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了解员工对道德准则的态度和认知及其相关因素:克罗地亚一家公立三级医院的横断面调查

Understanding Employees' Attitudes and Awareness of Code of Ethics and Associated Factors: A Cross-Sectional Survey at a Public Tertiary Hospital in Croatia.

作者信息

Hrgović Zrinka, Krstulović Jure, Tavra Ante, Krešo Ante, Batinović Franko, Znaor Ljubo, Marušić Ana

机构信息

School of Medicine, University of Split, Šoltanska 2A, 21000 Split, Croatia.

Department of Family Medicine, Split-Dalmatia Health Center, Kavanjinova 2, 21000 Split, Croatia.

出版信息

Healthcare (Basel). 2025 Aug 27;13(17):2131. doi: 10.3390/healthcare13172131.

Abstract

: Ethical challenges in healthcare require awareness and adherence to professional codes of ethics, particularly in interdisciplinary settings such as tertiary hospitals. This study aimed to assess the attitudes and awareness of healthcare professionals regarding codes of ethics at the University Hospital of Split in Croatia, which did not have an institutional code at the time of the study. : A cross-sectional survey using a structured, anonymous questionnaire was distributed both physically across hospital departments and online via email. Welch's -test, ANOVA, Kruskal-Wallis, and correlation tests were used to assess associations between favourability scores and participant characteristics. Linear and logistic regression analyses further examined predictors of favourable attitudes. : Of 442 returned questionnaires, 377 were complete and included in the analysis, mainly from nurses (56.5%) and physicians (42.7%). The median favourability score was 83.8% (88/105; IQR 78.1-88.6), with 87.0% scoring above the favourable threshold (≥75%). Female gender and higher education were significantly associated with more favourable attitudes. Participants strongly endorsed core principles such as patient confidentiality and autonomy, yet 57.6% considered ethics education during training inadequate, and only 36.3% viewed dual practices as a conflict of interest. Most respondents reported adherence to ethical standards (85.4%), while only over half were familiar with their professional ethics code (64.5%) and the hospital Ethics Committee (56.2%); a total of 66.3% supported introducing a hospital-specific code. Awareness and support for ethical structures were higher among women and those with more education. : This study reveals a gap between personal ethical commitment and institutional ethical infrastructure. Strengthening ethics education and implementing a hospital-specific ethics code may enhance organisational ethical culture.

摘要

医疗保健中的伦理挑战需要医护人员了解并遵守职业道德规范,尤其是在三级医院等跨学科环境中。本研究旨在评估克罗地亚斯普利特大学医院的医护人员对伦理规范的态度和认知,该医院在研究开展时没有机构层面的伦理规范。

采用结构化匿名问卷进行横断面调查,问卷通过医院各科室现场发放以及电子邮件在线发放。使用韦尔奇检验、方差分析、克鲁斯卡尔-沃利斯检验和相关性检验来评估支持度得分与参与者特征之间的关联。线性回归和逻辑回归分析进一步研究了积极态度的预测因素。

在442份回收问卷中,377份完整并纳入分析,主要来自护士(56.5%)和医生(42.7%)。支持度得分中位数为83.8%(88/105;四分位距78.1 - 88.6),87.0%的得分高于支持阈值(≥75%)。女性和高等教育与更积极的态度显著相关。参与者强烈认可患者保密和自主等核心原则,但57.6%的人认为培训期间的伦理教育不足,只有36.3%的人将兼职行为视为利益冲突。大多数受访者报告遵守伦理标准(85.4%),而只有一半多一点的人熟悉其职业道德规范(64.5%)和医院伦理委员会(56.2%);共有66.3%的人支持引入医院特定的伦理规范。女性和受教育程度较高者对伦理结构的认知和支持更高。

本研究揭示了个人伦理承诺与机构伦理基础设施之间的差距。加强伦理教育并实施医院特定的伦理规范可能会提升组织的伦理文化。

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