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Hadis Ashrafizadeh , Salem Said Al Touby , Maryam Rassouli ,
Volume 23, Issue 1 (3-2026)
Abstract

Palliative care is a critical component of Universal Health Coverage and a key approach for reducing serious health-related suffering; however, major educational gaps persist among nurses across the Eastern Mediterranean Region. Although nurses deliver palliative care in hospitals, communities, and homes, many report insufficient knowledge, skills, and confidence, especially in end-of-life communication, complex symptom management, and psychosocial–spiritual support. These gaps are driven by limited curricular integration, shortages of trained faculty, resource constraints, and scarce post-graduation training. Digital and virtual education models (e.g., Project ECHO, web-based modules, and virtual simulation/VR) offer scalable solutions by improving access, reducing time and cost barriers, and strengthening competence and self-efficacy. These models need to fit local health‑system capacities and the cultural and religious norms of Middle Eastern communities, especially around family‑centered decisions and sensitive conversations. Continued investment in faculty training, technology, and mentorship is essential for bringing culturally responsive virtual palliative care education into nursing programs.

Salem Said Al Touby , Hadis Ashrafizadeh , Mitra Hekmatafshar , Annie Young , Maryam Rassouli ,
Volume 23, Issue 2 (6-2026)
Abstract

Substantial inequities in cancer care persist across countries and population groups with lower levels of human development. Although very high- and high-Human Development Index (HDI) settings often report higher cancer incidence and comparatively lower mortality, low- and medium-HDI countries experience lower recorded incidence but disproportionately higher mortality-to-incidence ratios. This pattern reflects delayed diagnosis, restricted access to treatment, workforce shortages, and fragile health systems. This narrative policy paper examines how oncology nurses can contribute to reducing these inequities across the cancer care continuum in low- and medium-HDI settings. Drawing on evidence from nursing practice, health systems research, and cancer control initiatives, we emphasize the roles of oncology nurses in prevention, early detection, treatment, survivorship, and palliative care. Key contributions include health education, community-based screening, patient navigation, symptom management, psychosocial support, and culturally responsive end-of-life care. The paper also discusses innovative and scalable service-delivery models, including task-sharing approaches, nurse-led early detection initiatives, case management, telemedicine, and international capacity-building partnerships. Despite their strategic importance, oncology nurses remain constrained by limited access to specialized education, inadequate policy recognition, workforce shortages, burnout, and insufficient locally generated evidence. Addressing these barriers requires sustained investment in oncology nursing education, leadership development, research capacity, and supportive health policies. Strengthening oncology nursing is therefore a practical and potentially high-impact strategy for expanding access to care, improving service continuity, and advancing cancer care equity in resource-constrained settings.


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