Development Of Nursing Quality Indicators For Palliative Care In Dying Elderly

Objective:We established a quality indicator system of nursing for palliative care for elderly people in medical institutions in Chinese;We tested the reliability,feasibility and practicability of the evaluation tool;We investigated the status of nursing quality in order to improve the quality of nursing in medical institutions,in order to provide reference for supervision and management of relevant departments.Methods:1.We used the literature review,semi-structured interviews,group discussion and the Delphi method to form a quality indicator system of nursing for palliative care for elderly people and obtained the weights of each indicator.2.The questionnaire survey was used to test the reliability,validity and practicability of the evaluation tool for palliative care for elderly people.3.The questionnaire survey method was used to investigate nursing quality by using the evaluation tool for palliative care for elderly people.Results:1.Through literature search,semi-structured interviews,expert group discussions and Delphi method,the final quality indicator system of nursing for palliative care for elderly people was formed,including 4 first-level indicators,15 second-level indicators and34 third-level indicators.The recovery rate of the two rounds of Delphi expert consultation was 100%,the expert authority coefficient was 0.82,and Kendall’s was 0.50 and 0.64.The analytic hierarchy process was used to determine the weight of each dimension as symptom management 0.52,comfortable care 0.20,psychological and spiritual care 0.08,social and cultural support 0.20,and the CR value of each index was less than 0.1,indicating that the index system has a high degree of consistency.2.We selected 187 elderly people in Shenyang General Hospital for empirical research.The overall Cronbach’s α coefficient was0.811,and the Cronbach’s α coefficients of each dimension were from 0.637 to 0.800.The correlation coefficient between the two comprehensive evaluation results is r=0.94(P<0.01).3.The overall score of the quality of nursing for elderly people was(4.07±1.11)points,which was in the upper middle level.The average score of each dimension from high to low were comfort care(4.67±0.62)points,social and cultural support(4.14±1.21)points,symptom management(3.94±1.04)points,and psychological and mental care(3.55±1.21)points.Conclusion:1.This research had constructed a set of quality indicator system of nursing for palliative care for elderly people.The quality evaluation tool had good reliability and validity,and had a certain degree of practicability and scalability.This index system could be used by relevant departments and medical institutions to evaluate The quality of nursing for the elderly people provided a basis for improving the quality of nursing for the elderly people.2.The quality of nursing for palliative care for elderly people was in the upper middle level,but it still needs to be improved,especially in symptom management and psychological and spiritual care should be further strengthened and improved.