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

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Sofia Kjellström
Per Sjölander


The quality of care is substantially influenced by the staff‘s value priorities. The purpose of this study was to identify and characterize value systems among nursing assistants and nurses’ aides, and to assess relations between 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 to early (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 autonomy of older people. Assessment of value system, socio-demographic, and occupational variables showed that the value systems had a stronger predictive impact on views on care ethics, participation, and autonomy. The results indicate that staff with late conventional value systems prioritized older persons’ exercise of autonomy, while paternalism held priority in staff with early conventional value systems.


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