Construction of Outcome Quality Evaluation Indicators for Home Hospice Care in Older Patients with Terminal Cancer in...

With the rapid aging of the population and the increasing prevalence of terminal cancer among older adults worldwide, the demand for high-quality home hospice care is growing. However, there is a lack of culturally appropriate and systematic outcome quality evaluation indicators. This study aimed to construct a set of outcome quality evaluation indicators for home hospice care in older patients with terminal cancer in China, guided by the Harmony Nursing Theory.

A three-phase methodological design was employed. First, a 12-member multidisciplinary research team was established. Second, preliminary indicators were developed through a literature review of 18 relevant studies and qualitative interviews with 12 healthcare professionals. Third, two rounds of Delphi expert consultation were conducted to refine and validate the indicators. A pilot test was subsequently performed to assess feasibility. We calculated the expert positive coefficient (response rate), expert authority coefficient, and expert opinion coordination coefficient (Kendall's W).

In the first round of Delphi consultation, 24 questionnaires were distributed and 22 were returned, yielding a response rate of 91.7% In the second round, 22 questionnaires were distributed and all were returned (100% response rate). The expert authority coefficient was 0.96 in both rounds. Kendall's W was 0.247 and 0.296 in the first and second rounds, respectively. After the first round, three indicators were deleted, fifteen indicators were revised, and four indicators were added. Following the second round, two indicators were modified. The outcome quality evaluation indicator for home hospice care consisted of 4 first-level indicators, 12 second-level indicators, and 45 third-level indicators.

This study developed a culturally relevant and methodologically sound outcome quality evaluation indicator for home hospice care in older patients with terminal cancer in China. The indicators provide a tool for evaluating care quality, guiding clinical practice, and improving patient-centered outcomes in home hospice settings.