Moral sensitivity of long-term care givers: A qualitative study

BackgroundChina's rapidly aging population and the implementation of long-term care insurance have increased the demand for long-term care givers (LTCGs), a certified non-nursing workforce with both practical and ethical responsibilities. Research on moral sensitivity has predominantly focused on nurses, leaving the experiences of LTCGs underexplored, particularly through qualitative inquiry.Research aimThis study characterizes how moral sensitivity is experienced and enacted by certified Chinese LTCGs and examines how the provisional dimensions of moral duty, moral burden, and moral strength structure these experiences.Research designA descriptive qualitative design incorporating semi-structured interviews and non-participant observations.Participants and research contextTwelve certified LTCGs were selected through purposive sampling. Participants were employed in nursing institutions (n = 6) and home-based settings (n = 6), with a mean age of 44.2 years; 25% held managerial positions with practical care experience. Data saturation was achieved after 12 interviews.Ethical considerationsThe study was approved by the Biomedical Research Ethics Review Committee of (Anonymous) (Approval No. [Anonymous]). Informed consent was obtained from participating LTCGs and service recipients before interview and observation.ResultsThe analysis identified three primary dimensions of moral sensitivity: moral duty, encompassing fulfillment of care responsibilities, adherence to rules, and protection of dignity; moral burden, arising from emotional distress, structural constraints, and dilemmas related to professional identity; and moral strength, encompassing perceptual, communication, ethical decision-making, psychological resilience, and relational capacities. These results illustrate how LTCGs recognized and navigated morally salient situations in everyday care.ConclusionsThis study provides a context-specific account of moral sensitivity among certified non-nursing LTCGs. The findings can inform ethics-oriented training and organizational support for long-term care practitioners in long-term-care settings across China and other nations. Given the small sample drawn from China, the three-dimensional framework should be further investigated across other regions and care settings before broader application.