Exploring the Emotional Concerns of Oncology Nurses: A Qualitative Study

Mahdieh Poodineh Moghadam, Ahmad Nasiri, Gholamhossein Mahmoudirad


Background: Nursing care for patients with cancer is related to the nurses’ ability to manage their emotions and having appropriate behaviors in the clinical setting. Oncology nurses are emotionally influenced by their communication with cancer patients. Thus, this qualitative study was conducted to explore nurses’ emotional concerns in oncology wards.

Materials and Methods: This qualitative content analysis was performed among 14 oncology nurses in the oncology wards of cancer hospitals in the east and southeast of Iran (South Khorasan and Sistan and Baluchestan Provinces). The study participants were selected through purposeful sampling. Data were collected through face‑to‑face, semi‑structured interviews until data saturation was reached from January to September 2020. The interviews were analyzed after being typed word by word, based on Graneheim and Lundman (2004).

Results: The themes and subthemes that emerged from the data were related to the emotional concerns of oncology nurses. The main themes included emotional involvement and attachment (feeling of frustration in nurses, nurses’ suffering from painful experiences, and nurses’ emotional dependence), emotional ambiguity (nurses’ uncertainty emotions, avoidance of expressing real emotions, and having a positive mindset to maintain the patient’s positive mood), and emotional exhaustion (persistent chronic stress, excessive worrying about possible harms, and feelings of mental and physical exhaustion).

Conclusions: Based on the study results, cancer patient nursing care can be distressing and stressful for nurses. Oncology nurses have many emotional concerns in caring for cancer patients. The experiences of oncology nurses provide new insight into how to manage their emotional concerns.



Emotions, mental health, nurses, oncology nursing, qualitative research

Full Text:



Chuah PF, Lim M, Choo SL, Woo GY, To HK, Lau KY, et al. A qualitative study on oncology nurses’ experiences of providing palliative care in the acute care setting. Proc Singapore Healthcare 2017;17-25. doi:10.1177/2010105816660322.

Zamanzadeh V, Azimzadeh R, Rahmani A, Valizadeh L. Oncology patients’ and professional nurses’ perceptions of important nurse caring behaviors. BMC Nurs 2010;9. https://doi. org/10.1186/1472 6955 9 10.

Yang WF, Lee RZ, Kuparasundram S, Tan T, Chan YH, Griva K, et al. Cancer caregivers unmet needs and emotional states across cancer treatment phases. PLoS One 2021;16:e0255901. doi: 10.1371/journal.pone. 0255901.

Al Zoubi AM, Saifan AR, Alrimawi I, Aljabery MA. Challenges facing oncology nurses in Jordan: A qualitative study. Int J Health Plann Manage 2020;35:247 61.

Wazqar DY. Oncology nurses’ perceptions of work stress and its sources in a university teaching hospital: A qualitative study. Nursing open 2018;6:100 8.

Nwozichi CU, Guino O TA, Madu AM, Hormazábal Salgado R, Jimoh MA, Arungwa OT. The troubled nurse: A qualitative study of psychoemotional effects of cancer care on nurses in a Nigerian cancer care setting. Asia Pac J Oncol Nurs 2020;7:328 35.

Ortega Campos E, Vargas Román K, Velando Soriano A, Suleiman Martos N, Cañadas de la Fuente GA, Albendín García L, et al. Compassion fatigue, compassion satisfaction, and burnout in oncology nurses: A systematic review and meta analysis. Sustainability 2020;12:72. https://doi.org/10.3390/su12010072.

Wentzel D, Collins A, Brysiewicz P. Describing compassion fatigue from the perspective of oncology nurses in Durban, South Africa. Health SA 2019;24:1279. doi: 10.4102/hsag.v24i0.1279.

Heyhoe J, Birks Y, Harrison R, O’Hara JK, Cracknell A, Lawton R. The role of emotion in patient safety: Are we brave enough to scratch beneath the surface? J Royal Soc Med 2016;109:52 8.

Blackburn LM, Thompson K, Frankenfield R, Harding A, Lindsey A. The THRIVE© program: Building oncology nurse resilience through self care strategies. Oncol Nurs Forum 2020;1:47:E25 34.

Salyers MP, Bonfils KA, Luther L, Firmin RL, White DA, Adams EL, et al. The relationship between professional burnout and quality and safety in healthcare: A meta analysis. J Gen Intern Med 2017;32:475 82.

Alimohammadi N, Taleghani F, Mohammadi E, Akbarian R. Nursing in Islamic thought: Reflection on application nursing metaparadigm concept: A philosophical inquiry. Iran J Nurs Midwifery Res 2013;18:272 9.

Mojarad FA. Jouybari L. Sanagoo A. Rocky road ahead of nursing presence in the oncology care unit: A qualitative study. Open Access Maced J Med Sci 2018;6:2221 7.

Phillips CS, Volker DL. Riding the roller coaster: A qualitative study of oncology nurses’ emotional experience in caring for patients and their families. Cancer Nurs 2020;43:283 90.

Zamanzadeh V, Jasemi M, Valizadeh L, Keogh B, Taleghani F. Effective factors in providing holistic care: A qualitative study. Indian Palliat Care 2015;21:214 24.

Wentzel D, Brysiewicz P. Integrative review of facility interventions to manage compassion fatigue in oncology nurses. Oncol Nurs Forum 2017;44:124 40.

Permarupan PY, Al Mamun A, Samy NK, Saufi RA, Hayat N. Predicting nurses burnout through quality of work life and psychological empowerment: A study towards sustainable healthcare services in Malaysia. Sustainability 2020;12:388. doi: 10.3390/su12010388.

Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15:1277 88.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24:105 12.

Lincoln, YS. Guba, EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. N Dir Eval 1986;30:73 84.

Funes MM, Moraes MW, Cunha ML, Almeida FA. Caring for cancer patients facing death: Nurse’s perception and experience. Rev Bras Enferm 2020;73:e20190686. doi: 10.1590/0034 7167 2019 0686.

Pugh SD, Groth M, Hennig Thurau T. Willing and able to fake emotions: A closer examination of the link between emotional dissonance and employee well being. J Appl Psychol 2011;96:377 90.

Lovatt M, Nanton V, Roberts J, Ingleton C, Noble B, Pitt E, et al. The provision of emotional labour by health care assistants caring for dying cancer patients in the community: A qualitative study into the experiences of health care assistants and bereaved family carers. Int J Nurs Stud 2015;52:271 9.

Drach Zahavy A, Yagil D, Cohen I. Social model of emotional labour and client satisfaction: Exploring inter and intrapersonal characteristics of the client − provider encounter. Work Stress 2017;31:182 208.

Ko W, Kiser Larson N. Stress levels of nurses in oncology outpatient units. Clin J Oncol Nurs 2016;20:158 64.

Shi H, Shan B, Zheng J, Zhang Y, Zhang J, Hu X. Grief as a mediator of the relationship between empathy and compassion fatigue. Psychooncology 2022. doi: 10.1002/pon. 5875.

Kozlowski D, Hutchinson M, Hurley J, Rowley J, Sutherland J. The role of emotion in clinical decision making: An integrative literature review. BMC Med Educ 2017;17:255.

Fabi A, Pugliese P, Falbo PT, Corsi D, Fabbri MA, Vincenzi B, et al. The experience of oncology healthcare providers in the central Italy during the covid 19 lockdown. Cancers 2020;12:1 9. doi: 10.3390/cancers12103031.


  • There are currently no refbacks.