024 Dec;61(12):1981-1990. doi: 10.1177/10556656231190046. Epub 2023 Jul 24.

    PubMed 37488938
  • Behrens B, Swetlitz C, Pine DS, Pagliaccio D. The Screen for Child Anxiety Related Emotional Disorders (SCARED): Informant Discrepancy, Measurement Invariance, and Test-Retest Reliability. Child Psychiatry Hum Dev. 2019 Jun;50(3):473-482. doi: 10.1007/s10578-018-0854-0.

    PubMed 30460424

Questions about this trial

What is this clinical trial studying?

A study testing Utilization of a perioperative position management protocol for congenital microtia patients based on the ADDIE model. in people with Congenital Microtia, run by Eye & ENT Hospital of Fudan University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ear Reconstruction Effectiveness Scale (time frame: 3 months postoperatively.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06569927, which also lists 19 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Aug 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in