Factors Affecting the Ethical Behavior of Middle Managers of Nursing in Prefecture A, Japan

Abstract

To elucidate the factors affecting the ethical behavior of middle manager of nursing in Prefecture A, Japan, a questionnaire survey was conducted with 655 such managers from 57 institutions. The questionnaire gathered information on participant age, gender, duration of experience as a nursing manager and a nurse, experience in nursing management and ethics training, and nursing ethics conferences, and recognition of situations where ethical issues are involved based on Matsumoto's 18 ethical problems and Ode's ethical behavior scale. Responses were collected from 347 participants (recovery rate: 53%), of which 307 responses were analyzed (valid response rate: 89%). Results showed that 223 (72.6%) had attended the training for middle managers of nursing, while 263 (85.7%) and 213 (69.4%) attended a nursing ethics training and conference, respectively. Many participants indicated recognizing ethical issues in the following settings: patient's family making a decision on treatment without confirming the patient's intentions, and physical restrictions being used that would not be necessary if sufficient nursing staff were available. Those who attended nursing ethics training and nursing ethics conferences achieved high scores for ethical behavior under the headings: respect for autonomy, justice, and nonmaleficence/beneficence. Scores for ethical behavior were lower in those who indicated that they recognized ethical issues in 13 settings compared to those who indicated they did not. The results suggested that nursing ethics training and conferences are factors that facilitate ethical behavior in nurses. However, recognition of ethical issues does not necessarily lead to ethical behavior.