Oncology nurse competency in chimeric antigen receptor T-cell therapy: A qualitative study

Background: Chimeric antigen receptor (CAR) T-cell therapy is a promising therapeutic method in the field of tumor immunotherapy. An increasing number of patients are beginning to select CAR T-cell therapy in mainland China. It is characterized by a complex process, a long period of treatment, high individualization, quick disease status changes and unique side effects. Oncology nurses play a crucial role in the provision of CAR T-cell therapy. Objective: To explore oncology nurses' competency in CAR T-cell therapy with guidance from the iceberg model. Design: A descriptive qualitative study. Settings: This study was conducted with nurses on lymphoma wards in three tertiary hospitals in China. Participants: A total of 13 nurses and 2 nursing managers were approached, and all of them took part in this study. Methods: Data were collected face-to-face or via online video using a semistructured interview guide between November 2022 and February 2023 by the first author. The study was performed and reported following the Consolidated Criteria for Reporting Qualitative Research. Content analysis was used to analyze the data. Results: Nursing competency in CAR T-cell therapy was identified as including four main categories encompassing 12 subcategories and 40 codes. The main categories were theoretical knowledge, operation skills, personality traits and motives. The subcategories were basic knowledge of chemotherapy, professional knowledge of CAR T-cell therapy, basic skills, professional skills, relevant discipline skills, communication/coordination ability, critical thinking, basic traits, professional personality, enthusiasm for the nursing profession, empathy with patients and motivation to promote professional development. Conclusions: Medical staff can develop a competency-based nurse training program to improve the professional competencies of oncology nurses in CAR T-cell therapy and meet patients' supportive needs for optimal care. Additionally, the findings may be helpful for building measurement standards to assess oncology nurses' performance.