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Ethical climate in healthcare: a systematic review and meta-analysis

Ethical climate in healthcare: a systematic review and meta-analysis

Essex, Ryan ORCID: 0000-0003-3497-3137, Thompson, Trevor ORCID: 0000-0001-9880-782X, Evans, Thomas ORCID: 0000-0002-6670-0718, Fortune, Vanessa, Kalocsanyiova, Erika ORCID: 0000-0002-3535-1084, Miller, Denise A ORCID: 0000-0001-9947-0616, Markowski, Marianne ORCID: 0000-0003-4652-3168 and Elliott, Helen ORCID: 0000-0002-8798-1037 (2023) Ethical climate in healthcare: a systematic review and meta-analysis. Nursing Ethics. ISSN 0969-7330 (Print), 1477-0989 (Online) (doi:https://doi.org/10.1177/09697330231177419)

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Abstract

Background: Ethical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviours 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, subscales 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.

Item Type: Article
Uncontrolled Keywords: ethics; ethical climate; health; healthcare; nursing
Subjects: B Philosophy. Psychology. Religion > B Philosophy (General)
R Medicine > RA Public aspects of medicine
R Medicine > RT Nursing
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Inequalities
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Mental Health
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Professional Workforce Development
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families
Faculty of Education, Health & Human Sciences > School of Health Sciences (HEA)
Last Modified: 08 Aug 2023 09:37
URI: http://gala.gre.ac.uk/id/eprint/41792

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