Available online 8 November 2025, 152025

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Most Moroccan nurses showed low knowledge of palliative care.

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Psychosocial and spiritual care was the least known domain.

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Male gender and Training in oncology or palliative care strongly influence knowledge levels.

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Findings highlight urgent need for structured training programs in Morocco.

AbstractIntroduction

Despite the growing need for palliative care, limited evidence exists on Moroccan nurses' knowledge and perceptions in this field, representing a critical gap that may affect the quality of patient care. Addressing this gap is essential to ensure effective palliative care delivery. Therefore, this study aimed to assess Moroccan nurses' knowledge and perceptions of palliative care and to identify factors influencing their competencies in this area.

Methods

A cross-sectional analytical study was conducted among Moroccan nurses between April 2023 and April 2024. An anonymized online questionnaire (Palliative Care Quiz for Nursing) was distributed. Data were analyzed using descriptive and inferential statistics with R/RStudio and Excel software.

Results

A total of 480 nurses participated in the study. Overall, nurses demonstrated limited knowledge of palliative care, with a mean score of 5.6/20, corresponding to a 28.53 % correct response rate, particularly low in the psychological and spiritual dimensions. Independent predictors of a higher level of knowledge included male gender (OR = 5.46, p < 0.001), professional experience exceeding 16 years (OR = 2.12, p = 0.001), and training in oncology or palliative care (OR = 3.53, p = 0.006).

Conclusion

The study reveals a low level of palliative care knowledge among nurses in Morocco, despite institutional efforts. It recommends the early integration of palliative care into health systems, the development of multidisciplinary teams, access to essential medications, and the creation of educational programs tailored to low-resource settings.

Section snippetsImplications for Practice1.

Strengthening Palliative Care in Nursing Education

The consistently low knowledge scores among Moroccan nurses highlight the urgent need to integrate structured palliative care modules into higher institutes of nursing sciences and professions curricula and postgraduate training. Oncology-based clinical simulations could help bridge identified gaps.2.

Contextualized Continuing Education in Non-Specialized Settings

In-service training should be prioritized in hospitals and primary care centers

Design and participants

This descriptive, quantitative, and analytical study aimed to assess the knowledge of Moroccan nurses regarding palliative care for cancer patients across various public healthcare institutions. The study targeted public sector nurses with a final sample of 480 participants. The minimum required sample size was estimated at 378, based on a standard calculation method applied to a total population of approximately 23,000 nurses (Ministère de la santé marocain, 2020).

The inclusion criteria

Characteristics of participating nurses

In this study, 480 Moroccan nurses participated (97 approached directly by investigators and 383 online). The average age was 31,7 years, with only 19 % over 36. The sample was predominantly female (sex ratio M/F: 0.73). Most nurses worked in hospitals (54 %), with a strong presence of polyvalent nurses (70 %) and low representation in neonatology or intensive care (1–7 %). Urban health centers were the most common workplace (28 %). Most had 1 to 5 years of experience (34 %), and 82 % held a

Discussion

This study targeted all nurses working in diverse healthcare facilities across Morocco. It examined their knowledge of palliative care in the oncology context, where such services are the most developed and formally recognized through a national strategy that identifies palliative care as a key priority (Ministere de la santé marocain, 2020).

Our results suggest that the Moroccan nurses participating in this study had a low level of knowledge, with an average score of 5.6 out of 20. There was a

Conclusion

This study reveals a low level of knowledge among nurses regarding palliative care (average PCQN score of 5.6/20), particularly in psychosocial and spiritual care. Despite efforts by the Moroccan Ministry of Health—including the creation of palliative care units, home care equipment, and a dedicated guideline—these gaps persist. To address this, it is imperative to integrate early palliative care into primary, community, and home healthcare by training multidisciplinary teams and ensuring

CRediT authorship contribution statement

Mohamed Aboufaras: Writing – original draft, Supervision, Methodology, Conceptualization. Fahd Elkhalloufi: Software, Investigation, Formal analysis, Conceptualization. Loubna Zarouali: Investigation. Chaimae Sahir: Investigation. Rachid Fares: Writing – review & editing, Validation.

Ethical approval statement

The provincial health administration granted approval (number 2951/23) to conduct the study. The key condition was to uphold the participants' consent, anonymity, and confidentiality.

Declaration of Generative AI and AI-assisted technologies in the writing process

Generative AI and AI-assisted technologies were used in the writing process to translate and improve the readability and language of the manuscript.

Funding

“The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.”

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgments

We would like to express our sincere gratitude to all the nurses who participated in this study for their time and valuable insights. Special thanks to the healthcare institutions across Morocco for facilitating access and supporting this research. Finally, I acknowledge the support of the Ministry of Health for their ongoing commitment to improving palliative care services in Morocco.

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