Determinants of Psychological Distress Among Healthcare Workers in a Reference Medical Oncology Unit in Cameroon

Abstract

Introduction: Healthcare professionals working in oncology are exposed to intense and constant stressors, given the severity of the diseases and frequent confrontation with patient death, which can lead to significant psychological distress and professional burnout. This study's objective was to identify the sociodemographic, social, and work-related determinants contributing to this distress among the nursing staff in the medical oncology department of the Yaoundé General Hospital. Materials and Methods: This was a qualitative study conducted from July to December 2017 in a reference medical oncology unit in Cameroon. The study population comprised the entire nursing and medical staff of the department. A non-probability, exhaustive sampling method was used, resulting in seventeen healthcare workers (13 women, 4 men; 10 nurses, 7 doctors) participating. Data were collected through audio-recorded individual semi-structured interviews and subsequently analyzed using manual content analysis. Results: The analysis revealed that psychological distress is a multifaceted issue driven by three main categories of determinants. Sociodemographic factors identified as sources of pressure included female gender, place of residence (linked to long commutes and traffic stress), family pressure, and personal/financial difficulties. Social factors highlighted varying coping strategies, from prayer and communication to emotional detachment (disconnection/splitting) in the face of patient suffering and death. Work-related environmental determinants were found to be the primary cause of distress, unanimously described by staff. These organizational factors included an unbearably heavy workload due to understaffing, stress from managing patient pain and death (often reduced to administrative tasks), difficult interprofessional communication between nurses and doctors, a severe lack of continuous professional training, and a complete absence of gratification or recognition from management. Conclusion: Psychological distress among oncology healthcare professionals is strongly associated with sociodemographic, social, and, critically, pervasive work-related environmental determinants. The heavy and poorly managed workload, coupled with a lack of institutional support, training, and recognition, are major sources of suffering that require urgent attention from hospital administrators to mitigate psychosocial risks.