The Construction Of Internet-based Home Care Content Index System For Informal Caregivers Of Patients With Malignant Fungating Wounds

ObjectiveTo understand the care needs of informal caregivers of patients with malignant fungating wounds.To construct an Internet-based home care content index system for informal caregivers of patients with malignant fungating wounds,and to provide a basis for realizing scientific and standardized home care for them.Methods1.A sample of 120 informal caregivers of patients with malignant fungating wounds in a Grade A hospital of Hunan Province from December 2019 to July 2020 was investigated by using a self-compiled questionnaire to explore their care needs.2.A qualitative interviews of 12 informal caregivers was carried out to deeply explore their care needs.3.Based on the literature review,cross-sectional survey,qualitative interviews and group discussion,the first draft of home care content index system based on the Internet for informal caregivers of patients with malignant fungating wounds was formed.The Delphi method was used to conduct two rounds of consultation with 20 experts across the country,and the experts were asked to rate the importance and feasibility of each item.Revise the index system according to the consultation results and experts’ suggestions,and form the final version.Statistical data analysis was accomplished by SPSS20.0 statistical analysis software.Measurement data was described by mean and standard deviation,while frequency and composition ratio were used to describe enumeration data.The reliability of experts is described by expert positive coefficient,authority coefficient and Kendall’s W coefficient.The importance and feasibility of each item was described by means of standard deviation and coefficient of variation.Results1.Most informal caregivers of patients with malignant fungating wounds were female,46.66% were aged 36 to 59 years old,41.66% were primary/high school education,78.34% had jobs,and 67.50% spent 4 to7 hours per day on caring.According to the care needs questionnaire for informal caregivers of patients with malignant fungating wounds,the average scores of care needs from high to low were knowledge information needs(4.20±0.73),health care needs(4.14±0.73),psychological and social support needs(3.85±0.79).2.The qualitative interview extracted seven themes: maladaptive role of caregivers,strong willingness to acquire knowledge,unestablished belief in caregivers,desire for home care guidance,high economic burden,lack of social support and Internet technical support.3.The enthusiasm of experts in the two rounds of consultation was100%.Expert authority coefficient is 0.90;Kendall’s W of the first round were 0.402 and 0.395,respectively.Kendall’s W of the second round were 0.412 and 0.433,respectively,with statistical significance.According to the results of the two-round expert consultation,the group discussion was conducted to delete items with a mean importance and feasibility score below 3.50 and a coefficient of variation above 0.25 and modify items with high concentration of expert opinions.The final Internet-based home care content index system for informal caregivers of patients with malignant fungating wounds included 3 first-level indicators,11 second-level indicators,and 42 third-level indicators.Conclusion1.Informal caregivers of patients with malignant fungating wounds had higher care needs,which were mainly manifested in knowledge,health care,psycho-social support,which proved that it was important and necessary to construct a scientific and standardized home care content index system for informal caregivers of malignant fungating wounds.2.The Internet-based home care content index system for informal caregivers of patients with malignant fungating wounds constructed by Delphi expert consultation method in this study is scientific and reliable,and can provide a reference for the home care of informal caregivers of patients with malignant fungating wounds.