Oncology nurses often experience stress in their line of work, but the COVID-19 pandemic has heightened this due to overwork, compassion fatigue, personal stressors, or moral distress.
When providing care for cancer patients, oncology nurses have a heightened exposure to ethical challenges and patient deaths, oftentimes leading to psychological distress in their field of work. During the COVID-19 pandemic, these nurses have been prone to greater psychological distress.
Many patients delayed treatment or cancer screenings due to pandemic-related restrictions, so that they arrived sicker on their return to hospitals, thereby causing a higher workload for nurses. Add to this, personal stressors such as a nurse’s family member contracting COVID-19, along with ethical dilemmas relating to patient care, which can result in moral distress.
All these factors have resulted in many nurses experiencing depression or post-traumatic stress disorder (PTSD), necessitating mental health and wellness interventions to improve work-related quality of life (WRQOL) in nurses.
A study published in the Clinical Journal of Oncology Nursing examined the relationship between psychological distress and WRQOL among oncology nurses in during the COVID-19 pandemic. Overall, 63 nurses from several hospital units at a Boston medical center participated in the study survey that measured their mental health symptoms. Their depression, anxiety and stress levels were measured using a 21-item Depression, Anxiety, and Stress Scale (DASS). The nurses’ PTSD symptoms were also measured, using the 21-item Impact of Events Scale-Revised, as well as the 23-item WRQOL scale.
The study reported a DASS score of 33.4 out of 104, indicating low levels of depression, as well as mild anxiety and stress. The overall PTSD score was 29.3 out of 69. However, WRQOL was negatively correlated to PTSD, along with depression, anxiety, and stress. Nurses described their WRQOL as “average,” and their responses suggested partial PTSD.
A strong interaction effect was also found between depression, anxiety, stress, and PTSD. Independent of PTSD, psychological distress was a strong predictor of WRQOL, showing that these two factors correlate with the WRQOL of nurses and should be the focus of future interventions.
The study had several limitations: the distress levels of oncology nurses were self-reported, which may lead to bias or misreporting. A range of personal factors, as well as professional quality of life may also influence stress and low WRQOL among oncology nurses. The study was conducted in between surges during the COVID-19 pandemic, which may have led to lower reported psychological distress.
The study’s researchers noted that nurses who have completed palliative care training are “more likely to have greater self-confidence and knowledge” compared to nurses without training. Nurses who maintain resiliency during stressful situations are also less likely to experience low WRQOL. Early identification of stress and maladaptive coping mechanisms can help increase resilience among oncology nurses for the future.
Psychological Distress and Work-Related Quality of Life Among Oncology Nurses During the COVID-19 Pandemic: A Cross-Sectional Study
Impact of the COVID-19 Pandemic on Oncologist Burnout, Emotional Well-Being, and Moral Distress: Considerations for the Cancer Organization’s Response for Readiness, Mitigation, and Resilience