Mapping the digital landscape: A systematic environmental scan and evaluation of online resources about recovery after intensive care.

Abstract

Online resources may engage patients in their healthcare; several exist about recovery after intensive care (ICU). This study aims to identify and appraise online resources about recovery after ICU for survivors, caregivers, or clinicians. An environmental scan of online resources identified through Google™, Bing™ and Yahoo™. Online resources in website, webpage or downloadable format, written in English, were included. Appraisal was guided by the World Health Organization's principles of effective health communication and included common website and patient education metrics; Journal of American Medical Association (JAMA) criteria, Global Quality Score, Content Validity Index, DISCERN instrument, Suitability Assessment Measure, Patient Education Materials Assessment Tool and four readability measures. There were 127 online resources identified; 44% (n = 56) downloadable documents, 40% (n = 50) singular webpages, 9% (n = 12) multiple webpages, and 7% (n = 9) websites dedicated to recovery after ICU. Majority of online resources were for ICU survivors and/or caregivers (n = 123). Overall, credibility was fair (median JAMA criteria 2[1-3]/4), with online resources commonly lacking references or authorship details. Online resources were 'somewhat' relevant (median Global Quality Score 3[3-4]/5) but not comprehensive, with some important topics e.g., goal setting and post-intensive care syndrome-family, missing or inadequately explained. ICU survivor and caregiver resources were of poor quality (DISCERN instrument score 39[35-46]/80; cut-off <68 very good) and were understandable but not actionable (Patient Education Materials Assessment Tool 83%[75-87%]/100% and 60%[40-60%]/100% respectively; cut-off 70%). Only 51% included pictures amongst text and all readability assessments exceeded public literacy levels. Many online resources about recovery after ICU exist, however need to be optimised to meet principles of effective health communication. When designing information on recovery after ICU, content needs to align with ICU survivorship guidelines and consider the reader, including using plain language, providing actionable information and visual aids as an adjunct to text.