Perceptions Among Healthcare Professionals of Key Domains of Home-Based Palliative Care: A Multicriteria Comparative Cross-Sectional Survey (MULTIPAL)
Overview
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Sponsor
- Instituto de Investigacion Sanitaria La Fe
- Enrollment
- 580
- Locations
- 1
- Primary Endpoint
- 1. Multicriteria prioritization of home-based palliative care domains (TOPSIS)
Overview
Brief Summary
This observational cross-sectional study evaluates and compares healthcare professionals' perceptions of key domains of home-based palliative care. Using an anonymous online survey and multicriteria decision analysis (MCDA) methods, the study explores perceived importance, strategic prioritization, and self-assessed performance across five core palliative care domains. The study is conducted across Hospital-at-Home units throughout the Valencian Community (Spain).
Detailed Description
MULTIPAL is an observational, analytical, cross-sectional census survey designed to assess healthcare professionals' perceptions of home-based palliative care within Hospital-at-Home units. The study is grounded in international palliative care frameworks, including those promoted by the World Health Organization, which define palliative care as a multidimensional approach encompassing symptom control, psychosocial and spiritual care, communication, coordination, and professional well-being.
Differences in professional priorities may influence clinical decision-making, coordination, and care quality. Despite increasing attention to palliative care quality indicators, professionals' perspectives-particularly in home-based settings-remain underexplored.
The study applies complementary Multicriteria Decision Analysis methods (TOPSIS, PROMETHEE, Analytic Hierarchy Process) to evaluate and compare professional priorities across five predefined domains: symptom control; communication and shared decision-making; psychosocial and spiritual care; coordination and continuity of care; and support for healthcare professionals.
Initially conceived as a single-center study, MULTIPAL was expanded to all Hospital-at-Home units in the Valencian Community to enhance representativeness, external validity, and relevance for system-level quality improvement.
Study Design
- Study Type
- Observational
- Observational Model
- Other
- Time Perspective
- Cross Sectional
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Healthcare professionals working in Hospital-at-Home units providing home-based palliative care within the Valencian Community.
Exclusion Criteria
- •Healthcare professionals without direct clinical or care-related responsibilities (e.g., administrative or non-clinical support staff) within Hospital-at-Home units.
Arms & Interventions
Healthcare professionals in Hospital-at-Home units
Healthcare professionals with direct clinical responsibilities in Hospital-at-Home units providing home-based palliative care within the Valencian Community. Participants complete an anonymous cross-sectional survey assessing perceptions and prioritization of key domains of palliative care.
Outcomes
Primary Outcomes
1. Multicriteria prioritization of home-based palliative care domains (TOPSIS)
Time Frame: Baseline (single cross-sectional survey)
Relative prioritization of five predefined domains of home-based palliative care based on healthcare professionals' perceived importance and performance (symptom control; communication and shared decision-making; psychosocial and spiritual care; coordination and continuity of care; and support for healthcare professionals) . Measure: TOPSIS closeness coefficient for each domain . Unit of Measure: Closeness coefficient (0-1). Measurement Tool / Method: Multicriteria Decision Analysis using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS).
Secondary Outcomes
- Variation in domain prioritization by professional and experiential factors(Baseline (single cross-sectional survey))
- 2. Preference-based ranking of palliative care domains (PROMETHEE)(Baseline (single cross-sectional survey))
- 3. Hierarchical weighting and consistency of each domain importance (AHP)(Baseline (single cross-sectional survey))
- 4. Interprofessional consensus on domain prioritization(Baseline (single cross-sectional survey))
- 5. Importance-performance gap in palliative care domains(Baseline (single cross-sectional survey))
Investigators
Vicente Ruiz García
Principal Investigator
Instituto de Investigacion Sanitaria La Fe