Construction and clinical application of a staging assessment index scheme for home hospice care

Abstract

This study aimed to develop a comprehensive staging assessment framework for home hospice care in China and establishing evidence-based workflow standards. Through systematic literature review, Delphi technique, and Analytic Hierarchy Process, we identified staging parameters for four terminal disease categories. A detailed stage-specific care protocol was developed and rigorously clinically validated. Two-round expert consultation demonstrated high response rates (95.2 % and 100 %) with authoritative coefficients of 0.928 (SD=0.02) and 0.930 (SD=0.03). Kendall's coefficient of concordance for the primary and secondary indicators were 0.557 and 0.191 -0.288, respectively. The final staging assessment index scheme comprises 4 primary indicators and 31 secondary indicators, thereby establishing robust standards for assessment and nursing care plans. Utilizing Delphi method in constructing the staging assessment index scheme for home hospice care underscores its methodological rigor, reliability, and scientific robustness. Clinical validation has confirmed that the targeted care plan based on the care protocol derived can help rationally and effectively plan the frequency of visits and care preparation at different stages. This approach not only ensures the provision of psychological support and humanistic care but also enables the implementation of targeted nursing interventions. Consequently, it significantly improved the rationality and efficiency of work arrangement, as well as the satisfaction of patients and their families.