[Interventions for reducing moral distress in home care: An interview study with nurses and nursing ethicists].

BACKGROUND

Moral distress affects the health of home care nurses and can lead to the decision to leave the profession early. Little is known about the ways to reduce moral distress in the context of home care nursing.

OBJECTIVE

Identification of interventions to reduce moral distress in home care nurses.

METHOD

Interviews with home care nurses (n=20; 04-08/2023) from different organizations and with from different federal states and with care ethicists (n=6; 10/2023-04/2024) were conducted, transcribed and analyzed via qualitative content analysis.

RESULTS

On the one hand, interventions were identified that directly address the situations triggering moral distress or relate to the organization of work: e.g., support from superiors, evaluation of informal care, adaptation of the performance and billing system, family-friendly working time models, greater scope for decision-making, and improved cooperation between healthcare stakeholders. On the other hand, the respondents would like to see "ethical interventions", such as ethics counseling, and more opportunities for professional exchange, e.g., in the context of team meetings on ethical issues.

CONCLUSIONS

In addition to improving working conditions and creating a positive organizational culture, outpatient ethics consultations at provider level or across care services represent an important intervention.