Enhancing oncology nursing capacity in Cameroon: A mixed-methods evaluation of a palliative and psychosocial care training program

Nurses in Cameroon and other low-resource settings receive limited structured training in palliative and psychosocial oncology care, despite a substantial and growing burden of cancer-related physical and psychosocial distress.

To develop, implement, and evaluate a training program aimed at strengthening nurses' competencies in palliative and psychosocial oncology care in Cameroon, and the transfer of learning into clinical practice.

A quasi-experimental, mixed-methods pretest-posttest design was used, incorporating quantitative and qualitative data collection and analysis.

A 32-hour psychosocial oncology and palliative care training program was delivered across six hospitals in Cameroon. Fifty-two nurses participated in the training program. Quantitative data on knowledge, self-perceived competence, confidence, attitudes, and practice were collected pre- and immediately post-training. A sample of 18 nurses were selected for semi-structured interviews at six months to explored experiences and barriers to transfer of learning to practice. Quantitative data were analyzed using paired t-tests, McNemar tests, and descriptive statistics; qualitative data were thematically analyzed using the framework approach.

Forty-seven nurses completed the evaluation survey and 15 nurses participated in qualitative interviews. The mean age was 38.2 ± 8.3 years and 83% were female. Knowledge scores improved significantly post-training from pre-test mean of 8.91 ± 2.27 to post-test mean of 10.87 ± 1.95, p < 0.001, particularly in pain and symptom management. Self-perceived competence and confidence increased significantly in communication, assessment and care planning, symptom management, advance care planning, and professional values (p < 0.001). Practical knowledge and psychosocial care attitudes improved (p = 0.02), though behavioral practice changes were minimal. Qualitative findings supported these improvements, highlighting enhanced clinical skills, psychosocial support, family engagement, ethical decision-making, and interdisciplinary collaboration. Barriers including resource limitations, financial constraints, and emotional burden restricted learning transfer. Participants reported improved patient comfort and treatment adherence.

Tailored palliative and psychosocial oncology training improves nurses' competence and confidence, enhancing symptom management, patient support, and family engagement. Integrating these programs into health system reforms can strengthen patient-centred cancer care in Cameroon and similar settings.