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

April 23, 2026 updated by: Vicente Ruiz García, Instituto de Investigacion Sanitaria La Fe

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

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).

Study Overview

Status

Enrolling by invitation

Conditions

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 Type

Observational

Enrollment (Estimated)

580

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
    • Valencia
      • Valencia, Valencia, Spain, 46026
        • Hospital Universitari i Politecnic La Fe

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The survey will be addressed to healthcare professionals working in Hospital-at-Home units across the Valencian Community (Spain). Eligible participants will be professionals with direct clinical responsibilities in the care of patients and families receiving home-based palliative care.

The following professional profiles will be included:

Physicians Nursing assistants Nurse case managers (including those involved in remote monitoring and disease management) Clinical psychologists Social workers Physiotherapists

Professionals who do not have direct clinical or care-related responsibilities, such as administrative staff or other non-clinical support personnel within Hospital-at-Home units, will be excluded from the study.

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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).
Baseline (single cross-sectional survey)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
2. Preference-based ranking of palliative care domains (PROMETHEE)
Time Frame: Baseline (single cross-sectional survey)

Preference-based ranking of palliative care domains according to healthcare professionals' judgments: symptom control; communication and shared decision-making; psychosocial and spiritual care; coordination and continuity of care; and support for healthcare professionals.

Measure: Net preference flow for each domain. Unit of Measure: Net preference flow score. Measurement Tool / Method: Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE).
Baseline (single cross-sectional survey)
3. Hierarchical weighting and consistency of each domain importance (AHP)
Time Frame: Baseline (single cross-sectional survey)

Assessment of relative importance and internal consistency of professional judgments for the following domains: symptom control; communication and shared decision-making; psychosocial and spiritual care; coordination and continuity of care; and support for healthcare professionals.

Measure: Normalized priority weights and consistency ratio. Unit of Measure: Dimensionless. Measurement Tool / Method: Analytic Hierarchy Process (AHP). At survey completion.
Baseline (single cross-sectional survey)
4. Interprofessional consensus on domain prioritization
Time Frame: Baseline (single cross-sectional survey)

Degree of agreement between professional groups regarding domain priorities. Measure: Absolute difference in ranking positions. Unit of Measure: Rank difference. Measurement Tool / Method: Comparison of TOPSIS-derived rankings between groups.

At survey completion.
Baseline (single cross-sectional survey)
5. Importance-performance gap in palliative care domains
Time Frame: Baseline (single cross-sectional survey)

Difference between perceived importance and perceived performance for each domain.

Measure: Importance-performance gap score. Unit of Measure: Likert-scale score difference. Measurement Tool / Method: Direct calculation from survey ratings.
Baseline (single cross-sectional survey)
Variation in domain prioritization by professional and experiential factors
Time Frame: Baseline (single cross-sectional survey)

Exploratory differences in priorities according to professional role, experience, age, and gender.

Measure: Differences in MCDA-derived scores. Unit of Measure: Method-specific. Measurement Tool / Method: Subgroup analyses using TOPSIS, PROMETHEE, and AHP estimators.
Baseline (single cross-sectional survey)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Instituto de Investigacion Sanitaria La Fe

Collaborators

Universitat Politècnica de València

Investigators

  • Principal Investigator: Vicente Ruiz Garcia, Hospital at Home Unit - Hospital UiP La Fe, Valencia, Spain
  • Study Chair: Elisa Soriano Melchor, MD, PhD, Hospital at Home Unit - Hospital UiP La Fe, Valencia, Spain
  • Study Director: Alberto Muñoz Cano, MD, PhD, Hospital at Home Unit - Hospital UiP La Fe, Valencia, Spain

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 1, 2026

Primary Completion (Estimated)

June 30, 2026

Study Completion (Estimated)

September 30, 2026

Study Registration Dates

First Submitted

April 17, 2026

First Submitted That Met QC Criteria

April 23, 2026

First Posted (Actual)

April 28, 2026

Study Record Updates

Last Update Posted (Actual)

April 28, 2026

Last Update Submitted That Met QC Criteria

April 23, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2026-0194-1 (MULTIPAL)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Aggregated and fully anonymized data will be shared with all participating Hospital-at-Home units as part of a structured feedback and quality improvement process.

Study results and aggregated datasets will also be disseminated through peer-reviewed publications in journals focused on palliative care and health services research.

Shared data will include anonymized MCDA-derived summary scores and rankings (TOPSIS, PROMETHEE, AHP). No individual-level identifiable data will be shared.

Time Frame: Data sharing will begin after completion of data analysis and primary dissemination of results.

Access Criteria: Data will be shared upon reasonable request for academic, educational, or quality improvement purposes, in accordance with institutional data protection policies.

IPD Sharing Time Frame

De-identified and aggregated data will become available after completion of data analysis and publication of the main study results, expected within 6 months after study completion. Data will remain available for a minimum period of 5 years following initial dissemination, in accordance with institutional data retention policies

IPD Sharing Access Criteria

Access to the shared data will be granted to investigators from participating Hospital-at-Home units within the Valencian Community and to qualified researchers who submit a reasonable request. Shared data will consist of aggregated and fully de-identified datasets, including multicriteria decision analysis outputs (TOPSIS, PROMETHEE, AHP summary scores), descriptive subgroup analyses, and supporting documentation (e.g., data dictionary).

Requests for access will be reviewed by the study investigators. Data will be provided exclusively for academic research, quality improvement, or educational purposes, and users may be required to agree to conditions of use that prohibit re-identification attempts and unauthorized redistribution.

IPD Sharing Supporting Information Type

  • SAP
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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