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. 2025 Jun 23;33(7):617.
doi: 10.1007/s00520-025-09679-0.

Knowledge, attitude, and practices in febrile neutropenia among nurses at a tertiary care cancer center in rural India

Vineetha Raghavan  1 , Abhilash Menon  2 , Nandini Devi R  1 , Sajitha P  3 , Praveen Kumar Shenoy  1 , Jithin T K  1 , Gopakumar K G  1 , Ratheesan K  4 , Chandran K Nair  1
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Knowledge, attitude, and practices in febrile neutropenia among nurses at a tertiary care cancer center in rural India

Vineetha Raghavan et al. Support Care Cancer. .

Abstract

Purpose: Febrile neutropenia (FN) is a major cause of morbidity and mortality in chemotherapy patients. Nurses play a vital role in FN management, yet studies assessing their knowledge, attitude, and practices (KAP) in India are limited. This study aimed to evaluate KAP among nurses in a rural Indian tertiary cancer center.

Methodology: This cross-sectional KAP survey involved 111 staff nurses at a tertiary cancer center in rural India from October to November 2022. A validated questionnaire with 17 multiple-choice questions (five knowledge, five attitude, seven practice) was used. Demographic and professional details were collected.

Results: Among 111 participants, 86.4% were female, and 55% had over 10 years of experience. Most (93%) had administered chemotherapy, and 78% had cared for FN patients. The median knowledge score was 4 (range 1-7), with an 80.36% prevalence. Only 61% correctly calculated the absolute neutrophil count. Better scores were seen among permanent staff, those who had attended FN classes, and those with prior FN care experience. The median attitude score was 5 (range 2-7), with a 90.09% prevalence of positive attitude. Nurses with prior chemotherapy administration experience and FN care experience had better scores.The median practice score was 6 (range 1-7), with a 78.42% prevalence. A key gap was identified, as 77% answered incorrectly regarding blood culture sampling during FN episodes. Nurses who attended FN educational classes scored better.

Conclusion: Although nurses' knowledge and attitudes were found to be satisfactory, there are noticeable gaps in their practice, especially when it comes to blood culture sampling, which suggests that focused educational programs are necessary. Improving FN management results requires strengthening practical skills through training, simulations, and protocol reinforcement.

Keywords: Attitude; Febrile neutropenia; Knowledge; Nurses; Practice.

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Conflict of interest statement

Declarations. Ethics approval: A prior official approval from the Institutional Review Board (Institutional Review Board/Ethics Committee of Malabar Cancer Centre, Kerala, India) was obtained before the start of the study(1617/IRB-IEC/13/MCC/18-10-2022/5). The authors confirm that the study was conducted in accordance with the Helsinki Declaration. Consent to participate: Informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests.

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