A multi methods study to explore the impact of the COVID-19 pandemic on the psychological well-being of cancer nurses across Cheshire and Mersey.

backgroundCancer nurse well-being is crucial for the delivery of high-quality patient care. During the COVID-19 pandemic, fear and anxiety negatively impacted nurse well-being. Understanding the factors contributing to well-being amongst cancer nurses is a priority, as chronic stress can negatively influence job satisfaction and standards of care.

methodsA multi methods approach comprising a repeated measures survey (n = 69), semi-structured interviews (n = 29) and two focus groups was used. This enabled in-depth exploration of nurses' experiences over time. Following ethical approval, nurses from different cancer settings were recruited from NW England. The survey measured anxiety, depression, self-efficacy, resilience and well-being at three time-points [baseline; 3 months and 6 months]. Data was collected Feb-Oct 2022. Participants were also invited to participate in an interview and focus group. This data was subject to Thematic Analysis. Data sources were triangulated to substantiate findings. Ethical approval was obtained and participants provided informed consent.

resultsSurvey data revealed anxiety, well-being, self-efficacy and resilience were broadly consistent over time. The only significant difference was depression, where mean scores at times 2 and 3 were significantly lower than time 1. While most participants reported mild to moderate anxiety and depression throughout the study, at time 3 a significant minority (32%, 9/28) reported severe depression. Four themes arose from interviews: (i) the principles and practice of nursing, (ii) the impact of COVID-19 on nurses' identity, (iii) self-management strategies, (iv) organisational responses. Focus group data emphasised the need for improved communication concerning well-being services.

conclusionsNurses used coping strategies throughout the pandemic and beyond, drawing on professional and personal experiences and adapting to clinical service changes. Well-being was sustained through peer and patient interactions, and work routines. Workplace cultures supporting and normalising nurses' well-being should be encouraged and co-creation of interventions to build resilience and improve communication. Importantly interventions should be evaluated for their effectiveness and barriers to accessing support removed. Our findings build on theory addressing workplace culture, high stress environments and individuals' self-awareness of well-being needs. Research is needed to understand the well-being needs of cancer nurses according to banding, work setting, and pre-existing psychological morbidity. CLINICAL TRIAL NUMBER: Not applicable.