# Nurses’ Perspectives on Unmet Social, Psychological, and Spiritual Needs of Palliative Patients in Croatia: A Cross-Sectional Study

## TL;DR

Croatian nurses report that palliative patients' social, psychological, and spiritual needs are often unmet, and many nurses feel underprepared to address these issues.

## Contribution

This study provides insights into nurses' perspectives on unmet palliative care needs and highlights gaps in education and support.

## Key findings

- Most nurses felt emotionally exhausted and insufficiently trained in palliative care.
- There was a significant gap between the importance and satisfaction of patient needs like fear of death and future uncertainty.
- Over 90% of nurses reported that care responsibilities often fall on families.

## Abstract

Background: Palliative care addresses not only physical symptoms but also the social, psychological, and spiritual needs of patients. Nurses play a key role in identifying and responding to these needs, yet their perceptions and preparedness may vary. Objectives: This study aimed to explore nurses’ perspectives on the psychological, social, and spiritual needs of palliative patients, assess how well these needs are being met, and examine the influence of nurses’ self-assessed education levels on their evaluations. Methods: A cross-sectional survey was conducted among 237 registered nurses with palliative care experience in Split-Dalmatia County, Croatia. Two validated questionnaires were used to assess the perceived importance of 53 patient needs and the extent to which these needs were satisfied. Results: Findings revealed significant discrepancies between the perceived importance and satisfaction of nearly all psychological, social, and spiritual needs (p < 0.001), particularly regarding fear of death, suffering, and future uncertainty. Only 38.4% of nurses considered themselves adequately trained in palliative care, though most had some educational exposure to it. No statistical differences were found in need assessment based on nurses’ self-rated education. Most nurses reported emotional exhaustion (72.6%) and supported interdisciplinary care (95.8%), while 90.3% noted that responsibility for care often falls on families. Conclusions: Nurses recognize critical unmet needs in palliative patients and feel insufficiently prepared to address them. These findings underscore the need to improve palliative care education, provide emotional support for nurses, and implement systemic healthcare reforms to ensure comprehensive, dignified care.