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

Dilan Arıöz1, İlkay Boz2

  • 1Antalya City Hospital, Antalya, Turkey.

Nursing Ethics
|March 5, 2026
PubMed

BackgroundThe 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.AimThis 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 DesignAn explanatory sequential method, which is one of the mixed method designs.Participants and Research ContextThere 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 ConsiderationsThe 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).FindingsThe 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'.ConclusionIt 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.

Keywords:
conscientious objectionconscientious stressmidwifenursewomen’s health

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