Development of Quality Indicators for Palliative Care to the Elderly Chinese Patients: A Modified Delphi Study

Abstract

Aim: This study aimed to develop a list of quality indicators (QIs) for palliative care to elderly patients in Chinese general hospitals. Design: A modified Delphi method was used to develop the QIs. Methods: An extensive literature review, semi-structured interviews and a focus group discussion were performed to identify QIs. The finalized QIs were emailed to professionals in geriatrics or palliative care asking them to score importance and relavence of each item and to add suggestion about the QIs. The Analytic Hierarchy Process(AHP) was used to determine the weight of indicators. Results: The final list consisted of 4 first-level QIs, 15 second-level QIs, and 34 third-level QIs. Amongst the first-level indicators, symptom management had the highest weighting (0.53), followed by comfortable care (0.20), social and cultural support (0.20), and psychological and spiritual support (0.08). The Delphi experts' authority coefficient, judgment coefficient, and familiarity degree were 0.84, 0.86, and 0.81, respectively. Conclusion: Based on the improved Delphi method, this study established a set of palliative care quality indicators for general hospitals in China. These indicators provide practical reference for nurses to dynamically evaluate and improve nursing, in order to improve the comfort of elderly patients at the end of life, and promote patients to spend their last time peacefully and with dignity.

Keywords

Elderly / Palliative care / Delphi technique / Indicator / Nursing

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