Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study
OBJECTIVE: Moral distress emanating from value conflicts comprising ethical dimensions pose a threat to nurses’ health and retention, as well as to the quality of care. The aim of the present study was to investigate the relationships between the frequency of ethical value conflicts (EVC), and the p...
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| Format: | Article |
| Language: | English |
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Nordic Association of Occupational Safety and Health (NOROSH)
2024-03-01
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| Series: | Scandinavian Journal of Work, Environment & Health |
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| Online Access: |
https://www.sjweh.fi/article/4138
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| _version_ | 1797292557959430144 |
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| author | Pernilla Larsman Anders Pousette Maria Skyvell Nilsson Christian Gadolin Marianne Törner |
| author_facet | Pernilla Larsman Anders Pousette Maria Skyvell Nilsson Christian Gadolin Marianne Törner |
| author_sort | Pernilla Larsman |
| collection | DOAJ |
| description | OBJECTIVE: Moral distress emanating from value conflicts comprising ethical dimensions pose a threat to nurses’ health and retention, as well as to the quality of care. The aim of the present study was to investigate the relationships between the frequency of ethical value conflicts (EVC), and the perceived distress when they occur, respectively, and nurses’ work-related stress, burnout symptoms, turnover intent, team effectiveness, and patient safety. METHODS: A two-wave longitudinal cohort questionnaire study was performed among registered nurses at six hospitals in two Swedish regions. Cross-sectional analyses (T1) were based on 1817 nurses in 228 care units (CU), and longitudinal analyses (T1 – T2) on 965 nurses in 190 CU. Hypothesis testing was performed using multilevel controlled regression modeling. RESULTS: The results indicated that nurses who were often exposed to EVC also to a higher extent tended to report these conflicts as stressful. Frequent exposure to EVC induced by insufficient resources, inapt organizational structures or interpersonal staff relations were cross-sectionally associated with work-related stress, burnout symptoms, turnover intent, and team effectiveness. The longitudinal analyses indicated that EVC induced by a lack of resources primarily had negative effects on nurses’ health and well-being. At the CU level, such conflicts also impaired team effectiveness. At the individual level, EVC induced by organizational constraints or interpersonal relations negatively affected care effectiveness. CONCLUSIONS: EVC are related to negative consequences in healthcare, and such processes take place both on the individual and organizational levels. |
| first_indexed | 2024-03-07T19:58:10Z |
| format | Article |
| id | doaj.art-89eb607e60b84679b32c201f79aedee5 |
| institution | Directory Open Access Journal |
| issn | 0355-3140 1795-990X |
| language | English |
| last_indexed | 2024-03-07T19:58:10Z |
| publishDate | 2024-03-01 |
| publisher | Nordic Association of Occupational Safety and Health (NOROSH) |
| record_format | Article |
| series | Scandinavian Journal of Work, Environment & Health |
| spelling | doaj.art-89eb607e60b84679b32c201f79aedee52024-02-28T12:36:25ZengNordic Association of Occupational Safety and Health (NOROSH)Scandinavian Journal of Work, Environment & Health0355-31401795-990X2024-03-0150211312110.5271/sjweh.41384138Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire studyPernilla Larsman0Anders PousetteMaria Skyvell NilssonChristian GadolinMarianne TörnerDepartment of Psychology, University of Gothenburg, Box 500, SE-405 30 Gothenburg, Sweden.OBJECTIVE: Moral distress emanating from value conflicts comprising ethical dimensions pose a threat to nurses’ health and retention, as well as to the quality of care. The aim of the present study was to investigate the relationships between the frequency of ethical value conflicts (EVC), and the perceived distress when they occur, respectively, and nurses’ work-related stress, burnout symptoms, turnover intent, team effectiveness, and patient safety. METHODS: A two-wave longitudinal cohort questionnaire study was performed among registered nurses at six hospitals in two Swedish regions. Cross-sectional analyses (T1) were based on 1817 nurses in 228 care units (CU), and longitudinal analyses (T1 – T2) on 965 nurses in 190 CU. Hypothesis testing was performed using multilevel controlled regression modeling. RESULTS: The results indicated that nurses who were often exposed to EVC also to a higher extent tended to report these conflicts as stressful. Frequent exposure to EVC induced by insufficient resources, inapt organizational structures or interpersonal staff relations were cross-sectionally associated with work-related stress, burnout symptoms, turnover intent, and team effectiveness. The longitudinal analyses indicated that EVC induced by a lack of resources primarily had negative effects on nurses’ health and well-being. At the CU level, such conflicts also impaired team effectiveness. At the individual level, EVC induced by organizational constraints or interpersonal relations negatively affected care effectiveness. CONCLUSIONS: EVC are related to negative consequences in healthcare, and such processes take place both on the individual and organizational levels. https://www.sjweh.fi/article/4138 nursingnurseturnoverhealthcareethical value conflictteam effectivenesspatient safetylongitudinal questionnairequality of carenurses’ well-beingnurses' healthmoral distressethical dilemma |
| spellingShingle | Pernilla Larsman Anders Pousette Maria Skyvell Nilsson Christian Gadolin Marianne Törner Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study Scandinavian Journal of Work, Environment & Health nursing nurse turnover healthcare ethical value conflict team effectiveness patient safety longitudinal questionnaire quality of care nurses’ well-being nurses' health moral distress ethical dilemma |
| title | Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study |
| title_full | Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study |
| title_fullStr | Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study |
| title_full_unstemmed | Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study |
| title_short | Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study |
| title_sort | ethical value conflicts in healthcare and their effects on nurses health turnover intent team effectiveness and patient safety a longitudinal questionnaire study |
| topic | nursing nurse turnover healthcare ethical value conflict team effectiveness patient safety longitudinal questionnaire quality of care nurses’ well-being nurses' health moral distress ethical dilemma |
| url |
https://www.sjweh.fi/article/4138
|
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