Strategies to mitigate moral distress as reported by eldercare professionals

ABSTRACT

Eldercare workers experience higher levels of moral distress than other health and social care service workers. Moral distress is a psychological response to a morally challenging event. Very little is known about moral distress in the context of eldercare and about the mechanisms of preventing or mitigating moral distress. This qualitative study was conducted as part of the “Ensuring the availability of staff and the attractiveness of the sector in eldercareservices” project in Finland in 2021. The data were from 39 semi-structured interviews. This qualitative interview data were examined using two-stage content analysis. The key finding of this study, as reported by eldercare professionals, is that strategies to mitigate moral distress can be found at all organizational levels : organizational, workplace and individual. The tools that emerged from the interviews fell into four main categories: 1) organizational support and education 2) peer support 3) improving self-care and competence and 4) defending patients. The main identified categories confirmed the earlier findings but the qualitative, rich research interview data provided new insights into a little-studied topic: mitigating moral distress in eldercare. The main conclusion is that, in order to mitigate moral distress, ethical competence needs to be strengthened at all organizational levels.

KEYWORDS:

• Eldercare professionals
• moral distress
• interview study
• ethical competence
• workplace tools

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Our project “Ensuring the availability of staff and the attractiveness of the sector in elderly care services” (2020-2023), was funded by the Ministry of Social Affairs and Health and Finnish Institute for Health and Welfare.

Notes on contributors

Tiina Koivisto

Tiina Koivisto (Ph.D.) (Licentiate of Arts, Psychology) works as Senior Specialist in Finnish Institute of Occupational Health. Her current research interests relate to psychological resilience, digital agency and moral distress among social and health care workers.

Maria Paavolainen

Maria Paavolainen (MTh) is a researcher in the Finnish Institute of Occupational Health. She specializes in social ethics and her current research interest lie in the ethical aspects of elder care work.

Nina Olin

Nina Olin is senior consultant at the Institute of Occupation Health, Finland. Previous appointments include researcher, Turku University of Economics and researcher, University of Turku, Finland. She received her Master of Social Sciences (sociology) in 1998.

Eveliina Korkiakangas

Eveliina Korkiakangas, Ph.D. works as specialist researcher in Finnish Institute of Occupational Health. Her current research interests relate to employee and entrepreneurial well-being, recovery from work, job strain and moral distress among social and health care workers. https://orcid.org/0000-0002-7939-8749

Jaana Laitinen

Jaana Laitinen is responsible leader of several R&D projects on the promotion of well-being and work ability among health and social service employees. She is specialized on health promotion at workplaces. She has about 200 peer-reviewed publications.