Perceptions of conscience, stress of conscience and burnout among nursing staff in residential elder care

J Adv Nurs. 2010 Aug;66(8):1708-18. doi: 10.1111/j.1365-2648.2010.05288.x. Epub 2010 Jun 16.


Aim: This paper is a report of a study of patterns of perceptions of conscience, stress of conscience and burnout in relation to occupational belonging among Registered Nurses and nursing assistants in municipal residential care of older people.

Background: Stress and burnout among healthcare personnel and experiences of ethical difficulties are associated with troubled conscience. In elder care the experience of a troubled conscience seems to be connected to occupational role, but little is known about how Registered Nurses and nursing assistants perceive their conscience, stress of conscience and burnout.

Method: Results of previous analyses of data collected in 2003, where 50 Registered Nurses and 96 nursing assistants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire and Maslach Burnout Inventory, led to a request for further analysis. In this study Partial Least Square Regression was used to detect statistical predictive patterns.

Result: Perceptions of conscience and stress of conscience explained 41.9% of the variance in occupational belonging. A statistical predictive pattern for Registered Nurses was stress of conscience in relation to falling short of expectations and demands and to perception of conscience as demanding sensitivity. A statistical predictive pattern for nursing assistants was perceptions that conscience is an authority and an asset in their work. Burnout did not contribute to the explained variance in occupational belonging.

Conclusion: Both occupational groups viewed conscience as an asset and not a burden. Registered Nurses seemed to exhibit sensitivity to expectations and demands and nursing assistants used their conscience as a source of guidance in their work. Structured group supervision with personnel from different occupations is needed so that staff can gain better understanding about their own occupational situation as well as the situation of other occupational groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Burnout, Professional / psychology*
  • Conflict, Psychological
  • Conscience*
  • Cross-Sectional Studies
  • Female
  • Geriatric Nursing / ethics*
  • Humans
  • Male
  • Middle Aged
  • Nursing Assistants / psychology*
  • Nursing Homes / ethics
  • Nursing Staff / psychology*
  • Quality of Health Care / ethics
  • Surveys and Questionnaires
  • Sweden
  • Workload / psychology