Australian Oncology Nurses in the Genomic Era: Exploring Barriers and Enablers to Uptake of Genomic Innovations
- Publication Type:
- Thesis
- Issue Date:
- 2025
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The integration of genomics into oncology has transformed cancer prevention, diagnosis, and treatment. Nurses are central to this transformation, yet their preparedness to adopt genomics into practice remains uncertain. International research consistently shows that while nurses recognise genomics as relevant, their knowledge, confidence, and engagement are limited. In Australia, evidence in this area is particularly scarce, especially within oncology nursing, where genomics holds essential clinical relevance. This study sought to advance understanding of how Australian oncology nurses engage with genomics, and the barriers and enablers influencing its adoption into practice.
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A mixed-methods design was employed, incorporating a national online survey and interviews, complemented by a scoping review of the evidence on knowledge and attitudes to genetics/genomics. A survey assessed Australian oncology nursesโ knowledge, engagement, and adoption of genomics in practice, and identified individual characteristics associated with the uptake of genomics in nursing practice (n = 106). Nine semi-structured interviews were conducted to explore perceived barriers and enablers to integrating genomics into oncology nursing practice.
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The scoping review showed a fragmented, methodologically heterogeneous evidence base, lacking qualitative and oncology-specific research tools, and identified evidence gaps in the literature on oncology nursesโ genomic knowledge and attitudes. Survey findings revealed a workforce receptive to genomics but constrained by limited knowledge, confidence, and exposure. While most nurses held positive attitudes and recognised genomics as relevant to their practice, few reported confidence in applying it clinically. Likely adopters were characterised by greater clinical experience, advanced practice and higher education, openness to experience, and opinion-leadership traits. Interviews identified a range of barriers and enablers grouped across five interrelated domains: attributes of the genomics innovation, education-related factors, professional factors, organisational factors, and individual factors.
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This study provides the first national evidence of how multilevel barriers and enablers shape Australian oncology nursesโ engagement with genomics. Rogersโ Diffusion of Innovations theory (2003) was used as an interpretive lens to guide interpretation and discussion. By identifying adopter characteristics and the contextual factors influencing uptake, it establishes an evidence base to guide education, leadership, and policy reform. In doing so, it offers empirically grounded direction for embedding genomics within nursing education, clinical governance, and organisational systems. The findings lay a foundation for national strategies that align with Australiaโs genomic medicine agenda and provide evidence of how to best support a confident, capable oncology nursing workforce that is prepared for the genomic era.
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