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

BackgroundEthical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviour within teams.AimThis paper sought to explore perceptions of ethical climate amongst healthcare workers as measured by the Ethical Climate Questionnaire (ECQ), th...

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Authors: Essex, Ryan (Author) ; Thompson, Trevor (Author) ; Evans, Thomas Rhys (Author) ; Fortune, Vanessa (Author) ; Kalocsányiová, Erika (Author) ; Miller, Denise (Author) ; Markowski, Marianne (Author) ; Elliott, Helen (Author)
Format: Electronic Article
Language:English
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Published: Sage 2023
In: Nursing ethics
Year: 2023, Volume: 30, Issue: 7/8, Pages: 910-921
Further subjects:B Systematic Review
B Ethical Climate
B Meta-analysis
Online Access: Volltext (kostenfrei)

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520 |a BackgroundEthical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviour within teams.AimThis 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).MethodsA 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 considerationEthical approval was not required.ResultsThe 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, sub-scales 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.ConclusionsThe 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. 
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700 1 |a Kalocsányiová, Erika  |e VerfasserIn  |4 aut 
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700 1 |a Markowski, Marianne  |e VerfasserIn  |4 aut 
700 1 |a Elliott, Helen  |e VerfasserIn  |4 aut 
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