The work of an oncology nurse is inherently stressful, and the COVID-19 pandemic compounded the distress felt by many in the profession.

A team of researchers suspected that the weight of the pandemic may have exacerbated oncology nurses’ vulnerability to psychological distress and increased their risk for experiencing a reduction in their work-related quality of life (WRQOL). They launched a cross-sectional study to learn more, and their findings were published in the Journal of Clinical Oncology Nursing.

The researchers invited nurses from the solid, hematologic malignancy, and bone marrow transplant units at a Boston-area medical center to participate, and 63 nurses agreed to do so. The researchers measured the participants’ stress, anxiety and depression with a 21-item Depression, Anxiety, and Stress Scale (DASS), and they measured the participants’ post-traumatic stress disorder (PTSD) symptoms with the 21-item Impact of Events Scale-Revised. They also used the 23-item WRQOL Scale.

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The mean DASS score was 33.4, with a range from 0 to 104, which reflected low levels of depression, mild anxiety, and mild stress. The mean score for PTSD was 29.3, with a range from 4 to 69, and the researchers noted that WRQOL was negatively correlated to PTSD and to anxiety, depression, and stress. The mean WRQOL Scale score was 68.8, with a range of scores from 54 to 110.

The researchers wrote that the nurses described their work-related quality of life as “average.” “Furthermore, they reported lower levels of depression, anxiety, and stress with mean PTSD scores suggesting partial PTSD,” they wrote. They also noted that results from previous studies support their findings, but variations in factors such as practice setting, personal and cultural influences, and even perceptions of working conditions could account for differences in self-reported WRQOL. Also, the researchers suggested that the lower psychological distress could be due in part to the timing of the study in between COVID surges in 2020.

According to the study, “nurses who are resilient in stressful situations are less likely to experience lower WRQOL.” Enhancing oncology nurses’ resilience against work-related stress could be a worthwhile endeavor and could start with early identification of distress and “maladaptive coping strategies.”

The researchers also suggested that palliative care training could boost self-confidence and knowledge, which may help oncology nurses to navigate the challenges they encounter while providing patient care. “Self-confidence and knowledge may lessen the chronic distress oncology nurses face while providing care, and working to minimize psychosocial difficulties for patients with cancer may in turn mitigate oncology nurses’ own poor psychosocial health, particularly during the pandemic,” the researchers concluded.

One limitation of the study was the self-reporting of information used in the assessment of psychosocial distress, which lends to the possibility of a social desirability bias. “Causal inferences between psychological distress and WRQOL cannot be drawn, which is an inherent limitation of cross-sectional examination,” the researchers wrote.


Eche IJ, Eche IM, Aronowitz TB. Psychological distress and work-related quality of life among oncology nurses during the COVID-19 pandemic: a cross-sectional study. Clin J Oncol Nurs. 2022;26(3):268-274. doi:10.1188/22.CJON.268-274