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

IF 1.9 3区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Scandinavian Journal of Primary Health Care 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
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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.

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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。
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来源期刊
CiteScore
3.20
自引率
19.00%
发文量
47
审稿时长
>12 weeks
期刊介绍: Scandinavian Journal of Primary Health Care is an international online open access journal publishing articles with relevance to general practice and primary health care. Focusing on the continuous professional development in family medicine the journal addresses clinical, epidemiological and humanistic topics in relation to the daily clinical practice. Scandinavian Journal of Primary Health Care is owned by the members of the National Colleges of General Practice in the five Nordic countries through the Nordic Federation of General Practice (NFGP). The journal includes original research on topics related to general practice and family medicine, and publishes both quantitative and qualitative original research, editorials, discussion and analysis papers and reviews to facilitate continuing professional development in family medicine. The journal''s topics range broadly and include: • Clinical family medicine • Epidemiological research • Qualitative research • Health services research.
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