Perceived Barriers to Palliative Care Delivery Among Nurses in Palestinian Hospitals: Organizational, Family, and Professional Challenges.

BACKGROUND

Nurses are central to palliative and end-of-life care, yet organizational, family-related, and professional barriers may restrict person-centered support. Evidence from Palestinian governmental hospitals remains limited.

AIM: To assess nurses' perceived barriers to palliative care delivery and examine associated demographic and professional factors.

METHODS

A multicentre cross-sectional study was conducted in four hospitals in Hebron Governorate, Palestine, from January to March 2026. A convenience sample of 200 nurses completed a demographic questionnaire and a 15-item Perceived Barriers to Palliative Care Scale. Data were analyzed using descriptive statistics, Mann-Whitney U tests, Kruskal-Wallis tests with Dunn-Bonferroni post hoc comparisons, and multiple linear regression.

RESULTS

The mean perceived-barriers score was 2.05 (SD = 0.24), with a median of 2.07 and an interquartile range of 1.93-2.20. The highest-rated barriers were uncertainty regarding patients' wishes, family non-acceptance of poor prognosis, liberal visiting hours, family absence at death, inadequate consideration of nurses' opinions, and limited resources. Barrier scores differed across age groups, H(3) = 10.70, p = 0.013, although no pairwise comparison remained significant after Bonferroni adjustment. Nurses aged 50 years or older had higher barrier scores than those aged 20-29 years (B = 0.147, p = 0.026). However, the model was not significant, F(9, 189) = 1.87, p = 0.059, and explained 8.2% of the variance.

CONCLUSION

Nurses perceived multidimensional barriers involving patient preferences, family communication, resources, privacy, and participation in decision-making. Organizational, educational, and policy interventions are needed to strengthen palliative care delivery.