Developing a Nursing Assessment Chart for Patients Receiving Palliative Care at Home: A Delphi Method Study

Introduction: As the demand for home-based palliative care continues to grow, nurses play a critical role in assessing and managing the multifaceted needs of terminally ill patients. Despite international guidelines emphasizing comprehensive nursing assessment, a significant gap remains in structured tools tailored specifically for use in the home setting. Objective: To develop and validate a structured nursing assessment chart for patients receiving home-based palliative care using expert consensus through the Delphi method. Methods: A literature review was conducted to identify key nursing indicators relevant to home-based palliative care. A preliminary assessment chart was developed, encompassing seven core domains—vital signs, general examination, patient concerns, pain and symptom evaluation, functional status, pressure injury risk, and self-assessed quality of life. A panel of 21 experts (12 oncologists and 9 community nurses) participated in two Delphi rounds to evaluate the relevance and clarity of each item. Items were rated on a 5-point Likert scale, and consensus was defined as ≥75% agreement. Results: Consensus was achieved for most items during the first round (range: 85.5%-98.5%), with the exception of “Vital Signs Assessment” (74.4%) and “Self-Assessment of Quality of Life” (65.6%). After revisions, these two items reached 91.5% and 89.1% consensus, respectively, in the second round. Feedback from the panel led to several refinements, including the addition of oxygen saturation, spiritual needs, and expanded symptom categories. Conclusion: The Delphi process enabled the development of a validated, evidence-informed nursing assessment chart suitable for home-based palliative care. This tool addresses a previously unmet need by offering a structured approach to evaluating the clinical and psychosocial status of terminally ill patients in the community. It supports consistent nursing documentation, interdisciplinary communication, and person-centered care planning.