{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:38:07Z","timestamp":1792787887838,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":83,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Manipal Academy of Higher Education, Manipal","id":[{"id":"https:\/\/ror.org\/02xzytt36","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nurs"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Palliative care integration into primary healthcare is essential to improving access for patients with life\u2011limiting illnesses in low\u2011 and middle\u2011income countries. Frontline health workers require targeted capacity\u2011building to strengthen symptom management and community\u2011based care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of a structured capacity\u2011building program on the knowledge and attitudes of ASHA workers and ANMs\/Staff Nurses regarding palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A quasi\u2011experimental design was used among 984 ASHA workers and 335 ANMs\/Staff Nurses in southern India. Participants received structured training on symptom assessment, communication, and home\u2011based palliative care. Pre\u2011test and post\u2011test data were collected using validated knowledge and attitude scales. Data were analysed with Wilcoxon Signed\u2011Rank tests. The TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) checklist has been completed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ASHA workers demonstrated significant improvement in knowledge (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.714) and attitude (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.312) scores. Likewise, ANMs\/Staff Nurses showed large gains in knowledge (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.973) and substantial improvements in attitude (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009.682). The proportion of participants with strong knowledge increased from 9% to 35.2% among ASHAs and from 1.2% to 14% among ANMs\/Staff Nurses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Capacity\u2011building interventions significantly strengthen primary healthcare workers\u2019 competencies in palliative care. Integrating structured palliative care training into national primary healthcare systems enhances awareness and positive attitudes toward palliative care, thereby strengthening their preparedness to provide supportive care.<\/jats:p>\n                    <jats:p>Patient or Public Contribution: No Patient or Public Contribution was sought for this research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12912-026-04992-3","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T04:55:24Z","timestamp":1783140924000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating palliative care into primary healthcare: assessing the impact of capacity building programs for primary health workers in a coastal region of India"],"prefix":"10.1186","volume":"25","author":[{"given":"Malathi G.","family":"Nayak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhika R.","family":"Pai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Ghoshal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Salins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"4992_CR1","doi-asserted-by":"crossref","unstructured":"Connor SR, Sepulveda Bermedo MC. 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Permission was also obtained from the Medical Officers of all participating Primary Health Centres. The study adhered to the ethical principles of the Declaration of Helsinki and was approved by the institutional ethics committee of Kasturba Medical College, IEC # 164\/2020, dated 12th February 2020. All participants were informed of the study\u2019s purpose and procedures, and written informed consent was obtained before data collection.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable; the manuscript does not contain any identifiable individual data.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"886"}}