Moral Distress in Community and Hospital Settings for the Care of Elderly People. A Grounded Theory Qualitative Study

被引:18
作者
Villa, Giulia [1 ]
Pennestri, Federico [2 ]
Rosa, Debora [3 ]
Giannetta, Noemi [1 ]
Sala, Roberta [2 ]
Mordacci, Roberto [2 ]
Manara, Duilio Fiorenzo [1 ]
机构
[1] Univ Vita Salute San Raffaele, Ctr Nursing Res & Innovat, Via Olgettina 58, I-20132 Milan, Italy
[2] Univ Vita Salute San Raffaele, Fac Philosophy, Via Olgettina 58, I-20132 Milan, Italy
[3] Ist Auxol Italiano IRCCS, Dept Cardiovasc Neural & Metab Sci, Piazzale Brescia 20, I-20149 Milan, Italy
关键词
bioethics; caregiver; decision making; elderly; grounded theory; hospital; moral distress; nursing home; NURSE; STRESS; PERCEPTIONS; DEMENTIA;
D O I
10.3390/healthcare9101307
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Moral distress has frequently been investigated in single healthcare settings and concerning a single type of professional. This study aimed to describe the experience of moral distress in all the types of professionals providing daily care to elderly patients and residents. Methods: The Grounded Theory approach, developed by Corbin and Strauss, was used. This study included participants from hospital and nursing homes of northern Italy. Purposive and theoretical sampling was used. Between December 2020 and April 2021, semi-structured interviews were conducted. Results: Thirteen participants were included in the study. Four categories were derived from the data: talking and listening, care provider wellbeing, decision making, protective factors, and potential solutions. The core category identified was "sharing daily ". Interviewees confirm how hard it may be to communicate to the elderly, but at the same time, how adequate communication with the leader is a protective factor of moral distress. They also confirm how communication is key to managing or downsizing misunderstandings at all levels. Findings highlight the scarcity of operators as a fundamental trigger of moral distress. Conclusions: Many determinants of this phenomenon lie behind the direct control of professionals, but education can help them learn how to prevent, manage, or downsize the consequences.</p>
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页数:14
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