Ammari Nada, Gantare Abdellah
Hassan First University of Settat.
Nurs Ethics. 2024 Nov 2:9697330241296875. doi: 10.1177/09697330241296875.
Nursing shortages and turnover pose significant challenges for health organizations worldwide, driven by various organizational and individual factors. Ethical climate has emerged as a critical aspect influencing nurses' well-being and retention within healthcare settings, reflecting organizational practices with moral implications. Understanding the relationship between ethical climate and turnover intention among nurses is paramount for practitioners, managers, and policymakers.
This review aimed to examine evidence and synthesize findings from prior studies on the association between ethical climate and turnover intention among nurses and identify key variables influencing its dynamics.
A scoping review methodology was employed, encompassing studies retrieved up to February 2024 from major scientific databases, including PUBMED/MEDLINE, WEB OF SCIENCE, SCOPUS, and SCIENCE DIRECT. This study was conducted following ethical considerations and sound scientific guidelines.
Sixteen articles meeting the inclusion criteria were identified. Overall, a significant association between ethical climate and turnover intention was observed, with theoretical underpinnings demonstrated. Key variables frequently linked to both ethical climate and turnover intention included organizational commitment, job satisfaction, and moral distress, while organizational commitment, organizational cynicism, and organizational trust emerged as mediators.
Despite demonstrating a clear association, results underscore the necessity for replication studies, qualitative and longitudinal approaches, and standardized measurement. Enhancing the ethical climate through regular assessments, education, and interprofessional collaboration can improve retention. Future research should focus on theory building, ethical management and leadership, associated factors analysis, and intervention studies to develop comprehensive models and effective strategies for improving the ethical climate and reducing nurse turnover.
由于各种组织和个人因素，护理人员短缺和流动给全球卫生组织带来了重大挑战。道德氛围已成为影响护士在医疗机构中的幸福感和留任意愿的一个关键方面，反映了具有道德影响的组织实践。对于从业者、管理人员和政策制定者来说，了解道德氛围与护士离职意愿之间的关系至关重要。
本综述旨在审查证据，并综合先前关于道德氛围与护士离职意愿之间关联的研究结果，识别影响其动态变化的关键变量。
采用了一种范围综述方法，涵盖截至2024年2月从主要科学数据库检索到的研究，包括PUBMED/MEDLINE、科学网、Scopus和科学Direct。本研究是在遵循伦理考量和合理科学指南的情况下进行的。
确定了16篇符合纳入标准的文章。总体而言，观察到道德氛围与离职意愿之间存在显著关联，并展示了理论基础。经常与道德氛围和离职意愿相关的关键变量包括组织承诺、工作满意度和道德困扰，而组织承诺、组织犬儒主义和组织信任则成为中介变量。
尽管显示出明显的关联，但结果强调了重复研究、定性和纵向研究方法以及标准化测量的必要性。通过定期评估、教育和跨专业合作来改善道德氛围可以提高留用率。未来的研究应侧重于理论构建、道德管理和领导、相关因素分析以及干预研究，以开发全面的模型和有效的策略来改善道德氛围并减少护士流失。
