Construction of a preliminary quality indicator framework for palliative care nursing services for terminal cancer patients in China

Standardized nursing service quality evaluation is crucial to address regional disparities and optimize palliative care outcomes in China, yet a structured indicator framework remains lacking. To develop a preliminary SERVQUAL-informed, consensus-based indicator framework for palliative care nursing services for terminal cancer patients in China. An initial framework was developed through a literature review and structured according to the five dimensions of the SERVQUAL model. A two-round Delphi consultation was conducted with 17 nursing experts with experience relevant to palliative care recruited through purposive sampling. Response rates were 100% in both Delphi rounds. The expert authority coefficient was 0.918. Kendall's concordance coefficient for the indicators was statistically significant (W = 0.116-0.218, all P < 0.05), indicating a statistically significant but modest level of expert coordination. The final framework comprised 5 primary domains, 15 subdomains, and 52 measurable indicators. A preliminary consensus-based framework for evaluating palliative care nursing service quality was developed. The framework may provide a reference for future quality assessment and improvement initiatives, although further empirical validation is required before clinical application.