Nursing competencies across different levels of palliative care provision: A systematic integrative review with thematic synthesis


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This episode features Minna Hökkä (Research Unit of Nursing Science and Health Management, Medical Department, Oulu University, Oulu, Finland). Palliative care is provided across a wide range of healthcare settings, from tertiary hospitals to primary care. It has been recognized that palliative care services should be delivered in at least two or three levels (i.e., palliative care approach, generalist palliative care, specialist palliative care). All healthcare professionals should have the appropriate education and competencies to provide high-quality palliative care. Nurses have an important role in the provision of palliative care in all levels. This systematic integrative review is the first to focus on empirical studies defining the core competencies of palliative care nursing aligned with the different levels of palliative care provision. The results show that both the distinct levels of palliative care provision and corresponding palliative care nursing competencies are rarely defined.

Rather than describing which core nursing competencies are the most related to each level of palliative care, previous research has concentrated on identifying the diverse competencies necessary for different specific settings and how they can be categorized in different aspects of nursing (e.g., competencies related to patient–nurse relationship). Nurses with a specialized or advanced nurse practitioner role in palliative care have extended clinical competencies, which include the ability to provide informal education and guidance to colleagues. Nursing competencies in palliative care, especially the ones that are more relevant to each level of palliative care provision, should be better outlined to enhance palliative care development, education and practice. Further research that addresses how nursing competencies differ across the levels of palliative care provision is needed. Full paper available from:

If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu:

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