Beyond The Mask: Lived Experiences and Psychosocial Impacts of Chemotherapy Drug DispensingPersonnel in High-Risk Clinical Settings

Bingmin Wu; Sheilla M. Trajera; Gregory S. Ching

doi:10.14419/5c1k3h41

Authors

Bingmin Wu Graduate School, University of St. La Salle, Bacolod City 6100, Philippines Nursing School, Binzhou Medical University Hospital, Binzhou City 256603, Shandong ‎Province, China https://orcid.org/0009-0009-5746-3077 (unauthenticated)
Sheilla M. Trajera Chair, Nursing and Education Programs at University of St. La Salle Graduate School Faculty, BSN, MN, MAN, and PhD in Nursing, University of St. La Salle, Bacolod City 6100, ‎ Philippines https://orcid.org/0000-0003-1834-7275 (unauthenticated)
Gregory S. Ching Faculty, Graduate Institute of Educational Administration and Policy, National ChengChi ‎University, Taipei City 11605, Taiwan https://orcid.org/0000-0001-9148-0019 (unauthenticated)

DOI:

https://doi.org/10.14419/5c1k3h41

Published

17-10-2025

Keywords:

Occupational Exposure; Chemotherapy Drug Dispensing; Psychosocial Impact; Phenomenological ‎Research; Healthcare Worker Safety

Abstract

Healthcare professionals involved in dispensing intravenous chemotherapy drugs face ‎significant risks from cytotoxic exposure, which can lead to both physical harm and ‎psychological distress. Despite existing safety protocols, limited research has explored the ‎personal and emotional challenges encountered by personnel in high-risk clinical environments. ‎This study investigated the lived experiences of chemotherapy drug dispensing personnel ‎within the context of occupational exposure. Using a qualitative descriptive phenomenological ‎approach, ten participants from a tertiary hospital in Shandong Province, China, were ‎purposively selected. In-depth interviews were conducted, and data were analyzed using ‎Colaizzi’s seven-step method. Five major themes emerged: (1) challenges related to ‎occupational exposure safety, including operational risks, environmental constraints, and ‎equipment deficiencies; (2) difficulties in implementing protective measures; (3) mental health ‎struggles; (4) career development obstacles; and (5) coping and adjustment strategies. The ‎findings highlight that occupational exposure affects not only physical well-being but also ‎emotional resilience and professional trajectories. Participants emphasized the need for ‎improved protective infrastructure, mental health support, and institutional recognition of the ‎psychological burden of their work. The study concludes that occupational safety programs ‎must address the comprehensive needs of chemotherapy drug dispensing personnel‎.

References

Abalona, M. D., Trajera, S. M., & Ching, G. S. (2025). Adapting to change: Lived experiences of nursing students in rebuilding clinical confidence with limited face-to-face exposure. Edelweiss Applied Science and Technology, 9(2), 1353-1366. https://doi.org/10.55214/25768484.v9i2.4768.

Abu-Alhaija, D., Bakas, T., Shaughnessy, E., & Miller, E. (2023). The factors that influence chemotherapy exposure among nurses: An integrative review. Workplace Health & Safety, 71(5), 212-227. https://doi.org/10.1177/21650799221140583.

Antúnez-Blancat, A., Gago-Valiente, F.-J., García-Iglesias, J.-J., & Merino-Navarro, D. (2024). The role of nursing in the management of chemotherapy extravasation: A systematic review regarding public health. Healthcare, 12(14), 1456. https://doi.org/10.3390/healthcare12141456.

Aqtam, I., & Darawwad, M. (2018). Health Promotion Model: An integrative literature review. Open Journal of Nursing, 8(7), 86144. https://doi.org/10.4236/ojn.2018.87037.

Boiano, J. M., Steege, A. L., & Sweeney, M. H. (2014). Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs. Journal of Occupational and Environmental Hygiene, 11(11), 728-740. https://doi.org/10.1080/15459624.2014.916809.

Campbell, K., Afseth, J., Dunham, M., King, M., & Dicksit, D. (2024). Global cancer nurses' experiences and perceptions of potential occupational exposure to cytotoxic drugs: Mixed method systematic review with framework synthesis. Journal of Clinical Nursing, 33(12), 4585-4601. https://doi.org/10.1111/jocn.17488.

Chen, H.-C., Lu, Z.-Y. J., & Lee, S.-H. (2016). Nurses’ experiences in safe handling of chemotherapeutic agents: The Taiwan case. Cancer Nursing: An International Journal for Cancer Care Research, 39(5), E29-E38. https://doi.org/10.1097/NCC.0000000000000314.

Cho, H. N., Wells, L., & Halford, Z. (2024). Implementation and evaluation of APOTECAchemo in a community cancer center: A comparative study of robotic versus manual antineoplastic preparation. Journal of Pharmacy Technology, 40(6), 269-276. https://doi.org/10.1177/87551225241278203.

Clapp, R. W., Howe, G. K., & Jacobs, M. M. (2007). Environmental and occupational causes of cancer: A call to act on what we know. Biomedicine & Pharmacotherapy, 61(10), 631-639. https://doi.org/10.1016/j.biopha.2007.08.001.

Colaizzi, P. F. (1978). Psychological research as the phenomenologist views it. In R. S. Valle & M. King (Eds.), Existential-phenomenological alternatives for psychology (pp. 48-71). Oxford University Press.

Condes, K. A., Lachica, T.-A. B., Trajera, S. M., & Ching, G. S. (2025). Strength from within: Exploring self-compassion among frontline nurses during the COVID-19 pandemic. Edelweiss Applied Science and Technology, 9(5), 2471-2483. https://doi.org/10.55214/25768484.v9i5.7487.

Connor, T. H., Lawson, C. C., Polovich, M., & McDiarmid, M. A. (2014). Reproductive health risks associated with occupational exposures to antineoplastic drugs in health care settings: A review of the evidence. Journal of Occupational and Environmental Medicine, 56(9), 901-910. https://doi.org/10.1097/JOM.0000000000000249.

Coyne, E., Northfield, S., Ash, K., & Brown-West, L. (2019). Current evidence of education and safety requirements for the nursing administration of chemotherapy: An integrative review. European Journal of Oncology Nursing, 41, 24-32. https://doi.org/10.1016/j.ejon.2019.05.001.

Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods approach (3rd ed.). Sage.

Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative and mixed method approaches (5th, Ed.). Sage.

Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage.

Domingo-Echaburu, S., Lopez de Torre-Querejazu, A., Valcárcel, Y., Orive, G., & Lertxundi, U. (2022). Hazardous drugs (NIOSH's list-group 1) in healthcare settings: Also a hazard for the environment? Science of The Total Environment, 817, 152954. https://doi.org/10.1016/j.scitotenv.2022.152954.

Fadhil, I., & Hassan, H. (2018). Evaluation of nurses’ practices toward safe intravenous chemotherapy infusion in Baghdad city hospitals. Iraqi National Journal of Nursing Specialties, 31(2), 43-56. https://doi.org/10.58897/injns.v31i2.306.

Folkman, S. (2013). Stress: Appraisal and coping. In M. D. Gellman & J. R. Turner (Eds.), Encyclopedia of Behavioral Medicine (pp. 1913–1915). Springer. https://doi.org/10.1007/978-1-4419-1005-9_215.

Fundytus, A., Prasad, V., & Booth, C. M. (2021). Has the current oncology value paradigm forgotten patients’ time? Too little of a good thing. JAMA Oncology, 7(12), 1757-1758. https://doi.org/10.1001/jamaoncol.2021.3600.

Fusch, P. I., & Ness, L. R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report, 20(9), 1408-1416. https://doi.org/10.46743/2160-3715/2015.2281.

Galmarini, D., Galmarini, C. M., & Galmarini, F. C. (2012). Cancer chemotherapy: A critical analysis of its 60 years of history. Critical Reviews in Oncology/Hematology, 84(2), 181-199. https://doi.org/10.1016/j.critrevonc.2012.03.002.

Geersing, T. H., Pourahmad, D. M., Lodewijk, F., Franssen, E. J. F., Knibbe, C. A. J., & Crul, M. (2024). Analysis of production time and capacity for manual and robotic compounding scenarios for parenteral hazardous drugs. European Journal of Hospital Pharmacy, 31(4), 352-357. https://doi.org/10.1136/ejhpharm-2022-003576.

Gerding, J., Anhäuser, L., Eickmann, U., & Nienhaus, A. (2022). A simple approach to assess the cancer risk of occupational exposure to genotoxic drugs in healthcare settings. Journal of Occupational Medicine and Toxicology, 17, 8. https://doi.org/10.1186/s12995-022-00349-z.

Hellmann, M. D., Li, B. T., Chaft, J. E., & Kris, M. G. (2016). Chemotherapy remains an essential element of personalized care for persons with lung cancers. Annals of Oncology, 27(10), 1829–1835. https://doi.org/10.1093/annonc/mdw271.

Huang, X., Gao, C., Cai, W., Tao, Y., Zhong, X., Liu, H., Hong, X., Ding, X., Lu, H., Lai, W., Yi, X., & Gu, Y. (2022). Effect of occupational exposure to antineoplastic drugs on DNA damage in nurses: A cross-sectional study. Occupational and Environmental Medicine, 79(4), 253-258. https://doi.org/10.1136/oemed-2021-107913.

Jimenez, O.-J. B., Trajera, S. M., & Ching, G. S. (2022). Providing end-of-life care to COVID-19 patients: The lived experiences of ICU nurses in the Philippines. International Journal of Environmental Research and Public Health, 19(19), 12953. https://doi.org/10.3390/ijerph191912953.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

Li, C. (2024). A review of identity and roles of robotics in the healthcare industry. Journal of Biomedical and Sustainable Healthcare Applications, 4(1), 22-32. https://doi.org/10.53759/0088/JBSHA20240403.

Li, G., Xu, B., He, R.-X., & Zhang, S.-X. (2017). Using healthcare failure mode and effect analysis to reduce intravenous chemotherapy errors in Chinese hospitalized patients. Cancer Nursing: An International Journal for Cancer Care Research, 40(2), 88-93. https://doi.org/10.1097/NCC.0000000000000348.

Li, Y., Yu, W., Li, L., Yao, Q., Jiang, K., Zhu, T., & Jiang, E. (2023). Oncology nursing on the move: A contemporary issue on Chinese oncology nursing in cancer care. Frontiers in Public Health, 11, 1061572. https://doi.org/10.3389/fpubh.2023.1061572.

Lin, L., Zhang, X., & Wang, P. (2025). Interconnected stressors and well-being in healthcare professionals. Applied Research in Quality of Life, 20, 459-481. https://doi.org/10.1007/s11482-024-10419-5.

Lincoln, Y., & Guba, E. G. (1985). Naturalistic inquiry. Sage. https://doi.org/10.1016/0147-1767(85)90062-8.

Lombardo, J., Coles, J., Ryszka, D., Roussel, C., & Smith, W. (2022). Deviations from best practice: Findings from a certified patient safety organization remote-verification observational study of intravenous compounding of chemotherapeutic and ancillary drugs. Journal of Pharmacy Practice, 36(6), 1438-1447. https://doi.org/10.1177/08971900221134836.

Ma, Y., Xie, T., Zhang, J., & Yang, H. (2023). The prevalence, related factors and interventions of oncology nurses' burnout in different continents: A systematic review and meta-analysis. Journal of Clinical Nursing, 32(19-20), 7050-7061. https://doi.org/10.1111/jocn.16838.

Mapp, T. (2008). Understanding phenomenology: The lived experience. British Journal of Midwifery, 16(5), 308-311. https://doi.org/10.12968/bjom.2008.16.5.29192.

Masters, K. (2015). Nursing theories: A framework for professional practice. In. Jones & Bartlett Learning.

Moore, L. (2023). Oncology pharmacy technician contributions and challenges: A commentary on a busy infusion center facing changes and challenges. Journal of Pharmacy Technology, 39(6), 309-311. https://doi.org/10.1177/87551225231202388.

Naderifar, M., Goli, H., & Ghaljaie, F. (2017). Snowball sampling: A purposeful method of sampling in qualitative research. Strides in Development of Medical Education, 14(3), 67670. https://doi.org/10.5812/sdme.67670.

Olorunfemi, O., Akintoke, T. E., Owoyomi, D. O., Orobode, O. R., Owadokun, J. F., & Oahimijie, F. O. (2024). Nurses care for everyone: But who cares for a nurse? Current Medicine Research and Practice, 14(5), 228-232. https://doi.org/10.4103/cmrp.cmrp_43_24.

Omer, H., Salah, H., Tamam, N., Mahgoub, O., Sulieman, A., Ahmed, R., Abuzaid, M., Saad, I. E., Almogren, K. S., & Bradley, D. A. (2023). Assessment of occupational exposure from PET and PET/CT scanning in Saudi Arabia. Radiation Physics and Chemistry, 204, 110642. https://doi.org/10.1016/j.radphyschem.2022.110642.

Orem, D. E. (1995). Nursing: Concepts of practice (5th ed.). Mosby.

Ouedraogo, J.-M., El Baraka, S., Adade, C. A., Sitsopeh, J., Sessouma, A., Belahcen, M. J., & Rahali, Y. (2020). Risk reduction in a cancer chemotherapy production unit: Contribution of an automated drug dispensing system. Journal of Oncology Pharmacy Practice, 27(4), 863-870. https://doi.org/10.1177/1078155220941060.

Oyuku, M., & Nshakira, N. (2025). Factors influencing compliance with chemotherapy handling and administration standard operation procedures among nurses and pharmacists at Uganda cancer institute: Descriptive study. BMC Health Services Research, 25, 1010. https://doi.org/10.1186/s12913-025-13076-y.

Pacheco, C., Baião, A., Ding, T., Cui, W., & Sarmento, B. (2023). Recent advances in long-acting drug delivery systems for anticancer drug. Advanced Drug Delivery Reviews, 194, 114724. https://doi.org/10.1016/j.addr.2023.114724.

Paterson, C., Gobel, B., Gosselin, T., Haylock, P. J., Papadopoulou, C., Slusser, K., Rodriguez, A., & Pituskin, E. (2020). Oncology nursing during a pandemic: Critical reflections in the context of COVID-19. Seminars in Oncology Nursing, 36(3), 151028. https://doi.org/10.1016/j.soncn.2020.151028.

Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2011). Health promotion in nursing practice (6th ed.). Pearson.

Perego, G., Longobardo, G., Baldisserotto, A., Feliciani, M., & Fazio, M. (2022). Automated chemotherapy compounding: Process optimization for the preparation of admixture containing high-dose of cyclophosphamide. Journal of Oncology Pharmacy Practice, 29(1), 208-210. https://doi.org/10.1177/10781552221130012.

Polovich, M. (2016). Minimizing occupational exposure to antineoplastic agents. Journal of Infusion Nursing, 39(5), 307-313. https://doi.org/10.1097/NAN.0000000000000183.

Portela, T., Camozzato, T. S. C., de Cássia Flôr, R., Ribeiro, G., & de Melo, J. A. C. (2021). Occupational exposure in the working process of radiological nursing in nuclear medicine. Journal of Radiology Nursing, 40(3), 246-253. https://doi.org/10.1016/j.jradnu.2021.02.005.

Rahman, A. (2022). A scoping review of COVID-19-related stress coping resources among nurses. International Journal of Nursing Sciences, 9(2), 259-267. https://doi.org/10.1016/j.ijnss.2022.02.008.

Rimando, Y. M., Chua, L. A. A., Trajera, S. M., & Ching, G. S. (2025). Lived experiences of clinical instructors in facilitating online related learning experiences among nursing students in the Philippines: Challenges, adaptations, and insight. Edelweiss Applied Science and Technology, 9(3), 309-327. https://doi.org/10.55214/25768484.v9i3.5209.

Senarath, N. S. A. S. N., De Silva, D., Rathnayake, R. W. M. W. K., Warnakulasuriya, S. S. P., Meegoda, M. K. D. L., & Jayasinghe, S. S. (2025). Perceptions of occupational exposure and adherence to safety measures of handling systemic anti-cancer therapy (SACT) among oncology nurses at the national cancer institute, Sri Lanka. International Journal of Risk & Safety in Medicine. https://doi.org/10.1177/09246479251346172.

Soheili, M., Taleghani, F., Jokar, F., Eghbali-Babadi, M., & Sharifi, M. (2021). Occupational stressors in oncology nurses: A qualitative descriptive study. Journal of Clinical Nursing, 30(21-22), 3171-3181. https://doi.org/10.1111/jocn.15816.

Srisintorn, W., Geater, A., Polovich, M., & Thongsuksai, P. (2021). Factors influencing precautions against antineoplastic drug exposure among nurses and nurse assistants in Thailand. International Archives of Occupational and Environmental Health, 94, 813-822. https://doi.org/10.1007/s00420-020-01649-9.

Sypongco, A. G., Trajera, S. M., & Ching, G. S. (2025). Navigating hesitancy: Lived experiences of COVID-19 vaccine resistance and public health adaptations in the Philippines. Edelweiss Applied Science and Technology, 9(2), 1133-1146. https://doi.org/10.55214/25768484.v9i2.4696.

Tamon, A. S., Trajera, S. M., Lachica, T.-A. B., & Ching, G. S. (2025). Psychiatric nursing in crisis: Lived experiences and coping strategies during the COVID-19 pandemic in the Philippines. Edelweiss Applied Science and Technology, 9(3), 1795-1809. https://doi.org/10.55214/25768484.v9i3.5691.

van Huizen, P., Wembridge, P., Russo, P. L., Manias, E., & Connell, C. J. (2025). Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study. International Journal of Nursing Studies Advances, 8, 100331. https://doi.org/10.1016/j.ijnsa.2025.100331.

Villaran, K. C., Chua, L. A. A., Trajera, S. M., & Ching, G. S. (2025). Lived experiences of nursing education administrators during the COVID-19 pandemic: Challenges, adaptations, and insights. Edelweiss Applied Science and Technology, 9(3), 2149-2169. https://doi.org/10.55214/25768484.v9i3.5756.

Wang, Q., Wang, F., Zhang, S., Liu, C., Feng, Y., & Chen, J. (2023). Effects of a mindfulness-based interventions on stress, burnout in nurses: A systematic review and meta-analysis. Frontiers in Psychiatry, 14, 1218340. https://doi.org/10.3389/fpsyt.2023.1218340.

Xie, W., Wang, J., Zhang, Y., Zuo, M., Kang, H., Tang, P., Zeng, L., Jin, M., Ni, W., & Ma, C. (2021). The levels, prevalence and related factors of compassion fatigue among oncology nurses: A systematic review and meta-analysis. Journal of Clinical Nursing, 30(5-6), 615-632. https://doi.org/10.1111/jocn.15565.

Zakaria, M. M., Alaa, S. M., & Desoky, G. M. (2022). Oncology nurses' knowledge and practices regarding safe administration of intravenous chemotherapy. Egyptian Journal of Health Care, 13(1), 1218-1231. https://doi.org/10.21608/ejhc.2022.225111.

Zendeh, M. B., Maslakpak, M. H., & Jasemi, M. (2022). Nurses' perceptions of their supportive role for cancer patients: A qualitative study. Nursing Open, 9(1), 646-654. https://doi.org/10.1002/nop2.1112.

Zhang, L., Li, Q., Guan, L., Fan, L., Li, Y., Zhang, Z., & Yuan, S. (2022). Prevalence and influence factors of occupational exposure to blood and body fluids in registered Chinese nurses: A national cross-sectional study. BMC Nursing, 21, 298. https://doi.org/10.1186/s12912-022-01090-y.

Zhang, L., Liu, W., & Zhang, Y. (2022). Application of intelligent intravenous drug dispensing robot in clinical nursing. Contrast Media & Molecular Imaging, 2022, 769883. https://doi.org/10.1155/2022/4769883.

Zhang, X., Zheng, Q., Lv, Y., An, M., Zhang, Y., Wei, Y., & Feng, W. (2016). Evaluation of adverse health risks associated with antineoplastic drug exposure in nurses at two Chinese hospitals: The effects of implementing a pharmacy intravenous admixture service. American Journal of Industrial Medicine, 59(4), 264-273. https://doi.org/10.1002/ajim.22553.

Zhang, Y., Meng, X., & Zhou, L. (2024). The impact of job stress on perceived professional benefits among Chinese nurses caring for patients with gynecological cancer: Mediating effects of perceived social support and self-efficacy. Frontiers in Psychology, 15, 1344185. https://doi.org/10.3389/fpsyg.2024.1344185.

Zhu, M., Lachica, T.-A. B., Trajera, S. M., & Ching, G. S. (2025). Understanding health literacy for cancer prevention and care: A community-based study in rural Southwest China. Edelweiss Applied Science and Technology, 9(5), 2303-2316. https://doi.org/10.55214/25768484.v9i5.7464.

How to Cite

Wu, B., Trajera, S. M., & Ching, G. S. (2025). Beyond The Mask: Lived Experiences and Psychosocial Impacts of Chemotherapy Drug DispensingPersonnel in High-Risk Clinical Settings. International Journal of Basic and Applied Sciences, 14(6), 313-325. https://doi.org/10.14419/5c1k3h41

Download Citation