Effectiveness of a nurse-led, culturally adapted palliative and end-of-life training program (N-PELTP) for oncology nurses: a quasi-experimental controlled study

Oncology nurses play a central role in delivering palliative and end-of-life care, yet context-specific training remains limited in many settings. This study evaluated the effectiveness of a nurse-led, culturally adapted palliative and end-of-life training program (N-PELTP) for oncology nurses. Nurses contribute to the continuity, quality, and timeliness of palliative care through ongoing assessment, symptom monitoring, family support, and advocacy within multidisciplinary teams. In Oman, palliative and end-of-life care is commonly shaped by strong family involvement in decision-making, preferences for family-mediated disclosure, and the influence of Islamic values on perceptions of suffering, comfort, and end-of-life rituals. These cultural characteristics can affect communication, symptom management decisions (e.g., opioid concerns), and expectations around care planning. Nurses are central to navigating these dynamics because they provide continuous bedside care, translate clinical information for families, coordinate across disciplines, and support culturally and spiritually congruent care. A quasi-experimental pretest-posttest controlled study was conducted among registered nurses providing direct care to patients with cancer in Oman. Nurses in the intervention group received the nurse-led, culturally adapted N-PELTP, while a comparable control group received usual practice during the study period. Outcomes included palliative care knowledge, attitudes toward caring for dying patients, self-reported palliative care practice, and communication. Outcomes were assessed before and after the intervention using validated instruments. Palliative Care Knowledge Questionnaire (PEACE-Q) Frommelt Attitude Toward Care of the Dying Scale – Form B (FATCOD-B) Palliative Care Self-Reported Practices Scale (PCPS) A total of 189 nurses participated. At baseline, the groups were generally comparable across demographic and professional characteristics. Following the intervention, the intervention group demonstrated significant improvements in palliative care knowledge, attitudes, and communication compared with baseline and relative to the control group. In contrast, self-reported palliative care practice did not demonstrate meaningful short-term change. A nurse-led, culturally adapted palliative and end-of-life training program improved oncology nurses’ palliative care knowledge, attitudes, and communication outcomes. These findings support the value of culturally responsive palliative care training to strengthen oncology nursing workforce preparedness and palliative care delivery. ClinicalTrials.gov NCT07460570 05 March 2026 retrospectively registered.