Development of a core competency evaluation indicator system for weight management nurses: a Delphi and analytic hierarchy process study

Abstract

Weight management services increasingly require nurses to contribute to risk assessment, behavioural support, multidisciplinary coordination and long-term follow-up. However, there is limited consensus on the competencies required for nurses working in this emerging field. This study aimed to develop an evaluation indicator system for the core competencies of weight management nurses. A methodological study was conducted using semi-structured interviews, grounded theory coding, two rounds of Delphi consultation and the analytic hierarchy process. An initial indicator pool was developed from interviews with 20 weight management professionals and literature review. From April to June 2026, 18 experts in clinical nursing, nursing management, nursing education, clinical medicine and health management rated the importance of the indicators. Indicator screening was based on the mean importance score, coefficient of variation and expert comments. Expert consensus was evaluated using the coefficient of variation and Kendall’s coefficient of concordance, and indicator weights were determined using the analytic hierarchy process (AHP). The valid response rate was 100.0% in both Delphi rounds, and the expert authority coefficient was 0.843. Kendall’s coefficients of concordance for first-, second- and third-level indicators were 0.229, 0.183 and 0.139 in the first round and 0.241, 0.196 and 0.171 in the second round, respectively; all were statistically significant. In the second round, the coefficients of variation for all indicators were less than 0.25. The final system included 5 first-level, 21 second-level and 62 third-level indicators. The first-level weights were intervention implementation (0.211), knowledge integration (0.206), professional motivation (0.203), multidisciplinary coordination (0.198) and professional development (0.183). The indicator system provides a structured framework for competency-based training, selection and evaluation of weight management nurses. Further validation in different healthcare settings is needed before broad application.