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

positive perception of ethical climate. Being a female was related to a more positive evaluation of the ethical climate of the hospitals where they were employed. Additionally, nurses’ percep- tion of ethical climate was significantly related to the hospital and unit where they worked. There are several previous studies regarding factors influencing the HECS, although some are Table 3. Association between demographic variables and J-HECS26 total score (n = 605). n Mean SD Min Max p value Gender† 0.042� Female 561 95.1 14.8 47 130 Male 44 90.4 14.6 62 128 Hospital‡ 0.001� 1 410 93.4 14.9 47 130 2 130 96.8 14.1 51 127 3 65 99.5 14.6 62 130 License‡ 0.174 Registered Nurse 562 94.7 14.8 47 130 Midwife 29 98.6 14.2 71 127 Advanced Licensed Nurse 14 89.8 16.8 60 121 Position† 0.558 Manager 74 95.7 13.4 50 121 Staff 531 94.6 15.0 47 130 Unit§ (n = 604) < 0.001� Surgery�� 201 92.9 14.8 47 122 Internal medicine�� 174 97.3 12.0 63 128 Mixed surgery and internal medicine�� 69 99.0 13.4 64 126 Psychiatry�� 15 103.9 14.1 76 130 Pediatric�� 19 95.8 19.2 53 127 Obstetric�� 22 102.9 12.8 75 127 Emergency department�� 12 98.6 15.7 72 124 Operating room 16 73.0 11.8 50 95 ICU/CCU 35 88.1 13.9 61 113 SCU 7 91.0 6.8 77 98 SCU NICU�� 28 92.1 19.5 53 130 Others 7 87.7 14.5 71 116 Experience of ethics education† 0.035� Yes 430 95.6 14.2 50 130 No 175 92.8 16.0 47 130 In-service training in workplace on ethics†(n = 604) < 0.001� Yes 393 96.3 14.0 50 130

No 211 91.8 15.8 47 130 Workshops/ Academic conferences on nursing ethics† (n = 604) 0.023� Yes 122 92.0 14.4 50 127 No 482 95.4 14.9 47 130 Notes † student’ t-test ‡ one-way ANOVA: one-way analysis of variance § Kruskal-Wallis test; SD = standard deviation. � p< 0.05 �� Multiple comparison test p< 0.05 versus operating room https://doi.org/10.1371/journal.pone.0269034.t003 PLOS ONE Ethical climate and ethics education PLOS ONE | https://doi.org/10.1371/journal.pone.0269034 July 21, 2022 8 / 15