Oncology nurses at the frontline of palliative care: knowledge, attitudes, and factors associated with palliative care practice

Cancer is a major cause of mortality worldwide, and the demand for palliative care (PC) is increasing. In Oman, PC services remain limited, with oncology nurses providing most frontline care. However, little is known about their knowledge, attitudes, and practices (KAP) toward PC. A cross-sectional survey was conducted among 189 oncology nurses at the Royal Hospital and Sultan Qaboos Comprehensive Cancer Care and Research Center. Data were collected using the Palliative Care Knowledge Questionnaire (PEACE-Q), Frommelt’s Attitude Toward Care of the Dying – Form B (FATCOD-B), and the Palliative Care Self-Reported Practices Scale (PCPS). Descriptive statistics, Pearson correlations, t-tests, ANOVA, and multiple regression analyses were performed. Nurses reported a mean knowledge score of 28.95 (SD = 4.25), attitude score of 3.44 (SD = 0.38), and practice score of 3.60 (SD = 0.58). Knowledge correlated positively with attitude (r = .47, p < .001), while attitude correlated positively with practice (r = .18, p = .013). Knowledge was not significantly associated with practice (r = –.08, p = .248). Subscale analysis showed stronger practice in pain management and family support, but weaker performance in delirium and dyspnea management. Regression analysis indicated that attitude, knowledge, in-service training, and prior education were significantly associated with higher practice scores. Oncology nurses in Oman demonstrate good knowledge and positive attitudes toward PC, yet practice gaps remain. Structured, culturally relevant education and ongoing in-service training are needed to strengthen PC delivery.