Chinese Oncology Nurses Research Articles

“Why wouldn't we want to do this?” The challenge for oncology hospital nurses to engage in serious illness conversation and advance care planning

BackgroundThe viability of advance care planning (ACP) in cultures where discussing future desires is taboo is unclear, it is essential to examine the challenges faced by Chinese nurses lacking legal protection for ACP. AimsTo comprehend Chinese oncology nurses' perceptions of serious illness conversation and ACP, and identify barriers to engagement. MethodsA qualitative descriptive exploratory study involving semi-structured interviews with 13 experienced oncology nurses, analyzed using thematic analysis and critical incident technique, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. FindingsFour themes emerged: Inadequate Competence Causes Patient Harm, Cultural Influences to Patient Autonomy, Psychological Tolerance Neglects Best Interests, and Systemic and Legal Uncertainties Impact Patient Rights. ConclusionPolicy changes supporting nurses in ACP implementation, a 'whole-system strategic approach' involving legislative changes, organizational support, and public awareness are crucial for optimizing ACP and meeting diverse patient needs.

Behaviors and influencing factors of Chinese oncology nurses towards hospice care: a cross-sectional study based on social cognitive theory in 2022

BackgroundAlthough there is growing demand for hospice care in China due to its aging population and increasing cancer rates, the sector remains slow to expand. Oncology nurses are the primary providers of hospice care, but little is known about their behaviors towards hospice care and related factors.MethodsThis cross-sectional study conveniently sampled 933 oncology nurses from six grade A tertiary hospitals in Hubei Province between January to March 2022. The questionnaire was composed of seven parts: general information (including sociodemographic and work-related information), hospice care behaviors, hospice care knowledge, hospice care attitudes, hospice care self-efficacy, hospice care outcome expectancy, and hospice care environment. Data were analyzed using descriptive analysis, independent sample t-tests, one-way ANOVA, Pearson’s correlation, multiple linear regression, random forest regression, and BP neural network model analysis.ResultsA total of 852 questionnaires were valid. The mean score of hospice care behaviors was 50.47 ± 10.56, with a mean item score of 3.61 ± 0.75. The three highest scoring behaviors were “pain assessment of patients (4.21 ± 0.91)”, “satisfying the physical and mental needs of dying patients (4.04 ± 0.92)”, and “creating good relationships between the medical staff and family members (4.02 ± 0.87)”. The two lowest-scoring behaviors were “proactively recommending medical institutions for hospice care to terminally ill patients and their families (2.55 ± 1.10)” and “proactively talking to patients and families about death-related topics for patients who are critically ill and cannot be reversed (2.87 ± 1.03).” Multiple linear regression, random forest regression, and BP neural network models all showed that the frequency of sharing hospice care experiences with colleagues, hospice care attitudes, hospice care self-efficacy, and hospice care environments were positively associated with hospice care behaviors.ConclusionsThe frequency of hospice care behaviors among Chinese oncology nurses is generally at a moderate to high level. The results provide a basis for promoting hospice care behaviors among oncology nurses in order to improve the quality of life for terminally ill cancer patients.

Factors Influencing Coping with Death Competence Among Chinese Oncology Nurses: A National Cross-Sectional Study.

To identify the factors affecting Chinese oncology nurses' competency in coping with death, and their relationship with death attitudes and educational needs. A national cross-sectional descriptive study was conducted using an online survey of Chinese oncology nurses. Data were collected using the Coping with Death, Death Attitude Profile-Revised, and Death Education Needs Scales. A Pearson's correlation analysis was used to examine the relationships among the research variables. A multiple linear regression analysis was used to analyze the factors influencing coping with death. The total score of coping with death was 133.57±26.78, showing a moderate coping level among Chinese oncology nurses. The Pearson's correlation analysis showed that death attitude was significantly and positively correlated with coping with death competence, and there was a statistically significant positive relationship between coping with death competence and death education needs. Years of oncology care experience, bereavement experience, death attitude, and death education needs were identified as statistically significant factors influencing competency in coping with death. These factors explained 30.6% of the differences in coping with death. This study found that oncology nurses in China exhibited moderate levels of death coping competence, which needs to be improved to provide higher-quality end-of-life care. Further, death attitude and education needs were important factors affecting participants' coping with death competence. Tailored death education programs and continuing education on death should be provided for oncology nurses, to encourage them to actively participate in death competence-related training and promote an attitude of natural acceptance of death and positive care for terminally ill patients. In the future, virtual reality technology could complete course implementation designs with immersive, conceptual, and interactive characteristics, to enhance the death-coping education program. Nurses with less experience in oncology care and bereavement should improve their competency in coping with death.

Exploring the variations in death anxiety among oncology nurses in China: a latent class analysis

BackgroundVarious factors have been found to be associated with high levels of death anxiety experienced by oncology nurses. The aim of this study was to use a person-oriented approach to examine the death anxiety patterns of Chinese oncology nurses and to analyze the differences in anxiety characteristics and their associated influencing factors.MethodsA cross-sectional survey regarding palliative care among registered oncology nurses was conducted in Jiangsu Province, China.Latent class analyses was applied to identify their patterns of death anxiety. The score of PCQN-C (The Chinese version of the Palliative Care Quiz for Nursing) and FATCOD-B-C (The Chinese version of the Frommelt Attitude Toward Care of the Dying scale), the demographic and working characteristics were further analyzed through covariance analysis (ANCOVA) and multivariate (or logistic) regression across the subgroups.ResultsA two-potential-category model was selected based on the fit index. The results showed that 79% of oncology nurses belonged to the high pressure and pain group and 21% belonged to the low death anxiety group. The high pressure and pain group had significantly higher scores in the dimensions of emotion, stress and pain, time awareness, and cognition compared to the low death anxiety group. Factors influencing the high pressure and pain group included shorter working years, non-national or provincial oncology nursing specialists, non-national palliative care specialists, never discussing the topic of death with patients or family members, no palliative care related training, and PCQN and FATCOD scores.ConclusionsOur study suggests that oncology nurses’ death anxiety can be divided into two categories: low death anxiety and high stress pain, and certain factors, such as being female, having a short work experience, and lacking palliative care-related training, increase the likelihood of death anxiety.

A cross-sectional study on Chinese oncology nurses’ knowledge of bone health among cancer patients

ObjectiveTo understand the knowledge status, obstacle factors, and management confidence of oncology nurses on the bone health of cancer patients, and in addition to provide reference for establishing bone health knowledge training system for oncology nurses and guiding them to manage bone health of cancer patients.MethodsA total of 602 nurses engaged in oncology nursing in 6 hospitals in Hebei Province were selected by cluster sampling, and an online anonymous survey was conducted by sending questionnaires to oncology nurses from the Hebei Cancer Prevention and Control Association. The questionnaire was developed by the study team. There are 4 parts, namely general information, nurses’ role and job responsibilities, knowledge of skeletal-related events (SREs) and cancer treatment–induced bone loss (CTIBL), and understanding and confidence in bone health management, for a total of 33 questions.ResultsThirty-seven percent of oncology nurses received training on bone health and other related contents; 40.48% of oncology nurses used domestic and foreign guidelines when managing patients with bone metastases or CTIBL. Only approximately one-third of oncology nurses had confidence in managing the side effects of bone metastases and bone modification drugs and identifying patients at risk of CTIBL and fracture; only 33.04% of oncology nurses believed that weight-bearing exercise can prevent bone loss; less than 50% of oncology nurses believed that aromatase inhibitor therapy, ovarian suppression therapy, androgen deprivation therapy, and low body weight were risk factors for pathological fractures. The reasons that hindered oncology nurses from optimizing the management of patients with bone metastases and understanding the preventive measures and risk factors for bone loss mainly included lack of relevant knowledge training, lack of understanding of effective intervention measures, and lack of training and professionalism of specialized nurses, including insufficient development time and guidelines for clinical nursing practice.ConclusionManagers must continuously improve the training system of oncology nurses, enrich the content of training pertaining to bone health for cancer patients, formulate clinical nursing practice guidelines, and give oncology nurses more time for professional development.

Knowledge and Practice Behaviors Toward the Care of the Dying Among Chinese Oncology Nurses: A Cross-Sectional Survey.

The quality of care provided to patients with cancer at the end of their lives remains unsatisfactory, especially during their last days and hours of life. This study aimed to investigate knowledge and practice behaviors of oncology nurses in relation to the care of the dying and to analyze the influencing factors. A convenience sample of 222 oncology nurses was recruited from 14 hospitals in Beijing, China, in January 2022. These nurses completed an online survey that included a demographic and work characteristics questionnaire and knowledge and practice behavior questionnaires regarding the care needs of dying cancer patients. The self-perceived knowledge and practice behavior of oncology nurses toward the care of the dying were found to be moderate. However, their understanding of airway management, restlessness, and delirium management was insufficient. In addition, their ability to effectively communicate recommendations for discontinuing unnecessary procedures, medications, treatments, and monitoring was inadequate. Nurses' previous end-of-life care education and experience of caring for dying patients influenced their knowledge. Nurses' practice settings, experience of caring for dying patients, and their knowledge were key factors in shaping their behaviors. Providing targeted continuing education for nurses in hospital settings and exploring the nursing pathway may be important ways to bridge their knowledge gap and enhance their practice behaviors toward caring for dying patients.

Relationships between depression, self-efficacy, and professional values among Chinese oncology nurses: a multicenter cross-sectional study

ObjectivesMany factors are related to oncology nurses’ professional values. However, the evidence on the relevance of professional values among oncology nurses in China remains sparse. This study aims to investigate the relationship between depression, self-efficacy, and professional values among Chinese oncology nurses and analyze the mediating effect of self-efficacy on this association.MethodsIt was a multicenter cross-sectional study designed with the STROBE guidelines. An anonymous online questionnaire recruited 2530 oncology nurses from 55 hospitals in six provinces of China between March and June 2021. Measures included self-designed sociodemographic and fully validated instruments. Pearson correlation analysis was employed to explore the associations between depression, self-efficacy, and professional values. Bootstrapping analysis by the PROCESS macro was used to examine the mediating effect of self-efficacy.ResultsThe total scores of depression, self-efficacy, and professional values of Chinese oncology nurses were 52.75 ± 12.62, 28.39 ± 6.33, and 101.55 ± 20.43, respectively. About 55.2% of Chinese oncology nurses were depressed. Chinese oncology nurses’ professional values were generally intermediate. Their professional values were negatively related to depression and positively correlated with self-efficacy, while depression was negatively related to self-efficacy. Moreover, self-efficacy partially mediated the relationship between depression and professional values, accounting for 24.8% of the total effect.ConclusionsDepression negatively predicts self-efficacy and professional values, and self-efficacy positively predicts professional values. Meanwhile, depression in Chinese oncology nurses has an indirect effect on their professional values through self-efficacy. Nursing managers and oncology nurses themselves should develop strategies aimed at relieving depression and improving self-efficacy to strengthen their positive professional values.

Oncology nurses' and oncologists' experience of addressing sexual health concerns in breast cancer patients: A qualitative study.

This study aimed to explore the experiences of Chinese oncology nurses and oncologists who provide sexual health education for breast cancer patients in their practical work. This was a qualitative study using semistructured face-to-face interviews. Eleven nurses and eight oncologists who provided sexual health education to breast cancer patients were purposively recruited from eight hospitals in seven provinces of China. Data were analyzed using the thematic analysis method. Four main themes emerged: the surface of sexual health, stress and benefit finding, cultural sensitivity and communication, needs and changes. Both oncology nurses and oncologists found it difficult to solve sexual health problems, which were beyond their responsibilities and competencies. They felt helpless about the limitations of external support. Nurses hoped oncologists could participate in more sexual health education. Oncology nurses and oncologists experienced great challenges in educating breast cancer patients about sexual health. They are eager to obtain more formal education and learning resources for sexual health education. Specific training to improve the sexual health education competence of healthcare professionals is needed. Furthermore, more support is needed to create conditions to encourage patients to reveal their sexual challenges. It is necessary for oncology nurses and oncologists to communicate on sexual health in breast cancer patients, and to promote interdisciplinary communication and share responsibility.

Grief as a mediator of the relationship between empathy and compassion fatigue.

Oncology nurses are at high risk of developing compassion fatigue (CF) because of the persistent exposure to patients' suffering and death. Empathy is a prerequisite cognitive reaction for CF. Nurses with greater empathy levels are more prone to develop an emotional connection with patients. However, it is this kind of close bonds that led nurses to experience a deep sense of grief. Cumulative grief may eventually develop into CF. This study examined the levels of grief, empathy and CF, evaluated the correlation among empathy, grief and CF, and verified the role grief as a mediator of the relationship between empathy and CF. Participants were 794 Chinese oncology nurses in a cross-sectional study. We measures consisted a demographic questionnaire, the Interpersonal Reactivity Index, the Texas Revised Inventory of Grief-Present, and the Professional Quality of Life Scale. Oncology nurses showed moderate levels of empathy and grief, moderate to high levels of CF. Perspective taking was negatively related to grief and secondary traumatic stress (STS). Empathic concern was negatively related to burnout (BO). Personal distress was positively related to grief, STS and BO. Grief was positively related to STS and BO. Grief played a partial mediating role between empathy and STS. Oncology nurses commonly experience CF. There is a need to provide interventions and effective supports for oncology nurses to improve their empathy ability, and help them cope with grief and CF.

Factors Associated with Behaviors Toward End-of-life Care Among Chinese Oncology Nurses: A Cross-Sectional Study

The goal of this study was to describe the current status of oncology nurses' behaviors toward end of life (EOL) care in China and to explore the factors associated with oncology nurses' behaviors toward EOL care. A cross-sectional design was applied and a convenience sample of 1038 oncology nurses from 22 grade A hospitals were recruited into this study. A general social demographic data questionnaire was administered, and the Chinese version of Nurses' Behaviors of Caring for Dying Patients Scale was used to assess nurse behavior toward EOL care. The total score ranges from 40 to 200 points. Data were analyzed with SPSS 26.0 software. Chinese oncology nurses' average score of holistic EOL care behaviors was 2.97±0.59. Oncology nurses provide physical care most (3.81±0.76), followed by family care (3.02±0.86), and spiritual care (2.37±0.67). Multiple regression analysis showed that a higher frequency of sharing EOL care experience with colleagues, in-service palliative care education, higher level of head nurse support for EOL patient care, more cases of EOL care, higher working position, and nurse's perceived high level of support were positively associated with behavior toward EOL care. These six factors explained 16.2% of the total variance. The results may help provide a basis for converting behavior for EOL care among oncology nurses and design interventions to better improve quality of life for EOL patients with cancer in China.

Association between attitude towards death and spiritual care competence of Chinese oncology nurses: a cross-sectional study

BackgroundsAn understanding of the oncology nurse spiritual care competence would help nurse managers recognize weakness in spiritual practice and improve the quality of spiritual care. But the relationship between attitude towards death and spiritual care competence is unknown.MethodsWe recruited 326 nurses from hospitals in Guangzhou, China. The nurses completed the Chinese Spiritual Care Competence Scale and the Chinese Death Attitude Profile-Revised questionnaires.ResultsThe total score of spiritual care competence was 61.62 ± 16.10. And the lowest score of attitude towards death was for escape acceptance, 2.64 ± 0.82. Factors associated with nurse spiritual care competence were work department, whether trained in spiritual care, approaching acceptance, and escaping acceptance of attitude towards death.ConclusionNurses need to perfect their spiritual care competence and establish positive attitudes towards death.

Knowledge and attitudes regarding cancer pain management among oncology nurses in China.

ObjectiveThere are limited studies examining knowledge and attitudes among Chinese oncology nurses regarding cancer pain management.MethodsWe conducted a cross-sectional survey among oncology nurses from 26 hospitals in China. The nurses completed the Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire. Multivariate models were used to identify factors associated with nurses’ KASRP score.ResultsA total of 982 nurses completed the KASRP (mean score = 21.56 ± 4.00), and 8 (0.81%) nurses had a passing score. The results of multivariate regression indicated that clinical rank and experience in cancer pain management were associated with good knowledge and attitudes regarding cancer pain management.ConclusionThe Chinese nurses in our study did not have adequate knowledge of or positive attitudes related to cancer pain management. Clinical rank and experience caring for patients with cancer could be used to help identify nurses with inadequate knowledge and attitudes regarding treating cancer pain.

Knowledge and Attitudes of Chinese Oncology Nurses Regarding Cancer Pain Management-a Cross-Sectional Study.

To measure the knowledge and attitudes of Chinese oncology nurses regarding cancer pain management and explore related factors. A cross-sectional survey was conducted. A convenience sample of 505 Chinese oncology nurses from 20 provinces, 4 municipalities, and 4 autonomous regions was recruited between April and October 2018. A Chinese version of the Knowledge and Attitudes Survey Regarding Pain (KASRP) was used. Socio-demographic characteristics were also measured by a multi-item questionnaire. The mean accuracy of KASRP in all participants was 56.11% ± 11.05%. According to univariate analysis, oncology nurses' cancer pain knowledge and attitudes were positively correlated with age, region, education level, years of oncology nursing, clinical practice of cancer pain management, average monthly number of patients with cancer pain, and the experience of cancer pain-related training. The results of multiple linear regression revealed that nurses' age, education level, experience of cancer pain-related training and clinical practice of cancer pain management were independent influencing factors (all p < 0.05). Most Chinese oncology nurses had misconceptions about cancer pain management and lacked relevant knowledge. We should assign importance to targeted cancer pain training and develop training methods that closely relate to clinical practices.

Assessing oncology nurses’ attitudes towards death and the prevalence of burnout: A cross-sectional study

Burnout in nursing is a global phenomenon. Caring for dying patients could increase nurses' death anxiety. However, minimal information about oncology nurses' burnout and attitudes towards death in Chinese culture has been reported. This study aims to assess Chinese oncology nurses' burnout, and its relationship with attitudes towards death. A cross-sectional design was used. A total of 279 oncology nurses from a cancer hospital in northern China were recruited using convenience sampling, and completed a survey containing a demographic form, the Death Attitudes Profile Scale and the Maslach Burnout Inventory. Descriptive statistics, independent t-test and one-way ANOVA, Pearson correlation analysis and multiple regression analysis were conducted to analyze data. An average of 73.1%-86.9% of oncology nurses reported moderate to high levels of burnout. Specifically, 48.7%, 45.4% and 65.1% of oncology nurses reported high levels of emotional exhaustion, depersonalization and personal accomplishment, respectively. Multiple regression analysis showed that fear of death, escape acceptance, younger age and participation of death education/training were significantly associated with emotional exhaustion (p < 0.01), accounting for 22.0% of the variance; fear of death, escape acceptance, and neutral acceptance in total explained 17.8% of depersonalization; fear of death, escape acceptance and neutral acceptance accounted for 8.5% of personal accomplishment. Oncology nurses with more positive attitudes towards death experience less burnout. Death education and death related training including discussion of personal attitudes towards death should be part of nursing education programs, which would in turn prevent oncology nurses from burnout.

Palliative Care Nursing Competence of Chinese Oncology Nurses and Its Related Factors

In China, the development of palliative care is challenging because of limited available resources and rapidly increasing demands. The nurses' competence is a significant element in providing high-quality palliative care. This cross-sectional study aimed to describe the palliative care competence among oncology nurses and to examine the relationships between it and palliative care knowledge, attitudes, and workplace learning conditions. A total of 220 nurses with more than 6 months of experience and who worked in inpatient wards were invited to participate in this study. Four questionnaires were administered to collect data-the Palliative Care Quiz for Nurses, the Attitudes Toward Palliative Care Scale, the Workplace Learning Conditions scale, and the Palliative Care Nursing Self-competence Scale. The data were analyzed using descriptive statistics and Pearson correlations. The moderate level of competence was reported by 212 participants (response rate, 96.36%). The scores were lower in the aspects of competence such as spiritual care and ethical and legal issues. Competence was positively related to workplace learning conditions and knowledge but not attitudes. The results highlighted the necessity of improving the palliative care competence among oncology nurses. The optimization of learning conditions in the hospital is recommended to be a vital force in strengthening competence.

Influence of oncology nurses' empathy on lung cancer patients' cellular immunity.

BackgroundMedical staff’s empathy is closely related to patients’ outcome. This research aimed to verify the influence of Chinese oncology nurses’ empathy on the cellular immunity of lung cancer patients.Materials and methodsThe study included 365 lung cancer patients, who were attended by 30 oncology nurses between October 2016 and May 2017. At the time of admission and discharge, flow cytometric analysis was used to measure the cellular immunity of patients, including T-cell subsets and natural killer (NK)-cell activity. The level of empathy of the oncology nurses was measured by the Jefferson Scale of Empathy (JSE, Chinese version). The nurses were divided into high, moderate, and low empathy groups based on JSE scores. Associations between the empathy shown by nurses and the cellular immunity of patients were examined.ResultsOn admission, there was no statistical difference in the cellular immunity of the patients taken care of by the three groups of nurses (P>0.05). At discharge, patients whose nurses were in the high empathy group reported significantly higher B-cell and NK-cell percentages than those whose nurses were in the low empathy group (P<0.001). There was a positive correlation between nurse empathy and percentage of B cells (P=0.003) and NK cells (P<0.001), but no correlation was found between empathy and percentage of CD3+, CD4+, and CD8+ cells. Multiple linear regression analyses indicated that nurse empathy significantly contributed to patient percentage of B cells and NK cells after controlling for patient demographics, disease conditions, and lifestyle.ConclusionThe effect of oncology nurses’ empathy on cellular immunity was confirmed in lung cancer patients, suggesting empathy education, such as narrative medicine education, should be strengthened to improve patient outcome.

Psychological flexibility of nurses in a cancer hospital: Preliminary validation of a chinese version of the work-related acceptance and action questionnaire

Objective:To translate the English work-related acceptance and action questionnaire (WAAQ), make cross-cultural adaptations, and examine its psychometric properties when used by Chinese oncology nurses.Methods:After translation, the psychometric properties of the Chinese WAAQ were analyzed among 417 nurses, and content validity was determined by six experts.Results:Item-level content validity index (CVI) values were between 0.83 and 1.00; scale-level CVI/universal agreement (S-CVI/UA) and S-CVI/average were 0.86 and 0.98, respectively, which implicated a good content validity. The correlation of the Chinese WAAQ with AAQ-II (rs = −0.247, P < 0.001) suggested criterion validity, and those with General Health Questionnaire-12 (−0.250, <0.001) and general self-efficacy scale (0.491, <0.001) and Utrecht work engagement scale (UWES) (0.439, <0.001) suggested convergent validity. Exploratory factor analysis identified a seven-item, one-factor structure of WAAQ. The Chinese version of WAAQ had high internal consistency (Cronbach's α = 0.920), with an item-total correlation coefficient of 0.702–0.828 (P < 0.05), split-half reliability of 0.933, and test-retest reliability of 0.772.Conclusions:The Chinese WAAQ is a reliable and valid tool for assessing psychological flexibility in Chinese oncology nurses.

F11-B Factors Associated with Burnout Among Chinese Oncology Nurses

F11-B Factors Associated with Burnout Among Chinese Oncology Nurses

Prevalence and predictors of compassion fatigue, burnout and compassion satisfaction among oncology nurses: A cross-sectional survey

BackgroundCancer is a leading cause of death worldwide. Given the complexity of caring work, recent studies have focused on the professional quality of life of oncology nurses. China, the world's largest developing country, faces heavy burdens of care for cancer patients. Chinese oncology nurses may be encountering the negative side of their professional life. However, studies in this field are scarce, and little is known about the prevalence and predictors of oncology nurses’ professional quality of life. ObjectivesTo describe and explore the prevalence of predictors of professional quality of life (compassion fatigue, burnout and compassion satisfaction) among Chinese oncology nurses under the guidance of two theoretical models. DesignA cross-sectional design with a survey. SettingsTen tertiary hospitals and five secondary hospitals in Shanghai, China. ParticipantsA convenience and cluster sample of 669 oncology nurses was used. All of the nurses worked in oncology departments and had over 1 year of oncology nursing experience. Of the selected nurses, 650 returned valid questionnaires that were used for statistical analyses. MethodsThe participants completed the demographic and work-related questionnaire, the Chinese version of the Professional Quality of Life Scale for Nurses, the Chinese version of the Jefferson Scales of Empathy, the Simplified Coping Style Questionnaire, the Perceived Social Support Scale, and the Chinese Big Five Personality Inventory brief version. Descriptive statistics, t-tests, one-way analysis of variance, simple and multiple linear regressions were used to determine the predictors of the main research variables. ResultsHigher compassion fatigue and burnout were found among oncology nurses who had more years of nursing experience, worked in secondary hospitals and adopted passive coping styles. Cognitive empathy, training and support from organizations were identified as significant protectors, and ‘perspective taking’ was the strongest predictor of compassion satisfaction, explaining 23.0% of the variance. Personality traits of openness and conscientiousness were positively associated with compassion satisfaction, while neuroticism was a negative predictor, accounting for 24.2% and 19.8% of the variance in compassion fatigue and burnout, respectively. ConclusionsOncology care has unique features, and oncology nurses may suffer from more work-related stressors compared with other types of nurses. Various predictors can influence the professional quality of life, and some of these should be considered in the Chinese nursing context. The results may provide clues to help nurse administrators identify oncology nurses’ vulnerability to compassion fatigue and burnout and develop comprehensive strategies to improve their professional quality of life.

Nurses’ blame attributions towards different types of cancer: A cross-sectional study

BackgroundPublic health education increasingly emphasizes the link of personal lifestyle with cancer risk, which may result in unintended negative social effects such as triggering stigma and/or blame towards cancer patients when their illness is perceived to be caused by personal behaviours or disapproved lifestyles. ObjectivesTo explore nurses’ blame attributions towards patients with different types of cancer and to identify associated factors. DesignCross-sectional survey. SettingA tertiary cancer-specialized hospital in Beijing. Participants317 Chinese oncology nurses working in the cancer hospital. MethodsParticipant nurses completed a self-administrated anonymous questionnaire and rated how much they would blame someone with a diagnosis of breast cancer, cervical cancer, colon cancer, liver cancer, lung cancer, as well as leukaemia and obesity. ResultsMore than half of the oncology nurses (57.1%) attributed at least some blame to patients with leukaemia, following with breast cancer (67.5%), cervical cancer (79.2%), liver cancer (79.2%), and colon cancer (78.5%). Lung cancer patients attracted at least some blame by 82.0% of participating nurses. Attributions of blame for patients with lung, cervical, colon and liver cancer were most common among nurses with shorter working experience. ConclusionsThis study demonstrated that a high proportion of Chinese nurses attributed at least some blame to patients with different cancers despite being working in a cancer-specialized hospital. Future education and support for nurses are essential to avoid negative attitudes and blame attributions to cancer patients in order to enhance the quality of care.