Experience of Chinese oncology nurses in providing care for patients with cutaneous toxicity of immunotherapy: A qualitative study

Abstract

Abstract Background: Immune-related cutaneous adverse events are the most frequently observed reactions in patients with cancer and significantly affect their quality of life. Hence, the administration of immunotherapy to patients poses a challenge to and is the responsibility of nurses. However, currently, there is limited knowledge regarding the experience of Chinese oncology nurses in caring for patients with immunotherapy-induced cutaneous toxicity. Objective: To investigate the inner feelings and experiences of nurses providing care for patients with immunotherapy-induced cutaneous toxicity. Design: A qualitative descriptive study. Setting(s): Seven hospitals in Guangzhou, China. Participants: A purposive sample of 14 nurses providing care to patients with immune-related cutaneous adverse events. Methods: Semi-structured interviews were utilized to explore the perspectives of the nurses. Transcripts were entered into NVivo 11.0. Qualitative thematic analysis was used to analyze the data for significant statements and phrases that were organized into themes and subthemes. Results: Although cutaneous adverse eventsis a common adverse event related to immunotherapy, nurses still encounter obstacles and challenges in dealing with clinical scenarios such as time constraints, workload, and difficulties in managing severe cutaneous adverse events. It requires attention from leadership, communication among peers, patient cooperation and sufficient time in order to provide optimal skin management services. Three main themes were identified in the data: (I) Care for cancer patients with cutaneous toxicity; (II) A rich emotional experience; and (III) Factors affecting the management of cutaneous toxicity. Conclusions: Chinese nurses reported that they experience both challenges and satisfaction in their nursing practices, with coexisting positive and negative emotions. Gaining a comprehensive understanding of nurses' experience in managing immune-related cutaneous adverse events and recognizing the barriers they face during the management process is crucial for developing effective training programs to enhance their ability to handle immune-related cutaneous adverse events.