Gaby Jacobs, PhD, is professor, University of Humanistic Studies, Utrecht, the Netherlands.
J Hosp Palliat Nurs. 2022 Aug 1;24(4):E144-E150. doi: 10.1097/NJH.0000000000000868. Epub 2022 Mar 25.
Moral distress arises in the dynamic relationship between personal factors and the organizational and political contexts of care work. Whether moral distress actually leads to a reduced well-being of health care workers or a reduced quality of care in the sector depends to a large extent on how moral tensions are dealt with, also called moral resilience, and the protective conditions available. Research about moral distress and moral resilience within the field of health care has concentrated on staff nurses and physicians. Studies into palliative terminal care and/or about the role of coordinating staff are scarce. A study was conducted to gain insight into the moral challenges that coordinators in voluntary palliative terminal care encounter in their ambition to realize good care, how they deal with these challenges, and the individual and organizational characteristics that foster or hamper moral resilience. Interviews were conducted with 20 coordinators and were qualitatively analyzed. The results brought forward 3 moral challenges in working with volunteers and in collaborating with professional care, namely, striving for connection, negotiating autonomy, and struggling with open communication. However, coordinators seemed to face these challenges effectively. In conclusion, the relational narrative strategies used by coordinators to deal with these challenges, in combination with personal and organizational conditions, foster moral resilience.
道德困境产生于个人因素与医疗工作的组织和政治环境之间的动态关系。道德困境是否会导致医护人员的幸福感降低或该行业的护理质量降低，在很大程度上取决于如何应对道德紧张局势，也称为道德韧性，以及可用的保护条件。医疗保健领域内关于道德困境和道德韧性的研究集中在护士和医生等工作人员上。关于姑息终末关怀的研究和/或协调人员角色的研究很少。进行了一项研究，以深入了解志愿姑息终末关怀协调员在实现优质护理的过程中所面临的道德挑战，他们如何应对这些挑战，以及促进或阻碍道德韧性的个人和组织特征。对 20 名协调员进行了访谈，并进行了定性分析。结果提出了在与志愿者合作和与专业护理人员合作时面临的 3 项道德挑战，即努力建立联系、协商自主权和努力进行开放沟通。然而，协调员似乎有效地应对了这些挑战。总之，协调员用来应对这些挑战的关系叙述策略，结合个人和组织条件，促进了道德韧性。
