Challenges facing oncology nurses in Jordan: A qualitative study

What makes oncology nurses and registered nurses motivated to work in oncology specialty: a qualitative interview study

BACKGROUND

Oncology nursing in Saudi Arabia faces unique challenges, including a shortage of local nurses, cultural and linguistic barriers, and insufficient support systems. Understanding the factors that motivate, and challenge oncology nurses is crucial to addressing these issues and improving retention.

OBJECTIVES

This study aims to explore the motivations and challenges of oncology nurses and registered nurses in Saudi Arabia, focusing on both intrinsic and extrinsic factors influencing their work in the oncology specialty.

METHODS

A qualitative exploratory descriptive approach was employed, involving semi-structured interviews with 19 participants, including oncology registered nurses (ORNs) and registered nurses (RNs) from various specialties at King Saud University Medical City in Riyadh. The data were examined through thematic analysis to uncover patterns and insights related to the participants' experiences.

RESULTS

The study identified four primary themes: advantages of working in oncology, psychological difficulties, structural barriers, and workplace conditions affecting job satisfaction. Nurses reported a sense of achievement and personal fulfillment as key motivators. However, they also faced significant psychological challenges, including emotional exhaustion and inadequate psychological support. Structural barriers such as lack of specialized training and career pathways, as well as dissatisfaction with the salary scale, were major deterrents. Communication barriers and high workloads further reduced job satisfaction.

CONCLUSIONS

This study, the first of its kind in Saudi Arabia, highlights the complex interplay of factors influencing oncology nurses' experiences. Addressing these issues through targeted interventions, improved training programs, competitive salaries, and better psychological support can enhance job satisfaction and retention of oncology nurses in Saudi Arabia.

'I feel like the final missing piece of the puzzle': Examination of pediatric oncology nurses' experiences regarding healing care environment

PURPOSE

The purpose of this study is to explore pediatric oncology nurses' experiences related to the healing care environment in the pediatric hematology and oncology clinic, guided by Watson's Theory of Human Caring.

DESIGN AND METHOD

A descriptive qualitative design was used for the present study. Semi-structured interviews were conducted from December 2022 to February 2023. Data were collected through in-depth individual interviews with 16 nurses at a university hospital's pediatric hematology and oncology clinic. A content analysis was performed. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used to ensure transparent reporting.

RESULTS

The analysis identified three main themes, supported by 11 subthemes: 'contribution of healing care behaviors', 'advantages of being a pediatric oncology nurse', and 'barriers to creating a healing environment'.

CONCLUSION

Watson's Theory of Human Caring could provide a useful and practical framework for conceptualizing the experiences of pediatric oncology nurses in the context of a healing care environment. This study revealed that nurses recognize the contributions of healing care behaviors for both patients and their parents. They observed positive effects and received feedback when providing emotional support through their presence. Working in a pediatric oncology clinic provided professional and personal development opportunities. However, nurses encountered challenges in creating a healing care environment, including compassion fatigue, fear of compassion, communication problems, and high workloads.

PRACTICE IMPLICATIONS

This study revealed the beneficial effects of nurses' caring behaviors in the clinic, emphasizing the critical role these behaviors play in patient outcomes.

Impact of the Practice Environment on Oncology and Hematology Nurses: A Scoping Review

BACKGROUND

Practice environments have a significant impact on nurses' practice and their retention within the oncology and hematology specialty. Understanding how specific elements of the practice environment impact nurse outcomes is important for creating supportive and safe practice environments.

OBJECTIVE

To evaluate the impact of the practice environment on oncology and hematology nurses.

METHODS

A scoping review was conducted according to the PRISMA-ScR Statement Guidelines. Electronic databases (MEDLINE, CINAHL, PsychINFO, Google Scholar, and Scopus) were searched using key terms. Articles were assessed according to the eligibility criteria. Data extraction was conducted with results explained through descriptive analysis.

RESULTS

One thousand seventy-eight publications were screened with 32 publications meeting the inclusion criteria. The 6 elements of the practice environment (workload, leadership, collegial relations, participation, foundations, and resources) were found to significantly impact nurses' job satisfaction, psychological well-being, levels of burnout, and intention to leave. Negative practice environment elements were linked to increased levels of job dissatisfaction, higher levels of burnout, greater prevalence of psychological distress, and greater intention to leave both oncology and hematology nursing and the nursing profession.

CONCLUSIONS

The practice environment has a significant impact on nurses, their job satisfaction, well-being, and intention to stay. This review will inform future research and forthcoming practice change to provide oncology and hematology nurses with practice environments that are safe and lead to positive nurse outcomes.

IMPLICATIONS FOR PRACTICE

This review provides a foundation upon which to develop and implement tailored interventions that best support oncology and hematology nurses to remain in practice and provide high-quality care.

Mental Health in the Workplace from the Perspective of Oncology Nurses in Iran: A Qualitative Descriptive Study

Background

The workplace and the context in which oncology nurses work are unique due to the complex and dynamic nature of cancer care. Nurses who care for cancer patients are exposed to varying degrees of psychological pressure. The present study was conducted to explore oncology nurses' perceptions regarding mental health in the workplace.

Materials and Methods

This study was conducted in 2018-2019. The participants were recruited through purposive sampling from eight educational specialty cancer treatment centers in Iran. Data were collected through individual semistructured interviews and analyzed using the conventional qualitative content analysis method. The Consolidated criteria for Reporting Qualitative research (COREQ) checklist was used to document the report of the study.

Results

The extracted concepts were classified into three main categories and 17 subcategories. The main categories included attention to nurses' occupational stress-provoking factors, attention to emotional/psychological responses in the workplace, and healthy mental atmosphere in the workplace.

Conclusions

The findings indicate that oncology nurses need to be supported to enhance their mental health in the workplace. The findings of this study could help policymakers and nurse managers to understand the importance of improving the mental health of nurses in cancer care. In this regard, it is essential to make the necessary plans and scientific decisions to design and provide strategies to alleviate workplace problems and improve nurses' mental health.

Development and psychometric evaluation of a tool to assess oncology nurses' occupational health needs

BACKGROUND

Oncology nurses are confronted with various occupational hazards; consequently, it is of great importance to identify and measure their occupational health needs. Due to the fact that standard tools are not available to assess these needs, this study was conducted to develop a tool for assessing oncology nurses' occupational health needs.

MATERIALS AND METHODS

This study consisted of two phases from 2020 to 2021. The first phase was item generation and tool design. The initial development of the item pool was based on the result of the qualitative study and literature search. The second phase was item reduction and psychometric evaluation of the formulated tool including, face, content, and construct validity and reliability. Construct validity was assessed using exploratory factor analysis and convergent validity with the participation of 300 oncology nurses. The reliability of the tool was assessed using internal consistency (Cronbach's alpha) and test-retest (intra-cluster correlation coefficient).

RESULTS

The mean content validity index (CVI) of the tool was 0.95. The results of exploratory factor analysis showed that this tool consisted of 69 items and four factors, explaining 65.88% of the variance. The results of the convergent validity assessment showed a significant positive correlation between the mean scores of occupational health needs and occupational stress (P < 0.0001 and r = 0.40). Cronbach's alpha coefficient (0.98) and tool stability (0.98) confirmed the appropriate reliability of the tool.

CONCLUSION

The developed tool is recommended as a valid and reliable tool for assessing oncology nurses' occupational health needs that can be used both in practice and in future studies.

Factors Contributing to Grief Experience Among Oncology Nurses: A Qualitative Study

OBJECTIVES

Care provision to patients with cancer can cause varying levels of grief for oncology nurses. Grief in turn significantly affects nurses' personal and professional life. However, there is limited information about the contributing factors to grief experience among oncology nurses. The aim of this study was to explore the contributing factors to grief experience among oncology nurses.

DATA SOURCES

This qualitative study was conducted in Iran from May 2020 to October 2021. Participants were 18 oncology nurses purposively selected from several hospitals in Iran. Data were gathered via in-depth semistructured interviews and analyzed via the conventional content analysis method proposed by Graneheim and Lundman. Lincoln and Guba's criteria were used to ensure trustworthiness.

CONCLUSION

The four categories of the contributing factors to oncology nurses' grief experience were exposure to patients' painful death, depressing work atmosphere, knowing the heavy financial burden of cancer for patients, and patients' helplessness in the healthcare system. Oncology nurses experience deep grief due to a wide range of personal, professional, environmental, and sociocultural factors.

IMPLICATIONS FOR NURSING PRACTICE

The findings of this study can be used to better understand the contributing factors to grief experience among oncology nurses, determine their needs, and develop strategies to strongly support them.

Providing person-centered palliative care in conflict-affected populations in the Middle East: What matters to patients with advanced cancer and families including refugees?

Introduction

Universal health coverage highlights palliative care as an essential component of health services. However, it is unclear what constitutes person-centered care in populations affected by conflict, as they may have specific concerns in the dimensions of physical, emotional, social, and spiritual wellbeing. This study aimed to identify what matters to patients with advanced cancer and family caregivers in Jordan including refugees, to inform appropriate person-centered assessment and palliative care in conflict-affected populations.

Methods

Cross-sectional face-to-face, semi-structured interviews were conducted at two sites in Amman. Adult patients with advanced cancer and family caregivers were purposively sampled to maximize diversity and representation. Interviews were digitally audio recorded, anonymized, and transcribed verbatim for thematic analysis.

Findings

Four themes were generated from 50 patients (22 refugees; 28 Jordanians) and 20 caregivers (7 refugees; 13 Jordanians) (1). Information, communication, and decision-making. Truth-telling and full disclosure from clinicians was valued, and participants expressed concerns that information was not shared in case patients would disengage with treatment. (2) Priorities and concerns for care and support. Participants’ top priority remained cure and recovery (which was viewed as possible). Other priorities included returning to their “normal” life and their “own” country, and to continue contributing to their family. (3) Role of spirituality and Islam. Most participants had strong faith in God and felt that having faith could comfort them. For refugees whose social network was fractured due to being away from home country, prayer and Quran reading became particularly important. (4) Unmet support needs of family caregivers. Family caregivers were affected physically and emotionally by worrying about and caring for the patients. They needed support and training, but often could not access this.

Discussion

Truth-telling is highly valued and essential to achieving person-centered care and informed decision-making. This study also reveals specific concerns in conflict-affected populations, reflecting the experience of prior losses and fracturing of existing social networks and support. The role of religion is crucial in supporting refugee communities, and consideration should be paid to the needs of patients and caregivers when caring for a patient at home without access to their communities of origin and the support they accessed.

Global Oncology Nursing Recruitment and Retention: A SWOT Analysis

OBJECTIVES

This article documents the current status of global recruitment and retention of oncology nurses. A strengths, weaknesses, opportunities, and threats model was used to identify internal-to-nursing recruitment and retention factors/influences and external opportunities and threats as well as strategies and initiatives to improve the current situation.

DATA SOURCES

Data sources include published and grey literature from around the world.

CONCLUSION

Despite the increasing cancer burden threatening public health worldwide, recruitment and retention of oncology nurses remains challenging. Nursing strengths include action by oncology nursing associations, prelicensure nurse recruitment and preceptorships, and models of hospital shared governance. Nursing weaknesses include nurse bullying, practice models that curtail clinical nurses' autonomy, and hierarchical and inflexible nursing leadership. External to nursing are opportunities exemplified by international partnerships in oncology care and international oncology conferences for networking and learning. Examples of external threats are a lack of oncology nursing faculty, disrespectful media portrayal of nurses, community misconceptions about cancer curability, and hazards of cancer nursing.

IMPLICATIONS FOR NURSING PRACTICE

Governments and hospital authorities wishing to successfully address cancer control must strategically plan for the recruitment and retention of an adequate nursing workforce. Opportunities such as government recognition of oncology specialty training, shared governance, continuing specialized education, advanced practice nursing roles and career paths, and participation in national cancer control planning will increase and sustain a critical oncology nursing workforce.

Quality of work life and working conditions among oncology nurses: A national online descriptive cross-sectional study

The aim of this study was to examine the quality of work life (QoWL) and working conditions of oncology nurses in Turkey. The study utilized a descriptive cross-sectional design. The data were collected via the introductory information form and Brooks' Quality of Nursing Work Life Survey. The study was completed with 138 nurses. The factors affecting QoWL were determined using stepwise multiple linear regression. Nurses had a moderate QoWL, and age, duration of working in nursing, the number of nurses, and the working style were significantly associated with QoWL. To improve the QoWL, the nurses' socio-demographic factors should be considered and working conditions should be improved. Furthermore, well-designed institutional policies should be developed to improve the patient-nurse ratio and provide a quality healthcare.What this paper adds?In the current study, Turkish oncology nurses had a moderate quality of work life.Age, duration of working in the nursing, the number of nurses in the unit and the working style were linked to work-related quality of life in oncology nurses.Well-designed institutional policies should be developed to improve the working conditions and to increase work-related quality of life in oncology nurses.

Salivary cortisol concentrations in hematogy/oncology nurses on working days and days off

OBJECTIVE

to assess salivary cortisol concentrations in hematology/oncology nurses on working days and days off.

METHODS

a cross-sectional study carried out with 28 nurses from a university hospital. A sociodemographic, employment and health profile questionnaire was applied. For saliva collection, Salivette® tubes were used. Descriptive and analytical analysis was used.

RESULTS

there was no significant difference in cortisol concentrations between working days and days off (p>0.05). The high cortisol concentration was associated with not having children (0.621±0.340; p=0.046), not using medication (0.623±0.133; p=0.017) and birth control pills (0.556 ± 0.228; p=0.047) and intention to leave work (0.951±0.154; p=0.001). A positive correlation was identified between cortisol and absence from work due to health issues (0.72; p=0.05) and weight gain (0.935; p=0.02).

CONCLUSION

in general, cortisol concentration is within the reference parameters, with no significant difference in its secretion on working days and days off.

Occupational stressors in oncology nurses: A qualitative descriptive study

AIM AND OBJECTIVES

The present study aims at exploring oncology nurses' perceptions regarding work-related stressors.

BACKGROUND

Oncology nurses work in an environment with a high degree of stress, which can negatively affect their health. There is limited research on work-related stressors from the oncology nurses' perspective.

DESIGN

Qualitative descriptive study.

METHODS

Fifty-two oncology nurses were selected purposefully from eight cancer treatment centres in different cities of Iran. Data were collected through semi-structured interviews and analysed using conventional content analysis. The COREQ checklist was used to document the report of the study.

RESULTS

The extracted contents were classified into four main categories. The first category involved personal ability with two subcategories (person-job fit and psychological competencies). The second category included physical environment arrangements with two subcategories (physical working conditions and equipment and facilities). The third category involved psychosocial safety in the workplace with four subcategories (creating a safe work environment, overcoming the challenges of providing care to cancer patients, work/life balance and social recognition of the nursing status). The fourth category holds an organisational context with four subcategories (organisational support, interpersonal relations, justice at work and human resources).

CONCLUSION

It is necessary to find measures attenuating work-related stresses in oncology nurses. These measures should be in line with developing personal abilities in nurses and creating a safe environment in terms of optimising physical, psychosocial and organisational conditions. It is also important to develop programmes protecting the oncology nurses' occupational health.

RELEVANCE TO CLINICAL PRACTICE

The results of this study can help improve nursing work conditions, attenuate work-related stresses in nurses and introduce efficient interventions reducing occupational stressors.

Compounded trauma: A qualitative study of the challenges for refugees living with advanced cancer

BACKGROUND

Although palliative care is now an essential health service under Universal Health Coverage, ensuring access and appropriate care for refugees is a specific challenge for this large population.

AIM

To identify the needs and experiences of adult refugees in Jordan with advanced cancer and informal caregivers.

DESIGN

A qualitative study using semi-structured interviews.

SETTING/PARTICIPANTS

Participants were purposively sampled at two Jordanian hospitals to achieve heterogeneity by age, gender, country of origin, and primary diagnosis.

RESULTS

Twenty-nine refugees (22 patients, 7 caregivers) participated, and four themes were generated: (1) Psychological distress and sustaining social support. Refugees often experienced unmet psychosocial needs. However, psychosocial support was reported either absent or limited. (2) Knowledge and uncertainty. Lack of information and poor communication between healthcare providers and patients caused significant distress due to uncertainty. (3) Family anxiety and support roles. Being away from the home country cut patients and caregivers off from their wider social support network, which added increased anxiety and responsibilities to caregivers. (4) Compounded trauma and poverty. Many refugees have experienced trauma related to war that may affect their physical and mental health. They faced serious financial crises caused by the rising cost of medicines and treatment.

CONCLUSIONS

This study reveals the impact of fractured families and networks on social support in advanced cancer, and the compounding trauma of the disease for refugees. Detailed person-centred assessment and emphasis on psychosocial support is essential, and home-based care should not presume community support for patients to remain at home.

A qualitative study of Ghanaian pediatric oncology nurses' care practice challenges

BACKGROUND

Pediatric cancer is a global problem, and some studies have emphasized that nurses caring for these children experience work-related challenges. This has caused many children diagnosed with cancer to have a prolonged hospital stay and suffer unnecessary pain. However, there is insufficient documentary evidence on this issue. This study aims to explore and understand the challenges faced by pediatric oncology nurses in caring for children in Ghana.

METHODS

An exploratory qualitative research design study was conducted from August 2019 to April 2020. The study was conducted at the pediatric oncology unit which is located at the Tamale Teaching Hospital (TTH), Ghana. The study was conducted among 14 Ghanaian pediatric oncology nurses who were purposively sampled. A semi-structured interview guide was used to collect data. The interviews were recorded, transcribed verbatim, and analyzed inductively using Elo and Kyngas content analysis approach. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study.

RESULTS

From the analysis of participants transcripts, eight subcategories emerged from two major categories. The subcategories were; time-consuming care, low job motivations, inadequate logistics, work stress, reduced labour force, low knowledge level, lack of teamwork and the perception of contracting cancer.

CONCLUSIONS

The results point to several organizational and personal constraints experienced by the nurses who work at the pediatric oncology ward. It is hoped that by addressing these challenges, it would lead to further improvement in the care that is provided to children with cancer. There is the need for the administrative managers of hospitals, government and other stakeholders to invest in human, material and financial resources for delivering childhood cancer care services.

Striving to reduce suffering: A Phenomenological Study of nurses experience in caring for children with cancer in Ghana

Aim

To provide insights into nurses lived experiences in caring for children with cancer.

Background

Little is known about the paediatric oncology nurses shared practices of caring for children with cancer in Ghana.

Design

A hermeneutic phenomenological qualitative study.

Methods

A semi-structured interview with 14 purposely sampled Ghanaian paediatric oncology nurses. Findings were analysed using Diekelman, Allen and Tanner's approach.

Results

The theme "Striving to reduce suffering" and three relational subthemes: "knowing children's needs," "Rendering a hopeful fight" and "Ensuring continuity and coordination of care" emerged. Increased awareness of this phenomenon for the nurses who care for these children is vital to ensure quality and holistic care that is meaningful and satisfying by nurses for children with cancer. Paediatric oncology nurses can use the result of the study to evaluate their caring practice and as an avenue to develop better caring practice.

Meanings of the Feelings and Thoughts on Children's Hematology and Oncology Service Nurses' Experience: A Qualitative Study

AIM

This study aimed to analyze the feelings and thoughts related to working in the pediatric hematology-oncology unit of the nurses who have worked in this unit in the past, related and the meanings they attribute to it.

METHOD

In this qualitative study, 15 nurses between the age of 29 and 53 years, who had previously worked in the pediatric hematology-oncology unit and left the unit, were interviewed in depth. The interviews were held using a semi-structured interview form. Each interview lasted for 35 to 45 minutes.

RESULTS

In the study, 5 main themes and sub-themes related to these were identified from the perspective of the nurses with working experience in the pediatric hematology-oncology unit in the past with regard to their feelings and thoughts about this experience. These included 1) feelings: (a) fear and anxiety, (b) desperation, mercy, and guilt, (c) exhaustion, and (d) longing; 2) coping; 3) professional attributions; 4) meanings related to life; and 5) unmet requirements and suggestions.

CONCLUSION

Working in the pediatric hematology-oncology unit should be considered as a multi-dimensional condition that causes nurses to experience a wide variety of feelings and affects their perspectives on the profession and life. These findings can be used to strengthen the nurses working in hematology-oncology unit.