Abstract
BACKGROUND: Nursing care for terminally ill cancer patients is routinely provided by oncology nurses in Saudi Arabia. Shortages and retention of oncology nurses is an important concern for healthcare leaders. OBJECTIVES: To identify and describe predictors of nurses' intention toward working in the oncology specialty amongst three groups: undergraduate nursing students, oncology registered nurses and postgraduate oncology nursing students. In particular, the study sought to analyse association between individual characteristics, job-related factors, palliative care knowledge, attitude toward caring for dying patients, general self-efficacy, job satisfaction and intention to work in oncology. METHODS: A cross-sectional study was conducted involving 477 participants in five major hospitals in Saudi Arabia. The Palliative Care Quiz for Nursing, Frommelt Attitudes Toward Care of the Dying Scale, General Self-Efficacy Scale and Minnesota Satisfaction Questionnaire short form were used for data collection. Multilevel logistic regression analysis was used to identify predictors associated with intention to work in oncology. RESULTS: 43.9% (n = 208) of the sample reported an intention to work in oncology. Only one variable was a significant predictor of intention to work in oncology across all three groups studied: a more positive attitude toward caring for dying patients (Odds ratio (OR) = 1.09 [95% confidence interval (CI) 1.04-1.16]), (OR = 1.08 [95% CI 1.04-1.12]), (OR = 1.078 [95% CI 1.053-1.103] with P ≤ 0.001 for undergraduate, registered and postgraduate groups respectively. At post-graduate level, higher levels of palliative care knowledge and general self-efficacy were significantly associated with increased intention, whilst at undergraduate level, general self-efficacy was a significant predictor. Job satisfaction was a significant predictor of intention amongst registered nurses. CONCLUSIONS: Attitude toward caring for dying patients and general self-efficacy appear to be the most important predictors of intention to work in the oncology nursing specialty. However, the significance of influencing factors varied between the different groups of nurses studied. Perhaps surprisingly, palliative care knowledge was an influential factor amongst the postgraduate group only. The study results provide important insights for nursing leaders and policymakers in Saudi Arabia to inform the future planning of nursing workforce strategies to address shortages and retention of oncology nurses.