Perceptions of Key Domains of Home-Based Palliative Care Among Healthcare Professionals (MULTIPAL)

Официальное название

Perceptions Among Healthcare Professionals of Key Domains of Home-Based Palliative Care: A Multicriteria Comparative Cross-Sectional Survey (MULTIPAL)

Обзор

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).

Подробное описание

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.

Первичные конечные точки

• 1. Multicriteria prioritization of home-based palliative care domains (TOPSIS) [Срок оценки: Baseline (single cross-sectional survey)]

Вторичные конечные точки (5)

• 2. Preference-based ranking of palliative care domains (PROMETHEE) [Срок оценки: Baseline (single cross-sectional survey)]
• 3. Hierarchical weighting and consistency of each domain importance (AHP) [Срок оценки: Baseline (single cross-sectional survey)]
• 4. Interprofessional consensus on domain prioritization [Срок оценки: Baseline (single cross-sectional survey)]
• 5. Importance-performance gap in palliative care domains [Срок оценки: Baseline (single cross-sectional survey)]
• Variation in domain prioritization by professional and experiential factors [Срок оценки: Baseline (single cross-sectional survey)]

Критерии участия

Критерии включения

• Healthcare professionals working in Hospital-at-Home units providing home-based palliative care within the Valencian Community.

Критерии исключения

• Healthcare professionals without direct clinical or care-related responsibilities (e.g., administrative or non-clinical support staff) within Hospital-at-Home units.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Модель наблюдения

Другое

Центры проведения

Испания · 1 центр

• Hospital Universitari i Politècnic La Fe — Valencia

Публикации

• Khan I, Pintelon L, Martin H. The Application of Multicriteria Decision Analysis Methods in Health Care: A Literature Review. Med Decis Making. 2022 Feb;42(2):262-274. doi: 10.1177/0272989X211019040. Epub 2021 Jun 24. PMID 34166149
• Frazao TDC, Camilo DGG, Cabral ELS, Souza RP. Multicriteria decision analysis (MCDA) in health care: a systematic review of the main characteristics and methodological steps. BMC Med Inform Decis Mak. 2018 Nov 1;18(1):90. doi: 10.1186/s12911-018-0663-1. PMID 30382826
• Refolo P, Raimondi C, Masilla SS, Argo A, Capulli E, Ceruti S, Gonella S, Ingravallo F, Miccinesi G, Picozzi M, Redaelli P, Spagnolo AG. Attitudes of physicians, nurses, and the general public toward End-of-Life (EoL) decisions in European countries: an umbrella review. BMC Med Ethics. 2025 May 9;26(1):60. doi: 10.1186/s12910-025-01219-z. PMID 40346520
• Van Beek K, Woitha K, Ahmed N, Menten J, Jaspers B, Engels Y, Ahmedzai SH, Vissers K, Hasselaar J. Comparison of legislation, regulations and national health strategies for palliative care in seven European countries (Results from the Europall Research Group): a descriptive study. BMC Health Serv Res. 2013 Jul 17;13:275. doi: 10.1186/1472-6963-13-275. PMID 23866928
• Pastrana T, Wenk R, De Lima L. Consensus-Based Palliative Care Competencies for Undergraduate Nurses and Physicians: A Demonstrative Process with Colombian Universities. J Palliat Med. 2016 Jan;19(1):76-82. doi: 10.1089/jpm.2015.0202. Epub 2015 Oct 20. PMID 26485612
• De Roo ML, Leemans K, Claessen SJ, Cohen J, Pasman HR, Deliens L, Francke AL; EURO IMPACT. Quality indicators for palliative care: update of a systematic review. J Pain Symptom Manage. 2013 Oct;46(4):556-72. doi: 10.1016/j.jpainsymman.2012.09.013. Epub 2013 Jun 26. PMID 23809769
• Hui D, Hannon BL, Zimmermann C, Bruera E. Improving patient and caregiver outcomes in oncology: Team-based, timely, and targeted palliative care. CA Cancer J Clin. 2018 Sep;68(5):356-376. doi: 10.3322/caac.21490. Epub 2018 Sep 13. PMID 30277572
• Blay C, Martori JC, Limon E, Oller R, Vila L, Gomez-Batiste X. [Find your 1%: prevalence and mortality of a community cohort of people with advanced chronic disease and palliative needs]. Aten Primaria. 2019 Feb;51(2):71-79. doi: 10.1016/j.aprim.2017.07.004. Epub 2017 Nov 20. Spanish. PMID 29157932

Идентификаторы

NCT: NCT07554209 · 2026-0194-1 (MULTIPAL)

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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