Exploring conscientious stress and objection among women’s health nurses and midwives

Abstract

Background

The concepts of conscientious stress and conscientious objection in nursing and midwifery create an ethical and legal debate in terms of balancing the continuity of patient care and the individual rights of healthcare professionals.

Aim

This study aimed to determine the levels of conscientious stress and to explore the specific forms and contexts of conscientious objection experienced by nurses and midwives working in women’s health using an explanatory sequential mixed-methods design.

Research Design

An explanatory sequential method, which is one of the mixed method designs.

Participants and Research Context

There were 45 nurses and 35 midwives in the quantitative phase, and 7 nurses, 4 midwives in the qualitative phase. Data were collected using Conscience Stress Scale (CSS) and individual semi-structured interview form. Statistical Analysis System was used in the analysis of quantitative data, and content interpretive phenomenological analysis method was used in the analysis of qualitative data.

Ethical Considerations

The study followed the principles of the Helsinki Declaration. It was approved by the Ethics Committee of Akdeniz University Faculty of Medicine (KAEK-235, 30.03.2022).

Findings

The mean scores of the participants’ CSS total scores depend on the institution they work in (p = .0021), the adequacy of the number of nurses/midwives (p = .0129) and level of satisfaction with the working environment (p = .0425). 5 themes and 12 sub-themes were obtained in the qualitative analysis. The themes are ‘situations causing conscience stress’, ‘consequences of conscientious stress, ‘conscientious objection actions’, ‘motivations for conscientious objection’ and ‘consequences of conscientious objection’.

Conclusion

It has been determined that nurses and midwives working in the field of women’s health experience moderate conscientious stress, as a result of which they often resort to conscientious objection and that they carry out their conscientious objection experiences in order to increase the quality of patient care by considering the benefit of the patient.