Gender-sensitive and diversity-sensitive end-of-life care in Switzerland (GiveCare): a mixed-methods study protocol

Palliative care has been identified as one of the most inequitable areas of healthcare. In Switzerland, as globally, disparities in end-of-life care (EOLC) exist along socio-demographic lines, shaping the access to and quality of care received across services by patients and their caregivers. Research has linked these disparities to binary gender differences and other aspects of a person's social position. The GiveCare project aims to provide a systemic understanding of how aspects of gender and diversity intersect to shape the provision of EOLC in Switzerland and to translate the generated knowledge into practice, policy, education and training.

GiveCare employs a sequential mixed-methods design, combining a feminist intersectional approach with a systems thinking lens. It consists of four work packages (WPs): (1) A national survey will assess the perceived awareness of gender and diversity among palliative care professionals. (2) A focused ethnography will provide in-depth insights into the care journeys of patients and their significant others in two specialised inpatient palliative care units. (3) A social network analysis and discrete event modelling will unpack the complexity of such care journeys across inpatient and outpatient settings in the Canton of Zurich. 4. Throughout the process, an integrated knowledge translation approach will help to generate actionable evidence, co-created with patients, caregivers, professionals and policymakers, to enhance inclusivity and equity in EOLC practice and policy.

The Ethics Committee of the Canton of Zurich, Switzerland, granted ethical approval for WP2-4 (Req-2025-02241) and issued a waiver for WP1 (Req-2025-00211). The research team will conduct the research in accordance with the Swiss Federal Act on Data Protection and the rules and regulations of the Swiss Federal Data Protection and Information Commissioner. The findings will be disseminated through peer-reviewed publications and conference presentations as well as via the community of practice established through the integrated knowledge translation process.