Assessments of stress of conscience, burnout and social support amongst care providers in home care and residential care for older people

Abstract

Background Studies points to that levels of stress of conscience and burnout among staff in healthcare contexts may seriously affect their health. Aim To compare assessments and associations of stress of conscience, perceptions of conscience, social support and burnout amongst care providers working in home care respectively residential care for older people. Methods This cross‐sectional descriptive comparative study was performed among all care providers working in home care (n = 227) and residential care of older people (n = 354) in a municipality in northern Sweden. Data was collected using four different questionnaires. Analysis were performed using partial least square regression, descriptive statistics, statistical tests and effect size measures. Results Care providers in residential care of older people assessed higher levels of stress of conscience compared to those working in home care. Exhaustion was an important predictor for belonging to the group of care providers working in residential care of older people. The most important predictor for belonging to the group of care providers working in home care were social support from one's immediate superior and co‐workers. Women assessed significantly higher levels of stress of conscience and exhaustion compared to men. Conclusion Further research seems needed to investigate what the high levels of stress of conscience is caused by. A combined intervention consisting of work‐directed measures against burnout and measures aiming at reducing stress of conscience is suggested.

Registered nurses’ exposure to high stress of conscience in long-term care

“…8 Among the socio-demographic factors associated with reporting a high SCQ score, women were almost four times more likely to score high on stress than men, which is consistent with previous findings. 1,14 Age had little impact on the likelihood of reporting a high SCQ score in our study. Single care providers were 1.7 times more likely to report a high score than those who were cohabiting.…”

“…1,9 Examples of situations that contribute to stress of conscience in long-term care are the poor organisation of the working process, conflicting interpersonal relationships, difficulties with priorities and insufficient time to meet the patient's needs. [10][11][12] Burnout, low quality of care and a tendency to leave the profession are seen as consequences thereof 13,14 and raise concerns within the care setting that is already challenged due to staffing issues. 15 For instance, in 2018, Norwegian nursing homes and home care services reported a shortage of 8,000 registered nurses and other care providers, and since 2015, the shortage of registered nurses has doubled.…”

“…20 Since stress of conscience is perceived as related to both internal and external demands, 2 the phenomenon has been studied both from an individual and contextual perspective. Among contextual organisational factors, Åhlin et al 14 found that care providers in nursing homes report a higher degree of stress of conscience than care providers in home-based care, which the authors explained as being due to differences in the number of patients that an individual carer needs to care for at one time. Increased workload, in addition to organisational changes such as restructuring processes, has also been reported across environments and is linked to a higher degree of stress of conscience in general.…”

Intensive care unit nurses' conflict of conscience: Walking the Razor's edge

“…Moreover, evidence indicates that nurses have experienced conflict of conscience and moral stress in difficult moral situations and dilemmas (Åhlin, 2015;Juthberg et al, 2008;Sørlie et al, 2003). Rooted in the ICU context, these phenomena lead to a negative perception of the situation and the creation of conflict of conscience.…”

Teaming up to traverse loneliness: a co-creative journey toward a home care work model for supporting social participation among older adults

“…This demanding work situation has been described as one of low control, affecting care workers' health, quality of work life, and their output quality of care [28]. But while stress of conscience and exhaustion are common, home care workers often describe their jobs as meaningful and morally fulfilling [29]. And while the profession is known for its complexity, home care workers have low levels of formal education; usually assistant nurse training (training at a high school level), but a lack of formal care training is also common.…”