Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Catherine Dingley

Second Committee Member

Rosann Colosimo

Third Committee Member

Andrew Reyes

Fourth Committee Member

Jennifer Guthrie

Number of Pages



Nurses often witness suffering and loss. These experiences are intrinsic to the practice of nursing and can exert a strong, cumulative effect on nurses’ professional quality of life (QOL). Stamm (2010b) conceptualizes professional QOL as a composite of compassion fatigue and compassion satisfaction. Inferior professional QOL has been linked to numerous negative healthcare outcomes. Oncology nurses are particularly vulnerable to compassion fatigue. The Professional Quality of Life Scale (ProQOL), created by Stamm (2009), is the current survey used to measure professional QOL, but it may not be specific enough for oncology nurses.

The purpose of this grounded theory study was to explore how oncology nurses experience professional QOL. Specifically, this study aimed to inductively derive a theory regarding the actions and processes that influence professional QOL in a group of oncology nurses. The study addressed three gaps in the current literature: conflicting and inconsistent findings related to facilitators and barriers of professional QOL in oncology nurses, a lack of an inductively-derived theoretical perspective grounded in the views of those experiencing the phenomenon, and a lack of “voice” and perspective that reflects the uniqueness of the practice of, and the relationship between, oncology nursing and professional QOL.

Strauss and Corbin’s (2015) grounded theory was the guiding framework for this study. Data collection measures included the use of PhotoVoice and semi-structured interviews. Purposive, theoretical, and snowball sampling was used to identify a cohort of oncology nurses. The sample included oncology nurses with varying levels of self-perceived professional QOL from 13 oncology units or departments in ten health systems across six states. Interviews were conversational but guided by a tentative list of questions, including questions about any photographs submitted as part of PhotoVoice. Interviews were recorded and transcribed. Participants also completed the ProQOL Version 5 and a demographics survey to describe the sample. Recurring categories uncovered a middle-range theory of oncology nurses’ professional QOL, focused on how oncology nurses perceive their own professional QOL as well as actions and processes that influence their professional QOL.

The core concept of professional QOL for oncology nurses is Reconciling Incongruencies, which involves balancing and overcoming dissonance with competing conditions and factors. Examples of competing conditions and factors include personal/professional demands, sadness/joy, and energy draining/energy generating experiences. Four related categories include the processes of Accepting the Context of Oncology Nursing, Bettering the World, Pursuing a Calling, and Being Valued. The categories of extrinsic factors that can facilitate or inhibit oncology nurses’ professional QOL include patient factors, support relationships and networks, and system and organizational factors. Individually, oncology nurses described strategies for processing difficult experiences, regulating their approach, and caring for themselves to enhance their professional QOL.

This Theory of Oncology Nurses’ Professional QOL differs from the currently used definitions that apply to a broad base of caring professionals. Findings provide a theory-based foundation for future research and practice including instrument development and potential strategies to enhance professional QOL specific to oncology nurses. Novel constructs identified include the core category of Reconciling Incongruencies and the importance of presence of colleagues and being with patients. PhotoVoice contributed to the depth and richness of data from the participant pool by facilitating discussions during interviews, offering a visual representation of experiences, and priming participants thoughts about their professional QOL prior to interviews.


burnout; compassion fatigue; compassion satisfaction; grounded theory; oncology nurses; professional quality of life


Nursing | Oncology

File Format


File Size

2.5 MB

Degree Grantor

University of Nevada, Las Vegas




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