Nursing Staff Development as a Strategy for Improving Palliative Care Management: A Systematic Review

Abstract

Background Palliative care requires nurses to possess advanced knowledge and clinical skills to address the complex physical, psychological, social, and spiritual needs of patients with life-limiting illnesses. However, insufficient preparation and limited access to structured palliative care education remain important barriers to the delivery of high-quality end-of-life care. Objective To evaluate the effectiveness of structured palliative care education and training interventions in improving nurses’ knowledge, clinical competence, communication skills, confidence, psychological wellbeing, and patient-related outcomes. Methods A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA 2020) guidelines. PubMed/MEDLINE, Scopus, Web of Science, CINAHL, and the Cochrane Library were searched for eligible studies evaluating palliative care education and training interventions among nurses and nursing students. Randomized controlled trials, quasiexperimental studies, observational studies, and mixed-method studies were considered for inclusion. Data on study characteristics, intervention components, participant characteristics, and outcomes were extracted using a standardized form. Methodological quality was assessed using validated risk-of-bias and critical appraisal tools. Where sufficient clinical and methodological homogeneity was present, quantitative data were synthesized using random-effects meta-analysis. Results The search identified 1,247 records, with 26 studies included in the qualitative synthesis and 18 studies included in the quantitative meta-analysis. The included studies comprised approximately 2,850 nurses and nursing students across diverse healthcare and educational settings. Structured palliative care education was associated with improvements in nurses’ knowledge, clinical competence, communication skills, symptom management abilities, and confidence in providing end-of-life care. Interactive and experiential approaches, including simulationbased learning, case-based education, and role-playing, appeared to provide greater benefits than education based solely on traditional didactic methods. Conclusion Structured palliative care education may strengthen nurses’ professional competencies and preparedness to provide high-quality, patientcentered end-of-life care. Educational programs that combine theoretical knowledge with interactive and experiential learning may be particularly beneficial. Further high-quality randomized controlled trials with standardized outcome measures and longer follow-up are required to determine the comparative effectiveness and sustainability of different educational approaches. These findings may be particularly relevant to healthcare systems where palliative care education and services are still developing, including Kazakhstan.

Bangladesh Journal of Medical Science Vol. 25 No. 04 October’26 Page: 1045-1054