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  • The Nurse's Role in Translating Genomic Findings into Person-Centered Palliative Care Plans for Cancer Patients: A Scoping Review

  • Fatemeh Hasan Shiri,1 soolmaz moosavi,2,*
    1. Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran.
    2. Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


  • Introduction: Introduction: Rapid advances in genome sequencing technologies have transformed genomics from a specialized, laboratory-confined field into a foundational pillar of precision care across the cancer care continuum. Today, genomics is applied in early diagnosis, hereditary cancer risk assessment, targeted therapy selection, and symptom management (Limoges et al., 2024). However, the role of genomics in palliative care remains marginal and overlooked. A global policy review showed that out of 78 international policy documents, only two (2.56%) contained explicit recommendations for integrating genomics into palliative care, and no genetics document referenced palliative care in its background (White et al., 2023). Nurses, owing to their continuous, close, and long-term relationships with patients and families, occupy a unique position to identify genomic needs, provide comprehensible information, and facilitate informed decision-making; however, a substantial gap persists between genomic competencies and their practical translation into clinical settings (Brownlee et al., 2026).
  • Methods: Methods: This scoping review was designed based on the Arksey and O'Malley (2005) framework and JBI guidance, and reported according to PRISMA-ScR. A systematic search was conducted in PubMed/MEDLINE, Scopus, and Web of Science using keywords related to genomics, nursing, palliative care, and cancer. Inclusion criteria comprised quantitative, qualitative, mixed-methods studies and policy documents addressing the nurse's role in cancer genomics with a focus on palliative care. Title/abstract and full-text screening and data extraction were performed independently by two researchers.
  • Results: Results: From 361 identified sources (356 English, 5 Persian), after removing 14 duplicates and screening, 6 final studies were included in the analysis (Australia 2, England/Wales 2, Canada 1, Japan 1; timeframe 2010-2025). In White et al. (2024) study of 73 specialists, 79% took family health history, but only 51% constructed pedigrees and 35% performed genetic risk assessment. Only 2% of genetic test requests were initiated by the palliative care team. Confidence levels in genomic activities were low (12%), 91% had received no formal training, and 75% expressed interest in training. Significant differences with genetics specialists were reported in DNA banking discussions (p=0.001), disclosure of results (p=0.001), and management of legal responsibilities (p=0.003). Gonthier et al. (2018) study in Canada (58 specialists) replicated this pattern: 63% sometimes discussed family history with patients or relatives but had limited knowledge and confidence, and 78% requested specialized training. Metcalfe et al. (2010) study of 328 hospice nurses showed that nurses valued genetic care highly but lacked confidence for specialized genetic activities. Qualitative studies characterized the nurse's role as primarily psychosocial support, but identified their potential as a "rapid-response communication bridge" between patients/families and genetic services.
  • Conclusion: Discussion: Findings indicate that the primary gap is not the lack of importance of genomics, but the translation-to-practice gap. Nurses occupy a privileged clinical position, but educational, policy, and implementation structures for effectively fulfilling this role are not yet institutionalized. Limiting the nurse's role to emotional support is insufficient, as time in palliative care is often limited, and losing the opportunity to record, bank, or transfer genetic information before the patient's death can have significant consequences for relatives' future risk assessment and screening decisions (White et al., 2023). Targeted education (not general), systematic interdisciplinary collaboration through multidisciplinary teams, and development of clear policies and implementation pathways are three key strategies for activating this role. The geographical concentration of evidence in English-speaking countries limits generalizability to other contexts, including the Middle East. Conclusion: The nurse's role in translating genomic findings into palliative cancer care is important but under-operationalized. Nurses are attitudinally supportive of genetic integration, but knowledge-practice gaps and professional role ambiguity are the main barriers. Developing clear implementation pathways, structured tools (screening checklists, referral templates), and skills-based training can transform nurses from reactive actors into active facilitators of person-centered palliative care.
  • Keywords: Genomics, Palliative Care, Nursing, Cancer, Scoping Review, Genetics

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