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

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).

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.

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.