质量措施已经为老年癌症患者的临终关怀做出了设想，但是对于青少年和年轻成人（AYAs）而言还缺乏。我们之前与AYAs、家庭照料者和临床医务人员进行了访谈，以确定AYAs晚期癌症的优质护理的优先领域。本研究的目的是使用修改后的德尔菲过程就最高优先级质量指标达成共识。我们进行了一项修改后的德尔菲过程，与10名反复发作或转移性癌症的AYAs、11名家庭照料者和29名多学科医务人员进行了小组网络会议。参与者被要求对41个潜在的质量指标的重要性进行评分、排名前10个最重要的指标，并进行讨论以调和差异。在起初的41个指标中，有34个指标被超过70%的参与者评为非常重要（9分制中的7、8或9分）。该小组无法就前10个最重要的指标达成共识。相反，参与者建议保留更大的指标集以反映不同优先事项间的潜力，最终形成了32个指标集。推荐的指标广泛涵盖对身体症状、生活质量、心理社会和灵性护理、沟通和决策、与临床医生的关系、护理和治疗，以及独立性的关注。患者和家庭为中心的质量指标开发过程得到了德尔菲参与者对多个潜在指标的强力认可。我们将使用一项针对丧者家属的调查进行进一步的验证和完善。版权所有 © 2023，由Elsevier Inc.出版。

Quality measures have been devised for end-of-life care of older adults with cancer, but are lacking for adolescents and young adults (AYAs).We previously conducted interviews with AYAs, family caregivers, and clinicians to identify priority domains for high quality care of AYAs with advanced cancer. The goal of this study was to use a modified Delphi process to form consensus around the highest priority quality indicators.A modified Delphi process was conducted with 10 AYAs with recurrent or metastatic cancer, 11 family caregivers, and 29 multidisciplinary clinicians, using small group web conferences. Participants were asked to rate the importance of each of 41 potential quality indicators, rank the 10 most important, and engage in discussion to reconcile differences.Of 41 initial indicators, 34 were rated as highly important (rating 7, 8, or 9 on a 9-point scale) by >70% of participants. The panel was unable to reach consensus around the 10 most important indicators. Instead, participants recommended retaining a larger set of indicators to reflect potential for different priorities across the population, resulting in a final set of 32 indicators. Recommended indicators broadly encompassed attention to physical symptoms; quality of life; psychosocial and spiritual care; communication and decision-making; relationships with clinicians; care and treatment; and independence.A patient- and family-centered process for quality indicator development led to strong endorsement of multiple potential indicators by Delphi participants. Further validation and refinement will be performed using a survey of bereaved family members.Copyright © 2023. Published by Elsevier Inc.