{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:17:10Z","timestamp":1783405030700,"version":"3.54.6"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":186,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014895","name":"Southwest Medical University","doi-asserted-by":"publisher","award":["2024LZXNYDJ100"],"award-info":[{"award-number":["2024LZXNYDJ100"]}],"id":[{"id":"10.13039\/501100014895","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As the population ages, nursing homes are key end\u2010of\u2010life care settings, making high\u2010quality palliative care essential for safeguarding older adults\u2019 quality of life. However, China currently lacks a unified and systematic tool for evaluating the quality of palliative care services in nursing homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To develop a quality assessment index system for palliative care services tailored to Chinese nursing homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study employed a mixed\u2010methods design with three phases: (1) a literature review (40 studies, 36 policy\/guideline documents; 2013\u20132023) and semistructured interviews with stakeholders from 6 nursing homes; (2) three rounds of modified Delphi expert consultation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931, 27, 23) to revise and refine the indicators; and (3) application of the analytic hierarchy process (AHP) to determine indicator weights.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final index system comprises 3 first\u2010level, 22 second\u2010level, and 47 third\u2010level indicators. The expert authority coefficient (Cr) exceeded 0.85 across all consultation rounds. Expert consensus increased with each round (Kendall\u2019s W: 0.189 to 0.315, p\u2009&lt;\u20090.05). AHP results indicated that among the first\u2010level indicators, \u201cprocess\u201d had the highest weight (0.4114), followed by \u201cstructure\u201d (0.3208) and \u201coutcome\u201d (0.2678). Within these dimensions, the highest weighted second\u2010level indicators were \u201chuman resources planning and management\u201d (0.0836), \u201ccomfort care services\u201d (0.0861), and \u201cquality of symptom management\u201d (0.0438). Furthermore, key third\u2010level indicators included \u201cfinancial support and management\u201d (0.0632), \u201cbasic nursing services\u201d (0.0465), and \u201cquality of symptom assessment and management\u201d (0.0438).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study developed a scientifically grounded quality assessment index system for palliative care services in Chinese nursing homes, which offers a preliminary framework for institutional self\u2010evaluation and quality improvement efforts pending further empirical validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Management<\/jats:title>\n                    <jats:p>Once empirically validated, the framework may assist managers and staff in nursing homes to identify service gaps, optimize resource allocation, and support a shift toward an \u201colder adult\u2013centered\u201d holistic care model.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/6031056","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:33:46Z","timestamp":1783402426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a Quality Assessment Index System for Palliative Care Services in Chinese Nursing Homes: A Modified Delphi and Analytic Hierarchy Process Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9977-1320","authenticated-orcid":false,"given":"Lu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Qin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping-Pin","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Xiang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Fang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4574-2499","authenticated-orcid":false,"given":"Yue-Lin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5616-8791","authenticated-orcid":false,"given":"Jing","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_15_1_2","unstructured":"Ministry of Civil Affairs of the People\u2019s Republic of China 2024 Statistical Bulletin on the Development of Civil Affairs 2025 https:\/\/www.mca.gov.cn\/gdnps\/n2445\/n2451\/n2458\/n2681\/c1662004999980006189\/attr\/400985.pdf."},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076529"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32136-X"},{"key":"e_1_2_15_4_2","volume-title":"2024 National Development Bulletin on Aging Affairs","author":"Ministry of Civil Affairs of the People\u2019s Republic of China","year":"2025"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57010070"},{"key":"e_1_2_15_6_2","article-title":"Report on Advancing the Development of the Elderly Care Service System and Strengthening the Care for Seniors with Disabilities","author":"The State Council of the People\u2019s Republic of China","journal-title":"Presented at the 11th Session of the Standing Committee of the 14th National People\u2019s Congress on September 10, 2024"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/0142159X.2020.1832650"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.05.017"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.12102\/j.issn.1009-6493.2023.07.015"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-083018"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0319403"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/26323524251369121"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1744987117753275"},{"key":"e_1_2_15_14_2","volume-title":"Notice on Issuing the Palliative Care Practice Guideline (2025 Edition)","author":"General Office of the National Health Commission of the People\u2019s Republic of China","year":"2025"},{"key":"e_1_2_15_15_2","unstructured":"Chongqing Municipal Market Supervision Administration Specification for Hospice Care Services in Senior Care Organizations DB50\/T 1420-2023 2023 https:\/\/dbba.sacinfo.org.cn\/stdDetail\/9c17f9e2ce83d427a32ebbe22f6b8f0a7fb9be86f2efe8357e68ece1359a9432."},{"key":"e_1_2_15_16_2","volume-title":"Construction of a Quality Evaluation Index System for Community Hospice Care","author":"Ma X.","year":"2023"},{"key":"e_1_2_15_17_2","first-page":"325","article-title":"Establish Standards for Home-Based End-of-Life Care","volume":"29","author":"Xu J.","year":"2014","journal-title":"Journal of Chinese Medicine"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn211501-20210310-00700"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2014.10.013"},{"key":"e_1_2_15_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-018-0301-9"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.260.12.1743"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzad038"},{"key":"e_1_2_15_23_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.967431"},{"key":"e_1_2_15_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-017-0970-8"},{"key":"e_1_2_15_25_2","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S477877"},{"key":"e_1_2_15_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-066599"},{"key":"e_1_2_15_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-024-01401-x"},{"key":"e_1_2_15_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-10876-6"},{"key":"e_1_2_15_29_2","doi-asserted-by":"crossref","DOI":"10.1002\/9781444392029","volume-title":"The Delphi Technique in Nursing and Health Research","author":"Keeney S.","year":"2011"},{"key":"e_1_2_15_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"key":"e_1_2_15_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216317690685"},{"key":"e_1_2_15_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/0270-0255(87)90473-8"},{"key":"e_1_2_15_33_2","doi-asserted-by":"publisher","DOI":"10.1504\/IJSSCI.2008.017590"},{"key":"e_1_2_15_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-082930"},{"key":"e_1_2_15_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02169-4"},{"key":"e_1_2_15_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40271-014-0050-7"},{"key":"e_1_2_15_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-024-05770-y"},{"key":"e_1_2_15_38_2","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1674-2982.2023.01.007"},{"key":"e_1_2_15_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igad047"},{"key":"e_1_2_15_40_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13197-7"},{"key":"e_1_2_15_41_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18020829"},{"key":"e_1_2_15_42_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951522000207"},{"key":"e_1_2_15_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2016.04.020"},{"key":"e_1_2_15_44_2","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1008-9993.2021.02.008"},{"key":"e_1_2_15_45_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn101379-20190915-00075"},{"key":"e_1_2_15_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.05.018"},{"key":"e_1_2_15_47_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163221127808"},{"key":"e_1_2_15_48_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14767"},{"key":"e_1_2_15_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.02.027"},{"key":"e_1_2_15_50_2","doi-asserted-by":"publisher","DOI":"10.1071\/AH21090"}],"container-title":["Journal of Nursing Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/6031056","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jonm\/6031056","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/6031056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:34:01Z","timestamp":1783402441000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jonm\/6031056"}},"subtitle":[],"editor":[{"given":"Justin","family":"Fontenot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jonm\/6031056"],"URL":"https:\/\/doi.org\/10.1155\/jonm\/6031056","archive":["Portico"],"relation":{},"ISSN":["0966-0429","1365-2834"],"issn-type":[{"value":"0966-0429","type":"print"},{"value":"1365-2834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6031056"}}