A systematic review of palliative care knowledge, attitudes, and practices in Saudi Arabia: a global comparative...

Palliative care is an important component of enhancing quality of life for patients with life-limiting illness. Despite increasing infrastructure capacity in Saudi Arabia, there is a significant gap in the clinical competence of healthcare professionals in palliative care. This systematic review attempted to assess the Knowledge, Attitudes, and Practices (KAP) of healthcare professionals in Saudi Arabia and compare them to international standards.

A systematic review was conducted according to the guidelines of the PRISMA. Studies published between January 2012 and February 2026 were included, with a focus on the KAP of healthcare professionals regarding palliative care. A complete literature search was performed on the electronic databases (PubMed, Scopus, Web of Science, etc.). The review included cross-sectional and interventional studies of palliative care knowledge, attitudes, practices, and self-efficacy, quantitatively. The data from Saudi Arabia (9 studies) were compared to the international studies (21 studies) from other countries such as China, Taiwan, Ethiopia and Nigeria.

The research findings of studies carried out from 2012 to 2026 found low levels of knowledge on palliative care among health practitioners in Saudi Arabia. The problems included a lack of adequate knowledge, inadequate training, wrong beliefs about opioids, and poor end-of-life care plans. Global comparisons showed countries with an integrated and structured educational system, like Taiwan and China, had much higher competency levels; however, regions with ad hoc models of training, like Saudi Arabia, continued to show knowledge gaps. Major barriers were found to be lack of formal training in palliative care, opioid hesitancy and lack of implementation of end-of-life care protocols, especially in high acuity settings such as ICUs.

The findings suggest that reliance on clinical exposure and ad-hoc training alone is insufficient to develop palliative care competency among healthcare professionals in Saudi Arabia. To improve workforce preparedness, structured and mandatory palliative care education should be integrated into undergraduate and postgraduate healthcare curricula. International evidence indicates that formal training programs are associated with improved knowledge, confidence, and palliative care practice. These findings suggest that educational and training deficiencies may contribute more substantially to competency gaps than cultural resistance alone.