<![CDATA[Background: End-of-life palliative care depends on interacting determinants that have not been examined within a single theoretical framework. Purpose: To identify and synthesize the determinants of end-of-life palliative care implementation and to interpret them using Social Cognitive Theory. Method: This systematic literature review (PRISMA 2020; PEO framework) searched PubMed, Scopus, Web of Science, CINAHL, and Google Scholar, supplemented by Cochrane CENTRAL and PROSPERO, on 12 July 2026 for English-language original research published from 2020. Study quality was appraised with JBI, CASP, or MMAT tools, and findings were synthesized narratively (SWiM). Results: Of 420 records, 17 studies (16 independent samples) were included. Knowledge was suboptimal (64.5%–75% correct). Core competence was the strongest predictor of practice in one multicenter study (β = 0.656), in-service training was associated with better practice (β = 0.26, p = .006), and 73%–82% of professionals in four studies lacked formal training. In one Dutch study, 44% of patients and 24% of families had not discussed stopping curative treatment. Confidence in the findings was low to moderate. Conclusion: Individual, educational, and communication determinants appear to interact within organizational and family contexts, but the evidence is small and largely cross-sectional; longitudinal and interventional studies are needed.]]>
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