Development and preliminary feasibility evaluation of a health management checklist for older adults with chronic disease-related disability based on Fitch’s supportive care framework

Informed by Fitch’s Supportive Care Framework, this study aimed to develop a health management checklist for older adults with chronic disease-related disability and to conduct a preliminary evaluation of its feasibility and potential applicability. This methodological study was conducted in three sequential phases: evidence synthesis and preliminary item generation, two-round Delphi expert consultation, and a single-center preliminary feasibility evaluation. Guided by Fitch’s Supportive Care Framework, a preliminary draft of the health management checklist was developed on the basis of evidence-based practice. Two rounds of Delphi expert consultation were conducted to revise and finalize the checklist. In May 2025, 20 older adults with chronic disease-related disability from the Department of Geriatrics of a tertiary hospital in Fuyang were recruited through convenience sampling. Trained nurses and health managers applied the checklist. Subjective feedback was collected from patients and healthcare professionals, and exploratory pre–post changes in General Self-Efficacy Scale (GSES) and 36-Item Short Form Health Survey (SF-36) total scores were analyzed. The positive response rates for the two rounds of expert consultation were 93.33% and 100%, respectively, and the experts’ authority coefficients were 0.82 and 0.86. Kendall’s W values indicated statistically significant agreement among experts in both rounds. The finalized checklist comprised four domains, 13 subdomains, and 34 items. During the preliminary application involving 20 participants, patients and healthcare professionals generally reported that the checklist was understandable and potentially feasible. The mean GSES score increased from 15.35 ± 3.77 before implementation to 20.60 ± 4.04 after implementation ( Z = − 3.84, P < 0.001). The mean SF-36 total score increased from 295.89 ± 63.14 to 461.98 ± 106.30, with a mean change of 166.09 points (95% confidence interval: 128.37–203.80; t = 9.217, P < 0.001). Given the small uncontrolled sample, these findings represent exploratory pre–post changes rather than evidence of clinical effectiveness. This study developed a preliminary expert-consensus health management checklist for older adults with chronic disease-related disability. The findings provide initial information regarding item relevance, expert agreement, acceptability, potential feasibility, and exploratory changes in patient-reported outcomes. However, formal psychometric properties were not evaluated, and clinical effectiveness was not established. Further multicenter controlled studies with larger and more diverse samples are required to evaluate the checklist’s reliability, validity, usability, implementation outcomes, and effects on patient and caregiver outcomes.