Nurses’ and Family Caregivers’ Experiences in Meeting the Physiological Needs of Palliative Patients in the Home Setting: A Qualitative Content Analysis

Background Home-based palliative care is a critical service component for people living with advanced, life-limiting illness, where day-to-day care often falls on family caregivers in collaboration with nurses. Meeting physiological needs—such as pain relief, nutrition and hydration, elimination, breathing, mobility, hygiene, and comfort—is central to care at home, yet can be challenging due to symptom burden and functional decline. This study explored nurses’ and family caregivers’ experiences in meeting the physiological needs of palliative patients receiving home-based palliative nursing services. Methods A qualitative study using semi-structured interviews was conducted in November–December 2023. Participants were purposively recruited and included five general practice nurses providing home-based palliative nursing services (S1–S5) and four family caregivers caring for a palliative patient at home (A1–A4). Interviews were audio-recorded, transcribed verbatim, anonymised, and analysed using inductive qualitative content analysis. Study trustworthiness was supported through an audit trail, peer debriefing of codes/themes, and the use of verbatim quotations. Institutional administrative permission was obtained (2023-11-23, No. S25-124), and all participants provided written informed consent. Results Participants described caring mostly for patients with advanced (predominantly stage III–IV) cancer, often with metastases and comorbidities, and with markedly reduced independence. Nurses highlighted key care challenges: severe pain and difficulties achieving symptom control; nutrition and hydration issues related to nausea, medication effects, and fear of choking; elimination problems (particularly constipation, incontinence/retention); breathing difficulties (dyspnoea, cough, secretions); profound immobility with a strong emphasis on repositioning and pressure injury prevention; and the complexity of maintaining hygiene and comfort at home. Family caregivers emphasised intense pain during movement and care procedures, extreme dependency, and substantial physical workload. Pressure injuries were mentioned less frequently by caregivers despite describing severe immobility. Caregivers also reported considerable emotional strain when witnessing suffering and progressive deterioration. Conclusions Meeting physiological needs in home-based palliative care is a continuous, demanding process that requires symptom recognition, ongoing monitoring, and practical caregiving skills. Nurses’ consultation and caregiver education remain essential to support safe and effective care at home, reduce symptom burden, and strengthen continuity of care. The substantial physical and emotional burden reported by family caregivers indicates the need for enhanced support and targeted education for families providing home palliative care.