The relationship between ethical climate and nursing service behavior in public and private hospitals: a cross-sectional study in China.

BACKGROUND: Workplace climate is a great significant element that has an impact on nurses' behavior and practice; moreover, nurses' service behavior contributes to the patients' satisfaction and subsequently to the long-term success of hospitals. Few studies explore how different types of organizational ethical climate encourage nurses to engage in both in-role and extra-role service behaviors, especially in comparing the influencing process between public and private hospitals. This study aimed to compare the relationship between the five types of ethical climate and nurses' in-role and extra-role service behaviors in public and private hospitals. METHODS: This study conducted a cross-sectional survey on 559 nurses from China in May 2019. The questionnaire was distributed to nurses by sending a web link via the mobile phone application WeChat through snowball sampling methods. All participants were investigated using the Ethical Climate Scale and Service Behavior Questionnaire. SPSS 22.0 was used for correlation analysis, t-test, and analysis of variance test, and Mplus 7.4 was used for group comparison (p < .05). RESULTS: The law and code climate has a much greater influence on nurses' in-role service behavior in private hospitals than on that in public hospitals (ß = - 0.277; CI 95 % = [-0.452, - 0.075]; p < .01), and the instrumental climate has a stronger influence on nurses' extra-role service behavior private hospitals than on that in public hospitals (ß = - 0.352; CI 95 % = [-0.651, - 0.056]; p < .05). Meanwhile, the rules climate has a greater effect on nurses' extra-role service behavior in public hospitals than it does in private hospitals (ß = 0.397; CI 95 % = [0.120, 0.651]; p < .01). CONCLUSIONS: As the relationship between the five types of ethical climate and nurses' in-role and extra-role service behaviors in public and private hospitals were different, the strategies used to foster and enhance the types of ethical climate are various from public to private hospitals. The caring and instrumental climate are the key to promote extra-role service behavior for nurses in private hospitals. And the independent climate has a great effect on extra-role service behaviors for nurses in public hospitals.

Ethical climate and service behaviours in nurses: The moderating role of employment type.

AIM: To explore the relationship between ethical climate (EC) and nurses' service behaviours (SB) and examine the moderating effect of nurses' employment type. BACKGROUND: As most public hospitals in China implement the "dual-track system" of nurses' employment, the two different types of nurses, contract-employed nurses and state-employed nurses, receive the different pay for the same work, which results in they providing different SB. It has become critical for hospital administrators and nursing managers to understand better the state of two groups of nurses and to find an effective method to improve the service level of the nursing workforce. DESIGN: Stepwise multiple regression analyses of survey data collected in June and July 2017 from Chinese nurses employed in three tertiary hospitals. METHODS: Chinese nurses (298 of 350 [85.1%]) were interviewed using the Ethical Climate Scale and Nurses' Service Behaviour Scale. Data were analysed statistically using descriptive statistics, confirmatory factor analysis, correlation coefficients (Pearson), two-tailed t-test and stepwise multiple regression analyses were conducted to test the proposed hypotheses. Data were analysed using SPSS and AMOS. RESULTS: There were statistically significant correlations between EC and nurses' extra-role service behaviour (ERSB) and overall service behaviour and nurses' employment type moderated the proposed relationships. CONCLUSION: Healthcare institutions should pay more attention to cultivate EC and implement new incentive mechanism to better stimulate nurses to provide ERSB.

Chitosan-based core-shell structured particles for in vivo sustainable gene transfection.

A core-shell structured chitosan (CS)-based gene vector with a sustainable gene transfection effect was designed and successfully prepared in this study. The pEGFP was first combined with the thiolated and N-alkylated chitosan (TACS). Then, hydroxybutyl chitosan grafted with poly(ethylene glycol) (EG-HBC) was coated on the pEGFP-loaded TACS particles. The prepared pEGFP-loaded TACS@EG-HBC particles have a size of about 200 nm and little cytotoxicity. The in vitro and in vivo gene transfection experiments indicate that the pEGFP-loaded TACS@EG-HBC particles possess a better sustainable gene transfection capacity and a high transfection efficiency, which should be attributed to the biodegradation of the CS-based shell, the thiolation and N-alkylation modification on CS cores, and the grafted PEG chains with better biocompatibility. The in vivo gene expression of the loaded pEGFP can persist up to 60 days. This novel gene vector has a theoretical and practical significance for gene therapy with sustained transfection effect.