Skyvell Nilsson Maria, Gadolin Christian, Larsman Pernilla, Pousette Anders, Törner Marianne
Department of Health Sciences, University West, Trollhättan, Sweden.
School of Business, Economics and IT, University West, Trollhättan, Sweden.
J Adv Nurs. 2024 Feb;80(2):765-776. doi: 10.1111/jan.15889. Epub 2023 Sep 29.
To explore if and how nurses' perceived organizational support affects their ability to handle and resolve ethical value conflicts.
A mixed methods design with a longitudinal questionnaire survey and focus group interviews.
A questionnaire survey in six hospitals in two Swedish regions provided data from 711 nurses responding twice (November-January 2019/2020 and November-January 2020/2021). A cross-lagged path model tested the mutual prospective influence between the organizational climate of perceived organizational support, frequency of ethical value conflicts, and resulting moral distress. Four focus group interviews were conducted with 21 strategically selected nurses (April-October 2021). Qualitative data collection and analysis were inspired by Grounded Theory.
A climate of perceived organizational support was empowering, contributing to role security. It prospectively decreased the frequency of ethical value conflicts but not the moral distress when conflicts did occur.
It is important to facilitate the development of perceived organizational support among nurses, but also to reduce the occurrence of ethical value conflicts that the nurses cannot resolve.
By ensuring a shared care ideology, good inter-professional relations within the entire care organization, providing clear and supportive organizational structures, and utilizing competence adequately, healthcare managers can facilitate and support the development of perceived organizational support among nurses. Nurses who are empowered by perceived organizational support are stimulated by and take pride in their work and experience the work as meaningful and joyful.
The study addressed the question of whether healthcare organizations could support nurses to resolving ethical value conflicts, and thus reduce moral distress. Perceived organizational support is related to factors such as ideological caring alignment and supportive organizational preconditions. This study contributes specific knowledge about how healthcare organizations can empower nurses to effectively resolve ethical value conflicts and thereby reduce their moral distress.
No patient or public contribution.
探讨护士所感知到的组织支持是否以及如何影响其处理和解决伦理价值冲突的能力。
采用纵向问卷调查和焦点小组访谈相结合的混合方法设计。
对瑞典两个地区的六家医院进行问卷调查，收集了711名护士的数据（2019年11月至2020年1月以及2020年11月至2021年1月期间进行了两次回复）。采用交叉滞后路径模型检验所感知到的组织支持的组织氛围、伦理价值冲突频率以及由此产生的道德困扰之间的相互前瞻性影响。对21名经过策略性挑选的护士进行了四次焦点小组访谈（2021年4月至10月）。定性数据的收集和分析受到扎根理论的启发。
所感知到的组织支持氛围具有赋能作用，有助于角色安全感。它前瞻性地降低了伦理价值冲突的频率，但在冲突发生时并未减轻道德困扰。
促进护士所感知到的组织支持的发展很重要，但同时也需要减少护士无法解决的伦理价值冲突的发生。
通过确保共同的护理理念、整个护理组织内良好的跨专业关系、提供清晰且支持性的组织结构以及充分利用专业能力，医疗保健管理人员可以促进和支持护士所感知到的组织支持的发展。受到所感知到的组织支持赋能的护士会受到工作的激励并为之自豪，将工作体验为有意义且愉快的。
该研究探讨了医疗保健组织是否能够支持护士解决伦理价值冲突从而减少道德困扰这一问题。所感知到的组织支持与诸如思想关怀一致性和支持性组织前提条件等因素相关。本研究提供了关于医疗保健组织如何赋能护士有效解决伦理价值冲突从而减少其道德困扰的具体知识。
无患者或公众参与。
