Nurses´ palliative care literacy in non-specialized healthcare settings
DOI:
https://doi.org/10.29352/mill0222e.44548Keywords:
palliative care; health literacy; nurses; nursing care; hospitalizationAbstract
Introduction: Palliative Care (PC) is a fundamental human right. However, there are still people with palliative care needs hospitalized in acute care services, where the provision of PC is not always guaranteed.
Objective: To identify the palliative care literacy needs of nurses who provide care to individuals in palliative situations in non-specialized settings.
Methods: Exploratory, descriptive, qualitative study. Participants are nurses who provide care to people in palliative situations in inpatient settings, identified through intentional, snowball sampling. Data were collected through audio-recorded semi-structured interviews and analysed using Bardin’s content analysis framework.
Results: It was possible to identify the PC literacy needs of nurses, namely: principles and philosophy of PC; communication; symptom management; teamwork; family support; organization and activation of resources; and self-care of the professionals themselves. Additionally, several challenges were identified: lack of time; economic constraints; institutional routines; organizational difficulties; beliefs and myths associated with PC; and gaps in basic training. Two major strategies were highlighted: investing in the continuous training of health professionals - preferably as a team - and promoting PC literacy among the general population.
Conclusion: The findings demonstrate the importance of investing in nurses’ PC literacy by developing and implementing interventions tailored to the identified needs, contributing to the improvement of care provided.
Downloads
References
Alvarenga, M. (2021). Meandros sobre literacia em cuidados paliativos: Narrativa. A. Galvão (Coord.), Literacia em saúde e autocuidados: Evidências que projetam a prática clínica (pp. 296-304). Euromédice.
Bardin, L. (2018). Análise de Conteúdo (4ª ed.). Edições 70.
Bockorni, B. R. S., & Gomes, A. F. (2021). A amostragem em snowball (bola de neve) em uma pesquisa qualitativa no campo da administração. Revista De Ciências Empresariais Da UNIPAR, 22(1). https://doi.org/10.25110/receu.v22i1.8346
Bowerman, J., & Williams, A. (2024). Barriers to effective end of life care in the acute sector: A literature review. Cancer Nursing Practice. https://doi.org/10.7748/cnp.2024.e1874
Capelas, M. L., Sapeta, P., Mamede, A., Jorge, M., Oliveira, M., Pereira, C., Simões, N., Passos, V., Macedo, A. P., Mendes, C. M., Macedo, E., Macedo, J. C., Gomes, M. F., Mendes, M., Encarnação, P. C., Batista, S., Vilaça, S. P., & Coelho, S. P. (2018). Doentes paliativos nos hospitais públicos portugueses. Cadernos De Saúde, 10, 14-22. https://doi.org/10.34632/cadernosdesaude.2018.7263
Cardoso, L., Salgueiro, D., & Novais, S. (2017). Are we prepared to develop palliative actions in a ward? A literature review. Millenium - Journal of Education, Technologies, and Health, 2(3), 53-60. https://doi.org/10.29352/mill0203.06.00134
Coimbra, M. P. C. (2020). Literacia em cuidados paliativos de profissionais e não profissionais de saúde [Dissertação de mestrado, Universidade de Coimbra]. Estudo Geral. https://hdl.handle.net/10316/94268
Coimbra, M., Dixe, M. A., Tavares, P. N., & Dourado, M. (2025). Avaliação da literacia em cuidados paliativos em não profissionais de saúde. Revista Portuguesa De Medicina Geral e Familiar, 41(1), 42-51. https://doi.org/10.32385/rpmgf.v41i1.13390 Comissão Nacional de Cuidados Paliativos. (2023). Plano estratégico para o desenvolvimento dos cuidados paliativos em Portugal Continental – biénio 2023-2024. https://shre.ink/LEQJ Correia, R., Canhestro, A., & Pedro, M. (2021). A importância da capacitação dos profissionais de saúde na prestação de cuidados aos doentes com necessidades paliativas: Revisão sistemática da literatura. Revista Ibero-Americana De Saúde e Envelhecimento, 7(2), 218-234. https://doi.org/10.24902/r.riase.2021.7(2).502.218-234
Di Cristofaro, F., Davoli, L., Esposito, J. E., & Pedroni, C. (2025). Nurses' moral distress in palliative care: A systematic review of prevalence, contributing factors, and consequences. Journal of Nursing Advances in Clinical Sciences, 2(6), 335-345. https://doi.org/10.32598/JNACS.2505.1149
Dixe, M. D. A., Santo, I. D. O., Lopes, S., Catarino, H., Duarte, S., Querido, A., & Laranjeira, C. (2020). Knowledge and myths about palliative care among the general public and health care professionals in Portugal. International Journal of Environmental Research and Public Health, 17(13), 4630. https://doi.org/10.3390/ijerph17134630
Engel, M., Kars, M. C., Teunissen, S. C. C. M., & van der Heide, A. (2023). Effective communication in palliative care from the perspectives of patients and relatives: A systematic review. Palliat Support Care, 21(5), 890-913. https://doi.org/10.1017/S1478951523001165
Espejo-Fernández, V., & Martínez-Angulo, P. (2024). Psychosocial and emotional management of work experience in palliative care nurses: A qualitative exploration. International Nursing Review, 72, e13006. https://doi.org/10.1111/inr.13006
Gonçalves, J., Peixoto, Z., & Silva, P. (2023). Literacia em saúde e os cuidados de fim de vida. C. Almeida, & I. Fragoeiro (Coord.), Manual de Literacia em Saúde: Princípios e práticas (pp. 189-198). Pactor.
Jelly, P., & Rochmawati, E. (2022). Interventions to improve nurse therapeutic communications in the context of palliative care: Literature review. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal), 8(3). https://shre.ink/LEQi
Kennedy, R., Abdullah, N., Bhadra, R., Bonsu, N. O., Fayezizadeh, M., & Ickes, H. (2019). Barriers to effective use of palliative care services in the acute care setting with emphasis on terminal noncancer diseases. Indian Journal of Palliative Care, 25(2), 203-209. https://doi.org/10.4103/IJPC.IJPC_201_18
Kesonen, P., Salminen, L., Kero, J., Aappola, J., & Haavisto, E. (2022). An integrative review of interprofessional teamwork and required competence in specialized palliative care. Omega, 89(3), 1047-1073. https://doi.org/10.1177/00302228221085468
Kim, S., Lee, K., & Kim, S. (2020). Knowledge, attitude, confidence, and educational needs of palliative care in nurses caring for non-cancer patients: A cross-sectional, descriptive study. BMC Palliative Care, 19, 105. https://doi.org/10.1186/s12904-020-00581-6
Kmetec, S., Štiglic, G., Lorber, M., Mikkonen, I., McCormack, B., Pajnkihar, M., & Fekonja, Z. (2020). Nurses’ perceptions of early person-centred palliative care: A cross-sectional descriptive study. Scandinavian Journal of Caring Sciences, 34(1), 157-166. https://doi.org/10.1111/scs.12717
Lei n.º 52/2012 de 05 de setembro. (2012). Lei de Bases dos Cuidados Paliativos. Diário da República: 1ª Série, (172), 5119-5124.
Lei n.º 156/2015 de 16 de setembro. (2015). Estatuto da Ordem dos Enfermeiros. Diário da República: 1ª Série, (181), 8059-8105.
Li, L., Wang, F., Liang, Q., Lin, L., & Shui, X. (2023). Nurses´ knowledge of palliative care: Systematic review and meta-analysis. BMJ Supportive & Palliative Care. Advance online publication. https://doi.org/10.1136/spcare-2022-004104
Lucas, M. I. B. C. de S., Marques, A. R. S. R., Santos, I. F. de M., Silva, M. I. dos S. C., & Sardinha, P. A. N. de O. (2023). Sedação paliativa: Análise bioética de um caso real em final de vida. Cadernos de Saúde, 15(1), 51-55. https://doi.org/10.34632/cadernosdesaude.2023.11722
Nascimento, J. L., Mello, L. F., Martins, E. R., Peres, E. M., Rebello, C. V., Pires, B. M., Costa, C. C. P. C., & Gomes, A. M. T. G. (2023). Conhecimento dos profissionais de enfermagem sobre os cuidados paliativos. Enfermagem em Foco, 14, e-202351. https://doi.org/10.21675/2357-707X.2023.v14.e-202351
Neto, I. (2021). Princípios dos cuidados paliativos. A. Abejas, & C. Duarte (Coord.), Humanização em cuidados paliativos (pp. 3-10). Lidel.
Neves, J. C. O. (2021). Cuidados Paliativos: Identificação de necessidades em doentes internados em hospital de agudos [Dissertação de mestrado, Escola Superior de Enfermagem de Coimbra]. Repositório Científico da Escola Superior de Enfermagem de Coimbra. http://web.esenfc.pt/?url=u1eIatTk
Neves, T. M. A., Marques, A. M., Correia, M. G., Querido, A., & Marques, A. A. (2022). Conhecimento dos profissionais de saúde sobre cuidados paliativos: Análise de um hospital central português. Revista de Enfermagem Referência, 6(1), e21041. https://doi.org/10.12707/RV21041
Organização Mundial da Saúde. (2020). Palliative care. https://shre.ink/LEQq
Pitzer, S., Kutschar, P., Paal, P., Mülleder, P., Lorenzl, S., Wosko, P., Osterbrink, J., & Bükki, J. (2024). Barriers for adult patients to access palliative care in hospitals: A mixed methods systematic review. Journal of Pain and Symptom Management, 67(1), e16-e33. https://doi.org/10.1016/j.jpainsymman.2023.09.012
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality & Quantity, 52(4), 1893-1907. https://doi.org/10.1007/s11135-017-0574-8
Soares, M. S., & Mendes, F. (2022). A necessidade da literacia em saúde sobre os cuidados paliativos. Revista Ibero-Americana de Saúde e Envelhecimento, 8(3), 346-360. https://doi.org/10.24902/r.riase.2022.8(3).573.346-360
Sociedade Portuguesa de Literacia em Saúde. (2024). Sobre o conceito de literacia em saúde. https://splsportugal.com/sobre/
Souza, V. R. S., Marziale, M. H. P., Silva, G. T. R., & Nascimento, P. L. (2021). Tradução e validação para a língua portuguesa e avaliação do guia COREQ. Acta Paulista de Enfermagem, 34, eAPE02631. https://shre.ink/LEQo
Vaughn, L., & Santos Salas, A. (2022). Barriers and facilitators in the provision of palliative care in critical care: A qualitative descriptive study of nurses’ perspectives. The Canadian Journal of Critical Care Nursing, 33(1), 14-20. https://doi.org/10.5737/23688653-3311420
Velloso, I. S. C., & Tizzoni, J. S. (2020). Critérios e estratégias de qualidade e rigor na pesquisa qualitativa. Ciencia y Enfermería, 26, 1-10. https://doi.org/10.29393/CE26-22CEIS20022
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Millenium - Journal of Education, Technologies, and Health
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who submit proposals for this journal agree to the following terms:
a) Articles are published under the Licença Creative Commons (CC BY 4.0), in full open-access, without any cost or fees of any kind to the author or the reader;
b) The authors retain copyright and grant the journal right of first publication, allowing the free sharing of work, provided it is correctly attributed the authorship and initial publication in this journal;
c) The authors are permitted to take on additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, post it to an institutional repository or as a book), with an acknowledgment of its initial publication in this journal;
d) Authors are permitted and encouraged to publish and distribute their work online (eg, in institutional repositories or on their website) as it can lead to productive exchanges, as well as increase the impact and citation of published work
Documents required for submission
Article template (Editable format)
