Annaclara Ariander, Anna Olaison, Christer Andersson, Rune Sjödahl, Lena Nilsson, Lisa Kastbom
{"title":"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。","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":"{\"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}","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}
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.
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.
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