Bridging compassion and competence: an integrative literature review on the evolving role of palliative nursing in cancer care.

BACKGROUND: Palliative cancer care requires nurses to combine symptom management with compassionate communication, cultural awareness, ethical judgment and emotional resilience. However, evidence on these domains remains fragmented across nursing practice, education and workforce support. AIMS: This review synthesised evidence on the intersecting roles of competence, compassion, emotional labour and educational preparation in palliative oncology nursing. METHODS: An integrative literature review was conducted, and 45 eligible studies were analysed using thematic synthesis. FINDINGS: Seven interrelated themes were identified: palliative nursing practice, oncology nursing, nurse competencies, compassionate care, end-of-life care, nurse- patient relationships and compassion fatigue. Findings showed that nurses provide essential symptom management, emotional support, communication, and family guidance across the cancer trajectory. However, technical competencies were more consistently emphasised than psychosocial, spiritual, cultural and ethical preparation. Compassionate care and trust-based relationships improved patient and family experiences, while workload pressure and repeated exposure to suffering contributed to compassion fatigue. CONCLUSIONS: Palliative oncology nursing requires integration of technical competence and compassionate care. Strengthening education, competency standards, workplace support and compassion fatigue prevention is needed to sustain high-quality palliative nursing in cancer care.