<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE trials [
<!ELEMENT trials (trial+)>

<!ELEMENT trial (main,contacts,countries,criteria,health_condition_code,health_condition_keyword,intervention_code,
          intervention_keyword,primary_outcome,secondary_outcome,secondary_sponsor,secondary_ids,source_support,ethics_reviews)>

<!ELEMENT main (trial_id,utrn?,reg_name,date_registration,primary_sponsor,public_title,acronym?,scientific_title,scientific_acronym?,
          date_enrolment,type_enrolment,target_size,recruitment_status,url?,study_type,study_design,phase,hc_freetext?,i_freetext?,results_actual_enrolment,results_date_completed,results_url_link,results_summary,           results_date_posted,results_date_first_publication,results_baseline_char,results_participant_flow,results_adverse_events,results_outcome_measures,results_url_protocol,results_IPD_plan, results_IPD_description)>
<!ELEMENT trial_id (#PCDATA)>
<!ELEMENT utrn (#PCDATA)>
<!ELEMENT reg_name (#PCDATA)>
<!ELEMENT date_registration (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT primary_sponsor (#PCDATA)>
<!ELEMENT public_title (#PCDATA)>
<!ELEMENT acronym (#PCDATA)>
<!ELEMENT scientific_title (#PCDATA)>
<!ELEMENT scientific_acronym (#PCDATA)>
<!ELEMENT date_enrolment (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT type_enrolment (#PCDATA)>
<!ELEMENT target_size (#PCDATA)>
<!ELEMENT recruitment_status (#PCDATA)><!-- Pending,Recruiting,Suspended,Complete,Other -->
<!ELEMENT url (#PCDATA)>
<!ELEMENT study_type (#PCDATA)><!-- interventional,observational -->
<!ELEMENT study_design (#PCDATA)>
<!ELEMENT phase (#PCDATA)>
<!ELEMENT hc_freetext (#PCDATA)>
<!ELEMENT i_freetext (#PCDATA)>
<!ELEMENT results_actual_enrolment (#PCDATA)>
<!ELEMENT results_date_completed (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_url_link (#PCDATA)>
<!ELEMENT results_summary (#PCDATA)>
<!ELEMENT results_date_posted (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_date_first_publication (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_baseline_char (#PCDATA)>
<!ELEMENT results_participant_flow (#PCDATA)>
<!ELEMENT results_adverse_events (#PCDATA)>
<!ELEMENT results_outcome_measures (#PCDATA)>
<!ELEMENT results_url_protocol (#PCDATA)>
<!ELEMENT results_IPD_plan (#PCDATA)>
<!ELEMENT results_IPD_description (#PCDATA)>


<!ELEMENT contacts (contact+)>
<!ELEMENT contact (type,firstname,middlename,lastname,address,city,country1,zip,telephone,email,affiliation)>
<!ELEMENT type (#PCDATA)><!-- Public,Scientific -->
<!ELEMENT firstname (#PCDATA)>
<!ELEMENT middlename (#PCDATA)>
<!ELEMENT lastname (#PCDATA)>
<!ELEMENT address (#PCDATA)>
<!ELEMENT city (#PCDATA)>
<!ELEMENT country1 (#PCDATA)>
<!ELEMENT zip (#PCDATA)>
<!ELEMENT telephone (#PCDATA)>
<!ELEMENT email (#PCDATA)>
<!ELEMENT affiliation (#PCDATA)>

<!ELEMENT countries (country2+)>
<!ELEMENT country2 (#PCDATA)>

<!ELEMENT criteria (inclusion_criteria,agemin,agemax,gender,exclusion_criteria)>
<!ELEMENT inclusion_criteria (#PCDATA)>
<!ELEMENT agemin (#PCDATA)>
<!ELEMENT agemax (#PCDATA)>
<!ELEMENT gender (#PCDATA)>
<!ELEMENT exclusion_criteria (#PCDATA)>

<!ELEMENT health_condition_code (hc_code+)>
<!ELEMENT hc_code (#PCDATA)>

<!ELEMENT health_condition_keyword (hc_keyword+)>
<!ELEMENT hc_keyword (#PCDATA)>

<!ELEMENT intervention_code (i_code+)>
<!ELEMENT i_code (#PCDATA)>

<!ELEMENT intervention_keyword (i_keyword+)>
<!ELEMENT i_keyword (#PCDATA)>

<!ELEMENT primary_outcome (prim_outcome+)>
<!ELEMENT prim_outcome (#PCDATA)>

<!ELEMENT secondary_outcome (sec_outcome+)>
<!ELEMENT sec_outcome (#PCDATA)>

<!ELEMENT secondary_sponsor (sponsor_name+)>
<!ELEMENT sponsor_name (#PCDATA)>

<!ELEMENT secondary_ids (secondary_id+)>
<!ELEMENT secondary_id (sec_id,issuing_authority)>
<!ELEMENT sec_id (#PCDATA)>
<!ELEMENT issuing_authority (#PCDATA)>

<!ELEMENT source_support (source_name+)>
<!ELEMENT source_name (#PCDATA)>

<!ELEMENT ethics_reviews (ethics_review+)>
<!ELEMENT ethics_review (status,approval_date,contact_name,contact_address,contact_phone,contact_email)>
<!ELEMENT status (#PCDATA)><!-- Not approved,Approved,NA -->
<!ELEMENT approval_date (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT contact_name (#PCDATA)>
<!ELEMENT contact_address (#PCDATA)>
<!ELEMENT contact_phone (#PCDATA)>
<!ELEMENT contact_email (#PCDATA)>
]>
<trials>
  <trial>
    <main>
      <trial_id>IRCT20250727066652N1</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2025-11-13</date_registration>
      <primary_sponsor>Tehran University of Medical Sciences</primary_sponsor>
      <public_title>Assessment the effect of a comprehensive care program on quality of life and respiratory symptoms in patients with cystic fibrosis</public_title>
      <acronym></acronym>
      <scientific_title>Assessment the effect of a comprehensive care program on quality of life and respiratory symptoms in patients with cystic fibrosis</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2025-11-22</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>80</target_size>
      <recruitment_status>Complete</recruitment_status>
      <url>https://irct.ir/trial/86555</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: In the first stage, patients will be selected from among those who refer to the Cystic Fibrosis (CF) Association who meet the inclusion criteria.
Then, participants will be divided into two control and intervention groups using a block randomization method, such that the number of people in both groups will be equal. For this purpose, blocks of four will be used; so that the letter A will represent the intervention group and the letter B will represent the control group.
In each block, two people will be assigned to group A and two people to group B. All possible combinations of the sequence of letters A, A, B, and B, which includes the following six cases, will be considered.
1. AABB
2. ABBA
3. ABAB
4. BBAA
5. BAAB
6. BABA

Then, the numbers 1 to 6 will be written on cards and placed in a container. To determine the order of allocation, one number will be randomly removed from the container each time. For example, if the number 2 is chosen, the order of sample allocation will be according to the second combination, i.e. (ABBA); that is, the first and fourth people will be in the intervention group and the second and third people will be in the control group.
This process will continue until the required number of samples is completed. To ensure randomization of allocation and eliminate bias, numbered cards will be placed in sealed envelopes so that the researcher does not know their order. After each withdrawal, the card will be returned to the container. In total, 18 numbers will be randomly drawn from the container and the resulting sequence of numbers will determine the final order of the blocks.
Considering the conditions in the clinic, the random sampling method was changed as follows: The allocation of participants to study groups was done using the even and odd-numbered allocation method, so that people with even numbers on the patient list were placed in the intervention group and people with odd numbers were placed in the control group.</study_design>
      <phase>N/A</phase>
      <hc_freetext>Cystic fibrosis.</hc_freetext>
      <i_freetext>Intervention 1: Control group: Control group: Members of the Iranian CF Association have a channel and information group on the ETA messenger; in this environment, patients and CF specialists are members; patients visit online and ask their questions to specialists or other members of the organization; for this purpose, to prevent data contamination, sampling is first done for the control group and then for the intervention group. Sampling and intervention are carried out virtually on a shared domestic messenger (due to restrictions on international Internet access). In order to facilitate the work for patients, to consider respiratory problems and limitations resulting from the disease in their daily activity, to save time, and to prevent the imposition of travel costs on patients, the plan is implemented virtually. On the other hand, the intervention content is located on a special channel for the intervention group, and there is continuous access to the channel content and training for members of the intervention group. After obtaining informed consent from the control group, they fill out four electronic questionnaires (demographic information, quality of life, respiratory symptoms, and self-management) in two stages with an 8-week interval; the control group receives routine care during this period, and after the sampling from the control group is completed, the sampling from the intervention group begins. Intervention 2: Intervention group: After obtaining informed consent, all members of the intervention group become members of a shared messenger between members in the "information channel" that the research team has designed for the explanations of the intervention group; the channel settings are such that participants cannot see the channel members; only the channel admin, i.e. the researcher, has the ability to send messages in the channel, and if participants have any questions, they should ask the channel admin privately. The above is done to maintain the confidentiality of the sample information and to avoid influencing each other and the results of the research. Pre-prepared introductory messages, which include introducing the plan, goals, and how the intervention group members will cooperate, are placed in the channel. After that, four electronic questionnaires (demographic information, quality of life, respiratory symptoms, and self-management) are filled out by the intervention group members before the intervention. The intervention (comprehensive care program) is implemented for 8 weeks. Gradually and based on the designed comprehensive care program, training is placed in the channel every week in the form of PDFs, infographics, text messages, etc. for practice and repetition. Participants in the intervention group are asked to record all their activities in daily checklists with details such as the type of activity, date, and time. The format of the checklists is designed in advance by the research team and is placed in the channel step by step. During this period, individuals are continuously in touch with the project implementer to ask their questions and ambiguities through messengers; to ensure the correct implementation of the intervention, the researcher contacts all samples every week and, on the other hand, planning checklists are provided to the patients so that the patients can continuously complete it step by step along with the comprehensive care plan. After 8 weeks from the start of the program, four more questionnaires are filled out by the intervention group members and planning booklets are collected from them. In this study, the comprehensive care plan intervention will include four main parts: 1. Nutrition: Teaching the principles of proper nutrition for cystic fibrosis patients with an emphasis on the specific needs of these patients (such as calories, protein, vitamins); 2. Exercise and breathing exercises: Providing an exercise program including aerobic exercises and special breathing exercises to improve lung function and increase tolerance to daily activities; 3. Psychological care: Teaching stress management methods, psychological support, and coping strategies for anxiety and depression related to the disease; 4. Social care: Providing guidance for social support, increasing social interactions, and using support resources in the community. The content of this program will be developed based on a systematic review of current scientific literature, internationally recognized guidelines, and in consultation with several experts in the field of cystic fibrosis. To confirm the validity of the content, the draft of the program will be reviewed by 5 to 7 experts and the CVR and CVI indices will be calculated. Also, a small pilot test will be conducted with the presence of 5 to 10 patients to assess the understandability, acceptability, and applicability of the program, and necessary modifications will be made based on feedback. The data from this pilot will not be used in the final analysis.</i_freetext>
      <results_actual_enrolment></results_actual_enrolment>
      <results_date_completed></results_date_completed>
      <results_url_link></results_url_link>
      <results_summary></results_summary>
      <results_date_posted></results_date_posted>
      <results_date_first_publication></results_date_first_publication>
      <results_baseline_char></results_baseline_char>
      <results_participant_flow></results_participant_flow>
      <results_adverse_events></results_adverse_events>
      <results_outcome_measures></results_outcome_measures>
      <results_url_protocol></results_url_protocol>
      <results_IPD_plan>Yes - There is a plan to make this available</results_IPD_plan>
      <results_IPD_description>What will be shared:
All data is potentially shareable after anonymizing individuals.

When:
The access period will begin 6 months after the publication of the results.

To whom:
The data will not only be available to researchers working at academic and scientific institutions, but individuals employed in industry can also apply to access them.

Conditions:
No other specific condition is required.

Where to obtain:
They can refer to the person who is conducting the sampling.

How to obtain:
They can send a message to the mentioned number, and it will be sent to them within a week.

Comments:
</results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Haleh Jafari</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Dr. Mirkhani Street (East Nusrat), Towhid Square</address>
        <city>Tehran</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>1419733171</zip>
        <telephone>+98 21 6105 4000</telephone>
        <email>halejafari67@gmil.com</email>
        <affiliation>Tehran University of Medical Sciences</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Zahra Mansoor Samaei</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Dr. Mirkhani Street (East Nusrat), Towhid Square</address>
        <city>Tehran</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>1419733171</zip>
        <telephone>+98 21 6105 4000</telephone>
        <email>zahrasamaei1380@gmail.com</email>
        <affiliation>Tehran University of Medical Sciences</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Iran (Islamic Republic of)</country2>
    </countries>
    <criteria>
      <inclusion_criteria>- Greater age equal to 18 years;
- A confirmed diagnosis of CF by a physician;
- Fluency in Persian and ability to read and write;
- The patient resides in Tehran;
- Having a smartphone and being able to use it;
- Not participating in similar care programs in the past 6 months;
- Giving written informed consent to participate in the study.</inclusion_criteria>
      <agemin>18 years</agemin>
      <agemax>no limit</agemax>
      <gender>Both</gender>
      <exclusion_criteria>- Having a diagnosed severe psychiatric illness (such as schizophrenia or active bipolar disorder);
- Having severe chronic diseases (severe vital organ failure and active cancer);
- History of lung transplantation.</exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code>E84</hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword>Cystic fibrosis</hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>N/A</i_code>
      <i_code>Rehabilitation</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Control group: Control group: Members of the Iranian CF Association have a channel and information group on the ETA messenger; in this environment, patients and CF specialists are members; patients visit online and ask their questions to specialists or other members of the organization; for this purpose, to prevent data contamination, sampling is first done for the control group and then for the intervention group. Sampling and intervention are carried out virtually on a shared domestic messenger (due to restrictions on international Internet access). In order to facilitate the work for patients, to consider respiratory problems and limitations resulting from the disease in their daily activity, to save time, and to prevent the imposition of travel costs on patients, the plan is implemented virtually. On the other hand, the intervention content is located on a special channel for the intervention group, and there is continuous access to the channel content and training for members of the intervention group. After obtaining informed consent from the control group, they fill out four electronic questionnaires (demographic information, quality of life, respiratory symptoms, and self-management) in two stages with an 8-week interval; the control group receives routine care during this period, and after the sampling from the control group is completed, the sampling from the intervention group begins.</i_keyword>
      <i_keyword>Intervention group: After obtaining informed consent, all members of the intervention group become members of a shared messenger between members in the "information channel" that the research team has designed for the explanations of the intervention group; the channel settings are such that participants cannot see the channel members; only the channel admin, i.e. the researcher, has the ability to send messages in the channel, and if participants have any questions, they should ask the channel admin privately. The above is done to maintain the confidentiality of the sample information and to avoid influencing each other and the results of the research. Pre-prepared introductory messages, which include introducing the plan, goals, and how the intervention group members will cooperate, are placed in the channel. After that, four electronic questionnaires (demographic information, quality of life, respiratory symptoms, and self-management) are filled out by the intervention group members before the intervention. The intervention (comprehensive care program) is implemented for 8 weeks. Gradually and based on the designed comprehensive care program, training is placed in the channel every week in the form of PDFs, infographics, text messages, etc. for practice and repetition. Participants in the intervention group are asked to record all their activities in daily checklists with details such as the type of activity, date, and time. The format of the checklists is designed in advance by the research team and is placed in the channel step by step. During this period, individuals are continuously in touch with the project implementer to ask their questions and ambiguities through messengers; to ensure the correct implementation of the intervention, the researcher contacts all samples every week and, on the other hand, planning checklists are provided to the patients so that the patients can continuously complete it step by step along with the comprehensive care plan. After 8 weeks from the start of the program, four more questionnaires are filled out by the intervention group members and planning booklets are collected from them. In this study, the comprehensive care plan intervention will include four main parts: 1. Nutrition: Teaching the principles of proper nutrition for cystic fibrosis patients with an emphasis on the specific needs of these patients (such as calories, protein, vitamins); 2. Exercise and breathing exercises: Providing an exercise program including aerobic exercises and special breathing exercises to improve lung function and increase tolerance to daily activities; 3. Psychological care: Teaching stress management methods, psychological support, and coping strategies for anxiety and depression related to the disease; 4. Social care: Providing guidance for social support, increasing social interactions, and using support resources in the community. The content of this program will be developed based on a systematic review of current scientific literature, internationally recognized guidelines, and in consultation with several experts in the field of cystic fibrosis. To confirm the validity of the content, the draft of the program will be reviewed by 5 to 7 experts and the CVR and CVI indices will be calculated. Also, a small pilot test will be conducted with the presence of 5 to 10 patients to assess the understandability, acceptability, and applicability of the program, and necessary modifications will be made based on feedback. The data from this pilot will not be used in the final analysis.</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>Determining and comparing the average quality of life score of adult patients with cystic fibrosis in the intervention and control groups, before and after implementing a comprehensive care program. Timepoint: At the beginning of the study and 8 weeks after the intervention. Method of measurement: Persian version of the standard and validated Cystic Fibrosis Questionnaire-Revised for ages 14 and older (CFQ-R +14).</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome>Determining and comparing the mean clinical symptom scores of adult patients with cystic fibrosis in the intervention and control groups, before and after implementing a comprehensive care program. Timepoint: At the beginning of the study and 8 weeks after the end of the intervention. Method of measurement: Persian version of the standard questionnaire for total symptom score.</sec_outcome>
      <sec_outcome>Determining and comparing the average self-management score of adult patients with cystic fibrosis in the intervention and control groups, before and after implementing a comprehensive care program. Timepoint: At the beginning of the study and 8 weeks after the end of the intervention. Method of measurement: Persian version of the Partners in Health (PIH) questionnaire.</sec_outcome>
    </secondary_outcome>
    <secondary_sponsor>
      <sponsor_name></sponsor_name>
    </secondary_sponsor>
    <secondary_ids>
      <secondary_id>
        <sec_id></sec_id>
        <issuing_authority></issuing_authority>
      </secondary_id>
    </secondary_ids>
    <source_support>
      <source_name>Tehran University of Medical Sciences</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2025-09-17</approval_date>
        <contact_name>Research Ethics Committee of School of Nursing and midwifery And Rehabilitation- Tehran University</contact_name>
        <contact_address>6th floor. Central Headquarters of Tehran University of Medical Sciences, at the corner of Ghods Street, Keshavarz Boulevard Tehran Tehran Iran (Islamic Republic of)</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
