Ethical challenges causing moral distress: nursing home staff's experiences of working during the COVID-19 pandemic.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-06-01 Epub Date: 2024-02-09 DOI:10.1080/02813432.2024.2308573
Annaclara Ariander, Anna Olaison, Christer Andersson, Rune Sjödahl, Lena Nilsson, Lisa Kastbom
{"title":"Ethical challenges causing moral distress: nursing home staff's experiences of working during the COVID-19 pandemic.","authors":"Annaclara Ariander, Anna Olaison, Christer Andersson, Rune Sjödahl, Lena Nilsson, Lisa Kastbom","doi":"10.1080/02813432.2024.2308573","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the experiences of healthcare staff in nursing homes during the COVID-19 pandemic.</p><p><strong>Design: </strong>Individual interviews. Latent qualitative content analysis.</p><p><strong>Setting: </strong>Ten nursing homes in Sweden.</p><p><strong>Subjects: </strong>Physicians, nurses and nurse assistants working in Swedish nursing homes.</p><p><strong>Main outcome measures: </strong>Participants' experiences of working in nursing homes during the COVID-19 pandemic.</p><p><strong>Results: </strong>Four manifest categories were found, namely: <i>Balancing restrictions and allocation of scarce resources with care needs</i>; <i>Prioritizing and acting against moral values in advance care planning</i>; <i>Distrust in cooperation</i> and <i>Leadership and staff turnover - a factor for moral distress</i>. The latent theme <i>Experiences of handling ethical challenges caused by the COVID-19 pandemic</i> gave a deeper meaning to the categories.</p><p><strong>Conclusion: </strong>During the pandemic, nursing home staff encountered ethical challenges that caused moral distress. Moral distress stemmed from not being given adequate conditions to perform their work properly, and thus not being able to give the residents adequate care. Another aspect of moral distress originated from feeling forced to act against their moral values when a course of action was considered to cause discomfort or harm to a resident. Alerting employers and policymakers to the harm and inequality experienced by staff and the difficulty in delivering appropriate care is essential. Making proposals for improvements and developing guidelines together with staff to recognize their role and to develop better guidance for good care is vital in order to support and sustain the nursing home workforce.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003312/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02813432.2024.2308573","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To investigate the experiences of healthcare staff in nursing homes during the COVID-19 pandemic.

Design: Individual interviews. Latent qualitative content analysis.

Setting: Ten nursing homes in Sweden.

Subjects: Physicians, nurses and nurse assistants working in Swedish nursing homes.

Main outcome measures: Participants' experiences of working in nursing homes during the COVID-19 pandemic.

Results: Four manifest categories were found, namely: Balancing restrictions and allocation of scarce resources with care needs; Prioritizing and acting against moral values in advance care planning; Distrust in cooperation and Leadership and staff turnover - a factor for moral distress. The latent theme Experiences of handling ethical challenges caused by the COVID-19 pandemic gave a deeper meaning to the categories.

Conclusion: During the pandemic, nursing home staff encountered ethical challenges that caused moral distress. Moral distress stemmed from not being given adequate conditions to perform their work properly, and thus not being able to give the residents adequate care. Another aspect of moral distress originated from feeling forced to act against their moral values when a course of action was considered to cause discomfort or harm to a resident. Alerting employers and policymakers to the harm and inequality experienced by staff and the difficulty in delivering appropriate care is essential. Making proposals for improvements and developing guidelines together with staff to recognize their role and to develop better guidance for good care is vital in order to support and sustain the nursing home workforce.

伦理挑战导致道德困扰:养老院员工在 COVID-19 大流行期间的工作经历。
目的:调查护理院医护人员在 COVID-19 大流行期间的经历:调查护理院医护人员在 COVID-19 大流行期间的经历:设计:个别访谈。潜在定性内容分析:研究对象: 瑞典的 10 家养老院:主要结果测量:主要结果测量:参与者在 COVID-19 大流行期间在疗养院工作的经历:结果:发现了四个表现类别,即在稀缺资源的限制和分配与护理需求之间取得平衡;在预先护理计划中优先考虑道德价值观并违背道德价值观行事;对合作和领导力的不信任以及员工流失--道德困扰的一个因素。潜在主题 "应对 COVID-19 大流行病造成的道德挑战的经验 "赋予了这些类别更深刻的含义:结论:在大流行病期间,疗养院员工遇到了伦理挑战,造成了精神痛苦。道德困扰源于没有足够的条件让他们正常开展工作,因此无法给予居民足够的照顾。道德困扰的另一个原因是,当某项行动被认为会给住户带来不适或伤害时,他们感到自己被迫采取违背道德价值观的行动。提醒雇主和政策制定者注意员工所经历的伤害和不平等,以及在提供适当护理方面的困难是至关重要的。为了支持和维持疗养院的员工队伍,提出改进建议并与员工一起制定指导方针,以认识到他们的作用,并为良好的护理提供更好的指导,这一点至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信