The relationship between ethical climate and nursing service behavior in public and private hospitals: a cross-sectional study in China.

ABSTRACT

BACKGROUND: Workplace climate is a great significant element that has an impact on nurses' behavior and practice; moreover, nurses' service behavior contributes to the patients' satisfaction and subsequently to the long-term success of hospitals. Few studies explore how different types of organizational ethical climate encourage nurses to engage in both in-role and extra-role service behaviors, especially in comparing the influencing process between public and private hospitals. This study aimed to compare the relationship between the five types of ethical climate and nurses' in-role and extra-role service behaviors in public and private hospitals. METHODS: This study conducted a cross-sectional survey on 559 nurses from China in May 2019. The questionnaire was distributed to nurses by sending a web link via the mobile phone application WeChat through snowball sampling methods. All participants were investigated using the Ethical Climate Scale and Service Behavior Questionnaire. SPSS 22.0 was used for correlation analysis, t-test, and analysis of variance test, and Mplus 7.4 was used for group comparison (p < .05). RESULTS: The law and code climate has a much greater influence on nurses' in-role service behavior in private hospitals than on that in public hospitals (ß = - 0.277; CI 95 % = [-0.452, - 0.075]; p < .01), and the instrumental climate has a stronger influence on nurses' extra-role service behavior private hospitals than on that in public hospitals (ß = - 0.352; CI 95 % = [-0.651, - 0.056]; p < .05). Meanwhile, the rules climate has a greater effect on nurses' extra-role service behavior in public hospitals than it does in private hospitals (ß = 0.397; CI 95 % = [0.120, 0.651]; p < .01). CONCLUSIONS: As the relationship between the five types of ethical climate and nurses' in-role and extra-role service behaviors in public and private hospitals were different, the strategies used to foster and enhance the types of ethical climate are various from public to private hospitals. The caring and instrumental climate are the key to promote extra-role service behavior for nurses in private hospitals. And the independent climate has a great effect on extra-role service behaviors for nurses in public hospitals.