The relationship between hospital ethical climate and continuing education in nursing ethics

RESEARCH ARTICLE The relationship between hospital ethical climate and continuing education in nursing ethics Ayaka OkumotoID1*, Satoko Yoneyama1,2, Chiharu Miyata3, Ayae Kinoshita1 1 Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 2 Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan, 3 Course of nursing science, Mie University Graduate School of Medicine, Mie, Japan * okumoto.ayaka.l23@kyoto-u.jp Abstract Background In recent years, there has been a growing interest in the importance of creating a healthy ethical climate. Although relationship with various factors and the ethical climate have been reported, understanding of the relationship between ethical education and ethical climate is limited. Aim This study aims to investigate the relationship between ethical climate, personal characteris- tics, and continuing education for ethics. Methods This study conducted a quantitative cross-sectional survey of 605 nurses in 3 teaching hos- pitals in Japan. Multiple-regression analysis was used to assess the relationship between ethical climate and demographic characteristics and continuing education. Further mean of ethical climate scores were compared between received continuing education and did not, using analysis of covariance adjusted for demographic variables. Findings The ethical climate showed significant association with hospital, gender, specialty of the unit, experience of ethics education, in-service ethical training, and workshops/ academic

conferences on nursing ethics. In multiple-regression analysis, attending in-service ethical training increased the mean of ethical climate score (p = 0.031) and workshops/ academic conferences decreased the mean score (p = 0.028). Adjusted-mean of ethical climate score of nurses who had in-service training was significantly higher than those who had not (p = 0.038), whereas adjusted-mean of it of nurses who had attended workshops/ academic con- ferences was significant lower (p = 0.033). PLOS ONE PLOS ONE | https://doi.org/10.1371/journal.pone.0269034 July 21, 2022 1 / 15 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Okumoto A, Yoneyama S, Miyata C, Kinoshita A (2022) The relationship between hospital ethical climate and continuing education in nursing ethics. PLoS ONE 17(7): e0269034. https://doi.org/10.1371/journal.pone.0269034 Editor: Vijayalakshmi Kakulapati, Sreenidhi Institute of Science and Technology, INDIA Received: February 2, 2022 Accepted: May 13, 2022 Published: July 21, 2022 Copyright: © 2022 Okumoto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data within the paper and its Supporting Information files. Funding: This work was supported by the Charitable Trust Yamaji Fumiko Specialized Nursing Education and Research Grant Fund and the management expenses grants by Kyoto

University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist.