Ethical and Organizational Factors Related to Oncology Nurses’ Intention to Leave: Preliminary Results of a Descriptive Correlational Study

Abstract

Introduction: Oncology nurses work in complex care environments characterised by substantial emotional demands and recurrent ethical dilemmas. These conditions may increase moral distress and compassion fatigue, weaken organizational commitment, and heighten intention to leave. Although a positive ethical climate may serve as a protective factor, the relationships among moral distress, compassion fatigue, organizational commitment, perceived ethical climate, and intention to leave remain insufficiently investigated. This study aimed to assess these factors among oncology nurses and examine their associations with intention to leave.

Methods: A descriptive correlational study was conducted at an Italian oncology research hospital. Data were collected through an online questionnaire administered using REDCap. The questionnaire included sociodemographic and occupational characteristics and measures of intention to leave. Validated instruments included the Moral Distress Scale-Revised (MDS-R), Professional Quality of Life Scale (ProQOL), Organizational Commitment Questionnaire-Revised (OCQ-R), and Hospital Ethical Climate Survey (HECS). Data were analysed using descriptive and correlational statistics.

Results: Of the 180 nurses invited to participate, 109 completed the questionnaire, corresponding to a response rate of 60.5%. The sample was predominantly female, with a mean age of 42 years (SD = 12) and a mean professional experience of 11 years (SD = 10). Overall, 83.5% of participants did not intend to change unit, whereas 5.5% intended to do so within six months and 11.0% within one year. Similarly, 79.8% did not intend to leave the organization, while 4.6% intended to leave within six months and 15.6% within one year. An intention to leave the nursing profession was reported by 9.2% of participants. Mean satisfaction scores for the current role, nursing profession, and work team were 2.98, 2.98, and 2.74, respectively, on a 1–4 scale. Mean scores were 50 (SD = 45) for moral distress, 62 (SD = 40) for compassion fatigue, 34 (SD = 24) for organizational commitment, and 34 (SD = 25) for perceived ethical climate. Inferential analyses will be presented at the conference.

Discussion: Preliminary findings indicate moderate levels of moral distress and compassion fatigue, moderate job satisfaction, and a relatively low intention to leave the nursing profession. Targeted interventions aimed at strengthening the ethical climate and providing organizational and psychological support may help reduce professional distress and reinforce organizational commitment, thereby supporting staff retention and quality of care. The interpretation of these preliminary findings should be completed following analysis of the associations among the investigated variables.