Construction of an ICU Pre-experience Pattern for Patients Undergoing Lung Cancer Surgery and Their Family Members: A Delphi Study

Abstract

AIM: This study aims to construct an intensive care unit (ICU) pre-experience pattern for patients undergoing lung cancer surgery and their family members, to provide a novel mechanism of communication between healthcare professionals and patients that may improve treatment adherence and satisfaction with hospitalisation. METHODS: Initially, an item pool was created for pre-experienced ICUs through a comprehensive literature review, prior qualitative research, and expert panel discussions, resulting in 146 items. Inputs from experts were sought through Delphi surveys to construct an ICU pre-experience pattern for patients undergoing lung cancer surgery and their family members. The Delphi study included 22 multidisciplinary experts from intensive care, nursing management, clinical medicine, and social psychology. Subsequent rounds of consultation were guided by consistency in the findings of the consultation. Two rounds of consultations were performed using 5-point Likert scales to assess importance and feasibility. Consensus criteria included a mean score of ≥3.5 and a coefficient of variation (CV) of ≤0.25. RESULTS: A total of 146 items, including 5 primary, 29 secondary, and 112 tertiary items, were incorporated in the final pattern. These included items structured around 5 critical time phases: '24 hours preceding ICU admission', 'Postoperative ICU admission before anaesthesia emergence', 'Postoperative ICU admission after anaesthesia emergence', 'First postoperative day/transfer day', and 'Following ICU discharge'. Key dimensions include the objectives of ICU admission, description of ICU personnel and environment, psychological preparation, clinical procedures, and post-ICU care. Two rounds of expert consultations yielded a 100% recovery rate (RR). An acceptable level of consensus was achieved, with mean importance and feasibility scores ranging from 4.41 to 5.00 in Round 2, and a CV below 0.25 for all items. The high authority coefficients (Cr) (0.84 and 0.83) confirm a trend toward higher expert consensus on the clinical relevance and practical applicability of the developed pattern. CONCLUSIONS: This study developed an ICU pre-experience pattern for patients undergoing lung cancer surgery and their family members. This pattern provides a theoretical framework and a potential approach that may help alleviate anxiety and enhance treatment adherence.