{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:11:52Z","timestamp":1789578712690,"version":"build-2803163510"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"unspecified","delay-in-days":64,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S147895152610203X_sec1a\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Palliative and end-of-life (EOL) care is gaining increasing importance in Saudi Arabia due to the rising burden of chronic and life-limiting illnesses. Nurses play a central role in delivering comprehensive, culturally appropriate palliative care; however, their practices are influenced by educational preparation, institutional support, and sociocultural and religious contexts. To date, evidence on palliative nursing care in Saudi Arabia remains fragmented and insufficiently synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610203X_sec2b\">\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This systematic review aimed to synthesize existing evidence on palliative and EOL nursing care in Saudi Arabia, with a focus on nursing practices, challenges, cultural and spiritual influences, and patient and family outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610203X_sec3c\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted in January 2025 using PubMed, Scopus, CINAHL, Web of Science, Google Scholar, and Saudi grey literature sources. Empirical qualitative, quantitative, and mixed-methods studies addressing palliative or EOL nursing care in Saudi Arabia were included. Study selection followed PRISMA guidelines, and methodological quality was appraised using appropriate critical appraisal tools. A narrative thematic synthesis was undertaken due to heterogeneity among studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610203X_sec4d\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen studies met the inclusion criteria. Findings indicated that nurses are actively involved in symptom management, therapeutic communication, psychosocial support, spiritual care, and family-centered care. However, substantial barriers were identified, including gaps in knowledge and training, limited formal palliative education, emotional burden, ethical challenges related to nondisclosure, and inconsistent institutional policies. Cultural and religious norms strongly influenced communication practices and decision-making processes. Studies also showed that structured palliative care services, particularly home-based and multidisciplinary programs, were associated with improved patient comfort, dignity, and family satisfaction, although access to such services varied across regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610203X_sec5e\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Palliative and EOL nursing care in Saudi Arabia demonstrates commitment and potential but is constrained by educational, emotional, cultural, and systemic challenges. Strengthening nursing education, enhancing culturally sensitive communication and spiritual care training, expanding home-based palliative services, and providing institutional support for nurses\u2019 emotional well-being are essential to improving the quality and equity of palliative care nationwide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s147895152610203x","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:15:07Z","timestamp":1772788507000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Palliative and end-of-life nursing care in Saudi Arabia: A systematic review of nursing practices, challenges, and patient\u2013family outcomes"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-0017","authenticated-orcid":false,"given":"Ateya Megahed","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Prince Sattam Bin Abdulaziz University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donia Elsaid Fathi","family":"Zaghamir","sequence":"additional","affiliation":[{"name":"Prince Sattam Bin Abdulaziz University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"S147895152610203X_ref11","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.2027"},{"key":"S147895152610203X_ref16","unstructured":"Badreldin, HA , Al-Jedai, A , Alghnam, S , et al. (2025) Sustainability and resilience in the Saudi Arabian health system ."},{"key":"S147895152610203X_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02514-7"},{"key":"S147895152610203X_ref21","first-page":"520","article-title":"Critical care nurses\u2019 knowledge regarding palliative care in Saudi Arabia","volume":"7","author":"Mitwalli","year":"2024","journal-title":"Journal of International Crisis and Risk Communication Research"},{"key":"S147895152610203X_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/NHH.0000000000001255"},{"key":"S147895152610203X_ref10","doi-asserted-by":"publisher","DOI":"10.33546\/bnj.3040"},{"key":"S147895152610203X_ref17","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.1005946"},{"key":"S147895152610203X_ref13","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2023.0519"},{"key":"S147895152610203X_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-025-03658-w"},{"key":"S147895152610203X_ref4","doi-asserted-by":"publisher","DOI":"10.1177\/26323524241290828"},{"key":"S147895152610203X_ref6","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12161647"},{"key":"S147895152610203X_ref19","doi-asserted-by":"publisher","DOI":"10.1177\/0825859717743229"},{"key":"S147895152610203X_ref3","doi-asserted-by":"publisher","DOI":"10.4103\/JNSPP.JNSPP_1_25"},{"key":"S147895152610203X_ref18","doi-asserted-by":"publisher","DOI":"10.36348\/sjnhc.2024.v07i01.004"},{"key":"S147895152610203X_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.aggp.2025.100163"},{"key":"S147895152610203X_ref9","doi-asserted-by":"publisher","DOI":"10.5603\/pmp.103577"},{"key":"S147895152610203X_ref23","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13141717"},{"key":"S147895152610203X_ref14","article-title":"Assessment of knowledge and attitudes toward palliative care and end-of-life decision-making in Saudi Arabia: A cross-sectional study","volume":"15","author":"Alsolami","year":"2023","journal-title":"Cureus"},{"key":"S147895152610203X_ref2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21070931"},{"key":"S147895152610203X_ref22","first-page":"143","article-title":"The role of clinical nurse specialists in improving patient outcomes in Saudi Arabia","volume":"7","author":"Shareifi","year":"2024","journal-title":"Journal of International Crisis and Risk Communication Research"},{"key":"S147895152610203X_ref1","article-title":"Cancer palliative care in low-resource settings: challenges and innovations","volume":"5","author":"Abdullah","year":"2025","journal-title":"Regeneration"},{"key":"S147895152610203X_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-019-0385-4"},{"key":"S147895152610203X_ref15","first-page":"1665","article-title":"The vital role of nurses in promoting holistic patient care and safety in Saudi Arabia","volume":"7","author":"Alswaid","year":"2024","journal-title":"Journal of International Crisis and Risk Communication Research"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S147895152610203X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:15:11Z","timestamp":1772788511000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S147895152610203X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":23,"alternative-id":["S147895152610203X"],"URL":"https:\/\/doi.org\/10.1017\/s147895152610203x","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e82"}}