EXPLORING ETHICAL TENSIONS AND VULNERABILITIES EXPERIENCED BY PERSONAL SUPPORT WORKERS

Abstract

This thesis includes two manuscripts with an overarching objective to improve understanding of ethical tensions and vulnerabilities experienced by personal support workers (PSWs). The first manuscript (Chapter two) presents a scoping review exploring experiences and challenges faced by PSWs which contribute to ethical tensions. Using thematic analysis for qualitative description as presented by Sandelowski (2010) and drawing on data collected from included articles examining experiences of PSWs I identified five areas of challenges that potentially contribute to ethical tensions: 1) lack of support, 2) lack of respect and value, 3) lack of training and education, 4) demanding workloads and 5) situations of risk in PSW employment environment. These findings were explored using the Job Demand Control Support (JDCS) Model to better understand how PSWs can be supported to be better able to navigate ethical tensions in their workplace. The second manuscript (Chapter three) presents a qualitative study that was conducted to examine the experiences of PSWs and identify factors that contribute to their vulnerability based on the taxonomy of vulnerability presented by MacKenzie, Rogers and Dodds (2014). Qualitative interviews with 11 PSWs were conducted and analyzed using the methods of thematic interpretive analysis presented by Thorne (2016). Through the analysis, various factors were identified as contributing to inherent, situational and pathogenic vulnerability of PSWs. Study findings will inform recommendations for policy-makers and healthcare leaders to create better work conditions and improve PSWs’ well-being thereby and enhancing overall quality of care.