University of Cincinnati, College of Nursing

Purpose: The purpose of this research was to describe the factors that affect chemotherapy exposure among oncology nurses and strategies to foster chemotherapy safety by eliciting the perspectives of nurses and nurse managers. There were two specific aims for this research.  Aim 1: describe the factors that influence chemotherapy exposure among oncology nurses and strategies to foster chemotherapy safety from the viewpoints of nurses and nurse managers. Aim 2:  assess the psychometric properties of the revised Oncology Nurses Health Behaviors Determinants Scale (HBDS-ON) on a sample of oncology nurses. The HBDS-ON was revised based on findings from nurses’ interviews.

Design: This study employed a sequential exploratory mixed method design.

Methods: For Aim 1, semi-structured, individual interviews were conducted with 15 oncology nurses and 5 oncology nurse managers by phone. For Aim 2, one hundred and twenty-three oncology nurse participants completed online surveys to test the reliability and validity of the revised HBDS-ON. 

Results: Five main themes emerged from analyzing the transcribed interviews 1) description of chemotherapy exposure incidents, 2) nurse personal health beliefs, 3) cues to adhere to chemotherapy handling guidelines in the workplace, 3) invisible exposure to chemotherapy, and 5) strategies to promote the chemotherapy safety at workplace. Exploratory factor analysis of the revised HBDS-ON revealed seven-factor structure with good conceptual meaning. These factors represented the instrument subscales. Convergence validity and regression model testing provided further evidence of the instrument validity. Internal consistency testing supported the subscales’ reliability. 

Conclusion: Oncology nurses’ health beliefs and work-place related factors affect nurses’ chemotherapy safety. These factors should be taken into account when developing interventions to promote oncology nurses’ occupational health and safety. The Revised HBDS-ON is an instrument that showed evidence of reliability and validity and can be used to measure these factors.

Impact Statement: By identifying the factors that influence oncology nurses’ chemotherapy exposure and strategies to promote chemotherapy safety, interventions can be developed and implemented to foster chemotherapy safety among oncology nurses. In the long run, this would decrease the prevalence of chemotherapy exposure among oncology nurses and enhance oncology nurses’ safety against this threatening occupational risk.