Path to clear conscience and how to deal with troubled conscience in older people care: a phenomenological hermeneutical study.

Background: The study aimed to illuminate the meaning of conscience, and troubled conscience and how to deal with troubled conscience among nurses who take care of older people in Tehran province, Iran.

Methods: A phenomenological hermeneutical approach guided the study, involving three phases of data interpretation: naïve reading, structural analysis and comprehensive interpretation. In-depth individual interviews were conducted with eight nursing staff working in nursing homes or geriatric ward in hospital.

Results: The meanings of conscience, troubled conscience and dealing with troubled conscience were uncovered through three themes: "meaning of conscience", "path to clear conscience" and "meaning of and dealing with troubled conscience". These themes encompassed a total of eight subthemes. The nursing staff described conscience as an inherent power placed by God, shaped mainly though parent's upbringing along with personal characteristics, religious beliefs, societal, and educational factors. Troubled conscience is narrated as inner power which blames people for intentional or unintentional mistake and attributed to themselves as they have not lived up to the type of people that they should be.

Conclusions: The path to clear conscience was perceived as to do 'right' by helping others and to consider the others as one's own loved one. Dealing with a troubled conscience means striving to provide right compensation. The nursing staff who take care of older people need to be supported in their endeavours to keep their conscience 'clear' and prevent the experience of troubled conscience.