Assessing face validity of the hexcom model for capturing complexity in clinical practice: A delphi study

Xavier Busquet-Duran*, Eva Maria Jiménez-Zafra, Magda Tura-Poma, Olga Bosch de la Rosa, Anna Moragas-Roca, Susana Martin-Moreno, Emilio Martínez-Losada, Silvia Crespo-Ramírez, Lola Lestón-Lado, Núria Salamero-Tura, Joana Llobera-Estrany, Núria Oriol-Peregrina, Eduard Moreno-Gabriel, Josep Maria Manresa-Domínguez, Pere Torán-Monserrat

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)


Capturing complexity is both a conceptual and a practical challenge in palliative care. The HexCom model has proved to be an instrument with strong reliability and to be valid for describing the needs and strengths of patients in home care. In order to explore whether it is also perceived to be helpful in enhancing coordinated and patient-centred care at a practical level, a methodological study was carried out to assess the face validity of the model. In particular, a Delphi method involving a group of 14 experts representing the full spectrum of healthcare professionals involved in palliative care was carried out. The results show that there is a high level of agreement, with a content validity index-item greater than 0.92 both with regard to the complexity model and the HexCom-Red, HexCom-Basic, and the HexCom-Clin instruments, and higher than 0.85 regarding the HexCom-Figure and the HexCom-Patient instruments. This consensus confirms that the HexCom model and the different instruments that are derived from it are valued as useful tools for a broad range of healthcare professional in coordinately capturing complexity in healthcare practice.

Original languageEnglish
Article number165
Issue number2
Publication statusPublished - Feb 2021


  • Complexity
  • Coordinated care
  • Delphi technique
  • Home care services
  • Methodological study
  • Needs assessment
  • Palliative care


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