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Managers experiences of ethical problems in municipal elderly care: a qualitative study of written reflections as part of leadership training
Univ Boras, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Univ Boras, Sweden.ORCID iD: 0000-0003-0987-7653
Univ Boras, Sweden; Linnaeus Univ, Sweden.
2019 (English)In: Journal of Healthcare Leadership, ISSN 1179-3201, E-ISSN 1179-3201, Vol. 11, p. 63-74Article in journal (Refereed) Published
Abstract [en]

Background: Managers in elderly care have a complex ethical responsibility to address the needs and preferences of older persons while balancing the conflicting interests and requirements of relatives demands and nursing staffs work environment. In addition, managers must consider laws, guidelines, and organizational conditions that can cause ethical problems and dilemmas that need to be resolved. However, few studies have focused on the role of health care managers in the context of how they relate to and deal with ethical conflicts. Therefore, the aim of this study was to describe ethical problems experienced by managers in elderly care. Methods: We used a descriptive, interpretative design to analyze textual data from two examinations in leadership courses for managers in elderly care. A simple random selection of 100 out of 345 written exams was made to obtain a manageable amount of data. The data consisted of approximately 300 pages of single-spaced written text. Thematic analysis was used to evaluate the data. Results: The results show that managers perceive the central ethical conflicts relate to the older persons autonomy and values versus their needs and the values of the staff. Additionally, ethical dilemmas arise in relation to the relatives perspective of their loved ones needs and preferences. Legislations, guidelines, and a lack of resources create difficulties when managers perceive these factors as conflicting with the care needs of older persons. Conclusion: Managers in elderly care experience ethical conflicts that arise as unavoidable and perennial values conflicts, poorly substantiated values, and problematic organizational conditions. Structured approaches for identifying, reflecting on, and assessing ethical problems in the organization should therefore be implemented.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD , 2019. Vol. 11, p. 63-74
Keywords [en]
manager; ethical responsibility; municipal; older person; thematic analysis
National Category
Medical Ethics
Identifiers
URN: urn:nbn:se:liu:diva-159022DOI: 10.2147/JHL.S199167ISI: 000471092500001PubMedID: 31213938OAI: oai:DiVA.org:liu-159022DiVA, id: diva2:1338064
Available from: 2019-07-19 Created: 2019-07-19 Last updated: 2019-07-19

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