BPG is committed to discovery and dissemination of knowledge
Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Sep 24, 2025; 16(9): 110994
Published online Sep 24, 2025. doi: 10.5306/wjco.v16.i9.110994
Path analysis the influence of self-efficacy and professional identity on attitudes toward prescriptive authority among oncology nurse specialists
Cheng-Ping Qiao, Bin Yang, Jiao Ma, Qin Chen, Xin-Ying He, Xue Han
Cheng-Ping Qiao, Jiao Ma, Qin Chen, Xin-Ying He, Xue Han, Department of Gynecological Oncology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing 210004, Jiangsu Province, China
Bin Yang, Department of Oncology, Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nantong 226600, Jiangsu Province, China
Co-first authors: Cheng-Ping Qiao and Bin Yang.
Co-corresponding authors: Xin-Ying He and Xue Han.
Author contributions: Qiao CP and Yang B contribute equally to this study as co-first authors; He XY and Han X contribute equally to this study as co-corresponding authors; Yang B conceived and designed the study; Yang B and He XY performed the literature search; Ma J and Han X acquired data and drafted the manuscript; Chen Q and Qiao CP assisted in revising the manuscript; Ma J and He XY wrote the original draft; Chen Q wrote, reviewed, and edited the manuscript; Yang B and Ma J ensured the authenticity of all raw data; all authors have read and approved the final manuscript.
Institutional review board statement: This study has been reviewed by the Medical Ethics Committee of Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine (ethics approval No. HZYLL2022-084).
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: The authors have no relevant financial or non-financial interests to disclose.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Data is provided within the manuscript or supplementary information files. Deidentified data supporting this study’s findings are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Ying He, Deputy Director, Department of Gynecological Oncology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, No. 123 Tianfei Lane, Mochou Road, Qinhuai District, Nanjing 210004, Jiangsu Province, China. xinying@njmu.edu.cn
Received: June 24, 2025
Revised: July 30, 2025
Accepted: August 25, 2025
Published online: September 24, 2025
Processing time: 94 Days and 4.5 Hours
Abstract
BACKGROUND

Global tumor incidence rises and therapies advance, driving oncology nursing specialization. Granting nurses prescriptive authority optimizes care but polarizes nurses' attitudes due to factors like risk and competence, hindering policy implementation.

AIM

To investigate the current status of the attitudes of oncology specialist nurses toward having prescribing authority, specifically concerning symptom management and supportive care in oncology practice, and we conducted a path analysis of their influencing factors.

METHODS

As participants in the survey, oncology specialist nurses working in hospitals of different grades in Jiangsu Province were selected from March 2025 to May 2025 using a stratified sampling method. The questionnaires were administered using the general information questionnaire, the beliefs and attitudes about nurses' prescriptive authority scale, the nurses' professional identity scale, and the self-efficacy scale. Pearson’s method was used to analyze the correlation between beliefs and attitudes about the prescriptive authority, professional identity, and self-efficacy of nurses. Multiple linear regression was performed to analyze the factors influencing the beliefs and attitudes of nurses’ prescriptive authority. The Amos plug-in was used to construct structural equation models to analyze the influencing pathways.

RESULTS

A total of 329 questionnaires were distributed, and 328 valid questionnaires were returned (effective recovery rate: 99.70%). The total score of the 328 oncology nurses on the beliefs and attitudes about nurses' prescriptive authority scale was 101.88 ± 15.13, indicating a moderately high level. Univariate analysis revealed that gender and hospital grade were associated with this score (P < 0.05). The Pearson correlation analysis revealed that self-efficacy was positively correlated with the scores of the beliefs and attitudes about nurses’ prescriptive authority scale and the nurses’ professional identity scale (r = 0.4999, P < 0.0001 and r = 0.7048, P < 0.05, respectively), whereas occupational identity was positively correlated only with the former (r = 0.6209, P < 0.05). Multiple linear regression analysis revealed occupational identity and self-efficacy as the factors influencing the scores of the beliefs and attitudes about nurses’ prescriptive authority scale (P < 0.05). The results of the path analysis revealed that self-efficacy significantly positively affected nurses’ occupational identity and their beliefs and attitudes about having prescriptive authority; occupational identity played a mediating role between the two, with a mediating effect accounting for 54.46% of the total effect, and the structural equation model was well-fitted.

CONCLUSION

Oncology nurses have more positive attitudes toward prescriptive authority. In addition, self-efficacy positively and indirectly affects nurses’ attitudes toward prescriptive authority through the mediating effect of occupational identity. This can be used as a basis for clinical practice to take targeted measures to improve nurses’ self-efficacy and occupational identity, thus creating favorable conditions for effectively implementing the policy of prescriptive authority.

Keywords: Oncology nurse specialists; Self-efficacy; Professional identity; Nurse prescribing authority; Attitudes

Core Tip: This study examined the attitudes of oncology specialist nurses in Jiangsu Province toward prescribing authority and analyzed the influencing factors through a structured survey and path analysis. The model demonstrated good fit, indicating a robust relationship among these variables. The study concludes that oncology nurses hold positive attitudes toward prescribing authority, with self-efficacy playing a crucial role in shaping these attitudes both directly and indirectly through occupational identity. These findings provide a basis for clinical interventions aimed at enhancing nurses' self-efficacy and professional identity, thereby supporting the effective implementation of prescribing authority policies.