Intensive care nurses' perceptions of hospital ethical climate

Yıl 2014, Cilt: 16 Sayı: 1, 34 - 45, 01.04.2014

Şerife Karagözoğlu Dilek Özden Gülay Yıldırım.

Öz

Objective: This study was conducted to determine the intensive care nurses' perceptions of hospital ethical climate. Methods: The population of this descriptive and cross-sectional study included 190 nurses working in intensive care units of three university hospitals in Turkey. Among these nurses, 170 who agreed to participate in the study comprised the study sample. The demographic characteristics questionnaire and the Hospital Ethical Climate Scale HECS were used for data collection. The data were evaluated with percentage distributions, the MannWhitney U test, and Kruskal-Wallis test. Results: The nurses’ mean age was 26,60 ± 4,83 and 72,4% of them had a graduate degree. The average length of service of the participants in the intensive care units was 2,21 ± 3,62 years. The intensive care nurses’ mean score for the HECS was 100,57 ± 15,73. It was determined that while the nurses’ education levels affected their perceptions of hospital ethical climate p 0,05 . The nurses' mean scores for physicians and hospitals subscales of the HECS were 20,42 ± 4,90 and 21,77 ± 4,19 respectively. The nurses agreed to the following items in the HECS more: providing safe patient care; respect for patients’ requests; respect for managers Conclusion: It can be said that the intensive care nurses’ perceptions of the hospital ethical climate levels were high and positive, and their education level effected the perception level but their mean scores for physicians and hospitals subscales were lower

Anahtar Kelimeler

Ethical climate, intensive care, nursing

Yoğun bakım hemşirelerinin hastane etik iklim algısı

Öz

Amaç: Bu çalışma, yoğun bakım hemşirelerinin “hastane etik iklim algısı”nı belirlemek amacıyla yapılmıştır. Yöntem: Tanımlayıcı ve kesitsel tipteki bu araştırmanın evrenini, Türkiye’de üç üniversite hastanesinin yoğun bakım ünitelerinde çalışan toplam 190 hemşire oluşturmuştur. Örneklemine ise araştırmaya katılmayı kabul eden 170 hemşire alınmıştır. Verilerin toplanmasında Tanıtıcı Özellikler Formu ve Hastane Etik İklim Ölçeği HEİÖ kullanılmıştır. Veriler yüzdelik dağılım, Mann-Whitney U testi, Kruskall Wallis testi ile değerlendirilmiştir. Bulgular: Hemşirelerin yaş ortalaması 26,60±4,83 olup, %72,4’ü lisans mezunudur. Katılımcıların yoğun bakımda ortalama çalışma süresi 2,21±3,62 yıldır. Yoğun bakım hemşirelerinin HEİÖ puan ortalaması 100,57±15,73’dür. Hemşirelerin eğitim durumunun hastane etik iklim algısı üzerinde etkili olduğu p0,05 . Hemşirelerin HEİÖ’de doktorlar ve hastane alt boyut puan ortalamaları sırası ile 20,42±4,90 ve 21,77±4,19’dir. Hemşireler ölçekteki güvenli hasta bakımı verilmesi, hastanın istekleri ve yöneticilere saygı duyulmasına yönelik maddelere diğer maddelere göre daha yüksek oranlarda katılım göstermişlerdir. Sonuç: Yoğun bakım hemşirelerinin hastane etik iklim algılarının yüksek düzeyde pozitif olduğu, bu algıyı eğitim düzeyinin etkilediği, doktorlar ve hastane alt boyutuna yönelik ölçekten alınan puan ortalamalarının daha düşük olduğu söylenebilir

Anahtar Kelimeler

Etik iklim, yoğun bakım, hemşirelik

Kaynakça

• Olson LL. Hospital nurses’ perceptions of the ethical climate of their work setting. J Nurs Scholarsh 1998; 30(4):345-349.
• Ulrich C, O’Donnell P, Taylor C, Farrar A, Danise M, Grady C. Ethical climate, ethics stress, and the job satisfaction of nurses and social workers in the United States. Soc Sci &Med 2007; 65:1708–1719.
• World Health Report. (2006). Available from: /http://www.globalnews.idf.org/2006/04/world_health_da.html. (Accesed:1 September 2013).
• Hart SE. Hospital ethical climates and registered nurses’ turnover intentions. J Nurs Scholarsh 2005;37(2):173-177.
• Bahçecik N, Öztürk H. The hospital ethical climate survey in Turkey. JONAS Healthc Law, Ethics Regul 2003; 5(4):94-99.
• Victor B, Cullen JB. The organizational bases of ethical work climate. Admin Sci Q 1988; 33:101-25.
• Silen M, Kjellstrom S, Christensson L, Sidenvall B, Svantesson M. What actions promote a positive ethical climate? A critical incident study of nurses’ perceptions. Nurs Ethics 2012; 19(4): 501–512.
• Wang YD, Hsieh HH.Toward a beter understanding of the link between ethical climate and job satisfaction: A multilevel analysis. J BusEthics2012; 105:535–545.
• Ruggerio J. The bridge between an ethical climate and job satisfaction. Journal of US-China Public Administration 2011;8(5): 571-576.
• Bayram Ş, Dündar T. Sağlık sektöründe etik iklim ve yıldırma (mobbing) davranışları arasındaki ilişkinin incelenmesi. Ankara Üniversitesi SBF Dergisi 2011;66(1): 129-159.
• Büte M. Etik iklim, örgütsel güven ve bireysel performans arasındaki ilişki. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi 2011;25(1):171-192.
• HuangCC, You CS, Tsai MT. A multidimensional analysis of ethical climate, job satisfaction, organizational commitment, and organizational citizenship behaviors. Nurs Ethics 2012; 19(4): 513–529.
• Hwang JI, Park HA. Nurses’ perception of ethical climate, medical error experience and intent-to-leave. Nurs Ethics 2013, 1-15.
• Goldman A, Tabak N. Perception of ethical climate and its relationship to nurses’ demographic characteristics and job satisfaction. Nurs Ethics2010; 17(2):233-246.
• Charles H. Schwepker JR. Ethical climate’s relationship to job satisfaction, organizational commitment, and turnover intention in the salesforce. J Bus Res 2001; 54: 39– 52.
• Martin KD, Cullen JB. Continuities and extensions of ethical climate theory: A meta-analytic review. J Bus Ethics 2006; 69: 175–194.
• Tsai MT, Huang CC. The relationship among ethical climate types, facets of job satisfaction, and the three components of organizational commitment: A study of nurses in Taiwan. J Bus Ethics 2008;80:565–581.
• Cullen JB, Parboteeah KP,Victor B. The effects of ethical climates on organizational commitment: A two-study analysis. J Bus Ethics 2003; 46(2): 127-141.
• Hamric BL, Blackhall LJ. Nurse-physician perspectives on the care of dying patients in intensive care units: Collaboration, moral distress, and ethical climate. Crit Care Med 2007; 35( 2): 422-29.
• Lützén K, Cronqvist A, Magnusson A,Andersson L. Moral Stress: Synthesıs of a Concept. Nurs Ethics 2003; 10 (3): 312- 22.
• Pauly B, Varcoe C, Storch J, Newton L. Registered nurses’ perceptions of moral distress and ethical climate. Nurs Ethics 2009; 16(5): 561-573.
• Schulte, L. E. A comparison of cohort and non-cohort graduate student perceptions of the ethical climate and its importance in retention. J Coll Stud Ret 2003, 4(1): 29-38.
• Baykal Ü, Altuntaş S, Öztürk H, Sökmen S, İntepeler ŞS, Kantek F. Hemşirelik eğitimi veren kurumlarda etik çalışma iklimi. İ.Ü.F.N. Hem. Derg 2012; 20 (1): 26-34.
• Deshpande SP, Joseph J. Impact of emotional intelligence, ethical climate, and behavior of peers on ethical behavior of nurses. J Bus Ethics 2009;85:403–410.
• Başak T, Uzun Ş, Arslan F. Yoğun bakım hemşirelerinin etik duyarlılıklarının incelenmesi. Gülhane Tıp Dergisi 2010; 52: 76-81.
• Faber-Langendoen K,Lanken PN. Dying patients in the intensive care unit: for going treatment, maintaining care. Ann Intern Med 2000; 133(11): 886-892.
• Mobley MS, Rady MY, Verheijde JL, Patel B, Larson JS. The relationship between moral distres and perception of futility in the critical care unit. Intensive Crit Care Nurs 2007; 23: 256-263.
• Hamric AB, Borchers CT, Epstein EG. Development and testing of an instrument to measure moral distress in health care professionals. AJOB Prim Res 2012, 3(2): 1–9.
• Ganz FD, Raanan O, Khalaila R, Bennaroch K, Scherman S, Bruttin M, Sastiel Z, Fink NF, Benbenishty J. Moral distress and structural empowerment among a national sample of Israeli intensive care nurses. J Adv Nurs 2013; 69(2): 415–424.
• Yıldırım G, Kadioglu S, Sumer H. The concept of “Medical Ethics” according to doctors and nurses and their demands from Ethicists in Turkey. Pak J Med Sci 2011; 27(1): 28-3
• Ferrand E, Lemaire F, Regnier B, et al. Discrepancies between perceptions by physicians and nursing staff of intensive care unit end-of-life decisions. Am J Respir Crit Care Med. 2003; 167:1310-1315.
• Sert G. Hasta hakları. I. Baskı, İstanbul: Babil Yayınları, 2004; 1-350.
• T.C. Hasta hakları yönetmeliği 1998. Resmi Gazete, Tarih: 01.08.1998; Sayı: 23420.
• Aydın Pehlivan İ. Yönetsel, mesleki ve örgütsel etik. 3. Baskı, İstanbul: Pegema Yayıncılık, 2002; 62-241.