A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocol

BackgroundChronic wounds impose a significant burden on patients and caregivers because of complications such as pain, infection, and repeated trips to and from hospitals. These challenges are compounded by prolonged healing times and substantial socioeconomic costs, particularly in aging population...

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Main Authors: Lili Chen, Xuefang Zhuo, Hong Cai, Penghua Zeng, Hongyu Chen, Gang Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1591187/full
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author Lili Chen
Lili Chen
Xuefang Zhuo
Xuefang Zhuo
Hong Cai
Hong Cai
Penghua Zeng
Penghua Zeng
Hongyu Chen
Gang Chen
author_facet Lili Chen
Lili Chen
Xuefang Zhuo
Xuefang Zhuo
Hong Cai
Hong Cai
Penghua Zeng
Penghua Zeng
Hongyu Chen
Gang Chen
author_sort Lili Chen
collection DOAJ
description BackgroundChronic wounds impose a significant burden on patients and caregivers because of complications such as pain, infection, and repeated trips to and from hospitals. These challenges are compounded by prolonged healing times and substantial socioeconomic costs, particularly in aging populations and resource-limited settings. The Digitally Enabled Home-Based Wound Care (DE-HBWC) program facilitates the organization of home visits by caregivers through electronic devices and internet platforms, enabling patients to easily receive medication changes and treatments, thus allowing patients to continue to reside in familiar surroundings while enjoying the same treatment as they would in a hospital. The construction of DE-HBWC programs for chronic wound patients in China is hampered by a lack of scientific theoretical guidance and high-quality research. The PEDALs (Problem, Evidence, Determinants, Actions, Long-term, Scales) model, a theoretical framework used in implementation research, as a rational framework for the DE-HBWC program in this study. Unlike conventional approaches, the PEDALs model emphasizes iterative adaptation and long-term scalability, ensuring alignment with real-world clinical needs and technological advancements.MethodsWe 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 were undertaken to address the research questions. In Phase III, in-depth interviews will be conducted to identify barriers and facilitators to the implementation of the DE-HBWC program in chronic wound patients. In Phase IV, the DE-HBWC intervention protocol will be developed and followed by a randomized controlled trial of the DE-HBWC intervention program. In Phase V, a DE-HBWC 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 conducted.DiscussionThis study evaluated the impact of the DE-HBWC program on wound healing and quality of life in chronic wound patients and to assess its economic benefits. The findings are expected to help resolve challenges faced by patients with chronic wounds attending hospitals for wound care.Trial registrationProspectively registered at the Chinese Clinical Trials Registry on 24.12.2023, ChiCTR2300079030.
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spelling doaj-art-095953e888cf4e3f93b11f9cd8a6a54d2025-08-20T03:26:16ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.15911871591187A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocolLili Chen0Lili Chen1Xuefang Zhuo2Xuefang Zhuo3Hong Cai4Hong Cai5Penghua Zeng6Penghua Zeng7Hongyu Chen8Gang Chen9Shengli Clinical College of Fujian Medical University, Fuzhou, ChinaDepartment of Nursing, Fujian Provincial Hospital, Fuzhou, ChinaShengli Clinical College of Fujian Medical University, Fuzhou, ChinaFujian Key Laboratory of Geriatrics Diseases, Fujian Provincial Center for Geriatrics, Fuzhou, ChinaShengli Clinical College of Fujian Medical University, Fuzhou, ChinaDepartment of Nursing, Fujian Provincial Hospital, Fuzhou, ChinaShengli Clinical College of Fujian Medical University, Fuzhou, ChinaDepartment of Plastic and Burn Surgery, Fujian Provincial Hospital, Fuzhou, ChinaThe School of Nursing, Fujian Medical University, Fuzhou, ChinaDepartment of Endocrinology, Fujian Provincial Hospital, Fuzhou, ChinaBackgroundChronic wounds impose a significant burden on patients and caregivers because of complications such as pain, infection, and repeated trips to and from hospitals. These challenges are compounded by prolonged healing times and substantial socioeconomic costs, particularly in aging populations and resource-limited settings. The Digitally Enabled Home-Based Wound Care (DE-HBWC) program facilitates the organization of home visits by caregivers through electronic devices and internet platforms, enabling patients to easily receive medication changes and treatments, thus allowing patients to continue to reside in familiar surroundings while enjoying the same treatment as they would in a hospital. The construction of DE-HBWC programs for chronic wound patients in China is hampered by a lack of scientific theoretical guidance and high-quality research. The PEDALs (Problem, Evidence, Determinants, Actions, Long-term, Scales) model, a theoretical framework used in implementation research, as a rational framework for the DE-HBWC program in this study. Unlike conventional approaches, the PEDALs model emphasizes iterative adaptation and long-term scalability, ensuring alignment with real-world clinical needs and technological advancements.MethodsWe 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 were undertaken to address the research questions. In Phase III, in-depth interviews will be conducted to identify barriers and facilitators to the implementation of the DE-HBWC program in chronic wound patients. In Phase IV, the DE-HBWC intervention protocol will be developed and followed by a randomized controlled trial of the DE-HBWC intervention program. In Phase V, a DE-HBWC 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 conducted.DiscussionThis study evaluated the impact of the DE-HBWC program on wound healing and quality of life in chronic wound patients and to assess its economic benefits. The findings are expected to help resolve challenges faced by patients with chronic wounds attending hospitals for wound care.Trial registrationProspectively registered at the Chinese Clinical Trials Registry on 24.12.2023, ChiCTR2300079030.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1591187/fullchronic woundswound carePEDALs modeldigital healthhome-basedtelehealth
spellingShingle Lili Chen
Lili Chen
Xuefang Zhuo
Xuefang Zhuo
Hong Cai
Hong Cai
Penghua Zeng
Penghua Zeng
Hongyu Chen
Gang Chen
A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocol
Frontiers in Public Health
chronic wounds
wound care
PEDALs model
digital health
home-based
telehealth
title A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocol
title_full A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocol
title_fullStr A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocol
title_full_unstemmed A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocol
title_short A digitally enabled home-based wound care program using the PEDALs model: a mixed-methods study protocol
title_sort digitally enabled home based wound care program using the pedals model a mixed methods study protocol
topic chronic wounds
wound care
PEDALs model
digital health
home-based
telehealth
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1591187/full
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