Research Article
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Effects of Hospital Ethical Climate on Voice Behavior among Oncology Nurses’: Mediating Role of Courage

Year 2023, , 179 - 185, 01.08.2023
https://doi.org/10.31125/hunhemsire.1172125

Abstract

Aim: Ethical climate is an important organizational characteristic that affects employees' thoughts, attitudes, and behaviors. The voice of the nurses, one of the fundamental employees of the hospitals, is very valuable both in terms of the organizations they work in and the safety of their patients. However, the relationship between hospital ethical climate and voice behavior remains unclear. The aim of this study was to investigate the effects of the ethical climate on oncology nurses’ voice behaviors, considering courage as a mediator.
Material and Methods: This study was designed as a predictive cross-sectional study. The sample of this study consisted of 71 registered nurses who were employed as staff nurses in inpatient care services in Hacettepe University Oncology Hospital between October and December 2018.
Results: There is a positive and significant relation between the hospital’s ethical climate and oncology nurses’ voice behaviors, and that courage has a positive partial mediating effect.
Conclusion: Since the relationship between a hospital’s ethical climate and nurses’ voice behavior contains many different variables, courage can be deemed a mediator in this relationship, but courage is not may directly be effective on its own.

References

  • Zhou XC, Liao JQ, Liu YH, Liao SD. Leader Impression Management and Employee Voice Behavior: Trust and Suspicion as Mediators. Social Behavior and Personality 2017;45:1843-54.
  • Dyne LV and LePine JA. Helping and voice extra-role behaviors: Evidence of construct and predictive validity. Academy of Management Journal 1998;41:108-19.
  • Dundon T, Wilkinson A, Marchington M, Ackers P. The meanings and purpose of employee voice. International Journal of Human Resource Management 2004;15:1149-70.
  • Grant AM and Rothbard NP. When in doubt, seize the day? Security values, prosocial values, and proactivity under ambiguity. J Appl Psychol 2013;98: 810-9.
  • Alfayad Z and Arif LSM. Employee voice and job satisfaction: An application of Herzberg two-factor theory. International Review of Management 2017;7:150-6.
  • Lin XW, Lam LW and Zhang LL. The curvilinear relationship between job satisfaction and employee voice: Speaking up for the organization and the self. Asia Pacific Journal of Management 2020;37:587-607.
  • Bowen F and Blackmon K. Spirals of silence: The dynamic effects of diversity on organizational voice. Journal of Management Studies 2003;40:1393-417.
  • Karcıoğlu F. Örgüt kültürü ve örgüt iklimi ilişkisi. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi 2001;15:265-283.
  • Cullen JB, Parboteeah KP and Victor B. The effects of ethical climates on organizational commitment: A two-study analysis. J Bus Ethics. 2003;46:127-41.
  • Wang YD and Hsieh HH. Organizational ethical climate, perceived organizational support, and employee silence: A cross-level investigation. Human Relations 2013;66:783-802.
  • Göktaş Kulualp H. Çalışan sesliliği ile bazı kişisel ve örgütsel özellikler arasındaki İlişkinin belirlenmesi: Öğretim elemanları üzerine bir araştırma Ege Akademik Bakış 2016;16:745-61.
  • Jiang J, Gao A and Yang B. Employees’ Critical Thinking, Leaders’ Inspirational Motivation, and Voice Behavior. Journal of Personnel Psychology 2018;17:33-41.
  • Kanten P and Ulker FE. A relational approach among perceived organizational support, proactive personality and voice behaviour. Procedia Soc Behav Sci. 2012;62:1016-22.
  • Liang J, Farh CI and Farh JL. Psychological antecedents of promotive and prohibitive voice: A two-wave examination. Academy of Management Journal 2012;55:71-92.
  • LePine JA and Van Dyne L. Voice and cooperative behavior as contrasting forms of contextual performance: Evidence of differential relationships with big five personality characteristics and cognitive ability. J Appl Psychol 2001;86:326-36.
  • Yalçındağ B. Relationships between courage, self-construals and other associated variables [Yüksek Lisans Tezi]. Middle East Technical University: Ankara; 2009.
  • Numminen O, Repo H and Leino-Kilpi H. Moral courage in nursing: A concept analysis. Nurs Ethics 2017;24: 878-91.
  • Sadooghiasl A, Parvizy S and Ebadi A. Concept analysis of moral courage in nursing: A hybrid model. Nurs Ethics 2018;25:6-19.
  • Woodard CR and Pury CL. The construct of courage: Categorization and measurement. Consulting Psychology Journal: Practice and Research 2007; 9:135-47.
  • Day L. Courage as a virtue necessary to good nursing practice. Am J Crit Care. 2007;16:613-6.
  • Barchard F, Sixsmith J, Neill S, Meurier C. 6Cs and ten commitments: Nurses’ understanding and use of courage. Nurs Manag 2017;23:26-31.
  • Dinc MS and Huric A. The impact of ethical climate types on nurses’ behaviors in Bosnia and Herzegovina. Nurs Ethics 2017;24:922-35.
  • Schwappach DLB and Gehring K. Trade-offs between voice and silence: a qualitative exploration of oncology staff's decisions to speak up about safety concerns. BMC Health Serv Res. 2014;14:1-10.
  • Olson LL. Hospital nurses' perceptions of the ethical climate of their work setting. Image J Nurs Sch 1998;30:345-9.
  • Cole DA, Bersick E, Skarbek A, Cummins K, Dugan K, Grantoza R. The courage to speak out: A study describing nurses' attitudes to report unsafe practices in patient care. J Nurs Manag 2019;27:1176-81.
  • Islam T, Ahmed I and Ali G. Effects of ethical leadership on bullying and voice behavior among nurses: Mediating role of organizational identification, poor working condition and workload. Leadersh Health Serv 2019;32:2-17.
  • Lee MH, Woo CH and Bae YH. The effect of psychological Contract of Nurse on Voice Behavior. Journal of Digital Convergence 2018;16:235-42.
  • Victor B and Cullen JB. The organizational bases of ethical work climates. Administrative Science Quarterly 1988;33:101-25.
  • Hamric AB and 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;35:422-9.
  • Bartholdson C, Sandeberg Ma, Lützén K, Blomgren K, Pergert P. Healthcare professionals’ perceptions of the ethical climate in paediatric cancer care. Nurs Ethics. 2016;23:877-88.
  • Gok K, Sumanth JJ, Bommer WH, Demirtas O, Arslan A, Eberhard J, et al. You may not reap what you sow: How employees’ moral awareness minimizes ethical leadership’s positive impact on workplace deviance. Journal of Business Ethics 2017;146: 257-77.
  • Bai YT, Lin L and Liu JT. Leveraging the employee voice: a multi-level social learning perspective of ethical leadership. International Journal of Human Resource Management 2019;30:1869-901.
  • Gallagher A. Moral distress and moral courage in everyday nursing practice. Online J Issues Nurs 2011;16:1-8.
  • Taraz Z, Loghmani L, Abbaszadeh A, Ahmadi F, Safavibiat Z, Borhani F. The relationship between ethical climate of hospital and moral courage of nursing staff. Electron J Gen Med 2019;16:1-6.
  • Venkataramani V, Zhou L, Wang M, Liao H, Shi J. Social networks and employee voice: The influence of team members’ and team leaders’ social network positions on employee voice. Organ Behav Hum Decis Process. 2016;132:37-48.
  • Güncel Türkçe Sözlük. 11 ed. Ankara: Türk Dil Kurumu; 2011.
  • Derin N. İşyerinde kişiler arası güven ile işgören sesliliği arasındaki ilişkide psikolojik rahatlığın aracılık rolü. Yönetim Bilimleri Dergisi 2017;15:51-68.
  • Bahcecik N and Ozturk H. The Hospital Ethical Climate Survey in Turkey. JONAS Healthc Law Ethics Regul 2003;5:94-9.
  • Arslan A and Yener S. İşgören sesliliği ölçeğinin Türkçe'ye uyarlanması çalışması Yönetim ve Ekonomi Araştırmaları Dergisi 2016;14:173-91.
  • Browne MW and Cudeck R. Alternative ways of assessing model fit. Sociological Methods Research 1992; 1:230-258.
  • Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate data analysis. 7 th ed. USA: Pearson; 2014. p.579-80.
  • Wheaton B, Muthen B, Alwin DF, Summers GF. Assessing reliability and stability in panel models. Sociological Methodology 1977;8:84-136.
  • Gong Z and Li M. Relationship between nursing mentorship and transformational leadership of mentor: A cross‐sectional study. J Nurs Manag. 2022;30:413-420.
  • MacKenzie SB, Podsakoff PM and Podsakoff NP. Challenge‐oriented organizational citizenship behaviors and organizational effectiveness: Do challenge‐oriented behaviors really have an impact on the organization's bottom line? Personnel Psychology 2011;64:559-92.

Hastane Etik İkliminin Onkoloji Hemşirelerinin Seslilik Davranışlarına Etkisi: Cesaretin Aracılık Rolü

Year 2023, , 179 - 185, 01.08.2023
https://doi.org/10.31125/hunhemsire.1172125

Abstract

Amaç: Etik iklim, çalışanların düşünce, tutum ve davranışlarını etkileyen önemli bir örgütsel özelliktir. Hastanelerin asli çalışanlarından biri olan hemşirelerin sesi hem çalıştıkları kurumlar hem de hastalarının güvenliği açısından çok değerlidir. Ancak, hastane etik iklimi ile seslilik davranışı arasındaki ilişki belirsizliğini korumaktadır. Bu çalışmanın amacı cesareti bir aracı olarak ele alarak etik iklimin onkoloji hemşirelerinin seslilik davranışları üzerindeki etkilerini araştırmaktır.
Gereç ve Yöntem: Bu araştırma, kestirimsel kesitsel bir çalışma olarak tasarlanmıştır. Bu çalışmanın örneklemini Ekim-Aralık 2018 tarihleri arasında Hacettepe Üniversitesi Onkoloji Hastanesi’nin yatan hasta kliniklerinde hemşire olarak istihdam edilen 71 hemşire oluşturmuştur.
Bulgular: Hastanenin etik iklimi ile onkoloji hemşirelerinin seslilik davranışları arasında pozitif ve anlamlı bir ilişki vardır ve bu ilişkide cesaretin pozitif kısmi aracılık etkisi vardır.
Sonuç: Bir hastanenin etik iklimi ile hemşirelerin seslilik davranışı arasındaki ilişki birçok farklı değişkeni içerdiğinden, cesaret bu ilişkide aracı olarak kabul edilebilir ancak tek başına doğrudan etkili olmayabilir.

References

  • Zhou XC, Liao JQ, Liu YH, Liao SD. Leader Impression Management and Employee Voice Behavior: Trust and Suspicion as Mediators. Social Behavior and Personality 2017;45:1843-54.
  • Dyne LV and LePine JA. Helping and voice extra-role behaviors: Evidence of construct and predictive validity. Academy of Management Journal 1998;41:108-19.
  • Dundon T, Wilkinson A, Marchington M, Ackers P. The meanings and purpose of employee voice. International Journal of Human Resource Management 2004;15:1149-70.
  • Grant AM and Rothbard NP. When in doubt, seize the day? Security values, prosocial values, and proactivity under ambiguity. J Appl Psychol 2013;98: 810-9.
  • Alfayad Z and Arif LSM. Employee voice and job satisfaction: An application of Herzberg two-factor theory. International Review of Management 2017;7:150-6.
  • Lin XW, Lam LW and Zhang LL. The curvilinear relationship between job satisfaction and employee voice: Speaking up for the organization and the self. Asia Pacific Journal of Management 2020;37:587-607.
  • Bowen F and Blackmon K. Spirals of silence: The dynamic effects of diversity on organizational voice. Journal of Management Studies 2003;40:1393-417.
  • Karcıoğlu F. Örgüt kültürü ve örgüt iklimi ilişkisi. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi 2001;15:265-283.
  • Cullen JB, Parboteeah KP and Victor B. The effects of ethical climates on organizational commitment: A two-study analysis. J Bus Ethics. 2003;46:127-41.
  • Wang YD and Hsieh HH. Organizational ethical climate, perceived organizational support, and employee silence: A cross-level investigation. Human Relations 2013;66:783-802.
  • Göktaş Kulualp H. Çalışan sesliliği ile bazı kişisel ve örgütsel özellikler arasındaki İlişkinin belirlenmesi: Öğretim elemanları üzerine bir araştırma Ege Akademik Bakış 2016;16:745-61.
  • Jiang J, Gao A and Yang B. Employees’ Critical Thinking, Leaders’ Inspirational Motivation, and Voice Behavior. Journal of Personnel Psychology 2018;17:33-41.
  • Kanten P and Ulker FE. A relational approach among perceived organizational support, proactive personality and voice behaviour. Procedia Soc Behav Sci. 2012;62:1016-22.
  • Liang J, Farh CI and Farh JL. Psychological antecedents of promotive and prohibitive voice: A two-wave examination. Academy of Management Journal 2012;55:71-92.
  • LePine JA and Van Dyne L. Voice and cooperative behavior as contrasting forms of contextual performance: Evidence of differential relationships with big five personality characteristics and cognitive ability. J Appl Psychol 2001;86:326-36.
  • Yalçındağ B. Relationships between courage, self-construals and other associated variables [Yüksek Lisans Tezi]. Middle East Technical University: Ankara; 2009.
  • Numminen O, Repo H and Leino-Kilpi H. Moral courage in nursing: A concept analysis. Nurs Ethics 2017;24: 878-91.
  • Sadooghiasl A, Parvizy S and Ebadi A. Concept analysis of moral courage in nursing: A hybrid model. Nurs Ethics 2018;25:6-19.
  • Woodard CR and Pury CL. The construct of courage: Categorization and measurement. Consulting Psychology Journal: Practice and Research 2007; 9:135-47.
  • Day L. Courage as a virtue necessary to good nursing practice. Am J Crit Care. 2007;16:613-6.
  • Barchard F, Sixsmith J, Neill S, Meurier C. 6Cs and ten commitments: Nurses’ understanding and use of courage. Nurs Manag 2017;23:26-31.
  • Dinc MS and Huric A. The impact of ethical climate types on nurses’ behaviors in Bosnia and Herzegovina. Nurs Ethics 2017;24:922-35.
  • Schwappach DLB and Gehring K. Trade-offs between voice and silence: a qualitative exploration of oncology staff's decisions to speak up about safety concerns. BMC Health Serv Res. 2014;14:1-10.
  • Olson LL. Hospital nurses' perceptions of the ethical climate of their work setting. Image J Nurs Sch 1998;30:345-9.
  • Cole DA, Bersick E, Skarbek A, Cummins K, Dugan K, Grantoza R. The courage to speak out: A study describing nurses' attitudes to report unsafe practices in patient care. J Nurs Manag 2019;27:1176-81.
  • Islam T, Ahmed I and Ali G. Effects of ethical leadership on bullying and voice behavior among nurses: Mediating role of organizational identification, poor working condition and workload. Leadersh Health Serv 2019;32:2-17.
  • Lee MH, Woo CH and Bae YH. The effect of psychological Contract of Nurse on Voice Behavior. Journal of Digital Convergence 2018;16:235-42.
  • Victor B and Cullen JB. The organizational bases of ethical work climates. Administrative Science Quarterly 1988;33:101-25.
  • Hamric AB and 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;35:422-9.
  • Bartholdson C, Sandeberg Ma, Lützén K, Blomgren K, Pergert P. Healthcare professionals’ perceptions of the ethical climate in paediatric cancer care. Nurs Ethics. 2016;23:877-88.
  • Gok K, Sumanth JJ, Bommer WH, Demirtas O, Arslan A, Eberhard J, et al. You may not reap what you sow: How employees’ moral awareness minimizes ethical leadership’s positive impact on workplace deviance. Journal of Business Ethics 2017;146: 257-77.
  • Bai YT, Lin L and Liu JT. Leveraging the employee voice: a multi-level social learning perspective of ethical leadership. International Journal of Human Resource Management 2019;30:1869-901.
  • Gallagher A. Moral distress and moral courage in everyday nursing practice. Online J Issues Nurs 2011;16:1-8.
  • Taraz Z, Loghmani L, Abbaszadeh A, Ahmadi F, Safavibiat Z, Borhani F. The relationship between ethical climate of hospital and moral courage of nursing staff. Electron J Gen Med 2019;16:1-6.
  • Venkataramani V, Zhou L, Wang M, Liao H, Shi J. Social networks and employee voice: The influence of team members’ and team leaders’ social network positions on employee voice. Organ Behav Hum Decis Process. 2016;132:37-48.
  • Güncel Türkçe Sözlük. 11 ed. Ankara: Türk Dil Kurumu; 2011.
  • Derin N. İşyerinde kişiler arası güven ile işgören sesliliği arasındaki ilişkide psikolojik rahatlığın aracılık rolü. Yönetim Bilimleri Dergisi 2017;15:51-68.
  • Bahcecik N and Ozturk H. The Hospital Ethical Climate Survey in Turkey. JONAS Healthc Law Ethics Regul 2003;5:94-9.
  • Arslan A and Yener S. İşgören sesliliği ölçeğinin Türkçe'ye uyarlanması çalışması Yönetim ve Ekonomi Araştırmaları Dergisi 2016;14:173-91.
  • Browne MW and Cudeck R. Alternative ways of assessing model fit. Sociological Methods Research 1992; 1:230-258.
  • Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate data analysis. 7 th ed. USA: Pearson; 2014. p.579-80.
  • Wheaton B, Muthen B, Alwin DF, Summers GF. Assessing reliability and stability in panel models. Sociological Methodology 1977;8:84-136.
  • Gong Z and Li M. Relationship between nursing mentorship and transformational leadership of mentor: A cross‐sectional study. J Nurs Manag. 2022;30:413-420.
  • MacKenzie SB, Podsakoff PM and Podsakoff NP. Challenge‐oriented organizational citizenship behaviors and organizational effectiveness: Do challenge‐oriented behaviors really have an impact on the organization's bottom line? Personnel Psychology 2011;64:559-92.
There are 44 citations in total.

Details

Primary Language English
Subjects Fundamentals of Nursing, Nursing Workforce, Nursing Management
Journal Section Research Article
Authors

Şenay Sarmasoğlu Kılıkçıer 0000-0001-9220-5959

Gül Hatice Tarakçıoğlu Çelik 0000-0002-1376-4259

Şenay Gül 0000-0002-8808-5760

Eda Karaismailoğlu 0000-0003-3085-7809

Publication Date August 1, 2023
Submission Date September 7, 2022
Published in Issue Year 2023

Cite

Vancouver Sarmasoğlu Kılıkçıer Ş, Tarakçıoğlu Çelik GH, Gül Ş, Karaismailoğlu E. Effects of Hospital Ethical Climate on Voice Behavior among Oncology Nurses’: Mediating Role of Courage. HUHEMFAD. 2023;10(2):179-85.