Interventions supporting nurses’ palliative care education needs in low- and middle-income countries: a systematic review

Objectives

A lack of palliative care training for nurses has been identified as a barrier to patients’ access to palliative care services. Although nurses account for nearly 50% of the global healthcare workforce, those in low- and middle-income countries (LMICs) often lack sufficient training and education in palliative care. This review identified and synthesised literature on palliative care education for students and practicing nurses at LMICs.

Methods

A systematic review approach with narrative synthesis was employed to review studies published in English from January 2002 to October 2022, focusing on training interventions in palliative care education programmes for nurses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines guided this review. The study protocol was registered in PROSPERO.

Results

The review included 56 studies. Key topics in the palliative care education interventions focused on helping patients and their families understand disease processes, symptom management, empathetic communication, decision-making, cultural concerns, quality of life, breaking bad news, bereavement, and post-mortem care. The most common instructional materials were presentation slides. However, some programmes used e-learning resources, role-plays, high-fidelity simulation manikins, storytelling, reflection, riddles, and poems. Intervention outcomes included improved attitudes, confidence, and knowledge acquisition.

Conclusions

Palliative care education interventions can effectively enhance nurses’ knowledge and confidence in providing care to individuals needing such services. Findings suggest the need for further research and the implementation of practical, innovative educational approaches in various regions, particularly Africa and Eastern Europe.