Predictors of Secondary Traumatic Stress among Oncology Nurses in Palestine

The work environment of oncology nurses exposes them to patient suffering, making them vulnerable to developing Secondary Traumatic Stress (STS). Most research on STS has been conducted in high-income countries with stable healthcare systems, whereas little is known about its occurrence or risk factors in conflict-affected regions. This study aims to determine the prevalence of STS and identify its predictors among Palestinian oncology nurses who face unstable political conditions, insufficient resources, and limited mental health services.

A cross-sectional analytical study was conducted in ten oncology departments across hospitals in the West Bank and East Jerusalem between August and October 2024. A total of 293 participants completed a questionnaire assessing sociodemographic characteristics, STS, burnout, social and organizational support, and coping strategies. Data were analyzed using SPSS 27 with descriptive and inferential statistics, including regression analyses to identify significant predictors.

The mean STS score was 3.13 ± 0.73, with the intrusion-related symptoms being most prominent (3.18 ± 0.94). STS levels varied significantly with age, working hours, and parental status. Regression analysis identified the number of children as a negative predictor of STS (B = -0.081, p = 0.004), while education level (B = 0.096, p = 0.034) and Personal Accomplishment (B = 0.015, p < 0.001) were positive predictors. Perceived Organizational Support remained a strong negative predictor (B = -0.109, p < 0.001).

This study provides the first evidence of STS among oncology nurses in a conflict-affected work environment. Strengthening organizational support and tailoring coping strategies to the local context may help reduce STS while promoting nurse well-being. These findings underscore the global relevance of integrating stress management programs into oncology education and workplace policies.