背景：随着人口老龄化进程加速和疾病谱系转变，住院患者对专业化、人性化照护服务的需求与日俱增。作为院内护理服务提供的重要补充力量，医疗护理员的服务提供直接影响着患者的就医体验和医疗结局。然而目前行业内仍然存在行业人员整体素质参差、职业认证体系不完善、过程监测机制缺失、评价维度单一等情况，因此，完善对服务质量的评价监管尤为重要。

目的：本研究旨在构建一套适配我国公立医院护理员群体服务特征的质量评价体系工具，并以此为公立医院构建医院护理员的服务质量动态监测机制、精准识别服务短板提供科学工具，推动辅助护理服务从“基础技能达标”向“个性化人文照护”转型，为应对人口老龄化背景下的专业化照护需求、进一步深化优质护理服务提升患者体验提供改善建议和方向。

内容：（1）界定医院护理员概念、服务范畴、管理方式，通过文献分析、追踪方法学现场调查构建指标池；（2）通过德尔菲法专家函询形成初始评价工具并确定指标权重；（3）通过小范围预调查收集数据，检验工具信效度。

方法：首先基于文献研究结果和追踪方法学的现场调查结果提取并拟定指标池，并邀请领域专家成员对指标进行补充和调整；通过德尔菲专家咨询法对指标体系进一步补充修改及打分，并确定指标的权重。通过专家决策结合熵值法对指标进行权重确定，最终构建适用于公立医院护理员的服务评价体系。

结果：（1）基于SERVQUAL模型及追踪方法学框架的现场追踪结果，最终提炼初始指标包括一级指标5个，二级指标19个。

（2）两轮德尔菲函询共咨询17名权威专家，有效回收率均100%，Kendall’s W值分别为0.218、0.343，最终形成包含5个一级指标、23个二级指标初始评估体系，使用熵值法结合主观决策法确定指标权重，5个一级指标中移情性权重系数最高（0.405）。

（3）通过164份问卷的预调查发现使用护理员服务的患者在事前期望和事后感知两个维度的Cronbach’s α系数分别为0.957和0.961，平均量表水平效度（S-CVI/Ave）为0.969，全体一致性水平效度（SCVI/UA）为0.74，最终得到包括5个一级指标，23个二级指标的指标体系。

结论：本研究中参与咨询的专家展现出高度的积极性与权威性，通过两轮德尔菲法咨询后，专家对各项指标的意见协调程度显著提升。实证预调查结果显示，所构建的护理员服务质量评价体系信度与效度均达到科学标准，具备显著的实践应用价值。该体系突破传统评价模式的局限性，从结果导向出发拓展了护理员服务质量评价维度，为护理员行业专业化发展提供了可参考的评估框架，对推动护理员服务质量的系统性提升具有一定理论与现实意义。

Background: As population aging accelerates and disease patterns shift, the demand for specialized and humanized care services among hospitalized patients continues to rise. Medical caregivers, serving as a critical supplementary force in hospital care delivery, directly influence patients' healthcare experiences and medical outcomes. However, the sector still faces challenges such as uneven staff quality, inadequate vocational certification systems, lack of process monitoring mechanisms, and overly simplistic evaluation frameworks. Therefore, improving the evaluation and supervision of service quality is particularly important.

Objective: This study aims to construct a quality evaluation system tailored to the service characteristics of medical caregivers in Chinese public hospitals. The system will serve as a scientific tool for public hospitals to establish dynamic monitoring mechanisms for caregiver service quality, precisely identify service gaps, and drive the transformation of auxiliary care services from "basic skill compliance" to "personalized humanistic care." Ultimately, it seeks to provide improvement recommendations and directions for meeting the specialized care demands of aging populations and enhancing patient experiences through high-quality nursing services.

Content: (1) Define the concept, service scope, and management practices of hospital caregivers, and construct an indicator pool through literature analysis and tracer methodology field investigations. (2) Develop an initial evaluation tool and determine indicator weights through Delphi expert consultations. (3) Collect data via small-scale pre-surveys to test the tool's reliability and validity.

Methods: Methods: Initially, based on literature research and tracer methodology field investigations, an indicator pool was extracted and formulated. Expert panel members were invited to supplement and refine these indicators. Through two rounds of Delphi expert consultations, the indicator system was further revised, scored, and weights were determined. A combination of expert decision-making and entropy methods was used to finalize indicator weights, resulting in a service evaluation system tailored for public hospital nursing assistants.

Results:

(1) Based on the SERVQUAL model and tracer methodology framework, initial indicators were refined, including 5 primary indicators and 19 secondary indicators. (2) Two rounds of Delphi consultations involved 17 authorities, with 100% effective response rates. Kendall’s W coefficients were 0.218 and 0.343, respectively, leading to a preliminary assessment system with 5 primary indicators and 23 secondary indicators. Using entropy methods combined with subjective decision-making, indicator weights were determined, with "empathy" receiving the highest weight coefficient (0.405) among the primary indicators. (3) Pre-survey data from 164 questionnaires showed that Cronbach’s α coefficients for patients' pre-service expectations and post-service perceptions were 0.957 and 0.961, respectively. The average scale-level content validity index (S-CVI/Ave) was 0.969, and the universal agreement content validity index (S-CVI/UA) was 0.74. The finalized indicator system comprises 5 primary indicators and 23 secondary indicators.

Results: Systematically sort out the origin and service status of the nursing assistant profession, define the concept of nursing assistants, conduct on - site investigations of the service process through the tracking methodology, and initially construct the indicator pool. Based on the content of the indicator pool, form the initial version of the public hospital indicators. Carry out two rounds of expert consultation based on the Delphi method (17 authoritative experts, with an effective recovery rate of 100%), and screen to form an initial evaluation system with 5 first - level indicators and 23 second - level indicators. Use the entropy method combined with the subjective decision - making method to determine the indicator weights, among which the empathy weight coefficient is the highest. Collected 164 evaluations of nursing assistant service quality through questionnaires, tested the internal consistency reliability, split - half reliability, content validity, and structural validity of the indicator system, and further revised the indicator system. The Cronbach's α coefficients of the patients using nursing assistant services in the two dimensions of pre - event expectations and post - event perceptions are 0.957 and 0.961 respectively, the overall consistency validity (S -CVI) is 0.969, and the SCVI/UA is 0.74. Finally, an indicator system including 5 first - level indicators and 23 second - level indicators is obtained.

Conclusion: The experts consulted in this study demonstrated high enthusiasm and authority. After two rounds of Delphi consultations, the coordination of expert opinions on various indicators significantly improved. Empirical pre-survey results indicate that the constructed nursing assistant service quality evaluation system meets scientific standards of reliability and validity, showing significant practical application value. This system transcends the limitations of traditional evaluation models by expanding the evaluation dimensions of nursing assistant service quality from an outcome-oriented perspective. It provides a referable assessment framework for the professional development of the nursing assistant industry and holds theoretical and practical significance for promoting systematic improvements in nursing assistant service quality.