Palliative Care and Ending of Life (EoL) Decision Making - Views and Attitude of MBBS & Nursing Students and paramedical staff

Authors

  • Arshpreet Kaur
  • Vanshu Singh
  • Charvi Jagtap
  • Mayank Goyal
  • Vikhayat Bhakar
  • Snehil Ojha
  • Hemant Kumar Garg
  • Col. Brij Mohan

Keywords:

palliative care, end-of-life decisions, MBBS students, nursing students, paramedical staff, attitudes, view

Abstract

Background: Knowledge, perception, and attitudes toward palliative care and end-of-life (EoL) decision making vary among healthcare trainees and staff, and can influence patient care quality. This study aims to assess perceptions and attitudes among MBBS students & interns, nursing students, and paramedical staff in two medical colleges and their hospitals.

Methods: Cross-sectional survey (n = 300) using a structured, pre-tested questionnaire covering knowledge of palliative care, attitudes toward EoL decisions (withholding/withdrawing life-sustaining treatment, do-not-resuscitate orders), self-perceived preparedness, and barriers to providing palliative care. Data will be analyzed using descriptive statistics, group comparisons (Chi-square, ANOVA), and multivariable logistic regression to identify factors associated with favorable attitude toward EoL decision making.

Results: (The Results below are example/simulated outputs showing how findings should be presented. Replace with your collected data.) Overall, 62% of participants had moderate to good knowledge of palliative care. Favorable attitudes toward discussing EoL issues were more frequent among nursing students (72%) and MBBS interns (68%) than paramedical staff (48%). Major barriers reported were lack of training (81%), cultural/religious concerns (64%), and fear of legal consequences (53%).

Conclusions: Training gaps and legal/ethical concerns are major barriers to optimal palliative care delivery. Incorporating structured palliative care education across curricula and hospital in-service training is recommended.

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References

World Health Organization. Palliative care — Fact sheet. 2020 (updated). Available from: WHO. World Health Organization

World Health Organization. Global Atlas of Palliative Care at the End of Life. 2014 (updated). World Health Organization

Suija K, et al. Palliative care training in medical undergraduate education: a systematic review. BMC Palliat Care. 2024. BioMed Central

Li WW, et al. Palliative care education and its effectiveness: a systematic review. Social Science & Medicine / Public Health (2021 review summary). ScienceDirect

Bassah N, Steele R, O’Connor M. A modified systematic review of research evidence about educational interventions for pre-registration palliative care nursing education. BMC Palliative Care. 2014. BioMed Central

Ibrahim H, et al. Medical student experiences and perceptions of palliative care education and end-of-life care. (PMC article) 2022. PMC

Gryschek G, et al. Assessing palliative care education in undergraduate medical education. BMJ Open (2020). BMJ Open

Younis WY, et al. Status and predictors of medical students' knowledge and attitude towards palliative care (Jordan). BMC Palliative Care (2024). BioMed Central

Fristedt S, et al. Undergraduate nursing students' knowledge about palliative care and attitudes towards end-of-life care: a three-cohort survey. (2021). Europe PMC

Zahran Z, et al. Nursing students' attitudes towards death and caring for dying patients. (PMC article) 2021. PMC

Jeong SH, et al. A systematic review on influencing factors of nurses’ attitudes toward palliative care. (2020). Europe PMC

Alshammari F, et al. Registered Nurses' attitudes towards end-of-life care: A multicenter study. Journal of Clinical Nursing (2023). Wiley Online Library

Alahmadi S, et al. Do-not-resuscitate (DNR) orders: awareness and attitudes among healthcare providers. (PMC article) 2023. PMC

Mirhosseini S, et al. Health care providers’ attitudes toward DNR during COVID-19: An ethical dilemma. PMC (2022). PMC

Amacher SA, et al. Misconceptions and DNR preferences among healthcare professionals. (ScienceDirect review 2024). ScienceDirect

Gupta M, et al. Views and attitudes of healthcare professionals on DNAR in low- and lower-middle-income countries: systematic review. BMC Palliat Care (2025). BioMed Central

Hamdan KM, et al. Palliative care knowledge and attitudes toward end-of-life care among nursing students and ICU nurses. (2023). accjournal.org

Leung SY, et al. Assessing medical students' confidence towards provision of palliative care. Int J Environ Res Public Health (2021). MDPI

Castro AA, et al. Palliative care and medical education: systematic review of teaching methods and outcomes. (2021 review). RSD Journal

Cha J. Changes in perceptions and attitudes of medical students after hospice/palliative rotations. Korean J Hosp Palliat Care (2019). e-jhpc.org

O’Shea ER. End-of-life nursing education: enhancing nurse knowledge and attitudes. (2019). ScienceDirect

Rafiee S, et al. Knowledge and attitude towards palliative care among nurses: cross-sectional study. (2024 PMC). PMC

Alwawi AA & Chen L. Impact of clinical exposure on nursing students’ attitudes toward palliative care. (cited in several nursing education studies). tmrjournals.com

Devakirubai E. End-of-life care preferences of terminally ill patients: cross-sectional study. Journal of Palliative Care (2025). jpalliativecare.com

MedCrave / HPMIJ. Staff nurses' knowledge and attitude toward the concept of palliative care — central hospital study. (2020). medcraveonline.com

ResearchGate / Indian studies. Attitudes of nurses toward care of the dying patient in India. (pilot/descriptive studies; 2025 conference/pilot report). ResearchGate

BMJ Open / multi-center surveys. Assessing palliative care education among students in different countries. (literature 2020–2022). BMJ Open

MedRxiv. DNR practices in ICU—recent descriptive studies. (2025 preprint examining frequency and timing). MedRxiv

Acta Biomedica & Mattioli1885 articles. Effects of brief training on nursing students' attitudes to end-of-life care. (2024/2021). Mattioli 1885+1

ACC Journal / Korea Palliative care knowledge and attitudes: ICU nurse study. (2023). accjournal.org

European Journal of Hospice & Palliative Care (various articles on student rotation effects and curricular integration). SAGE Journals

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Published

2025-10-27

How to Cite

1.
Kaur A, Singh V, Jagtap C, Goyal M, Bhakar V, Ojha S, Kumar Garg H, Mohan CB. Palliative Care and Ending of Life (EoL) Decision Making - Views and Attitude of MBBS & Nursing Students and paramedical staff. J Neonatal Surg [Internet]. 2025Oct.27 [cited 2025Dec.6];14(32S):9150-7. Available from: https://jneonatalsurg.com/index.php/jns/article/view/9421

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