Weiste Elina, Paavolainen Maria, Olin Nina, Korkiakangas Eveliina, Saari Eveliina, Koivisto Tiina, Laitinen Jaana
Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
Healthcare (Basel). 2023 Jan 18;11(3):291. doi: 10.3390/healthcare11030291.
Elderly care practitioners are at specific risk of experiencing prolonged moral distress, which is associated with occupational health-related problems, low job satisfaction, and staff turnover. So far, little attention has been paid to the moral concerns specific to elderly care, a field whose importance is constantly growing as the populations in Western countries age. By drawing on seven workshop conversations as data and interaction-oriented focus group research, conversation analysis and discursive psychology as methods, we aim to study the ways in which elderly care practitioners discuss moral distress in their work. We found that the moral distress experienced was related to three topics that arose when client work and teamwork contexts were discussed: the power to influence, equal treatment of people, and collaboration. The interaction in client work and teamwork contexts differed systematically. The discussion on client work was characterised by negotiations on the rights and wrongs of care work, whereas the teamwork discussion engendered emotional outbursts, a potential manifestation of work-related burnout. Hence, attempts to improve the work-related health of elderly care practitioners require time and space for sharing the emotional load, followed by reflection on what could be improved in the work and what institutional solutions could help in morally distressing situations.
老年护理从业者特别容易经历长期的道德困扰,这与职业健康相关问题、低工作满意度和员工流动率有关。到目前为止,很少有人关注老年护理特有的道德问题,随着西方国家人口老龄化,这个领域的重要性在不断增加。通过将七次研讨会对话作为数据,并以互动为导向进行焦点小组研究,采用对话分析和话语心理学作为方法,我们旨在研究老年护理从业者在工作中讨论道德困扰的方式。我们发现,所经历的道德困扰与在讨论客户工作和团队合作背景时出现的三个主题相关:影响力、平等对待他人以及合作。客户工作和团队合作背景下的互动存在系统性差异。关于客户工作的讨论以护理工作是非对错的谈判为特征,而团队合作讨论则引发了情绪爆发,这可能是与工作相关的倦怠的一种表现。因此,要改善老年护理从业者与工作相关的健康状况,需要有时间和空间来分担情感负担,随后要反思工作中可以改进的地方以及在道德困扰情况下哪些制度性解决方案会有所帮助。