Evidence map›Paper›PMID 38658812›Full record

ArticleBMC geriatrics2024

"Just pee in the diaper" - a constructivist grounded theory study of moral distress enabling neglect in nursing homes.

Stine Borgen Lund, Wenche K Malmedal, Laura Mosqueda, John-Arne Skolbekken

Abstract readMulticenter Study
In one paragraph

Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Stine Borgen LundDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, PO Box 8905, Norway. stine.b.lund@ntnu.no.
Wenche K MalmedalDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, PO Box 8905, Norway.
Laura MosquedaDepartment of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA.
John-Arne SkolbekkenDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, PO Box 8905, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA growing body of evidence shows that many nursing home residents' basic care needs are neglected, and residents do not receive qualitatively good care. This neglect challenges nursing staff´s professional and personal ideals and standards for care and may contribute to moral distress. The aim of this study was to investigate how nursing staff manage being a part of a neglectful work culture, based on the research question: "How do nursing home staff manage their moral distress related to neglectful care practices?"

methodsA qualitative design was chosen, guided by Charmaz´s constructivist grounded theory. The study was based on 10 individual interviews and five focus group discussions (30 participants in total) with nursing home staff working in 17 different nursing homes in Norway.

resultsNursing staff strive to manage their moral distress related to neglectful care practices in different ways: by favouring efficiency and tolerating neglect they adapt to and accept these care practices. By disengaging emotionally and retreating physically from care they avoid confronting morally distressing situations. These approaches may temporarily mitigate the moral distress of nursing staff, whilst also creating a staff-centred and self-protecting work culture enabling neglect in nursing homes.

conclusionsOur findings represent a shift from a resident-centred to a staff-centred work culture, whereby the nursing staff use self-protecting strategies to make their workday manageable and liveable. This strongly indicates a compromise in the quality of care that enables the continuation of neglectful care practices in Norwegian nursing homes. Finding ways of breaking a downward spiralling quality of care are thus a major concern following our findings.

Indexed as

Grounded TheoryNursing HomesAdultAgedElder AbuseFemaleFocus GroupsHomes for the AgedHumansMaleMiddle AgedMoralsNorwayNursing StaffQualitative ResearchStress, PsychologicalConstructivist grounded theoryCopingLong-term careMissed careMoral distressNeglectNursing home

Identifiers

PMID38658812
PMCPMC11040955

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.