Ethical climate in the primary healthcare setting: a cross-sectional study
DOI:
https://doi.org/10.12957/reuerj.2024.83070Keywords:
Public Health Nursing, Primary Health Care, Occupational Health, Ethics, Institutional, Working ConditionsAbstract
Objective: to evaluate the ethical climate in the work environments of primary healthcare units in a town in the Amazon region and analyze its correlation with socio-occupational variables. Method: this cross-sectional and correlational study was conducted with workers from seven healthcare units, with a sample of 170 participants. A socio-occupational questionnaire and the Brazilian version of the Ethical Climate Questionnaire were used. Results: principles and rules, benevolence, and individualism were identified as factors in the ethical climate of the work environments studied, in that order of relevance. A weak correlation was found with years since graduation, and a moderate correlation was found with sick leave. Conclusion: a concern for professional duty and collective responsibility prevails in the ethical climate described here. Professional experience is positively related to the value of benevolence and to the principles and rules that should guide the work of healthcare professionals.
References
Fernandez M, Lotta G, Corrêa M. Challenges for Primary Health Care in Brazil: an analysis on the labor of community health workers during a COVID-19 pandemic. Trab. educ. saúde. 2021 [cited 2021 Aug 06]; 19:e00321153. DOI: https://doi.org/10.1590/1981-7746-sol00321.
Pereira LEM, Ramos FRS, Brehmer LCF, Diaz PS. Healthy work environment in primary health care: integrative literature review. Rev. baiana enferm. 2022 [cited 2023 Jun 19]; 36:38084. DOI: https://doi.org/10.18471/rbe.v36.38084.
Tasca R, Massuda A, Carvalho WM, Buchweitz C, Harzheim E. Recomendações para o fortalecimento da atenção primária à saúde no Brasil. Rev Panam Salud Publica. 2020 [cited 2023 Jun 18]; 44:e4. DOI: https://doi.org/10.26633/RPSP.2020.4.
Almeida JG, Porto JB. Ethical climate index: evidence of validity of the Brazilian version. Human and Social Management. 2019 [cited 2022 Dec 18]; 20(3):eRAMG190030. DOI: https://doi.org/10.1590/1678-6971/eRAMG190030.
Ribeiro PECD, Porto JB, Puente-Palacios K, Resende MM. Ethical Climate within Organizations: Validity Evidence of a Measure’s Scale. Temas psicol. 2016 [cited 2022 Dec 18]; 24(2):415-25. DOI: http://doi.org/10.9788/TP2016.2-02.
Dalmolin GL, Lanes TC, Bernardi CMS, Ramos FRS. Conceptual framework for the ethical climate in health professionals. Nurs Ethics. 2022 [cited 2023 Jun 19]; 29(5):1174-85. DOI: http://doi.org/10.1177/09697330221075741.
Lanes TC, Dalmolin GL, Silva AM, Ramos FRS, Olson LL. Cross-cultural adaptation of the Hospital Ethical Climate Survey to Brazil. J Nurs Meas. 2022 [cited 2023 Jun 19]; 31(2):148-62. DOI: http://doi.org/10.1891/JNM-2021-0036.
Van den Bulcke B, Metaxa V, Reyners AK, Rusinova K, Jensen HI, Malmgren J, et al. Ethical climate and intention to leave among critical care clinicians: an observational study in 68 intensive care units across Europe and the United States. Intensive Care Med. 2020 [cited 2023 Jun 18]; 46(1):46–56. DOI: https://doi.org/10.1007/s00134-019-05829-1.
Tei-Tominaga M, Nakanish M. Factors related to turnover intentions and work-related injuries and accidents among professional caregivers: a cross-sectional questionnaire study. Environ Health Prev Med. 2020 [cited 2023 Jun 18]; 25:24. DOI: https://doi.org/10.1186/s12199-020-00863-8.
Dalmolin GL, Lanes TC, Facin MB, Schutz TC, Andolhe R, Ramos FRS. Estratégias para promoção do clima ético positivo sob a perspectiva de enfermeiros hospitalares. Rev. enferm. UERJ. 2023 [cited 2024 Mar 23]; 31(1):e71003. DOI: https://doi.org/10.12957/reuerj.2023.71003.
Aloustani S, Atashzadeh-Shoorideh F, Zagheri-Tafreshi M, Nasiri M, Barkhordari-Sharifabad M, Skerrett V. Association between ethical leadership, ethical climate and organizational citizenship behavior from nurses’ perspective: a descriptive correlational study. BMC Nurs. 2020[cited 2022 Dec 18]; 19:15. DOI: https://doi.org/10.1186/s12912-020-0408-1.
Tehranineshat B, Torabizadeh C, Bijani M. A study of the relationship between professional values and ethical climate and nurses’ professional quality of life in Iran. Int J Nurs Sci. 2020 [cited 2023 Jun 18]; 7(3):313-19. DOI: https://doi.org/10.1016/j.ijnss.2020.06.001.
IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.
Callegari-Jacques SM. Bioestatística: princípios e aplicações. 2ª reimpressão. Porto Alegre: Artmed; 2005.
Paraizo CB, Bégin L. Organizational Ethics in Health Settings. Ciênc. saúde coletiva. 2020 [cited 2021 Dec 13]; 25(1):251-9. DOI: https://doi.org/10.1590/1413-81232020251.28342019.
Ventura PFEV, Silva DM, Alves M. Organizational culture in nursing work: influences in adherence to quality and safety practices. REME - Rev Min Enferm. 2020 [cited 2021 Dec 10]; 24:e-1330. DOI: https://doi.org/10.5935/1415-2762.20200067.
Ramos FRS, Brehmer LCF, Dalmolin GL, Silveira LR, Schneider DG, Vargas MAO. Association between moral distress and supporting elements of moral deliberation in nurses. Rev. Latino-Am. Enfermagem. 2020 [cited 2023 Jan 09]; 28:e3332. DOI: http://dx.doi.org/10.1590/1518-8345.3990.3332.
Robichaux C, Grace P, Bartlett J, Stokes F, Saulo Lewis M, Turner M. Ethics education for nurses: foundations for an integrated curriculum. J Nurs Educ. 2022 [cited 2023 Jun 19]; 61(3):123-30. DOI: http://doi.org/10.3928/01484834-20220109-02.
Okumoto A, Yoneyama S, Miyata C, Kinoshita A. The relationship between hospital ethical climate and continuing education in nursing ethics. PLoS One. 2022 [cited 2023 Jun 19]; 17(7):e0269034. DOI: http://doi.org/10.1371/journal.pone.0269034.
Haahr A, Norlyk A, Martinsen B, Dreyer P. Nurses experiences of ethical dilemmas: a review. Nursing ethics. 2020 [cited 2023 Jun 19]; 27(1):258-72. DOI: https://doi.org/10.1177/0969733019832941.
Enzveiler FC, Warmling CM, Pires FS. O acolhimento e o trabalho de enfermeiros na estratégia de Saúde da família: práticas de cuidado. Saberes Plurais. 2020 [cited 2023 Jun 19]; 4(2):129-32. DOI: http://doi.org/10.54909/sp.v4i2.109879.
Morley G, Sankary LR. Re‐examining the relationship between moral distress and moral agency in nursing. Nurs Philos. 2023 [cited 2023 Jun 19]; 25(1):e12419. DOI: https://doi.org/10.1111/nup.12419.
Schutz TC, Lanes TC, Villagran CA, Bernardi CMS, Dalmolin GL. Fatores associados ao clima ético em ambiente hospitalar. Rsd. 2021 [cited 2023 Mar 22]; 10(2):e36910212577. DOI: http://dx.doi.org/10.33448/rsd-v10i2.12577.
Silva-Costa A, Griep RH, Rotenberg L. Percepção de risco de adoecimento por COVID-19 e depressão, ansiedade e estresse entre trabalhadores de unidades de saúde. Cad Saúde Pública. 2022 [cited 2023 Mar 23]; 38(3):e00198321. DOI: https://doi.org/10.1590/0102-311X00198321.
Hughes MT, Rushton CH. Ethics and Well-Being: The health professions and the COVID-19 pandemic. Acad Med. 2022 [cited 2023 Dec 23]; 7(3S):S98-103. DOI: http://doi.org/10.1097/ACM.0000000000004524.
Lima E. Estudo aponta trabalhadores da saúde mais expostos à Covid-19. Portal Fiocruz: 2022 [cited 2022 Mar 18]. Available from: https://portal.fiocruz.br/noticia/estudo-aponta-trabalhadores-da-saude-mais-expostos-covid-19.
Monteiro WF, Ferreira DS, Lima KJV, Tavares IC, Ramos FRS. The organization of healthcare work in the light of ergology: experiences in the COVID-19 pandemic. Rev Esc Enferm USP. 2023 [cited 2023 Mar 23]; 57:e20220261. DOI: https://doi.org/10.1590/1980-220X-REEUSP-2022-0261en.
Queiroz AM, Sousa AR, Moreira WC, Nóbrega MPSS, Santos MB, Barbossa LJ, et al. The novel COVID-19: impacts on nursing professionals’ mental health? Acta Paul Enferm. 2021 [cited 2023 Jun 19]; 34:eAPE02523. DOI: https://doi.org/10.37689/acta-ape/2021AO02523.
Ramos FRS, Silva DMGV, Lima KJV, Monteiro WF, Sachett JAG, Monteiro W. Path of fear: experiences of health professionals in the fight against COVID‐19. Nurs Inq. 2023 [cited 2023 Jun 19]; 30(4):e12578. DOI: https://doi.org/10.1111/nin.12578.
Antonietti L, Esandi ME, Duré I, Cho M, Ortiz Z. Condiciones y medio ambiente de trabajo en salud: modelo conceptual para áreas remotas y rurales Rev Panam Salud Publica. 2020 [cited 2022 Dec 18]; 44:e111. DOI: https://doi.org/10.26633/RPSP.2020.111.
Fradelos EC, Alikari V, Tsaras K, Papathanasiou I, Tzavella F, Papagiannis D, et al. Assessment of psychological distress in end stage renal disease: is it spirituality related? Med Pharm Rep. 2021 [cited 2022 Dec 18]; 94(1):79-87. DOI: http://doi.org/10.15386/mpr-1623.
Marques, V. Cinco grandes motivos para viver perto do trabalho. Rede Jornal Contábil. 2020 [cited 2022 Dec 18]. Available from: https://www.jornalcontabil.com.br/5-grandes-motivos-para-viver-perto-do-trabalho/.
Jiang W, Zhao X, Jiang J, Zhang H, Sun S, Li X. The association between perceived hospital ethical climate and self-evaluated care quality for COVID-19 patients: the mediating role of ethical sensitivity among Chinese anti-pandemic nurses. BMC Med Ethics. 2021 [cited 2022 Dec 18]; 22(1):144. DOI: https://doi.org/10.1186/s12910-021-00713-4.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Lenna Eloisa Madureira Pereira, Graziele de Lima Dalmolin, Priscila Orlandi Barth, Laura Cavalcanti de Farias Brehmer, Flávia Regina Souza Ramos
This work is licensed under a Creative Commons Attribution 4.0 International License.
When publishing in Revista Enfermagem UERJ, the authors declare that the work is their exclusive authorship and therefore assume full responsibility for its content.
Authors retain copyright to their article and agree to license their work using a Creative Commons Attribution International Public License (CC BY), thereby accepting the terms and conditions of this license (https://creativecommons.org/licenses/by/4.0/legalcode.en), which allows material created by the author to be distributed, copied and displayed by third parties. The original work must be cited and present a link to the article available on the website of the journal in which it was published.
The Copyright of the articles published in Revista Enfermagem UERJ belongs to their respective author(s), with the rights of first publication assigned to Revista Enfermagem UERJ, with the work simultaneously licensed under a Creative Commons License CC BY, which allows sharing of work with recognition of authorship and initial publication in this journal.
The authors grant Revista Enfermagem UERJ the right of first publication, to identify themselves as the original publisher of the work and grant the magazine a license of non-exclusive rights to use the work in the following ways:
- Sell and/or distribute the work in printed copies and/or electronic format;
- Distribute parts and/or the work as a whole with the aim of promoting the magazine through the internet and other digital and printed media;
- Record and playback work in any format, including digital media.
In line with the journal's policies, each published article will be assigned a Creative Commons Attribution (CC BY) license.
