The E-Hah Program for Patients with Chronic Wounds Based on the PEDALs Model: A Mixed Methods Study Protocol

Introduction: Chronic wounds impose a significant burden on patients and caregivers because of complications such as pain, infection, amputation, and repeated trips to and from hospitals. The electronic-based hospital-at-home program (e-HaH) facilitates the organization of home visits by caregivers through electronic devices and internet platforms, enabling patients to easily receive medication changes and treatments, thus lowering the cost of hospitalization for patients and allowing them to live in familiar surroundings and enjoy the same treatment as they would in a hospital. The construction of e-HaH programs for chronic wound patients in China and other countries is hampered by a lack of scientific theoretical guidance and high-quality research. The effectiveness of e-HaH applications in wound management for chronic wound patients still needs to be further explored. The PEDALs model is a theoretical framework used in implementation research, and implementation science based on the PEDALs theory is a new exploration as a rational wheel framework for this study.Methods and analysis: We designed a combined quantitative and qualitative study consisting of five phases and one monitoring step, following the PEDALs model. In Phase I, the clinical problem was defined as wound management challenges in patients with chronic wounds. In Phase II, a literature review and evidence-based practice was undertaken to address the research questions. In Phase III, in-depth interviews will be conducted with four groups: chronic wound patients, patient caregivers, wound specialty nurses, and healthcare facility administrators, using a semi-structured interview methodology, to identify barriers and facilitators to the implementation of the e-HaH program in chronic wound patients. In Phase IV, the e-HaH intervention protocol will be developed and a small sample of 10 patients with chronic wounds will be recruited for a one-month pre-trial to generate an applied version of the intervention program. This will be followed by a randomized controlled trial of the e-HaH intervention program. In Phase V, an E-HaH implementation plan that is sustainable over the long term will be developed to promote its use. Monitoring of the implementation of interventions in phases III to V will be carried out.Ethics and dissemination: Ethics approval for the study was obtained from the Ethics Committee of Fujian Provincial Hospital (K2023-12-002). Findings will be published in peer-reviewed journals and presented at national and international academic conferences.