Moral distress in home-care nursing

What is it about?

Nurses frequently face situations in their daily practice that are ethically difficult to handle and can lead to moral distress. This study aimed to explore the phenomenon of moral distress and describe its work-related predictors and individual consequences for home-care nurses in Germany. A cross-sectional design was employed. The moral distress scale and the COPSOQ III-questionnaire were used within the framework of an online survey conducted among home-care nurses in Germany. Frequency analyses, multiple linear and logistic regressions, and Rasch analyses were performed. Participants and research context The invitation to participate was sent to every German home-care service (n = 16,608). A total of 976 home-care nurses participated in this study. Job characteristics, such as high emotional demands, frequent work-life-conflicts, low influence at work, and low social support, were associated with higher disturbance caused by moral distress in home-care nurses. Organizational characteristics of home-care services, such as time margin with patients, predicted moral distress. High disturbance levels due to moral distress predicted higher burnout, worse state of health, and the intention to leave the job and the profession, but did not predict sickness absence. To prevent home-care nurses from experiencing severe consequences of moral distress, adequate interventions should be developed. Home-care services ought to consider family friendly shifts, provide social support, such as opportunities for exchange within the team, and facilitate coping with emotional demands. Sufficient time for patient care must be scheduled and short-term takeover of unknown tours should be prevented. There is a need to develop and evaluate additional interventions aimed at reducing moral distress, specifically in the home-care nursing sector.

Featured Image

Photo by Georg Arthur Pflueger on Unsplash

Photo by Georg Arthur Pflueger on Unsplash

Why is it important?

The findings have important implications to form intervention strategies to prevent moral distress among home-care nurses. We believe that our study makes a significant contribution to the literature because it addresses the lack of empirical investigation on the root causes and consequences of moral distress among nurses in home-care settings.

Perspectives