Core needs screening items for informal caregivers of older adults: an online modified Delphi study

Identifying the needs and risks of family caregivers for older adults can enable timely recognition and support for informal caregivers and older adults. However, the literature highlights substantial variation in how caregiver needs and risks are assessed. This study aimed to identify a set of core items to be included in a needs screening for informal caregivers of older adults through a modified Delphi approach.

The Delphi study engaged an expert panel in Hong Kong comprising three stakeholder groups: service providers, policymakers/think tanks, and academics. We started by identifying items reflecting caregiver needs through literature review and item generation meeting. The consensus-building process included two rounds of surveys where panel members rated the importance of items, followed by a feedback meeting. Panel members could suggest additional items in the first survey round, which were reviewed by an external panel of social workers before being added to the second survey round. Consensus was reached with ≥ 70% agreement. Informal caregivers were invited to review the items derived from the Delphi study to ensure comprehensibility.

Forty panel members joined the item generationmeeting, 40 completed the round 1 survey, 43 completed the round 2 survey, and 20 joined the feedback meeting. Ten informal Caregivers evaluated the face and content validity of the items. The total number of items in the final round dropped from 62 to 37. There were 27 caregiver-related items (e.g., care burden, caregiving self-efficacy, family relationship, social support, financial and job conflicts, physical health, mental health, and service utilization), six care recipient-related items (e.g., care recipient's characteristics), and four care dyad-related items (e.g., care dyad relationship and physical environment). Consensus was achieved for 35 items in the surveys and two items in the feedback meeting.

This set of core needs screening items can potentially reduce the heterogeneity of needs and risk assessments across studies and clinical practices and inform the development of a standardized need screening tool.