en Nursing Original Article <div style="text-align: justify;"><span style="font-size:12px;"><span style="font-family:Times New Roman;"><b>Background:</b> Nurses are continuously present at the bedside and work closely with both children and families; therefore, their perspectives can provide a detailed understanding of end-of-life care. This study examined the quality of dying and death among hospitalized children from the perspective of Pediatric Intensive Care Unit (PICU) nurses and explored nurse-related factors associated with their evaluations.<br> <b>Methods:</b> In this cross-sectional study, 176 nurses working in the PICUs of four teaching hospitals (6 PICU wards) in Tehran, Iran, participated. Inclusion criteria were at least a bachelor&#39;s degree in nursing, at least 12 months of PICU experience, experience caring for terminally ill children, and no personal history of losing a child. A census sampling method was used. Data were collected by self-report using the PICU-QODD (Quality of dying and death) questionnaire. Independent t-tests, one-way ANOVA, Pearson correlations, and multiple linear regression were performed using SPSS version 24.<br> <b>Results:</b> The overall QODD score was 68.44 &plusmn; 15.6, suggesting a moderate to favorable perceived quality. The highest domain scores were observed for continuity and coordination of care (84.4 &plusmn; 18.1), fulfillment of the parental role (77.04 &plusmn; 21.9), emotional support for the family (76.91 &plusmn; 19.3), and pain and symptom management (76.81 &plusmn; 15.5), whereas the physical and instrumental needs of the family (49.1 &plusmn; 29.2) and spirituality and religious‑cultural issues (33.46 &plusmn; 24.1) had the lowest scores. In the multivariable analysis, only fixed work shift remained independently associated with higher QODD scores (B = 7.01, 95% CI (0.343,13.688)).<br> <b>Conclusion</b>: PICU nurses rated children&#39;s quality of dying and death as generally acceptable but identified shortcomings in spiritual and practical support for families. Promoting continuity of care and providing targeted education on holistic, family-centered end-of-life care may be beneficial.</span></span></div> Palliative care, Death, Nursing, Children 38 44 http://nmj.goums.ac.ir/browse.php?a_code=A-10-2464-1&slc_lang=en&sid=1 Nafise Ebrahimi Khozani nafisehjan1378@gmail.com 100319475328460017984 0009-0003-0980-4590 No Department of Pediatric and Neonatal Intensive Care Nursing, Iran University of Medical Sciences, Tehran, Iran Robert Truog robert_truog@hms.harvard.edu 100319475328460017985 100319475328460017985 No Medical School, Boston, Massachusetts, United States of America; Pediatric Intensive Care Unit, Boston Children’s Hospital, Boston, Massachusetts, United States of America Mahnaz Shoghi shoghimmahnaz@yahoo.com 100319475328460017986 100319475328460017986 Yes Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran