Nursing Perspectives on Cancer-related Symptom Management in Palliative Care: A State-of-the-Art (SotA) Review Focused on Iran

Abstract

Context: Integrating palliative care (PC) into oncology is essential for improving the quality of life (QoL) of patients with cancer. This review aims to provide a comprehensive and critical analysis of the current nursing perspective on cancer-related symptom management in PC, while identifying gaps and opportunities for improving PC services in Iran. Evidence Acquisition: This study was designed as a state-of-the-art (SotA) review methodology to provide a comprehensive and analytical up-to-date synthesis of the current state of knowledge on PC in oncology nursing. A literature search was conducted across international and national databases, including Scopus, PubMed, Google Scholar, Web of Science, SID, Magiran, and Islamic World Science and Technology Monitoring and Citation Institute (ISC), covering studies published from 2014 to 2025. The focus was on articles addressing nurses’ roles, care strategies, and challenges in symptom management within PC settings. Results: Oncology nurses in Iran play a key role in managing cancer-related symptoms across physical, psychological, social, and spiritual domains. However, their ability to deliver comprehensive care is hindered by limited specialized training, unclear national policies, nursing shortage, and cultural barriers. Most Iranian studies focus on single symptoms rather than symptom clusters, and the use of digital tools such as telemedicine remains minimal. Conclusions: Oncology nurses in Iran play a critical role in symptom management, but face barriers such as limited training in PC, workforce shortages, cultural sensitivities, and policy gaps. Increasing training, developing national frameworks, and utilizing telemedicine can improve the quality and access to PC.