An Evaluation of Websites Offering Caregiver Education for Tracheostomy and Home Mechanical Ventilation

Published:November 10, 2020DOI:


      • As high as 98% of parents search for child health information on the Internet.
      • The lack of oversight of health-related information found online is concerning.
      • Valid tools exist to evaluate quality and readability of health information online.
      • Websites on tracheostomy that are high quality are difficult to read and understand.
      • Nurses should recommend high quality, easy-to-read websites for caregivers' education.



      Parental and familial caregivers of a child with a tracheostomy, and possibly home mechanical ventilation (HMV), face the overwhelming task of learning to medically care for their child prior to discharge. Caregivers may cope by seeking health information on the Internet. This is concerning because information found during an Internet search may not be accurate, comprehensive, or up to date. The purpose of this project was to evaluate the quality and content of websites offering information about tracheostomies and HMV using a valid assessment tool.


      A total of 46 websites were identified for evaluation using the DISCERN instrument for quality and reliability, and the Flesch Reading Ease (FRE) and Flesh- Kincaid (FK) grade level instruments for readability. Accuracy of content was determined by expert opinion.


      Few of the websites met the recommended quality and/or readability levels. The websites recommended had a range of DISCERN scores 21–40, adjusted FRE 61–89.1, and adjusted FK 3.4–6.9. Many of the highest quality websites had a readability level at high school or college levels.


      The quality and readability of websites offering caregiver education for tracheostomy and HMV are not at a level suitable for caregivers. There was often a mismatch between DISCERN quality and readability. Many high-quality websites would not be easily read and understood by the general lay population.

      Application to practice

      DISCERN alone is not sufficient to determine whether a website should be recommended. One should consider reliability, quality, and readability when developing patient education materials, including those on the Internet.


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