A Multi-country Comparative Study on Palliative Care Knowledge and Attitudes Toward End-of-Life Care Among Undergraduate Nursing Students

Joshua K. Muliira*, Eilean Rathinasamy Lazarus, Ephraim C. Mirafuentes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The global burden of human death after experiencing serious health-related suffering (SHRS) requiring palliative care (PC) and end-of-life care (EOLC) is increasing. The largest increase in SHRS, death situations, PC, and EOLC needs continues to be in developing countries with limited access to PC. It is critical that nursing human resources in countries with limited access to PC are well trained and have adequate knowledge, attitudes, and skills to provide PC and EOLC. This study aimed to compare the PC knowledge and attitudes toward EOLC of future nursing human resources in Oman, India, and the Philippines. A comparative, cross-sectional design and two standardized questionnaires (the PEACE-Q and FATCOD-B) were used to collect data from 547 undergraduate nursing students (NSs). Overall, the NSs had positive attitudes toward EOLC (102.5 ± 15.39), but moderate PC knowledge (20.99 ± 3.59). The NSs were least knowledgeable about dyspnea, cancer pain, delirium, and side effects of opioids. Most of the NSs reported that their program did not include specific content about PC (56.1%) and hospice care (54.1%). The differences between countries and the predictors of PC knowledge and attitude toward EOLC were identified. The findings reveal gaps that need to be addressed in order to enhance access to PC and EOLC through well-trained nursing human resources.

Original languageEnglish
JournalJournal of Cancer Education
Publication statusAccepted/In press - 2022


  • Attitude
  • Cancer
  • End-of-life
  • India
  • Knowledge
  • Nursing
  • Nursing students
  • Oman
  • Palliative care
  • Philippines

ASJC Scopus subject areas

  • Oncology
  • Public Health, Environmental and Occupational Health

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