Hrgović Zrinka, Ursić Luka, Krstulović Jure, Viđak Marin, Znaor Ljubo, Marušić Ana
Department of Family Medicine, Health Center of Split- Dalmatia County, Split, Croatia.
University of Split School of Medicine, Split, Croatia.
BMC Med Ethics. 2025 May 7;26(1):59. doi: 10.1186/s12910-025-01217-1.
In this cross-sectional study, we assessed the ethical climate at the University Hospital of Split in Croatia and investigated its potential indicators.
We used a validated Croatian translation of the 36-item Ethical Climate Questionnaire, which we distributed online (via an e-mail sent by the hospital administration to hospital employees) and as a paper and pen survey directly to all hospital departments. We compared ECQ scores between doctors of medicine (MDs)/doctors of dental medicine (DMDs) and other employees; MDs/DMDs and nurses; employees working with patients and those not working with patients; and employees working in the ICU versus those not working in the ICU using the Mann-Whitney U test. We used linear regression to explore the relationship of each ethical climate with gender, age, degree level, and years spent working in the hospital.
We collected 325 physical and 222 online questionnaires (547 responses in total), after which we excluded 146 incomplete responses. This left 401 questionnaires for analysis, primarily from doctors (n = 175; 43.6%) and nursing staff (n = 131; 32.7%). The two dominant climates were 'Company rules' and 'Laws and professional codes'. Stratified by profession, we observed higher scores for 'Personal morality' among doctors of medicine or dental medicine, whereas the group comprising other health professionals and non-medical staff had higher scores for 'Team interests', 'Efficiency', 'Social responsibility', and 'Laws and professional codes'. In comparing nurses and doctors of medicine/dental medicine, we observed the former group had higher scores for 'Social responsibility', 'Efficiency', and 'Team interest', while the latter had higher scores for 'Personal morality'. Those who worked outside of the ICU had higher scores for 'Social responsibility' compared to those who did not. In the regression analyses, age was a significant positive predictor of the 'Laws and professional codes' climates, and years spent working in the hospital acted as a positive predictor of the 'Self-interest' climate.
A large university hospital center in a fully publicly funded national healthcare system has a positive ethical work climate, which could be further developed by further development and implementation of codes of ethics to outline expected behaviors from all employees.
在这项横断面研究中，我们评估了克罗地亚斯普利特大学医院的道德氛围，并调查了其潜在指标。
我们使用了经过验证的36项道德氛围问卷的克罗地亚语翻译版本，通过在线方式（通过医院管理部门发送给医院员工的电子邮件）以及以纸笔形式直接向所有医院科室发放。我们使用曼-惠特尼U检验比较了医学博士（MD）/牙医学博士（DMD）与其他员工之间、MD/DMD与护士之间、与患者接触的员工和不与患者接触的员工之间，以及在重症监护室工作的员工和不在重症监护室工作的员工之间的道德氛围问卷得分。我们使用线性回归来探讨每种道德氛围与性别、年龄、学位水平以及在医院工作年限之间的关系。
我们收集了325份纸质问卷和222份在线问卷（共547份回复），之后我们排除了146份不完整的回复。这留下401份问卷用于分析，主要来自医生（n = 175；43.6%）和护理人员（n = 131；32.7%）。两种主要的氛围是“公司规则”和“法律与职业规范”。按职业分层，我们观察到医学或牙医学博士中“个人道德”得分较高，而其他卫生专业人员和非医务人员组成的群体在“团队利益”、“效率”、“社会责任”和“法律与职业规范”方面得分较高。在比较护士与医学/牙医学博士时，我们观察到前一组在“社会责任”、“效率”和“团队利益”方面得分较高，而后者在“个人道德”方面得分较高。与不在重症监护室工作的人员相比，在重症监护室外工作的人员在“社会责任”方面得分较高。在回归分析中，年龄是“法律与职业规范”氛围的显著正向预测因素，在医院工作的年限是“自身利益”氛围的正向预测因素。
在一个完全由公共资金资助的国家医疗保健系统中的大型大学医院中心具有积极的道德工作氛围，通过进一步制定和实施道德准则来概述所有员工的预期行为，这种氛围可以得到进一步发展。
