ESG activity recognition enhances organizational commitment and service-oriented organizational citizenship behavior among insurance call center staff.

Service-oriented organizational citizenship behavior refers to service workers' helping, cooperating, sharing, and donating actions that benefit others at a cost to themselves. Based on ethical climate theory, this research investigates whether corporations adopting environmental, social, and governance (ESG) management enhance service-oriented organizational citizenship behavior (SO OCB) among service employees. A total of 230 surveys were collected from call center workers in the insurance industry, and STATA 14.0 was used to analyze the 204 responses with useable data. The results show that employees' recognized ESG activities enable SO OCB through organizational commitment. Additionally, ESG activity recognition has a positive relationship with self-efficacy and empowerment, which helps service employees regulate external expectations. Thus, this finding is significant for call center workers experiencing emotional labor. Furthermore, the results suggest that firms can contribute to employees' SO OCB by practicing ESG activities. Firms should inform employees of their ESG management efforts as employees' recognition of an ethical climate can enhance their willingness to perform service-oriented behavior. Finally, ESG activity recognition can increase employees' organizational commitment, an important predictor of employee satisfaction and negative turnover rates.

Moral Distress Healthcare Providers in Spain: Observational Study.

Objective: To evaluate the moral distress (MD)in health professionals of pediatric and adult units to show how the complexity of care in the pediatric field causes the professionals who carry out their activity in these units to present a higher level of moral distress and a worse climate ethical. Design: Observational study with health professionals who currently work in Spanish Hospitals. Methods: A 58-item questionnaire was electronically distributed which included sociodemographic and employment characteristics, the Spanish version of the Measure of Moral Unrest for Healthcare Professionals (MMD-HP-SPA) and the Hospital Ethical Climate Survey (HECS). Results: A total of 169 health professionals completed the questionnaire. The moral distress was significantly higher among nurses than among physicians and nursing assistant care technicians. Focusing on the type of unit, moral distress it was only significantly higher for those physicians treating adult patients compared to those treating pediatric patients. Regarding the total score of the HECS survey, the medical group shows higher scores compared to the nursing group. Conclusion: Statistically significant differences have been found only in the medical group that treats adult patients, presenting a higher level of moral unrests than the pediatrician group. The MMD-HP-SPA questionnaire is a valid and useful instrument to detect MD in our hospital units in order to be able to implement strategies/interventions that improve the ethical climate and other factors that can mitigate and prevent this MD.

Assessing Ethical Climate: Adaptation and Psychometric Properties in the Indonesian Context.

Background: Despite the importance of understanding ethical climates in Indonesian organizations, a standardized scale for measuring this is lacking. Therefore, this study aims to adapt, validate, and ensure the consistency of the Ethical Climate Questionnaire (ECQ) within Indonesia's cultural context. Methods: Data were collected from 565 Indonesian individuals aged 18 or older, using an online survey and convenience sampling. To ensure accurate measurements, Beaton's guidelines were followed. Reliability was assessed using Cronbach's alpha and McDonald's omega, while validity was examined through various analyses including content validity index and confirmatory factor analysis. Results: The Indonesian version of the ECQ measures egoist, benevolent, and principled ethical climates reliably (Cronbach's alpha: egoism=0.809, principle=0.920, benevolence=0.910). Validity analyses confirm the questionnaire's validity. Demographic analysis shows age impacts the principle dimension, while organizational type affects all dimensions. Conclusion: The Indonesian version of the ECQ demonstrates strong psychometric properties and cross-cultural adaptability, making it a valuable tool for assessing ethical climates among Indonesian individuals aged 18 or older.

Construed Organizational Ethical Climate and Whistleblowing Behavior: The Moderated Mediation Effect of Person-Organization Value Congruence and Ethical Leader Behavior.

An organizational ethical climate enhances the degree of collaboration and cohesion among employees and facilitates the development and interests of organizations. Such roles lead to organizational sustainable development and survival. Therefore, the importance of ethical climate in organizations is becoming increasingly apparent. In this background, this study aims to explore whether an organizational ethical climate can improve whistleblowing behavior and the mediating role of organizational identification in promoting whistleblowing behavior. Most previous studies have only focused on the mediating or moderating role of the model. This study expands the research field, adds the dual moderation of person-organization value congruence and leader ethical behavior, and verifies two moderated mediation models. Overall, the purpose of this study is to determine the behavior of employees under the influence of an organizational ethical climate and, on this basis, propose suggestions for strengthening organizational ethical climate, expanding the scope of research on organizational climate and providing a theoretical basis for related research. In order to achieve the research goals, the data were collected from 344 Chinese SMEs for empirical analysis. The results showed that an organizational ethical climate has no direct impact on whistleblowing behavior but could have a positive effect on whistleblowing formation through the mediating variable of organizational identification. In addition, person-organization value congruence and leader ethical behavior significantly moderated the mediating role of organizational identification between organizational ethical climate and whistleblowing behavior. Finally, the directions that can contribute to future research were suggested.

A multi-country mixed-method study identifying the association between perceived ethical work climate and problems among critical care nurses.

BACKGROUND: Given the grave ethical tension and dilemmas posed continuously which are aggravated in the intensive care unit context and its related caregiving provision, combined with their impact on critical care nurses' job satisfaction and work-related risks, exploring and analyzing these tensions and conflicts is crucial. This study was conducted to examine the relationship between perceived ethical work climate and problems among critical care nurses in addition to exploring their perspectives on the ethical work climates while caring for patients with infectious diseases. DESIGN AND METHOD: A mixed-method research design was used to conduct this study among 635 participants, comprising 170 from Egypt, 144 from Jordan, 161 from Saudi Arabia, and 160 from the United Arab Emirates. Online or paper-based survey forms were distributed to all eligible critical care nurses who agreed to take part in the study. The survey contained both quantitative and qualitative data that were analyzed separately and integrated during the discussion. The study was reported following the STROBE guidelines. FINDINGS: The overall ethical work climate was fairly good and was significantly associated with ICU nurses' personal and professional characteristics. The findings also identified three main themes: (1) an ethical sense of failure, (2) environmental condemnation, and (3) an instant action plan for resolving ethical conflicts. CONCLUSIONS: ICU nurses perceived that ICU ethical climate was fairly good. The results indicated that ICU nurses generally had a relatively fair perception of the ethical work climate, with implications for addressing ethical issues and conflicts in various settings. IMPACT: Mentorship and/or close supervision concerning ethical resilience, consultation, and decision-making is crucial in the ICU milieu. Metacognitive strategies to reinforce problem-solving and decision-making ICU nurses' skills could help them overcome the different ethical challenges. Adequate resources, teamwork, and organizational support are promising tactics to improve ICU nurses' ethical skills. TRIAL REGISTRATION: Not applicable.

Multi-professional perspectives to reduce moral distress: A qualitative investigation.

BACKGROUND: Encounters of moral distress have long-term consequences on healthcare workers' physical and mental health, leading to job dissatisfaction, reduced patient care, and high levels of burnout, exhaustion, and intentions to quit. Yet, research on approaches to ameliorate moral distress across the health workforce is limited. RESEARCH OBJECTIVE: The aim of our study was to qualitatively explore multi-professional perspectives of healthcare social workers, chaplains, and patient liaisons on ways to reduce moral distress and heighten well-being at a southern U.S. academic medical center. PARTICIPANTS & RESEARCH CONTEXT: Purposive sampling and chain-referral methods assisted with recruitment through hospital listservs, staff meetings, and newsletters. Interested participants contacted the principal investigator and all interviews were conducted in-person. Consent was attained prior to interviews. All interviews were recorded and transcribed verbatim. RESEARCH DESIGN: Directed content analysis was used to deductively organize codes and to develop themes in conjunction with the National Academy of Medicine's National Plan for Health Workforce Well-Being. Rigor was attained through peer-debriefing, data triangulation methods, and frequent research team meetings. ETHICAL CONSIDERATIONS: Ethics approval was obtained from the university and medical center institutional review boards. FINDINGS: Themes demonstrate that rather than offering interventions in the aftermath of moral distress, multilevel daily practices ought to be considered that pre-emptively identify and reduce morally distressing encounters through (1) the care team, (2) management and leadership, and (3) the health care industry. Strategies include interdisciplinary decision-making, trusting managerial relationships, and organizational policies and practices that explicitly invest in mental health promotion and diverse leadership opportunities. CONCLUSION: Moral distress interventions ought to target short-term stress reactions while also addressing the long-term impacts of moral residue. Health systems must financially commit to an ethical workplace culture that explicitly values mental health and well-being.

Ethical climate, moral resilience, and ethical competence of head nurses.

BACKGROUND: The ethical competence of head nurses plays a pivotal role in nursing ethics. Ethical climate is a prerequisite for ethical competence, and moral resilience can positively influence an individual's ethical competence. However, few studies have focused on the relationship between ethical climate, moral resilience, and ethical competence among them. OBJECTIVES: To investigate the relationship between ethical climate, moral resilience, and ethical competence, and examine the mediating role of moral resilience between ethical climate and ethical competence among head nurses. DESIGN: A quantitative, cross-sectional study. METHODS: A total of 309 Chinese head nurses completed an online survey, including ethical climate questionnaire, Rushton moral resilience scale, and ethical competence questionnaire. Inferential statistical analysis includes Pearson's correlation and a structural equation model. ETHICAL CONSIDERATIONS: This study received ethical approval from the Institutional Review Board of Xiangya Nursing School of Central South University (No. E2023146). RESULTS: Head nurses' ethical climate score positively impacted ethical competence (r = 0.208, p < .001), and ethical climate could affect ethical competence through the mediating role of moral resilience. CONCLUSION: This study emphasized the value of ethical climate in moral resilience of head nurses, ultimately leading to an enhancement in their ethical competence.

Relation between innovative work behavior and ethical climate perceptions among nursing personnel.

BACKGROUND: Globalization and innovative technologies forced organizations to adopt innovative approaches and innovations for gaining a sustainable competitive advantage. Innovative Work Behavior (IWB) is related to the employees, ability, and enthusiasm to create innovative ideas. It exhibits a dynamic framework that is easier to be impacted by the ethical climate. METHODS: Descriptive correlational design was applied and the study was performed at different inpatient units in Kafrelsheikh Governorate General Hospital. Two hundred twenty-two staff nurses and 45 head nurses from the aforementioned setting were chosen as a purposive sample. Two instruments were utilized to obtain the data; Innovative Work Behavior questionnaire and Ethical Climate Questionnaire. The significance of the acquired data was evaluated at the 5% level. Number and percentage were used to describe qualitative data and Range frequency, mean, standard deviation, and Pearson coefficient were used to characterize quantitative data. RESULTS: More than half of staff nurses had a positive perception of innovative work behavior and more than three quarters of them had a negative Ethical climate perception. CONCLUSION: The study proved a significant relation between Efficiency dimension and the overall innovative work behavior perception p = 0.044, and the economic affairs and innovation dimension and the overall ethical climate perception p = 0.033.

Factors of Hospital Ethical Climate among Hospital Nurses in Korea: A Systematic Review and Meta-Analysis.

In the current healthcare landscape, nurses frequently encounter various ethical dilemmas, necessitating situation-specific ethical judgments. It is crucial to thoroughly understand the factors that shape the hospital ethical climate and the elements that are influenced by this climate. This study aims to identify the variables associated with the hospital ethical climate perceived by Korean nurses. A literature search was conducted using the core database, and the effect sizes of relevant variables were analyzed using a comprehensive meta-analysis. The overall effect size analysis incorporated 56 variables, and a meta-analysis was performed on 7 variables. This study found correlations between ethical sensitivity (ESr = 0.48), moral distress (ESr = -0.30), empathy (ESr = 0.27), ethical leadership (ESr = 0.72), job satisfaction (ESr = 0.64), and intention to leave (ESr = -0.34) with the hospital ethical climate. Both personal and organizational attributes were moderately related to the hospital ethical climate. Enhancing the hospital ethical climate could positively affect both individuals and the organization. The protocol for this study has been registered with PROSPERO (CRD42022379812).

Developing LHS scholars' competency around reducing burnout and moral injury.

Despite the known benefits of supportive work environments for promoting patient quality and safety and healthcare worker retention, there is no clear mandate for improving work environments within Learning Health Systems (LHS) nor an LHS wellness competency. Striking rises in burnout levels among healthcare workers provide urgency for this topic. Methods: We brought three experts on moral injury, burnout prevention, and ethics to a recurring, interactive LHS training program "Design Shop" session, harnessing scholars' ideas prior to the meeting. Generally following SQUIRE 2.0 guidelines, we evaluated the prework and discussion via informal content analysis to develop a set of pathways for developing moral injury and burnout prevention programs. Along these lines, we developed a new competency for moral injury and burnout prevention within LHS training programs. Results: In preparation for the session, scholars differentiated moral injury from burnout, highlighted the profound impact of COVID-19 on moral injury, and proposed testable interventions to reduce injury. Scholar and expert input was then merged into developing the new competency in moral injury and burnout prevention. In particular, the competency focuses on preparing scholars to (1) demonstrate knowledge of moral injury and burnout, (2) measure burnout, moral injury, and their remediable predictors, (3) use methods for improving burnout, (4) structure training programs with supportive work environments, and (5) embed burnout and moral injury prevention into LHS structures. Conclusions: Burnout and moral injury prevention have been largely omitted in LHS training. A competency related to burnout and moral injury reduction can potentially bring sustainable work lives for scholars and their colleagues, better incorporation of their science into clinical practice, and better outcomes for patients.

Ethical Climate in the Delivery Wards of Educational Hospitals in Southeast Iran.

Ethical climate is one of the important factors in the working climate of the hospital. Considering the difference in the Ethical climate in different departments of the hospital and the importance of the ethical climate in the delivery ward, this study aimed to assess the characteristics of hospital ethical climate in delivery ward of educational hospitals in southeast Iran. This descriptive and multi-center study was conducted from 2020 to 2021 in educational hospitals in southeast Iran. Two hundred forty midwives working in delivery wards, midwifery instructors, and midwifery students were included in the study by census method. Data collection tools included a demographic information form, Olson's Hospital Ethical Climate Survey, completed using the self-report method. The mean ethical climate in the midwifery group (3.82 ± 0.63 out of 5) was higher than in the instructors' and students' groups. The lowest mean score obtained from the ethical climate questionnaire of participants was associated with the inability to use their experiences in the delivery ward. The lowest mean of ethical climate from the midwives' point of view is the Physicians' dimension and the patient's dimension from the instructors' point of view. The highest mean score belonged to the ethical climate of the supervisors. According to the results of the present study, it is suggested to implement protective laws to support the higher independence of midwives to improve the ethical climates by using their experiences in the delivery department.

Workplace Ethical Climate and Workers' Burnout: A Systematic Review.

Objective: Workplace ethics is a central theme in occupational health; an ethical climate aims to implement and uphold standards of integrity and fairness. Furthermore, the correlation between ethical climate and burnout has been highlighted in several studies, and the impact of a negative ethical climate in the workplace has been reported to affect workers' mental health and job performances, resulting in increased burnout incidence. The aim of this systematic review is to assess the relationship between ethical climate and burnout in the workplace. Method: This review was conducted following the PRISMA statements. Three databases were screened, including research articles written in the English language during the last 10 years, investigating the relationship between burnout and ethics in the workplace. The quality of articles was assessed with the Newcastle-Ottawa Scale. Results: 1153 records were found across three databases; after duplicate removal and screening for title and abstract, 46 manuscripts were screened by full text, resulting in 13 included studies. The majority of the included studies were performed on healthcare workers (n=7, 53.8%), and with a majority of female participants (n=9, 69.2%). Most of the included studies (n=9, 69.2%) evaluated the correlation between ethical climate and burnout, while the other four (n=4, 30.8%) evaluated ethical leadership. Four studies reported a positive correlation between ethics and work engagement. Two studies highlighted that an ethical workplace climate reduced turnover intention. Conclusions: Ethical climate plays an important role in burnout mitigation in workers and in improving work engagement, thus helping to reduce turnover intentions. Since all of these variables have been reported to be present in clusters of workers, these aforementioned factors could impact entire workplace organizations and their improvement could lead to a better work environment overall, in addition to improving the single factors considered. Further studies are needed to investigate the role of ethical climate in the workplace.

A structural equation model for cyber academic dishonesty in higher education: Evidence from Taiwan.

With the continued spread of the rise of online teaching, and the massive use of 3C products (computer, communication, and consumer electronics), the cases of academic plagiarism or using others' works as own works caused by inappropriate use of the Internet are occurring all the time. However, very little research has been conducted on the cyber ethical climate in relation to cyber academic dishonesty. This study investigates the structural relationship between cyber ethical climate, cyber self-efficacy, cyber ethical attitude and cyber academic dishonesty, among university and graduate students, and develops a multiple mediation model. A total of 812 university and graduate students from 32 universities in Taiwan completed the online questionnaire. The results of the study show that the multiple mediation model is valid and find that the cyber ethical climate creates a favorable context for organizing members to demonstrate cyber ethical behavior, demonstrating the importance of mutual influence on cyber academic dishonesty between the cyber ethical climate created by teachers and the cyber ethical climate of class peers. Based on these results, we deeply examine the practical implications and make specific recommendations to improve the cyber ethical behavior of university and graduate students.

Nurturing moral community: A novel moral distress peer support navigator tool.

Moral distress is a pervasive phenomenon in healthcare for which there is no straightforward "solution." Rhetoric surrounding moral distress has shifted over time, with some scholars arguing that moral distress needs to be remedied, resolved, and eradicated, while others recognize that moral distress can have some positive value. The authors of this paper recognize that moral distress has value in its function as a warning sign, signaling the presence of an ethical issue related to patient care that requires deeper exploration, rather than evidencing identification of the "right" course of action. Once the experience of moral distress is identified, steps ought to be taken to clarify the moral issue, and, if possible and reasonable, the patient's values ought to be prioritized. This paper offers concrete actions steps, drawn from theory, which can be used in clinical practice to provide peer support or to facilitate self-reflection for morally distressed individuals. This approach empowers morally distressed individuals to explore ethical issues, identify concrete steps that can be taken, and mitigate feelings of powerlessness that are often associated with moral-constraint distress. The questions guide individuals and peers to reflect first on the micro-space and then more broadly on the institutional culture, facilitating meso- and macro-reflection and action.

Impacts of ethical climate and ethical sensitivity on caring efficacy.

BACKGROUND: Caring practice begins with awareness of the suffering of patients in a given context. Understanding the interrelationship between the perceived ethical climate of the clinical environment and the ethical sensitivity and caring efficacy of nurses is crucial for strengthening the caring competency of nurses. RESEARCH AIM: This study aimed to examine the associations between the ethical climate of the clinical environment and the ethical sensitivity and caring efficacy of nurses and to investigate the mediating effect of ethical sensitivity on the association between ethical climate and caring efficacy. RESEARCH DESIGN: This was a quantitative study with a cross-sectional descriptive correlational design. The participants completed an online survey that measured the ethical climate, ethical sensitivity and caring efficacy using the Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire-Revised and Caring Efficacy Scale, respectively. PARTICIPANTS AND RESEARCH CONTEXT: The study recruited 293 nurses from two general hospitals that provided acute in-patient and extended care in Hong Kong. ETHICAL CONSIDERATIONS: Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. RESULTS: Ethical climate was associated with caring efficacy (ß = 0.340, p < .001) and ethical sensitivity (ß = 0.197, p < .001). After adjusting for ethical climate, ethical sensitivity was associated with caring efficacy (ß = 0.860, p < .001). Ethical sensitivity showed a significant mediating effect on the association between ethical climate and caring efficacy (indirect effect = 0.169, 95% confidence interval: 0.097 to 0.261), which accounted for 50% of the total effect. CONCLUSIONS: The study reveals the complex and interwoven relationship between contextual and personal factors that affect nurses' caring efficacy from an ethical perspective. It provides insights into the significant roles of ethical climate and ethical sensitivity in strengthening caring efficacy. The results suggest theoretical and clinical implications for professionalisation.

Clima ético egoísta y el teletrabajo en el sector eléctrico colombiano. El papel moderador del liderazgo ético

El sector eléctrico colombiano ha impulsado políticas organizacionales fundamentadas en la inclusión y el bienestar de la sociedad en general, que pretenden trasladarse al teletrabajo a través de un estilo de liderazgo ético. Sin embargo, el egoísmo -que se caracteriza por maximizar el interés propio como base de razonamiento moral-, es un factor subyacente que puede deteriorar cualquier iniciativa que busque un equilibrio institucional justo e íntegro, mediante un clima ético donde las decisiones descuiden las necesidades colectivas. Por consiguiente, el objetivo de esta investigación es determinar la relación entre un clima laboral egoísta y el teletrabajo, a través del rol moderador de liderazgo ético. El estudio aplicó un diseño cuantitativo, transversal y correlacional explicativo. La muestra fue de 448 empleados evaluados por una encuesta en línea. Se encontró que el clima ético egoísta (X) y el liderazgo ético (W) se asocian significativamente con el teletrabajo (Y). Sin embargo, cuando el liderazgo ético regula la relación entre las variables independiente y dependiente (6X - Y/W), se hace visible que a mayor percepción de una dirección ética más débil se torna el efecto del clima egoísta sobre el teletrabajo hasta desaparecer. En conclusión, el sector eléctrico colombiano, por su enfoque en la responsabilidad social y erradicación de conductas deshonestas mediante un liderazgo ético, no es compatible con un clima laboral egoísta. De hecho, el impulsar una cultura de trabajo, a través del interés propio, neutraliza todo el esfuerzo ético propuesto por el sector eléctrico colombiano en los últimos siete años, puesto que su finalidad ha sido propender por iniciativas sociales e inclusivas.

The Colombian electricity sector promotes organizational policies based on the inclusion and well-being of society in general, which also intend to transfer to teleworking through an ethical leadership style. However, the selfishness that is characterized by maximizing self-interest as the basis of moral reasoning is an underlying factor that can deteriorate any initiative that seeks a fair and comprehensive institutional balance through an ethical climate where decisions neglect collective needs. Therefore, the objective of this research is to determine the relationship between a selfish climate and teleworking through the moderating role of ethical leadership. The study applies a quantitative, cross-sectional, explanatory correlational design. The sample is 448 employees who are evaluated with an online survey. The selfish ethical climate (X) and ethical leadership (W) are significantly associated with telecommuting (Y). However, when ethical leadership regulates the relationship between the independent and dependent variables (6X - Y/W) it becomes visible that the greater the perception of a weaker ethical leadership, the effect of the selfish climate on telework becomes until it disappears. The Colombian electricity sector, due to its focus on social responsibility and on eradicating dishonest conduct through ethical leadership, is not compatible with a selfish climate. In fact, promoting only individual interests in virtual work environments would nullify all the ethical effort proposed by the sector in question in the last seven years. Since its purpose has been to promote social and inclusive initiatives.

Perspectives on the role of the nurse ethicist.

This paper offers four contrasting perspectives on the role of the nurse ethicist from authors based in different areas of world, with different professional backgrounds and at different career stages. Each author raises questions about how to understand the role of the nurse ethicist. The first author reflects upon their career, the scope and purpose of their work, ultimately arguing that the distinction between 'nurse ethicist' and 'clinical ethicist' is largely irrelevant. The second author describes the impact and value that a nurse in an ethics role plays, highlighting the 'tacit knowledge' and 'lived experience' they bring to clinical ethics consultation. However, the second author also warns that the 'nurse ethicist' must be cautious in their approach to avoid being viewed as a resource only for nurses. The third author questions the introduction of additional professional distinctions such as 'nurse ethicist' on the basis that distinctions threaten the creation of egalitarian healthcare systems, while also acknowledging that clinical ethicists ought not strive for objective attachment in their work. In direct contrast, the final author suggests that the nurse ethicist can play a pivotal role in highlighting and addressing ethical challenges that are specific to nurses. These four short pieces raise questions and point to concepts that will be expanded upon and debated throughout this special issue of Nursing Ethics.

Physiotherapists' Ethical Climate and Work Satisfaction: A STROBE-Compliant Cross-Sectional Study.

(1) Background: This study aimed to examine the relationship between Spanish physical therapists' perceptions of the ethical climate, their moral sensitivity (awareness of ethical issues), and job satisfaction. (2) Methods: the study analyzed descriptive correlational data on 104 physical therapists from three Spanish metropolitan hospitals. Respondents completed a demographic data form, an ethical climate questionnaire, a job satisfaction survey, and a moral sensitivity scale. This study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. (3) Results: With a mean score of 4.2, physical therapists are typically content with their jobs. The mean scores for the moral sensitivity and ethical climate questionnaires are high, at 40.1 (SD 6.3) and 96.8 (SD 17.1), respectively. There is a significant positive correlation between job satisfaction and ethical climate (r between 0.59 and 0.79) but only a weak correlation between job satisfaction and moral sensibility (r between 0 and 0.32 for the three aspects measured). (4) Conclusions: Generally speaking, physical therapists reported that they had high job satisfaction, a positive workplace environment, and excellent management support. Despite a weak relationship with moral sensibility, there is a strong association between ethical behavior, hospital organization, and higher levels of job satisfaction. It is important to encourage the development of moral sensibilities to boost psychological well-being and therapeutic decision-making.

The predictive factors of moral courage among hospital nurses.

BACKGROUND: Having moral courage is a crucial characteristic for nurses to handle ethical quandaries, stay true to their professional obligations towards patients, and uphold ethical principles. This concept can be influenced by various factors including personal, professional, organizational, and leadership considerations. The purpose of this study was to explore the predictors of moral courage among nurses working in hospitals. METHODS: In 2018, an observational cross-sectional study was carried out on 267 nurses employed in six hospitals located in the northern region of Iran. The participants were selected through a simple random sampling technique. To collect data, a demographic information form was used along with two questionnaires. The first questionnaire was a standard survey on moral courage, while the second questionnaire was designed to assess the ethical climate. Linear regression was used to assess the predictors of moral courage. RESULTS: Nurses had an average moral courage score of 87.07 ± 15.52 and an average moral climate score of 96.12 ± 17.17. The study showed that 16% of the variation in moral courage scores among nurses was explained by ethical climate and monthly overtime hours. CONCLUSION: This study underscores the significance of establishing an ethical work environment and minimizing overtime hours in order to enhance moral courage among nurses. These findings carry weight for both nursing practice and organizational policies focused on fostering ethical conduct within healthcare settings.

The relationship between moral distress, ethical climate, and attitudes towards care of a dying neonate among NICU nurses.

BACKGROUND: Nurses working in neonatal intensive care units play a crucial role in providing care to critically ill or premature neonates. However, is not without its challenges, particularly when it comes to making difficult ethical decisions about end-of-life care. In some cases, neonates do not survive despite the best efforts of medical professionals. The present study aimed to investigate the relationship between moral distress, ethical climate, and attitudes towards end-of-life care among nurses working in neonatal intensive care units. METHODS: This is a descriptive-analytical cross-sectional study (May 21, 2021).The research population included 126 nurses working in neonatal intensive care units in Kerman province (Kerman, Jiroft, Bam, and Rafsanjan). Data collection tools included four questionnaires: demographic information, the Frommelt Attitudes towards Care of the Dying (FATCOD), the Hospital Ethical Climate Survey, and the Moral Distress Scale. SPSS22 was used to analyze the data. RESULTS: The results revealed that the mean frequency and intensity of moral distress were 44.42 ± 17.67 and 49.45 ± 17.11, respectively. The mean ethical climate was 92.21 ± 17.52 and the FATCOD was 89.75 ± 9.08, indicating NICU nurses' positive perceptions of ethical climate and their favorable attitudes towards EOL care, respectively. The results showed a direct and significant relationship between ethical climate and the FATCOD (P = 0.003, r = 0.26). DISCUSSION: We suggest policymakers and managers design strategies for better ethical climate in hospitals and reduction of moral distress among nurses.