Journal: BMC palliative care
This qualitative study examines what competencies Indian nurses need to deliver effective palliative care, given the country’s rapidly rising demand and extremely limited service coverage (<4% access; poor performance on the Quality of Death Index).
Design:
- • Seven focus group discussions with nurses providing care for patients with life-limiting illness.
- • Thirty-five in-depth interviews with patients and caregivers across the disease trajectory (from diagnosis to end of life).
- • Data were coded line-by-line and analyzed using Braun and Clarke’s thematic analysis in Open Code 4.02.
- • Rigor supported through member checking and peer debriefing.
Key findings:
- • Seven competency domains for palliative nursing were identified. These span:
- • Foundations of palliative care (principles, goals, and scope).
- • Communication skills (including sensitive discussions around prognosis, goals of care, and end of life).
- • Ethical, legal, and professional responsibilities.
- • Symptom management and comfort-focused care.
- • Psychosocial, cultural, and spiritual care.
- • Team collaboration and interdisciplinary work.
- • Stakeholders stressed the need for holistic, compassionate care that is:
- • Culturally grounded in Indian family structures.
- • Sensitive to local attitudes toward death and dying.
- • Respectful of diverse spiritual and religious beliefs.
- • There was strong concordance between nurses’ and patient/caregiver perspectives on what constitutes essential palliative care competencies.
Implications:
- • The resulting set of empirically derived competency domains provides a context-specific framework to:
- • Guide palliative nursing curriculum design.
- • Shape in-service training and capacity-building.
- • Inform national and institutional policy to strengthen palliative care integration within India’s health system.
The study is registered in the Clinical Trials Registry of India (CTRI/2023/07/055216).