{"title":"[减少家庭护理中道德困扰的干预措施:对护士和护理伦理学家的访谈研究]。","authors":"Julia Petersen , Ulrike Rösler , Gabriele Meyer , Christiane Luderer","doi":"10.1016/j.zefq.2025.05.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Moral distress affects the health of home care nurses and can lead to the decision to leave the profession early. Little is known about the ways to reduce moral distress in the context of home care nursing.</div></div><div><h3>Objective</h3><div>Identification of interventions to reduce moral distress in home care nurses.</div></div><div><h3>Method</h3><div>Interviews with home care nurses (n<!--> <!-->=<!--> <!-->20; 04−08/2023) from different organizations and with from different federal states and with care ethicists (n<!--> <!-->=<!--> <!-->6; 10/2023−04/2024) were conducted, transcribed and analyzed via qualitative content analysis.</div></div><div><h3>Results</h3><div>On the one hand, interventions were identified that directly address the situations triggering moral distress or relate to the organization of work: e.g., support from superiors, evaluation of informal care, adaptation of the performance and billing system, family-friendly working time models, greater scope for decision-making, and improved cooperation between healthcare stakeholders. On the other hand, the respondents would like to see “ethical interventions”, such as ethics counseling, and more opportunities for professional exchange, e.g., in the context of team meetings on ethical issues.</div></div><div><h3>Conclusions</h3><div>In addition to improving working conditions and creating a positive organizational culture, outpatient ethics consultations at provider level or across care services represent an important intervention.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"196 ","pages":"Pages 15-21"},"PeriodicalIF":1.7000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interventionen, um Moral Distress in der ambulanten Pflege zu reduzieren: eine Interviewstudie mit Pflegenden und Pflegeethiker*innen\",\"authors\":\"Julia Petersen , Ulrike Rösler , Gabriele Meyer , Christiane Luderer\",\"doi\":\"10.1016/j.zefq.2025.05.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Moral distress affects the health of home care nurses and can lead to the decision to leave the profession early. Little is known about the ways to reduce moral distress in the context of home care nursing.</div></div><div><h3>Objective</h3><div>Identification of interventions to reduce moral distress in home care nurses.</div></div><div><h3>Method</h3><div>Interviews with home care nurses (n<!--> <!-->=<!--> <!-->20; 04−08/2023) from different organizations and with from different federal states and with care ethicists (n<!--> <!-->=<!--> <!-->6; 10/2023−04/2024) were conducted, transcribed and analyzed via qualitative content analysis.</div></div><div><h3>Results</h3><div>On the one hand, interventions were identified that directly address the situations triggering moral distress or relate to the organization of work: e.g., support from superiors, evaluation of informal care, adaptation of the performance and billing system, family-friendly working time models, greater scope for decision-making, and improved cooperation between healthcare stakeholders. On the other hand, the respondents would like to see “ethical interventions”, such as ethics counseling, and more opportunities for professional exchange, e.g., in the context of team meetings on ethical issues.</div></div><div><h3>Conclusions</h3><div>In addition to improving working conditions and creating a positive organizational culture, outpatient ethics consultations at provider level or across care services represent an important intervention.</div></div>\",\"PeriodicalId\":46628,\"journal\":{\"name\":\"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen\",\"volume\":\"196 \",\"pages\":\"Pages 15-21\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1865921725001461\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1865921725001461","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
Interventionen, um Moral Distress in der ambulanten Pflege zu reduzieren: eine Interviewstudie mit Pflegenden und Pflegeethiker*innen
Background
Moral distress affects the health of home care nurses and can lead to the decision to leave the profession early. Little is known about the ways to reduce moral distress in the context of home care nursing.
Objective
Identification of interventions to reduce moral distress in home care nurses.
Method
Interviews with home care nurses (n = 20; 04−08/2023) from different organizations and with from different federal states and with care ethicists (n = 6; 10/2023−04/2024) were conducted, transcribed and analyzed via qualitative content analysis.
Results
On the one hand, interventions were identified that directly address the situations triggering moral distress or relate to the organization of work: e.g., support from superiors, evaluation of informal care, adaptation of the performance and billing system, family-friendly working time models, greater scope for decision-making, and improved cooperation between healthcare stakeholders. On the other hand, the respondents would like to see “ethical interventions”, such as ethics counseling, and more opportunities for professional exchange, e.g., in the context of team meetings on ethical issues.
Conclusions
In addition to improving working conditions and creating a positive organizational culture, outpatient ethics consultations at provider level or across care services represent an important intervention.