儿童重症监护室安宁疗护质量评价指标体系的构建及适用性分析

doi:10.3761/j.issn.2096-7446.2026.01.005

Abstract

Abstract:

Objective To initially construct a quality evaluation index system for palliative care in pediatric intensive care units（PICUs），providing a basis for monitoring and managing the quality of palliative care in PICUs. Methods Based on the Donabedian theoretical framework，a literature review，expert Delphi method，and analytic hierarchy process were used to construct a quality evaluation index system for nursing care，including specific contents in structure，process，and outcome dimensions. Results Three rounds of expert consultation were conducted，with a 100% response rate for each round. The expert authority coefficients were 0.97，0.96，and 0.98，respectively，and the Kendall’s coefficient of concordance was 0.102，0.312，and 0.344（P<0.01）. Ultimately，a quality evaluation index system for palliative care in PICUs was constructed，including 3 first-level indicators，11 second-level indicators，and 40 third-level indicators. Conclusion The index system ultimately formed in this study is both scientific and clinically applicable. It can be used as a reference for the quality review of palliative care，providing nurses with a clear working framework and norms，and offering quantifiable evaluation standards for exploring the effectiveness of palliative care intervention measures.

Key words: Pediatric Intensive Care Unit, Palliative Care, Nursing Quality, Index, Delphi Method, Analytic Hierarchy Process

ZHAO Huiyun, WU Bo, XU Xiaoying, TANG Shi. Development of a quality assessment indicator system for palliative care in pediatric intensive care units[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 36-41.

Figures/Tables 1

References 20

[1]	Akard TF, Hendricks-Ferguson VL, Gilmer MJ. Pediatric palliative care nursing[J]. Ann Palliat Med, 2019, 8(Suppl 1):S39-S48. doi: 10.21037/apm.2018.06.01
[2]	李琳玉, 孙畅, 陈晓飞, 等. 新生儿重症监护室护士对死亡态度与安宁疗护教育需求的相关性分析[J]. 中华急危重症护理杂志, 2022, 3(5):431-436.
	Li LY, Sun C, Chen XF, et al. Correlation analysis between death attitude and hospice education needs of the nurses in neonatal intensive care unit[J]. Chin J Emerg Crit Care Nurs, 2022, 3(5):431-436.
[3]	Moresco B, Moore D. Pediatric palliative care[J]. Hosp Pract (1995) 2021, 49(sup1):422-430. doi: 10.1080/21548331.2021.1964867
[4]	蒋思珊, 成琴琴, 罗听薇, 等. 儿童安宁疗护质量评估工具的系统评价[J]. 中华护理杂志, 2025, 60(5):611-618. doi: 10.3761/j.issn.0254-1769.2025.05.015
	Jiang SS, Cheng QQ, Luo TW, et al. A systematic review of quality assessment tools for pediatric palliative care based on COSMlN guidelines[J]. Chin J Nurs, 2025, 60(5):611-618. doi: 10.3761/j.issn.0254-1769.2025.05.015
[5]	Davis S, Nunn M. Palliative communication in the pediatric intensive care unit[J]. Crit Care Nurs Clin North Am, 2023, 35(3):287-294.
[6]	Donabedian A. Evaluating the quality of medical care[J]. Milbank Q, 2005, 83(4):691-729. doi: 10.1111/j.1468-0009.2005.00397.x pmid: 16279964
[7]	Vasli P, Karami M, AsadiParvar-Masouleh H. Pediatric palliative care for children with cancer:a concept analysis using Rodgers’ evolutionary approach[J]. World J Pediatr, 2022, 18(12):791-803. doi: 10.1007/s12519-022-00600-x
[8]	Chen L, Zhang YJ, Li C, et al. Construction of haemodialysis nursing-sensitive quality indicators based on Donabedian theory:a Delphi method study[J]. Nurs Open, 2023, 10(2):807-816. doi: 10.1002/nop2.v10.2
[9]	王草源, 任义梅, 陈方圆. NICU终末期患儿安宁疗护质量评价量表的编制及信效度检验[J]. 中华急危重症护理杂志, 2024, 5(12):1081-1087.
	Wang CY, Ren YM, Chen FY. Development and psychometric tests of the Palliative Care Quality Assessment Scale in the neonatal intensive care setting[J]. Chin J Emerg Crit Care Nurs, 2024, 5(12):1081-1087.
[10]	Boyden JY, Bogetz JF, Johnston EE, et al. Measuring pediatric palliative care quality:challenges and opportunities[J]. J Pain Symptom Manage, 2023, 65(5):e483-e495. doi: 10.1016/j.jpainsymman.2023.01.021
[11]	Feudtner C, Beight LJ, Boyden JY, et al. Goals of care among parents of children receiving palliative care[J]. JAMA Pediatr, 2023, 177(8):800-807. doi: 10.1001/jamapediatrics.2023.1602 pmid: 37306979
[12]	Stone W, Keim-Malpass J, Cozad MJ, et al. Pediatric end-of-life care in rural America:a systematic review[J]. Am J Hosp Palliat Care, 2022, 39(9):1098-1104. doi: 10.1177/10499091211064202
[13]	Postier AC, Wolfe J, Hauser J, et al. Education in palliative and end-of-life care-pediatrics:curriculum use and dissemination[J]. J Pain Symptom Manage, 2022, 63(3):349-358. doi: 10.1016/j.jpainsymman.2021.11.017
[14]	Weaver MS, Mooney-Doyle K, Kelly KP, et al. The benefits and burdens of pediatric palliative care and end-of-life research:a systematic review[J]. J Palliat Med, 2019, 22(8):915-926. doi: 10.1089/jpm.2018.0483
[15]	Seino Y, Kurosawa H, Shiima Y, et al. End-of-life care in the pediatric intensive care unit:Survey in Japan[J]. Pediatr Int, 2019, 61(9):859-864. doi: 10.1111/ped.v61.9
[16]	Constantinou G, Garcia R, Cook E, et al. Children’s unmet palliative care needs:a scoping review of parents’ perspectives[J]. BMJ Support Palliat Care, 2019, 9(4):439-450. doi: 10.1136/bmjspcare-2018-001705
[17]	Mishra S, Mukhopadhyay K, Tiwari S, et al. End-of-life care:consensus statement by Indian academy of pediatrics[J]. Indian Pediatr, 2017, 54(10):851-859. doi: 10.1007/s13312-017-1149-4
[18]	Levine DR, Mandrell BN, Sykes A, et al. Patients’ and parents’ needs,attitudes,and perceptions about early palliative care integration in pediatric oncology[J]. JAMA Oncol, 2017, 3(9):1214-1220. doi: 10.1001/jamaoncol.2017.0368 pmid: 28278329
[19]	Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique[J]. J Adv Nurs, 2000, 32(4):1008-1015. pmid: 11095242
[20]	商君婷, 陈燕, 赵军亚, 等. 数字化健康干预在青少年癌症患者安宁疗护中的应用进展[J]. 中华护理杂志, 2023, 58(23):2940-2944. doi: 10.3761/j.issn.0254-1769.2023.23.018
	Shang JT, Chen Y, Zhao JY, et al. Progress in the application of digital health interventions in the palliative care of adolescent cancer patients[J]. Chin J Nurs, 2023, 58(23):2940-2944. doi: 10.3761/j.issn.0254-1769.2023.23.018

Development of a quality assessment indicator system for palliative care in pediatric intensive care units

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 1

References 20

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	REN Guangxiu, QIN Xiaoxin, ZHANG Yanfang, WANG Wenran, HAN Chao, WANG Shouxi. The status and latent profile analysis of palliative care competence among nurses in intensive care unit [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 89-95.
[2]	PENG Li, XU Cuirong, FENG Bo, YAO Yuanyuan, XING Xingmin, YU Lin. Construction and applicability analysis of management scheme for preventing unexpected interruption of continuous renal replacement therapy in ICU patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1036-1041.
[3]	LIU Yuting, QI Mengying, MENG Siya, WANG Binghan, WANG Qiaosha, HE Guilan. Construction and application effects of an analgesia and sedation management program for adult patients undergoing extracorporeal membrane oxygenation therapy [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 901-907.
[4]	XIONG Xingyu, ZHANG Dandan, CHENG Shouzhen. Application and development of of ICU nursing quality evaluation indicators：a scoping review [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 758-764.
[5]	XU Yanan, LIU Yahui, WANG Danruo, KANG Yubiao, YUAN Ling. A meta-synthesis of the qualitative studies of the influencing factors of palliative care implemented by ICU medical staff [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 737-743.
[6]	ZHANG Jian, WANG Xiaoping, SHI Xusheng, XUE Xue, GAI Yubiao, GAO Silong, Guo Xiaojing, WEI Lili. Construction and validation of a risk assessment tool for acute skin failure in ICU patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(5): 517-523.
[7]	CHEN Huijuan, HUANG Wei, LIU Yue, ZHAO Feifan, CHENG Jing, SUN Libing. Construction and applicability analysis of nursing quality evaluation index system of severe trauma care [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(4): 428-433.
[8]	CHEN Chen, GUAN Yan, SU Yunyan, XIE Xiaoli, JIN Hua, WANG Zheyun. Construct of a core competence evaluation index system for cardiac surgery specialist nurses and analysis of speciality features [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 309-316.
[9]	ZHAO Rui, JIANG Mei, LÜ Yang. Construction of evaluation index system for core competence of maternal ICU specialist nurses and analysis of speciality features [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 303-308.
[10]	HE Shasha, WANG Zhimin, JIANG Dandan, LIU Jing, TAN Caixia, ZOU Licheng. Construction and applicability analysis of whole-process nursing plan from pre-hospital first aid to in-hospital rehabilitation for emergency severe trauma patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 275-282.
[11]	TAO Qian, GAO Mingrong, BAI Liping, CHEN Shaozhen, CHENG Shouzhen. Quality evaluation of airway management in prone position mechanically ventilated patients：a qualitative study from the perspective of medical staff [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(2): 214-218.
[12]	XIONG Xinjuan, PI Hongying. The construction and applicability analysis of early nursing assessment indicators for critically burned patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(2): 146-152.
[13]	HE Yemei, HU Yaxuan, LIU Xiumei, LIAO Shiyi, CHEN Ouying. Visual analysis of research hotspots and development trends in palliative care for pediatric intensive care units [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(12): 1503-1509.
[14]	XU Yajie, LUO Feixiang, CHEN Xiaofei, CHENG Xiaoying, MENG Sijia, CHEN Shuohui. The core competence elements of palliative care among nurses in neonatal intensive care unit：a qualitative study [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(10): 1195-1200.
[15]	ZHANG Jian, Ding Yaoyao, XUE Xue, ZHOU Meng, GAO Silong, LIU Chenchen, SHI Xusheng. Predictive value of peripheral perfusion index combined with sequential organ failure score for acute skin failure in ICU patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(10): 1169-1174.