Modifiable Protective Strategies and System-Level Predictors of Professional Quality of Life in Oncology Nurses: A...

Oncology nurses experience heightened risk for burnout and secondary traumatic stress (STS) due to sustained exposure to patient suffering, high mortality, and emotionally demanding care. These challenges are multifactorial, and limited research has examined modifiable protective factors or system-level predictors that support nurses' well-being.

To identify relationships among emotional well-being, protective strategies, and professional quality of life, and to examine modifiable predictors of burnout, STS, and compassion satisfaction in oncology nurses.

This secondary analysis drew from baseline quantitative and qualitative data collected in two feasibility studies of the Storytelling Through Music intervention for oncology nurses recruited from U.S. inpatient and outpatient cancer centers (2018-2023). Quantitative measures included anxiety, depression, self-compassion, self-reflection and insight, and professional quality of life (burnout, STS, compassion satisfaction). Data were analyzed using descriptive statistics, correlations, and multiple regression. Qualitative data were analyzed using a descriptive approach to contextualize quantitative findings.

Among 67 oncology nurses (M age = 40 years, 96% female, 91% White), burnout correlated positively with anxiety and depression, and negatively with self-compassion, insight, and compassion satisfaction (all p's < .001). Regression analyses showed burnout was predicted by lower self-compassion (p = .006), lower insight (p = .012), and greater perceived workplace support (p = .040; R² = 0.42). Self-compassion predicted higher compassion satisfaction (p = .012). Qualitative findings contextualized these results, revealing limited workplace support and superficial self-care education as systemic barriers to oncology nurses' well-being.

Healthcare organizations and nursing schools must move beyond passive approaches to emotional support by embedding structured, skills-based interventions into practice and education. In clinical settings, this includes routine grief debriefings, accessible counseling, and psychologically safe spaces for peer and counseling support. Nursing curricula should embed experiential training in emotion regulation and self-compassion to prepare clinicians to manage grief, sustain empathy, and prevent burnout.