Construction of a postoperative home-based pulmonary rehabilitation program protocol for lung cancer patients delivered using the internet: A Delphi-based study.

Abstract

Objective: To construct a protocol to guide standardized home-based pulmonary rehabilitation for postoperative lung cancer patients based on the Internet + .

Methods: A postoperative home-based pulmonary rehabilitation protocol via the Internet (PHPRPI) for patients with lung cancer was developed through a literature review. The protocol was modified based on the opinions and suggestions of experts in two rounds of expert consultation, utilizing the Delphi method. A three-level, hierarchical structure was employed in the Delphi method, with primary indicators representing broad, overarching concepts, secondary indicators providing more specific details within those concepts, and tertiary indicators offering the most granular and actionable measures. The following coefficients were calculated to assess the robustness of the Delphi method: the positive coefficient was calculated as the percentage of experts completing the questionnaire, with a recommended level of ≥ 70%. The expert authority coefficient (Cr) was calculated as the arithmetic mean of familiarity criteria (Ca) and the degree of familiarity (Cs), with a recommended level of ≥ 0.70. The coefficient of variation (CV) and Kendall's harmony coefficient (ω) were used to indicate the degree of variation and coordination, which range from 0 to 1, with higher values indicating more consistent expert opinions.

Results: Eighteen experts completed two rounds of consultation, with the Cr being 0.91, the ω being 0.159 (P < 0.01), and the CV ranging from 0.0477 to 0.1352, indicating good reliability of the Delphi method. The final protocol includes four primary indicators (including composition of the staff, establishment of patient health records, off-line intervention, and online intervention), 14 secondary indicators (e.g., personnel professional, specialized assessment, training frequency, and breathing training methods), and 44 tertiary indicators (e.g., vital sign assessment, content of health education, resistance training, and flexibility training).

Conclusion: The PHPRPI provides preliminary evidence to guide postoperative home-based rehabilitation management for lung cancer patients, aiming to improve their health outcomes and well-being. Future randomized controlled trials (RCTs) are needed to further validate the safety and effectiveness of this model and assess whether it is acceptable to patients and healthcare providers.