The quality of nursing care as perceived by hospitalized patients with advanced illness has not been examined. A concept of quality nursing care for this population was developed by integrating the literature on constructs defining quality nursing care with empirical findings from interviews of 16 patients with advanced illness. Quality nursing care was characterized as competence and personal caring supported by professionalism and delivered with an appropriate demeanor

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. Although the attributes of competence, caring, professionalism, and demeanor were identified as common components of quality care across various patient populations, the caring domain increased in importance when patients with advanced illness perceived themselves as vulnerable. Assessment of quality nursing care for patients with advanced illness needs to include measures of patient perceptions of vulnerability.

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Our goal is the development of an instrument to measure quality of nursing care process from the perspective of hospitalized patients with advanced illness. In this paper, the authors report the results of efforts to delineate the conceptual underpinnings of a future instrument.

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The specific aim of this phase of instrument development was to define the concept of quality nursing care and identify its attributes from the perspective of patients with advanced illness, integrating findings from the literature with empirical findings from interviews.

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