| 61. |
- Glasberg, Ann-Louise, et al.
(författare)
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Burnout and 'stress of conscience' among healthcare personnel
- 2007
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Ingår i: Journal of Advanced Nursing. - : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 57:4, s. 392-403
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper reports a study examining factors that may contribute to burnout among healthcare personnel.Background: The impact on burnout of factors such as workload and interpersonal conflicts is well‐documented. However, although health care is a moral endeavour, little is known about the impact of moral strain. Interviews reveal that healthcare personnel experience a troubled conscience when they feel that they cannot provide the good care that they wish – and believe it is their duty – to give.Methods: In this cross‐sectional study, conducted in 2003, a sample of 423 healthcare personnel in Sweden completed a battery of questionnaires comprising the Maslach Burnout Inventory, Perception of Conscience Questionnaire, Stress of Conscience Questionnaire, Social Interactions Scale, Resilience Scale and a personal/work demographic form.Results: Regression analysis resulted in a model that explained approximately 59% of the total variation in emotional exhaustion. Factors associated with emotional exhaustion were ‘having to deaden one's conscience’, and ‘stress of conscience’ from lacking the time to provide the care needed, work being so demanding that it influences one's home life, and not being able to live up to others’ expectations. Several additional variables were associated with emotional exhaustion. Factors contributing to depersonalization were ‘having to deaden one's conscience’, ‘stress of conscience’ from not being able to live up to others’ expectations and from having to lower one's aspirations to provide good care, deficient social support from co‐workers, and being a physician; however, the percentage of variation explained was smaller (30%).Conclusion: Being attentive to our own and others’ feelings of troubled conscience is important in preventing burnout in health care, and staff need opportunities to reflect on their troubled conscience. Further research is needed into how a troubled conscience can be eased, particularly focusing on the working environment.
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| 62. |
- Glasberg, Ann-Louise, et al.
(författare)
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Development and initial validation of the Stress of Conscience Questionnaire.
- 2006
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:6, s. 633-48
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Tidskriftsartikel (refereegranskat)abstract
- Stress in health care is affected by moral factors. When people are prevented from doing 'good' they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach's alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: 'internal demands' and 'external demands and restrictions'. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts.
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| 63. |
- Glasberg, Ann-Louise, et al.
(författare)
-
Factors associated with 'stress of conscience' in healthcare.
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:2, s. 249-58
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The main purpose of this study was to examine factors related to 'stress of conscience' i.e. stress related to a troubled conscience in healthcare. METHODS: A series of questionnaires was completed by 423 healthcare employees in northern Sweden as part of this cross-sectional study. The series of questionnaires comprised the 'Stress of Conscience Questionnaire', 'Perception of Conscience Questionnaire', 'Revised Moral Sensitivity Questionnaire', Social Interactions Scale, Resilience Scale and a Personal/Work Demographic form. RESULTS: Nonautomatic stepwise regression analysis with forward inclusion resulted in a model that explained approximately 39.6% of the total variation in stress of conscience. Individual items associated with stress of conscience were; perceiving that conscience warns us against hurting others while at the same time not being able to follow one's conscience at work and having to deaden one's conscience to keep working in healthcare. In addition moral sensitivity items belonging to the factor 'sense of moral burden' were; one's ability to sense patient's needs means that one is doing more than one has strength for, having difficulty to deal with feelings aroused when a patient is suffering and one's ability to sense patient's needs means feeling inadequate all added significantly to the model. In addition, deficient social support from superiors, low levels of resilience and working in internal medicine wards were all associated with stress of conscience. CONCLUSION: Healthcare employees seem to experience stress of conscience in their everyday practise. Particular contributing factors are not being able to follow one's conscience at work, and the 'negative' dimension of moral sensitivity - moral burden - which is an inability to deal with moral problems. Thus, in order for conscience and moral sensitivity to become an asset instead of a burden, healthcare employees need to be able to express their moral concerns.
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| 64. |
- Glasberg, Ann-Louise, et al.
(författare)
-
Sources of burnout among healthcare employees as perceived by managers
- 2007
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Ingår i: Journal of Advanced Nursing. - : Blackwell Verlag. - 0309-2402 .- 1365-2648. ; 60:1, s. 10-19
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This paper is a report of a study to investigate healthcare managers’ perspectives on factors contributing to the increase of healthcare employees on sick leave for burnout symptoms.Background: Current turbulent healthcare reorganization has resulted in structural instability, role conflicts and vague responsibility commitments, all of which contribute to increasing numbers of sick days caused by burnout symptoms. Managers’ perceptions of burnout sources are important as these perceptions guide the actions taken to prevent burnout.Method: Interviews were carried out with 30 healthcare managers, with different occupational backgrounds and from different units. The data were collected in Sweden in 2003 and analysed using thematic qualitative content analysis.Findings: According to the healthcare managers, continuous reorganization and downsizing of healthcare services has reduced resources and increased demands and responsibilities. These problems are compounded by high ideals and expectations, making staff question their own abilities and worth as well as making them feel less confirmed and less valued as people. The main finding indicates that healthcare employees are thrown into a spiralling sense of inadequacy and an emerging sense of pessimism and powerlessness.Conclusion: To understand and influence people’s actions, one has to understand their perceptions and thoughts – their explanatory models. This study shows the complexity and interconnection between sources of burnout as perceived by healthcare managers, and highlights the encouragement of realism without the destruction of enthusiasm as an important factor in management and healthcare practice.
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| 65. |
- Gustafsson, Gabriella, et al.
(författare)
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Burnout and perceptions of conscience among health care personnel : a pilot study.
- 2010
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 17:1, s. 23-38
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Tidskriftsartikel (refereegranskat)abstract
- Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one's conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group.
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| 66. |
- Gustafsson, Gabriella, 1951-, et al.
(författare)
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Meanings of becoming and being burnout : phenomenological-hermeneutic interpretation of female healthcare personnel's narratives
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - Umeå : Institutione för omvårdnad. - 0283-9318 .- 1471-6712. ; 22:4, s. 520-528
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of burnout has increased in many industrialized countries. Burnout is mainly studied among people still at work and with quantitative methods. The present study aimed to illuminate the meanings of becoming and being burnout as narrated by healthcare personnel on sick leave because of symptoms of burnout. Interviews with 20 female healthcare personnel were performed, tape-recorded and transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. The result shows that the meanings of becoming and being burnout are to be torn between what one wants to be and what one manages. It is as one's ideals have become more like demands and no matter the circumstances, one must be and show oneself as being capable and independent. It is also to be dissatisfied with oneself for not living up to one's ideals as well as disappointed with other people for not giving the confirmation one strives for. Feelings of being a victim of circumstances emerge. Thus, becoming and being burnout is leading a futile struggle to live up to one's ideal, failing to unite one's ideal picture with one's reality and experiencing an overwhelming feebleness. This is interpreted in the light of Buber's philosophy as well as relevant empirical studies about burnout. One conclusion is that it seems important to reflect on as well as discuss between one another about our everyday reality; what are reasonable vs. unreasonable demands. Hopefully, such reflections will increase our tolerance of ourselves and others and our insightfulness of what is possible to achieve in work as well as in private life. This study is ethically approved.
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| 67. |
- Gustafsson, Gabriella, et al.
(författare)
-
Personality traits among burnt out and non-burnt out health-care personnel at the same workplaces : a pilot study
- 2009
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 18:5, s. 336-348
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Tidskriftsartikel (refereegranskat)abstract
- Stress-related illnesses, such as burnout, have increased over the last decade, but not everyone at the same workplace develops burnout, suggesting that individual factors may contribute to this phenomenon. The aim of this study was to describe patterns of personality traits among two groups of health-care personnel from the same workplaces, one group on sick leave due to medically-assessed burnout, and one group with no indication of burnout, respectively. Fourteen psychiatric- (n = 7) and elderly (n = 7)-care units, located in one specific area in a municipality in northern Sweden, participated in this questionnaire-based study. The participants (n = 40), on sick leave due to medically-assessed burnout (n = 20), and those with no indication of burnout (n = 20), respectively, completed Cattell's 16 Personality Factors Questionnaire between February and December 2004. Conventional statistical methods and partial least square regression were used to analyze data. The results showed that the burnout group had lower scores regarding emotional stability and higher scores regarding anxiety than the non-burnout group, but the results also showed a wide variation of personality traits within groups. The most important indicators for belonging to the burnout group were 'openness to changes' and 'anxiety', and for belonging to the non-burnout group, 'emotional stability', 'liveliness', 'privateness' (i.e. forthright or discreet), and 'tension'. The result indicates complex interactions between personality traits and the context in which the individual lives. It seems to be important to increase our awareness of when personality traits may constitute opportunities versus risks in dealing with one's existing circumstances.
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| 68. |
- Lindahl, Elisabeth, et al.
(författare)
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Nurses' ethical reflections on caring for people with malodorous exuding ulcers.
- 2010
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 17:6, s. 777-790
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate nurses' reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews were analysed using qualitative content analysis. Our interpretations of participants' reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to 'do good' and 'be good'. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to 'do good' for patients and 'be good' nurses.
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| 69. |
- Lindahl, Elisabeth, et al.
(författare)
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Striving for purity : shared understandings in retired Swedish care providers' narratives on nursing care around 1950.
- 2004
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Ingår i: Journal of Holistic Nursing. - : SAGE Publications. - 0898-0101 .- 1552-5724. ; 22:4, s. 333-350
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Tidskriftsartikel (refereegranskat)abstract
- Caring for the sick has been important throughout all times. Nursing care has been illuminated from various perspectives. The aim of this study was to illuminate nursing care as narrated by 27 retired care providers in northern Sweden. The themes of cleanliness, order, and clear conscience stood out as important in the text. The results are interpreted as pointing to purity. Purity is a complex phenomenon within the cultural context. Some literature states that in the past, physical cleanliness, moral purity, and order were closely interrelated. Nurses were expected to be religious, morally pure persons in clean and perfect uniforms, always prepared to serve and do their duty. Purity is not always readily apparent. It is often revealed through its absence or opposite. Purity and conscience are seldom addressed in contemporary nursing research. More research is needed to further reflect on purity and its significance for nursing care today.
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| 70. |
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