Factors associated with stress of conscience in caring for older people with delirium in a hospital setting: An exploratory cross-sectional study

Background: Nurses caring for older people with delirium encounter moral challenges in hospitals which could trouble their conscience, if they perceive limitations that prevent them from fulfilling their duties. Little is known about the stress associated with troubled conscience, that is stress of conscience, beyond nursing homes. Aim: To explore factors associated with stress of conscience among nurses caring for older people with delirium in a hospital setting. Method: An exploratory cross-sectional study was conducted. A total of 223 nurses completed the questionnaire at a tertiary hospital in Australia. Findings: The stress of conscience mean sample score, comparable to previous studies, was 63.6. Younger age, more years of nursing experience, lower levels of perceived person centeredness were associated with higher stress of conscience (p < 0.001). The regression model explained 24% of the total variation in Stress of Conscience (R-2 = 0.24: F = 13.874: p < 0.001). Discussion: The levels of stress of conscience (mean score of 63.6) in this study were comparable to studies of nurses caring for older people with cognitive impairment in nursing homes. Younger age and longer working experience correlated with higher levels of stress of conscience, consistent with previous research. The novel contribution was that higher perceived levels of person centeredness could mitigate nurses stress of conscience. Conclusion: Higher levels of person-centredness which positively correlated with less stress of conscience in the hospital setting, provide a foundation to explore barriers and facilitators to support quality care and staff health. Further studies would be valuable as the regression model accounted for 24% of the total variance in stress of conscience. (C) 2020 Australian College of Nursing Ltd. Published by Elsevier Ltd.