<journal article>
Individual and Organizational Factors Affecting Ethical Behavior among Hospital Nurses
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Abstract | Purpose: The purpose of this study was to clarify the individual and organizational factors that affect the ethical behavior of hospital nurses, as well as the interaction between these factors. Mater...ial and methods: We conducted an anonymous self-administered questionnaire survey on nurses working at 21 hospitals in Japan. The survey was conducted from August to November 2019. We created a conceptual framework for the factors that influence the ethical behavior of nurses based on reference to previous studies, and verified it using structural equation modeling. In addition, multi-group structural equation modeling was performed for each type of organizational climate and compared. Results : Questionnaires were distributed to 1,048 nurses, out of which 535 responded, and responses from 517 nurses were analyzed (valid response rate 49.3%). The individual factors affecting the ethical behavior of hospital nurses were locus of control and moral sensitivity; job position affected ethical behavior through locus of control and moral sensitivity. The nursesʼ age, gender, and experience of ethical learning in basic nursing education did not affect ethical behavior. In terms of organizational factors, the organizational climate affected the ethical behavior of nurses, while the bed size, management base, ethical training in hospitals, and ethical conferences did not affect ethical behavior. No interaction effects were observed between the individual and organizational factors. A multi-group structural equation model by type of organizational climate showed that moral sensitivity influence “good care” in all types of organizations. Furthermore, ethical training in the hospital affected moral sensitivity in an organization with low group coercion and imperative atmosphere, and a high group cohesiveness. Both models obtained favorable goodness of fit. Conclusion: The ethical behavior of nurses is affected by the locus of control, moral sensitivity, and organizational climate, and the job position influences ethical behavior through locus of control and moral sensitivity. It was also found that the factors influencing the ethical behavior of nurses differ with the type of organizational climate. 【目的】本研究の目的は,病院看護師の個人要因,組織要因の相互作用およびこれら各要因の倫理的行動への影響を明らかにすることである. 【方法】本研究では,全国21病院に勤務する看護師を対象に,無記名の自記式質問紙調査を行った.調査期間は2019年8月から11 月である.先行研究を参考に,看護師の倫理的行動に影響する要因に関する概念枠組みを作成し,構造方程式モデリングを用いて検証した.また組織風土のタイプ別に多母集団同時分析を行い,比較を行った. 【結果】1,048 名の対象者に質問紙を配布し,535名から回答を得,517 名を分析対象とした(有効回答率49.3%).病院看護師の倫理的行動に影響している個人要因は,Locus of Control と道徳的感受性であり,職位はLocus of Control と道徳的感受性を介して影響していた.年齢や性別,看護基礎教育における倫理学習経験は影響していなかった.組織要因では,組織環境のよい風土が看護師の倫理的行動に影響しており,病床規模や経営母体,病院内の倫理研修や倫理カンファレンスは倫理的行動に影響していなかった.また個人要因と組織要因間の相互の影響も認められなかった.組織風土のタイプ別に多母集団同時分析を実施したところ,全てのタイプの組織で,道徳的感受性は「善いケア」に影響していることが示された.さらに強制・命令的な雰囲気が少なく集団凝集性の高い組織では,院内の倫理研修が道徳的感受性に影響していること,集団凝集性の低い組織風土では,職位や経験年数,経営母体などが倫理的行動に影響することが認められた.いずれのモデルも良好な適合度を得た. 【結論】看護師の倫理的行動には,Locus of Control と道徳的感受性,組織環境のよい風土が影響しており,職位はLocus of Control と道徳的感受性を介して倫理的行動に影響していることが示された.また看護師の倫理的行動に影響する要因には組織風土のタイプごとに違いがあることが明らかになった.show more |
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Created Date | 2021.03.22 |
Modified Date | 2021.03.22 |