The effectiveness of nurse-led palliative care needs assessment on patients' quality of life and symptom burden: a systematic review

Gursharan K Singh; Claudia Virdun; Megan Rattray; Roslyn Prichard; Rochelle Wynne

doi:10.1016/j.ijnsa.2025.100343

The effectiveness of nurse-led palliative care needs assessment on patients' quality of life and symptom burden: a systematic review

Int J Nurs Stud Adv. 2025 May 1:8:100343. doi: 10.1016/j.ijnsa.2025.100343. eCollection 2025 Jun.

Authors

Gursharan K Singh^{1

2}, Claudia Virdun^{1

2

3}, Megan Rattray⁴, Roslyn Prichard⁵, Rochelle Wynne^{6

7}

Affiliations

¹ Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
² Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
³ Flinders Research Centre for Palliative Care, Death, and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.
⁴ College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
⁵ School of Health, University of Sunshine Coast, Sippy Downs, QLD, Australia.
⁶ School of Nursing & Midwifery, Centre for Quality & Patient Safety in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
⁷ Western Health, St Albans, VIC, Australia.

Abstract

Background: Optimal palliative care requires a correct assessment of needs. Nurses are well-placed to undertake this task, but the effectiveness of nurse-led palliative care needs assessment remains uncertain.

Aim: To evaluate the evidence regarding the impact of nurse-led palliative care needs assessment on adult patients with oncological and non-oncological illnesses quality of life, symptom burden and hospitalisations.

Design: Systematic review. The review was registered on the international Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42023429259).

Data sources: Databases searched were CINAHL, PubMed, Embase, and MEDLINE from inception to April 2024.

Methods: A systematic review of English language, randomised controlled trials, conducted in May 2023, and updated in April 2024, on the impact of nurse-led palliative care needs assessment was undertaken. Two independent reviewers screened papers, and two reviewers independently conducted data extraction and risk of bias assessment using the Cochrane Risk of Bias 2 tool. The data were analysed using a narrative synthesis approach by combining studies according to the outcomes of interest.

Results: Six trials were included, involving oncological patients (n = 4), non-oncological patients (n = 1) and deceased aged-care residents (n = 1). Two studies had 'low' risk of bias, two had 'some concerns,' and two had 'high concerns.' There was heterogeneity in the needs assessment tools used and the outcome measures assessed. Researchers who conducted a nurse-led and social worker-led trial in non-oncological patients demonstrated statistically significant improvements in patient quality-of-life and symptom burden. Researchers in two trials found no difference, and two others reported statistically non-significant improvements in quality of life and symptom burden. One group of researchers found no difference in hospitalisations at 6 months. No studies evaluated the inpatient length of stay.

Conclusion: There is a paucity of high-quality evidence on the effectiveness of nurse-led palliative care needs assessments. Future researchers must identify what level of needs predicts poor quality of life, assess interventions tailored to local contexts, and determine how best to evaluate their impact using clinically relevant outcome measures.

Keywords: Needs assessment; Nursing; Palliative care; Quality of life; Symptom burden; Systematic review.

Publication types

Review