The level of development of nursing assistants’ value system predicts their views on paternalistic care and personal autonomy

摘要

The quality of care is substantially influenced by the staff’s value priorities.The purpose of this study was to identify and characterize value systemsamong nursing assistants and nurses’ aides, and to assess relationsbetween their value systems and views on good care. A cross-sectional,quantitative study in a Swedish municipality was performed (N 226).Three distinct value systems were identified, and they corresponded toearly (n 121), middle (n 88), and late (n 17) conventional stages ofego development. Early conventional value systems emphasized strict rules,routines and working conditions of staff, while middle and, in particularly,late conventional value systems stressed individualization and autonomyof older people. Assessment of value system, socio-demographic, andoccupational variables showed that the value systems had a strongerpredictive impact on views on care ethics, participation, and autonomy.The results indicate that staff with late conventional value systemsprioritized older persons’ exercise of autonomy, while paternalism heldpriority in staff with early conventional value systems.