Development and validation of a prediction model for caregiving unpreparedness among informal caregivers of ICU patients transferred to general wards

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Abstract
This study aims to investigate the incidence and risk factors of caregiving unpreparedness among informal caregivers of adult ICU patients transferred to general wards, and to develop and validate a predictive model for caregiving unpreparedness. A cross-sectional study following the TRIPOD statement was conducted. Data were collected from 323 pairs of ICU patients and their informal caregivers who were transferred to general wards at the Second Affiliated Hospital of Harbin Medical University, Heilongjiang Province, between May and December 2024. Whether caregiving unpreparedness occurred was used as the outcome measure. LASSO and logistic regression identified risk factors and constructed a nomogram. Receiver operating characteristic (ROC) curve analysis and calibration curves were used to assess the discrimination and calibration of the predictive model. Decision curve analysis was performed to evaluate the clinical net benefit of the model. Of the 323 caregivers, 230 (71.2%) experienced caregiving unpreparedness. Six factor-caregiving experience, co-caregiver, disease knowledge, anxiety, depression, and patient self-paid status-were included in the nomogram. The area under the ROC curve was 0.863 (training) and 0.744 (validation). Calibration curves showed close alignment between predicted and actual probabilities. Decision curve analysis showed a net benefit for threshold probabilities of 0 to 0.75. The nomogram developed in this study effectively predicts caregiving unpreparedness among informal caregivers of ICU patients transferred to general wards and may assist healthcare professionals in identifying high-risk populations for caregiving unpreparedness.
Funding Information
  • National Natural Science Foundation of China (No. 72174048)

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