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Organisational and Ethical Challenges While Caring for Older People During the COVID-19 Pandemic in Sweden: A Focus Group Study
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0001-8557-8714
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. The School of Health and Welfare, Dalarna University, Falun, Sweden .ORCID iD: 0000-0003-2511-9502
2024 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 19, no 6, article id e12663Article in journal (Refereed) Published
Abstract [en]

Introduction: During the COVID-19 pandemic, older people in Sweden's residential care facilities and home care services experienced high mortality rates. Prior to the pandemic, the care of older people in Sweden was challenged by organisational and regulatory changes, an ageing population and insufficient increases in staff numbers. These issues led to high staff turnover, increased workloads, stress, burnout and a perceived inability to provide satisfactory care. The pandemic brought about increased job strain, stress, anxiety, depression and post-traumatic stress disorder among the staff who cared for older people. The aim of this study was therefore to focus on assistant nurses and care aides' experiences of their work environments when caring for older people during the pandemic in Sweden. Methods: The data were collected through four focus groups interviews and analysed using qualitative content analysis. Results: The results showed that the care staff had to navigate organisational and ethical challenges in poor and unsafe work environments. They lacked supportive leadership in their respective organisations, were neither valued, seen nor heard and were treated as ‘plain doers’. During the pandemic, they were unable to protect or communicate easily with the older people in their care, which had harsh consequences. Conclusion: According to the participants, the pandemic left them, their working conditions and this part of the care system in a worse situation than before the pandemic. The pandemic thus revealed more unsustainable and unethical working conditions for the staff than before it, including the vulnerability of the older people in their care. Implications for Practice: The findings highlights the need of policies that ensure adequate training and instruction on medical issues, for managers responsible for overseeing the care of older people. There are also a need of provision of sufficient support for care staff and health care professionals during crises. The findings also underscore the need of feasible and efficient strategies do disseminate care information and address the psychosocial needs of older people. 

Place, publisher, year, edition, pages
John Wiley and Sons Inc , 2024. Vol. 19, no 6, article id e12663
Keywords [en]
care of older people, health care ethics, home care, leadership, multiprofessional working, residential care, Adult, Aged, COVID-19, Female, Focus Groups, Geriatric Nursing, Humans, Male, Middle Aged, Pandemics, Qualitative Research, SARS-CoV-2, Sweden, coronavirus disease 2019, epidemiology, ethics, human, information processing, pandemic, Severe acute respiratory syndrome coronavirus 2
National Category
Nursing
Identifiers
URN: urn:nbn:se:mdh:diva-68998DOI: 10.1111/opn.12663ISI: 001368181600001PubMedID: 39470135Scopus ID: 2-s2.0-85208081979OAI: oai:DiVA.org:mdh-68998DiVA, id: diva2:1912956
Available from: 2024-11-13 Created: 2024-11-13 Last updated: 2025-10-10Bibliographically approved

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Lövenmark [Åberg] [Engström], AnnicaMarmstål Hammar, Lena

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