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Ethical climate in healthcare: A systematic review and meta-analysis.

Authors :
Essex, Ryan
Thompson, Trevor
Evans, Thomas Rhys
Fortune, Vanessa
Kalocsányiová, Erika
Miller, Denise
Markowski, Marianne
Elliott, Helen
Source :
Nursing Ethics; Nov-Dec2023, Vol. 30 Issue 7/8, p910-921, 12p
Publication Year :
2023

Abstract

Background: Ethical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviour within teams. Aim: This paper sought to explore perceptions of ethical climate amongst healthcare workers as measured by the Ethical Climate Questionnaire (ECQ), the Hospital Ethical Climate Survey (HECS) and the Ethics Environment Questionnaire (EEQ). Methods: A systematic review and meta-analysis was utilised. PSYCINFO, CINAHL, WEB OF SCIENCE, MEDLINE and EMBASE were searched, and papers were included if they sampled healthcare workers and used the ECQ, HECS or EEQ. Ethical consideration: Ethical approval was not required. Results: The search returned 1020 results. After screening, 61 papers were included (n = 43 HECS, n = 15 ECQ, n = 3 EEQ). The overall sample size was over 17,000. The pooled mean score for the HECS was 3.60. Mean scores of individual studies ranged from 2.97 to 4.5. For the HECS studies, meta-regression was carried out. No relationship was found between the country of the studies, the study setting (ICU v non-ICU settings) or the mean years of experience that the sample had. For the ECQ, sub-scales had mean scores ranging from 3.41 (instrumental) to 4.34 (law) and were all observed to have significant and substantial heterogeneity. Three studies utilised the EEQ so further analysis was not carried out. Conclusions: The above results provide insight into the variability of scores as measured by the HECS, ECQ and EEQ. To some extent, this variability is not surprising with studies carried out across 21 countries and in a range of healthcare systems. Results also suggest that it may be that more local and context specific factors are more important when it comes to predicting ethical climate. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09697330
Volume :
30
Issue :
7/8
Database :
Complementary Index
Journal :
Nursing Ethics
Publication Type :
Academic Journal
Accession number :
174099479
Full Text :
https://doi.org/10.1177/09697330231177419