E-CARE as core competencies for palliative social workers: a systematic review

Abstract

Purpose: To identify the core competencies of social workers in palliative care.

Method: A systematic review of 19 high-quality studies published in English and Chinese up to February 2025 was conducted.

Results: The study identified five core competencies-Ethics, Coordination, Assessment, Resource Allocation, and Education-establishing the core competencies of social workers. They serve as interdisciplinary coordinators, communication facilitators, and educators, addressing psychosocial, emotional, and environmental challenges while navigating systemic resource constraints. The framework emphasizes ongoing assessment, resource allocation, and educational interventions, positioning social workers as system navigators and existential educators essential to compassionate, patient- and family-centered care.

Discussion: E-CARE framework equips social workers to navigate complex care ecosystems, foster team cohesion, mediate conflicts, advocate for patient autonomy, destigmatize end-of-life discussions, and promote resilience through ongoing training, particularly in resource-constrained settings.

Keywords: Core competencies; End-of-life care; Hospice; Palliative care; Social work.

Fig. 1

The PRISMA flowchart of data screening. 2. Duplicate records removed in each database are as follows: CNKI(n = 0), WanfangData(n = 25), VIP(n = 48), PubMed(n = 78), APA(n = 26), Scopus(n = 229), Embase(n = 151), Cochrane(n = 4), Web of Science(n = 469). Records removed for Ineligible types is as follows: book section(n = 241), book(n = 208), conference(n = 33), thesis(n = 217), newspaper(n = 1). Records excluded by manual reading of titles, abstracts, and keywords is as follows: non-social workers(n = 891), non-palliative care(n = 196), non-core competence(n = 334), non-coincidence type study(n = 132), non-social workers: The criteria for non-social workers refers to the research whose objects are not social workers, but nurses, residents, and nursing workers, and those in the fields of medicine, diagnostics, pharmacy, and oncology where the words “staff”, “staff”, and “group” include social workers but do not focus on social workers. Non-core competence: The criteria of non-core competence refers to the research whose content does not involve core competence defined by “competence”, “knowledge”, “skills” and “values”, “attitudes”, “ethics”, “functions” and “roles”, including policy advice and advocacy, needs assessment, feasibility, verification of the need for social workers, and population census. Non-palliative care: The criteria for non-palliative care refers to the research topic was not related to “hospice care” “palliative care” “end-of-life care”. Non-coincidence type study: The criteria for non-coincidence type study refers to the research types are literature review, book review and conference summary