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Nursing
Ethics
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Nurses' perception of ethical climate and organizational commitment
Fariba Borhani, Tayebe Jalali, Abbas Abbaszadeh and Aliakbar Haghdoost
Nurs Ethics 2014 21: 278 originally published online 9 September 2013
DOI: 10.1177/0969733013493215
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Article
Nurses’ perception of ethical
climate and organizational
commitment
Nursing Ethics
2014, Vol. 21(3) 278–288
ª The Author(s) 2013
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10.1177/0969733013493215
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Fariba Borhani
Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran
Tayebe Jalali
Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran;
Kerman University of Medical Sciences, Iran
Abbas Abbaszadeh
Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
Aliakbar Haghdoost
Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of
Medical Sciences, Kerman, Iran
Abstract
The high turnover of nurses has become a universal issue. The manner in which nurses view their
organization’s ethical climate has direct bearing on their organizational commitment. The aim of this
study was to determine the correlation between nurses’ perception of ethical climate and
organizational commitment in teaching hospitals in the southeastern region of Iran. A descriptive
analytical design was used in this study. The sample consisted of 275 nurses working in four teaching
hospitals in the southeastern region of Iran. The instruments used in this study included a
demographic questionnaire, Ethical Climate Questionnaire, and Organizational Commitment
Questionnaire. Data analysis was carried out using Pearson’s correlation, t-test, and descriptive
statistic through Statistical Package for Social Science, version 16. The result of this research indicated
a positive correlation among professionalism, caring, rules, independence climate, and organizational
commitment. Therefore, findings of this study are a guideline for researchers and managers alike who
endeavor to improve organizational commitment.
Keywords
Affective commitment, continuance commitment, ethical climate, normative commitment, nurses
Introduction
The issue of shortage of nurses and quitting nursing is a major problem in developed and developing
countries, and Iran is no exception.1 In the United States, the need for nursing services will increase
Corresponding author: Tayebe Jalali, Kerman University of Medical Sciences, Haft Bagh Highway, Kerman, 7614868641, Iran.
Email: [email protected]
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Borhani et al.
by almost 30% by 2020.2 The statistics reported in 2008 indicate that 90,026 nurses are employed in Iran,
while 220,000 nurses are needed to provide adequate nursing services for patients. As reported by the
‘‘Nursing Organization of Iran,’’ 200 nurses with an average of 8 years work experience gained in Iran’s
health system leave and migrate to other countries. There are numerous factors that lead to nurses’ leaving
the profession, one of which is lack of organizational commitment of nurses.3
Organizational commitment indicates the employees’ degree of interest and attachment in an organization, their acceptance of its objectives and values, and their desire to remain as a member within that
organization.4
An efficient workforce is a major advantage of an organization over other organizations. A committed
workforce highlights the organization’s reputation in the community and prepares the ground for its
growth and development. Therefore, having highly motivated employees who are loyal to the organizational values and are willing to perform beyond their usual job descriptions is vitally important for any
organization.5 Healthcare organizations also require committed individuals for improving their performance, attracting clients, and maintaining and promoting health in order to meet the needs of the community. Given that nurses comprise a major part of the healthcare system, they play an important role
in presenting health services in that healthcare organizations cannot succeed without an effective nursing
workforce.6 Today, one of the main challenges for healthcare organizations is retention of committed
nurses in the workplace.
There is evidence indicating that nurses would be more satisfied and consequently stay in their jobs if
they had been more committed to the organizational values and objectives.7 Thus, managers ought to pay
more attention to meeting the employees’ needs at work, so that they could have higher morale, job
satisfaction, and organizational commitment. One of the steps to be taken is provision of an appropriate
moral atmosphere within the organization. An ethical climate shows employees’ understanding of their
organization, affects their behavior and perception, and provides the ground for decision making and behaviors.8 In an ethical climate with humanitarian values, choice, and sense of belonging, employees are more
satisfied with and committed to the organization.9 As a result, nurses’ organizational commitments include
better quality of care, reduced leaving of the profession, and reduced absenteeism.10 An assessment of factors affecting organizational commitment, such as the effect of the ethical climate, can provide reliable evidence for nursing managers in their long- and short-term planning.
The importance of this study
Studies on the moral climate are still not enough and strong evidence for us. Previous studies that have investigated ethical climate are all associated with business and there have been limited studies with respect to
nursing. During our research, we only found studies by Tsai and Huang2 and Filipova.9 Goldman, in his
2010 study, suggests the need for further research into the subject of the impact of ethical climate on organizational commitment in nursing.11
Closer to home, in the context of Iran, there is no published research looking at the correlation between
ethical climate and nurses’ organizational commitment. This study was conducted in a southeastern town in
Iran, and it is one of the first of its kind conducted in Iran.
Numerous studies have examined nurses’ organizational commitment in Iran, but not the relationship between ethical climate and organizational commitment. This investigation examines the types of
ethical climates existing in hospitals and their relationship to organizational commitment among
nurses in teaching hospitals in the southeastern region of Iran; subsequently, this study prompted a
question: What is the relationship between nurses’ perception of ethical climate and organizational
commitment?
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Review of the literature
Some studies have pointed out the relationship between ethical climate and organizational commitment,
including a study by Tsai and Huang on Taiwanese nurses in 2008, which showed a positive and significant
correlation between affective and normative commitments and ethical climates of caring, rule, professionalism, and independence and a negative correlation with instrumental climate. In addition, there is a positive
and significant correlation between continuance commitment and instrument climate.2
Likewise, Filipova9 in 2007 found a significant relationship between ethical climate and organizational
commitment. Cullen et al. conducted two studies in 2003 investigate the effect of ethical climate on organizational commitment of employees of 7 telephone companies and also 4 accounting firms. The results
indicate that in both studies, there is a positive correlation between caring climate, rule, and professionalism
and organizational commitment and a negative correlation between instrumental climate and organizational
commitment of employees.12 A study by Shafer13 shows that in climates that are relatively instrumental,
organizational identification is less observed among employees, while in climates with more emphasis
on utilitarianism, deontology, or rules, employees tend to feel more identified with the organization.
Employees with ethical work climate of caring are probably alien to climates that focus on maximizing personal or organizational interest.
Organizational commitment
The concept of organizational commitment is complex and multidimensional, and can be defined as
strongly believing in the organization and accepting its values, being willing to do one’s best for the organization, and desiring to remain as a member of the organization.14 Different models have been proposed for
organizational commitment, but the Meyer and Allen4 model has received the most clinical trials and
researchers’ support. It has been extensively used to assess organizational commitment because it illustrates
the multidimensional nature of organizational commitment and defines organizational behaviors more
appropriately. There is convincing body of evidence that the Meyer and Allen model is highly valid and
reliable.4
According to Meyer and Allen,4 organizational commitment consists of three parts of affective commitment, normative commitment, and continuance commitment. The affective commitment reflects
emotional bonding of the employee and identification with values and objectives of the organization
and the employee’s level of involvement. The normative commitment is a sense of duty and obligation
to stay with the organization. Those with this type of commitment believe that remaining in the organization is their duty and it is a debt that must be paid. Continuance commitment represents individual’s
recognition and understanding of the costs associated with leaving the organization. Employees whose
initial contact has been on the basis of continuance commitment will remain in the organization as they
regard staying in the organization as a necessity for them.15 According to Meyer and Allen,4 a person
with high affective commitment belongs to an organization because he or she wants to. An individual
with high levels of continuance commitment stays with an organization because he or she needs to (i.e.
they care about prestige, monetary incentives, and/or status). While individuals with high levels of normative commitment stay with an organization because they feel that it is the ‘‘morally right’’ thing to do
for the organization.4
Ethical climate
Studies in the past two decades indicate that organizational ethical climate has been investigated by extensive
research, one of which is the study by Victor and Cullen.16
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Borhani et al.
Theory of ethical climate. The concept of ethical work climate was first introduced by Cullen et al.12 One
dimension of work climate is defined as ‘‘shared perceptions of what is ethically correct and how ethical
issues should be handled within an organization.’’16
Cullen et al.12 reported that organizational ethical climates grow along dimensions similar to ethical theories. Major classes of ethical theory consist of egoism, utilitarianism, and deontology. A tendency to maximize self-interest is characteristic of the egoism category of ethical theory, actual concern for the
well-being of others is determined by utilitarianism, and allegiance to duties, rules, and laws is characteristic of the deontology category of ethical theory. Victor and Cullen have suggested that there are five distinct types of organizational ethical climate, including caring, professionalism, rules, independence, and
instrumental.9
Caring. A caring climate may be based on the utilitarianism ethical criterion,2 in which the most important
concern is what is best for others and people look out for each other’s interests, while the primary goal is to
offer the greatest good for the greatest number of people.9
Professionalism. This dimension is related to the deontology ethical criterion. In this climate, the first consideration is whether a decision violates law and codes. People are expected to strictly follow legal or professional standards, and the law or ethical code of the profession is the major consideration. People are
expected to comply with legal and professional standards over and above all other considerations.2,11
Rules. The rules climate is related to the deontology ethical criterion.2 Based on this climate, it is very important to follow the organization’s rules and procedures strictly and everyone is expected to do so. People in
facilities with this climate follow organization policies to the letter.17
Independence. The independence dimension is associated with the deontology ethical criterion. In this
climate, people are expected to follow their own personal and moral beliefs. Each person decides for himself
or herself what is right or wrong; in other words, people are guided by their own personal ethics.2
Instrumental. This dimension is associated with the egoistic criterion, and its primary goal is to provide
personal benefits. In this climate, people protect their own interests above all else and are mostly out for
themselves.9
Victor and Cullen’s studies do suggest that one dominant criterion (egoism, utilitarianism, and deontology) will emerge in an organization and ultimately define the organization’s ethical climate. In addition,
different dimensions of ethical climates may also exist within organizational departments.
Hypothesis 1: The ethical climate types of ‘‘caring,’’ ‘‘independent,’’ ‘‘professionalism,’’ and
‘‘rules’’ have significant positive influences on affective commitment, but the ethical climate type
of ‘‘instrumental’’ has a significant negative influence.
Hypothesis 2: The ethical climate types of ‘‘caring,’’ ‘‘independent,’’ ‘‘professionalism,’’ and
‘‘rules,’’ have a significant positive influence on normative commitment, but the ethical climate type
of ‘‘instrumental’’ has a significant negative influence.
Hypothesis 3: The ethical climate types of ‘‘caring,’’ ‘‘independent,’’ ‘‘professionalism,’’ and
‘‘rules’’ have significant negative influences on continuance commitment, but the ethical climate type
of ‘‘instrumental’’ has a significant positive influence.
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Method
This is a descriptive analytical study carried out in 2011. The sample size was calculated to be 88 people, considering a ¼ 5% and the correlation coefficient between ethical climate and organizational commitment was
0.18. Due to modeling and examination of intervening factors, and maximum 5 variables in the final model,
the sample size was upgraded to 185 people. To eliminate the effect of clustering, design effect ¼ 1.5 was
considered and the final sample size was obtained to be 300 people. The statistical population under study
was chosen out of nurses employed at various hospitals in the southeastern region of Iran who were selected
randomly on a quota basis. This quota was determined according to the number of nurses in each ward and the
number required. The study’s inclusion criteria were as follows: having a Bachelor or Master of Science
degree in nursing and having been working as a nurse for more than 6 months on their present ward.
Participation was on a voluntary basis, and it was explained to nurses that they did not have to write down
their names on the questionnaire and that all the information obtained would remain confidential. After obtaining university ethical committee (ethical committee code K/90/522) and head nurse approval, 300 questionnaires were distributed to the four hospitals which had agreed to participate, and a total of 280 completed
questionnaires were received. After deleting the missing cases, 275 questionnaires remained and constituted
the sample for this study. The 275 questionnaires were personally completed by nurses. For the collection of
data, Victor and Cullen’s Ethical Climate Questionnaire (ECQ) and Meyer and Allen’s Organizational Commitment Questionnaire (OCQ) were used.4,16 The ECQ contains 26 items that investigate 5 types of ethical
climates, namely, caring (items 1, 5, 7, 9, 15, 19), rule (items 2, 8, 10, 22), instrumental (items 6, 14, 16,
18, 20, 23, 25), professionalism (4, 12, 17, 24), and independence (3, 11, 13, 21), which are based on a 5point Likert scale from 0 (completely false) to 5 (completely true). In each dimension, the answers were scored
as follows: 0 (completely false), 1 (mostly false), 2 (sometimes false), 3 (sometimes true), 4 (mostly true), and
5 (completely true). The OCQ also contains 18 items, including three components of affective commitment
(items 1 to 6), normative commitment (items 7 to 12), and continuance commitment (items 13 to 18), with
every 6 questions measuring one of the three dimensions and based on a 7-point Likert scale from 1 (totally
disagree) to 7 (totally agree). Each item was scored 1 for totally disagree, 2 for relatively disagree, 3 for disagree, 4 for no comment, 5 for relatively agree, 6 for agree, and 7 for totally agree. In order to have a more
reasonable score, we computed the score means in the subscale question, which was a number between 1 and 5
for the ECQ and 1–7 for the OCQ, and then the range was converted to 0–20.
These questionnaires were first translated to Farsi, they were translated back to English, and consistency
of the two English copies was examined. Their content validity was reviewed using the opinions of 10
faculty members specializing in ethics and management. Although the internal consistency of the ECQ has
been investigated in previous studies (a ¼ 0.86–0.92) (12), we examined the reliability of the translated
scale using alpha coefficients for each of the domain scores. A Cronbach’s alpha higher than 0.70 indicated
internal consistency: caring (0.747), instrumental (0.725), independence (0.711), professionalism (0.754),
and rules (0.758). The Cronbach’s coefficients for affective commitment, normative commitment, and
continuance commitment components of commitment were 0.869, 0.854, and 0.728, respectively.
Data obtained from the questionnaires were analyzed by Statistical Package for Social Science (SPSS)
software, version 16, using descriptive statistics (mean and standard deviation), and inferential statistics
(Pearson’s correlation and independent t-test), to achieve the study objectives.
Results
Some 275 nurses from city hospitals in the southeastern region of Iran participated in this study. These included
four teaching hospitals of A (28.7%), B (35.6%), C (27.3%), and D (8.4%), and nonsurgical wards (internal,
pediatrics, infectious diseases, oncology, and orthopedics, 39.3%), surgical wards (21.5%), special care units
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Borhani et al.
Table 1. The mean and standard deviations (SDs) for ethical climate dimensions.
Rank
SD
Mean
Ethical climate
1
2
3
4
5
3.68
4.01
3.95
3.88
2.95
13.45
13.41
12.92
11.35
8.93
Professionalism
Rules
Caring
Independence
Instrumental
Means and SDs ranged between 0 and 20.
Table 2. The means and standard deviations (SDs) for components of organizational commitment dimensions.
Rank
SD
Mean
Organizational commitment
1
2
3
4
2.68
3.50
3.28
2.29
10.35
10.09
9.84
10.09
Affective commitment
Normative commitment
Continuance commitment
Overall organizational commitment
Means and standard deviations ranged between 0 and 20.
(19.6%), and emergency wards (19.6%). A total of 21% of the participants worked in nonsurgical wards, 10.5%
in surgical wards, 16.1% in special care units, and 6.9% in emergency wards. There were 69.9% participants
who had less than 10 years of work experience, and 37.1% had over 10 years of experience. The mean age of the
participants was 32.7 years, where a total of 82.2% were female and 53.6% were married.
To investigate the ethical climate according to Victor and Cullen’s16 perspective, scores of the questionnaire, summary, and results obtained were reported in tables. Accordingly, Table 1 shows mean, standard
deviation, and rank of ethical climate governing hospitals under study from the nurses’ perspective. The
ethical climate of professionalism scored the highest level of governing climate, and the least in the opinion
of nurses was the instrumental climate.
Table 2 presents the mean and standard deviation of dimensions of organizational commitment of participating nurses, with the highest level of commitment associated with affective commitment and least
level of commitment of nurses associated with continuance commitment.
Table 3 indicates that ethical climate has an impact on organizational commitment of nurses employed at
Kerman University of Medical Sciences Hospitals in such a way that the more ethical the hospital climate is,
the higher the organizational commitment of its personnel would become. According to these results, the
climate of professionalism has a direct correlation with affective and normative commitments. The rule
climate has a direct and significant correlation with only affective commitment, and caring climate too has
a direct and significant correlation with affective and normative commitments and the same applies to independence climate. Finally, instrumental climate has no significant correlation with affective commitment. It
must be noted that other than instrumental climate, none of the other four climates has any significant
correlation with continuance commitment.
Discussion
Given the objectives of this study that was to determine the correlation between ethical climate and
organizational commitment, results indicated that in general, there is a correlation between the two. This
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Nursing Ethics 21(3)
Table 3. The relationship among ethical climate types and components of organizational commitment.
Variables
Professionalism
Rules
Caring
Independence
Instrumental
Affective commitment
Normative commitment
Continuance commitment
1
1.000
0.749
>0.001**
0.691
>0.001**
0.114
0.062
0.387
>0.001**
0.160
0.008**
0.105
0.08*
0.054
0.37
2
3
4
5
6
7
8
1.000
0.727
>0.001**
0.009
0.880
0.284
>0.001**
0.176
0.003**
0.051
0.40
0.80
0.18
1.000
0.126
0.037*
0.217
>0.001**
0.260
>0.001**
0.119
0.04*
0.12
0.074
1.000
0.440
>0.001**
0.266
>0.001**
0.164
0.006
0.075
0.21
1.000
0.097
0.110
0.130
0.13
0.221
>0.001**
1.000
0.293
>0.001**
0.199
0.001**
1.000
0.341
>0.001**
1.000
Under each correlation coefficient, its p-value is given.
*Correlation is significant at the 0.05 level.
**Correlation is significant at the 0.01 level.
finding concurs with results of studies in which there is a positive and significant correlation between organizational commitment and individuals’ understanding of ethical climate, which means that the more ethical a hospital’s climate, the higher the organizational commitment could be expected of nurses.2,12,18–20 Employees
regard relationships and interactions within their organization as just if they feel the workplace climate is ethical, and this makes for workers’ increased satisfaction and commitment. In addition, organizations with
ethical climates endeavor not to use misleading methods and practices. Thus, ethical climate causes
employees to have a positive outlook on their jobs and stay longer with their organizations and think less
about leaving. Accordingly, Schwepker21 believes a desirable ethical climate could play a role in increased
job satisfaction and organizational commitment, and in contrast, it could reduce leaving intentions. Mulki
et al.22 found that ethical climate has a positive correlation with job satisfaction, and this leads to a reduction in tendency to leave service and increased organizational commitment and job performance.
The findings of this study showed that from the nurses’ perspective, the city of Kerman teaching hospitals climates are of the ‘‘professionalism’’ kind, followed by other climates of ‘‘rule,’’ ‘‘caring,’’ ‘‘independence,’’ and ‘‘instrumental’’ in order. Given that the mean scores of ethical climates of ‘‘professionalism’’
and ‘‘rule’’ are quite close (13.45 for professionalism and 13.41 for rules), it appears that in these hospitals,
obeying the rules and professional standards and also practical requirement for adherence to the rules and
organizational procedures are highly important. In similar studies, the first priority of nurses in identification of ethical climates in nursing has been professionalism. Similar results were observed in a Taiwanese
study2 and in another study in Russia investigating the ethical climate in an organization, where the most
common climate governing the organization was found to be climate of professionalism.23
Existence of ethical climate of professionalism as the climate governing hospitals under study from the
nurses’ perspective indicates that professional principles based on ethical codes and attention to professional ideals, which are those of health improvement, are the first driving factor in development of ethical
climate in hospitals. Considering scientific development of various subjects of health sciences, especially
nursing in Iran and also development of complementary education, it is expected to see its effects in
hospitals in the shape of impact on ethical climate and rule of professional principles.
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According to the results of this study, rule climate is the second climate determined by nurses. This
finding is in accordance with Tsai and Huang’s2 study. Rule climate describes rule of legal guidelines
on behaviors of health professionals. In ethics, adherence to rules and regulations of the hospital is highly
important, and lack of these could affect personnel’s understanding of method of care and treatment and
cause disharmony in care for the patients.24 It has been observed in some studies that rule of law and
regulations have increased nurses’ job satisfaction and have induced the feeling that the organization pays
attention to them.23 Lawfulness does not imply that the organization is rigidly inflexible, but means loyalty
to principles. Successful and ambitious organizations are adamantly loyal to their values and rarely change
them, but equally seek improvement and progress. Responsibility is rooted in law and adherence to ethical
principles. It is worth noting that reliance on law alone does not increase employees’ accountability much, it
is those principles and beliefs institutionalized in a person that can increase his or her sense of responsibility.
On the contrary, lawfulness cannot be equated to ethics. Therefore, legal commitment and doing the work
only because of legal requirements are the basic and the least degree of professional ethics. What is more
valuable to us than just attention to professional rules and regulations is human values and those interpersonal relationships that are the basis for benevolence. All these values are manifested in the climate of interest. In this study, the third climate reported by nurses is caring climate that causes identification of personnel
with the organization and all associated subjects. It is in appropriate interpersonal relationships that one
would expect better teamwork in care for patients. Adherence to rules alone cannot guarantee strong interpersonal relationships. It was thought that after attention to professional problems (professional climate),
nurses pay more attention to interpersonal relationships (caring climate). Although in some studies, such
as those of Cullen et al.12 and Koh and Boo,25 caring climate has been reported as the first of ethical climates
and in Tsai and Huang’s2 study it ranked last, in our study, caring climate ranked higher than independence
and instrumental climates.
Another climate according to the perspective of nurses is independence climate. In this climate, people
behave according to their own beliefs and interests, but try not to be in conflict with the rules and regulations
of the organization. In other words, their interests are a collection of moral principles. Even though in the
independence climate adherence to the rules is somewhat observed, following personal interests can cause
dysfunction of the rules and regulations, and as this climate ranked fourth from nurses’ perspective, it shows
that personal interests are not the guidance nurses would use for their work in hospitals. Therefore, it can be
expected that activities would be in accordance with professional objectives and adherence to the rules. This
result is mentioned in various studies in different forms so that the independence climate ranks third in Tsai
and Huang’s2 study, and in Filipova’s9 study, it ranks last.
The last climate governing the hospitals in the study is the instrumental climate, according to nurses.
Considering that in instrumental climate people only think of their own advantage and prefer personal
interests over organizational interests, the finding that such climate is least prioritized is encouraging. This
finding concurs with Filipova’s9 results, but disagrees with the results of Tsai and Huang2 in which instrumental climate was fourth.
This study reports a medium level of organizational commitment by nurses. As organizational commitment of nurses is an important factor in quality of care of patients,9 it appears that a medium level of
organizational commitment of nurses, due to sensitivity of the job they do, would not be adequate or
satisfactory.
In this study, organizational commitment of nurses is of the affective commitment kind followed by
normative and continuance commitments. This finding is in agreement with a study by Jahangir and
Shokrpour10 in Iran and a study by Vacharakiat26 in the United States, which report the highest level of
commitment of nurses to be affective.
In addition, in this research, evidence has been found that confirms a correlation between aspects of
ethical climate and organizational commitment, so that there is a positive and significant correlation
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Nursing Ethics 21(3)
between climates of ‘‘professionalism,’’ ‘‘rule,’’ ‘‘caring,’’ and ‘‘independence’’ and organizational commitment, while instrumental climate has no correlation with affective commitment. Affective commitment
indicates the employee’s emotional dependence, determines identity and his or her level of involvement with
the organization, and has a positive correlation with moral and occupational values of the employees27 and
their higher needs.28 Therefore, as moral values find manifestation in the four ethical climates mentioned earlier, they lead to nurses’ increased organizational commitment. In explaining the correlation between ‘‘professionalism’’ and ‘‘rule’’ commitments and affective commitment, it could be reasoned that the
correlation between ethical climate based on rules and organizational commitment of people can only be
observed in specific occasions, so that whenever employees of an organization are committed to principles
of professionalism and regulations of hospital and feel that the organization’s conduct is also wholly in accordance with rules and regulations, their commitment to their organization increases.14 Therefore, with importance of hospital rules and professionalism in hospital, organizational commitment of employees increases.
Thus, given that predominant climate of the hospitals in the study is of the professionalism and rule kind, the
correlation between professionalism and rule climates and affective commitment seems logical. When there is
a climate of interest in hospital, nurses are benevolent and consideration for one another becomes a priority. It
is imperative that whenever there is such a climate in hospital, employees identify themselves with their hospital and feel emotionally committed to their colleagues, leading to desire to stay with their organization and
be committed to it. Additionally, climate of caring encourages better understanding of organizational supports
by employees. Consequently, they regard their organization as if it considers them its top priority.9 This most
probably causes a positive work experience for the employee, and to make up for it, he or she becomes more
committed to the organization. This positive correlation between affective commitment and the understood
organizational support by the employees has been proved in past studies.29
In independence climate, employees behave according to their own beliefs and moral values, which are
based on a series of fair principles. Whenever employees feel that in their organization moral values are taken
into account at the time of decision making, their tendency to remain with the organization increases. This
occurs more when staff feel their personal moral values are compatible with those of the organization.21,30
Various studies show that the ethical ideology (personal ethics) could be used as an alternative to external
financial incentives (rewards), and this helps increase organizational commitment.19 Accordingly, it is
imperative that in an independence climate, organizational commitment of personnel increases due to the fact
that they make their own decisions based on personal beliefs and moral values. In addition, data analysis indicates that instrumental climate has no correlation with affective commitment. Whenever employees focus on
maximizing self-interest, affective commitment decreases. In a climate of instrumentalism, tendency toward
candid and righteous behaviors is less seen, which causes employees to identify less with the organization.12
The results of this study indicate that there is a significant and positive correlation between caring and
professionalism climates and normative commitment. The construct of normative commitment is in fact
indicative of a kind of ethical commitment that a person feels about organization’s investment in him.
This feeling is created in him when organization has spent time and/or money so that he can perform his
duties better. He would feel indebted, and thus stays with the organization. In the Iranian culture, people
feel indebted to others for their goodness and graces and endeavor to recompense them. The results of this
study also indicate that this culture is inbred in Iranian nurses.
Our study showed that there is a positive and significant correlation between instrumental climate and continuance commitment that concurs with the results of past studies of Tsai and Huang2 in Taiwan, Cullen et al.12
in the United States, Kaplan et al. in Turkey.2,12,31 Continuance commitment is a form of psychological attachment of a person to his organization, which is rooted in the person’s understanding of what he might lose if he
left the company. It is evident that in this type of commitment, a kind of egoism and self-interest can be seen.
Therefore, in organizations with instrumental climate, where personal advantage and self-interest take priority
at the time of decision making, increased continuance commitment is observed.
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Borhani et al.
Limitations of the study
In this study, we did not have access to the demographic variables; in addition, we used self-reported data,
which is one of the limitations of surveys. In order to minimize the impact of this error, subjects were
approached by expert interviewers in a very friendly environment.
Conclusion
In general, results of this study showed that there is a positive and significant correlation between hospital
climates and organizational commitment of nurses. Climate of professionalism was the predominant
climate in hospitals, and climate of instrumentalism had the least priority.
Organizational commitment of participating nurses was at a medium level. There was a positive correlation between different types of ethical climate and some aspects of organizational commitment, and in some
cases, there was no correlation. There was a positive correlation between professional, rule, caring, and
independence climates and affective commitment. Results indicate the more enhanced and favorable ethical
climate (caring, independence, professionalism, and rule) is, the more improved the organizational commitment (affective, normative).
Results of this study are a guideline for researchers and managers alike who endeavor to improve
organizational commitment. Nursing managers ought to pay attention to factors that enhance ethical
climate. Thus, it is recommended that future research examine factors affecting ethical climate.
Acknowledgments
The authors express their gratitude to all those nurses who sincerely helped this research by completing
questionnaires.
Funding
The authors extend their thanks to the Research Deputy of Kerman University of Medical Sciences for the
financial support provided for this study.
Conflict of interest
The authors declare that there is no conflict of interest.
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9. Filipova A. Perceived organizational support and ethical work climates as predictors of turnover intention of
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Ethics
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Nurses' perception of ethical climate and organizational commitment
Fariba Borhani, Tayebe Jalali, Abbas Abbaszadeh and Aliakbar Haghdoost
Nurs Ethics 2014 21: 278 originally published online 9 September 2013
DOI: 10.1177/0969733013493215
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Article
Nurses’ perception of ethical
climate and organizational
commitment
Nursing Ethics
2014, Vol. 21(3) 278–288
ª The Author(s) 2013
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Fariba Borhani
Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran
Tayebe Jalali
Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran;
Kerman University of Medical Sciences, Iran
Abbas Abbaszadeh
Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
Aliakbar Haghdoost
Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of
Medical Sciences, Kerman, Iran
Abstract
The high turnover of nurses has become a universal issue. The manner in which nurses view their
organization’s ethical climate has direct bearing on their organizational commitment. The aim of this
study was to determine the correlation between nurses’ perception of ethical climate and
organizational commitment in teaching hospitals in the southeastern region of Iran. A descriptive
analytical design was used in this study. The sample consisted of 275 nurses working in four teaching
hospitals in the southeastern region of Iran. The instruments used in this study included a
demographic questionnaire, Ethical Climate Questionnaire, and Organizational Commitment
Questionnaire. Data analysis was carried out using Pearson’s correlation, t-test, and descriptive
statistic through Statistical Package for Social Science, version 16. The result of this research indicated
a positive correlation among professionalism, caring, rules, independence climate, and organizational
commitment. Therefore, findings of this study are a guideline for researchers and managers alike who
endeavor to improve organizational commitment.
Keywords
Affective commitment, continuance commitment, ethical climate, normative commitment, nurses
Introduction
The issue of shortage of nurses and quitting nursing is a major problem in developed and developing
countries, and Iran is no exception.1 In the United States, the need for nursing services will increase
Corresponding author: Tayebe Jalali, Kerman University of Medical Sciences, Haft Bagh Highway, Kerman, 7614868641, Iran.
Email: [email protected]
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Borhani et al.
by almost 30% by 2020.2 The statistics reported in 2008 indicate that 90,026 nurses are employed in Iran,
while 220,000 nurses are needed to provide adequate nursing services for patients. As reported by the
‘‘Nursing Organization of Iran,’’ 200 nurses with an average of 8 years work experience gained in Iran’s
health system leave and migrate to other countries. There are numerous factors that lead to nurses’ leaving
the profession, one of which is lack of organizational commitment of nurses.3
Organizational commitment indicates the employees’ degree of interest and attachment in an organization, their acceptance of its objectives and values, and their desire to remain as a member within that
organization.4
An efficient workforce is a major advantage of an organization over other organizations. A committed
workforce highlights the organization’s reputation in the community and prepares the ground for its
growth and development. Therefore, having highly motivated employees who are loyal to the organizational values and are willing to perform beyond their usual job descriptions is vitally important for any
organization.5 Healthcare organizations also require committed individuals for improving their performance, attracting clients, and maintaining and promoting health in order to meet the needs of the community. Given that nurses comprise a major part of the healthcare system, they play an important role
in presenting health services in that healthcare organizations cannot succeed without an effective nursing
workforce.6 Today, one of the main challenges for healthcare organizations is retention of committed
nurses in the workplace.
There is evidence indicating that nurses would be more satisfied and consequently stay in their jobs if
they had been more committed to the organizational values and objectives.7 Thus, managers ought to pay
more attention to meeting the employees’ needs at work, so that they could have higher morale, job
satisfaction, and organizational commitment. One of the steps to be taken is provision of an appropriate
moral atmosphere within the organization. An ethical climate shows employees’ understanding of their
organization, affects their behavior and perception, and provides the ground for decision making and behaviors.8 In an ethical climate with humanitarian values, choice, and sense of belonging, employees are more
satisfied with and committed to the organization.9 As a result, nurses’ organizational commitments include
better quality of care, reduced leaving of the profession, and reduced absenteeism.10 An assessment of factors affecting organizational commitment, such as the effect of the ethical climate, can provide reliable evidence for nursing managers in their long- and short-term planning.
The importance of this study
Studies on the moral climate are still not enough and strong evidence for us. Previous studies that have investigated ethical climate are all associated with business and there have been limited studies with respect to
nursing. During our research, we only found studies by Tsai and Huang2 and Filipova.9 Goldman, in his
2010 study, suggests the need for further research into the subject of the impact of ethical climate on organizational commitment in nursing.11
Closer to home, in the context of Iran, there is no published research looking at the correlation between
ethical climate and nurses’ organizational commitment. This study was conducted in a southeastern town in
Iran, and it is one of the first of its kind conducted in Iran.
Numerous studies have examined nurses’ organizational commitment in Iran, but not the relationship between ethical climate and organizational commitment. This investigation examines the types of
ethical climates existing in hospitals and their relationship to organizational commitment among
nurses in teaching hospitals in the southeastern region of Iran; subsequently, this study prompted a
question: What is the relationship between nurses’ perception of ethical climate and organizational
commitment?
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Review of the literature
Some studies have pointed out the relationship between ethical climate and organizational commitment,
including a study by Tsai and Huang on Taiwanese nurses in 2008, which showed a positive and significant
correlation between affective and normative commitments and ethical climates of caring, rule, professionalism, and independence and a negative correlation with instrumental climate. In addition, there is a positive
and significant correlation between continuance commitment and instrument climate.2
Likewise, Filipova9 in 2007 found a significant relationship between ethical climate and organizational
commitment. Cullen et al. conducted two studies in 2003 investigate the effect of ethical climate on organizational commitment of employees of 7 telephone companies and also 4 accounting firms. The results
indicate that in both studies, there is a positive correlation between caring climate, rule, and professionalism
and organizational commitment and a negative correlation between instrumental climate and organizational
commitment of employees.12 A study by Shafer13 shows that in climates that are relatively instrumental,
organizational identification is less observed among employees, while in climates with more emphasis
on utilitarianism, deontology, or rules, employees tend to feel more identified with the organization.
Employees with ethical work climate of caring are probably alien to climates that focus on maximizing personal or organizational interest.
Organizational commitment
The concept of organizational commitment is complex and multidimensional, and can be defined as
strongly believing in the organization and accepting its values, being willing to do one’s best for the organization, and desiring to remain as a member of the organization.14 Different models have been proposed for
organizational commitment, but the Meyer and Allen4 model has received the most clinical trials and
researchers’ support. It has been extensively used to assess organizational commitment because it illustrates
the multidimensional nature of organizational commitment and defines organizational behaviors more
appropriately. There is convincing body of evidence that the Meyer and Allen model is highly valid and
reliable.4
According to Meyer and Allen,4 organizational commitment consists of three parts of affective commitment, normative commitment, and continuance commitment. The affective commitment reflects
emotional bonding of the employee and identification with values and objectives of the organization
and the employee’s level of involvement. The normative commitment is a sense of duty and obligation
to stay with the organization. Those with this type of commitment believe that remaining in the organization is their duty and it is a debt that must be paid. Continuance commitment represents individual’s
recognition and understanding of the costs associated with leaving the organization. Employees whose
initial contact has been on the basis of continuance commitment will remain in the organization as they
regard staying in the organization as a necessity for them.15 According to Meyer and Allen,4 a person
with high affective commitment belongs to an organization because he or she wants to. An individual
with high levels of continuance commitment stays with an organization because he or she needs to (i.e.
they care about prestige, monetary incentives, and/or status). While individuals with high levels of normative commitment stay with an organization because they feel that it is the ‘‘morally right’’ thing to do
for the organization.4
Ethical climate
Studies in the past two decades indicate that organizational ethical climate has been investigated by extensive
research, one of which is the study by Victor and Cullen.16
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Theory of ethical climate. The concept of ethical work climate was first introduced by Cullen et al.12 One
dimension of work climate is defined as ‘‘shared perceptions of what is ethically correct and how ethical
issues should be handled within an organization.’’16
Cullen et al.12 reported that organizational ethical climates grow along dimensions similar to ethical theories. Major classes of ethical theory consist of egoism, utilitarianism, and deontology. A tendency to maximize self-interest is characteristic of the egoism category of ethical theory, actual concern for the
well-being of others is determined by utilitarianism, and allegiance to duties, rules, and laws is characteristic of the deontology category of ethical theory. Victor and Cullen have suggested that there are five distinct types of organizational ethical climate, including caring, professionalism, rules, independence, and
instrumental.9
Caring. A caring climate may be based on the utilitarianism ethical criterion,2 in which the most important
concern is what is best for others and people look out for each other’s interests, while the primary goal is to
offer the greatest good for the greatest number of people.9
Professionalism. This dimension is related to the deontology ethical criterion. In this climate, the first consideration is whether a decision violates law and codes. People are expected to strictly follow legal or professional standards, and the law or ethical code of the profession is the major consideration. People are
expected to comply with legal and professional standards over and above all other considerations.2,11
Rules. The rules climate is related to the deontology ethical criterion.2 Based on this climate, it is very important to follow the organization’s rules and procedures strictly and everyone is expected to do so. People in
facilities with this climate follow organization policies to the letter.17
Independence. The independence dimension is associated with the deontology ethical criterion. In this
climate, people are expected to follow their own personal and moral beliefs. Each person decides for himself
or herself what is right or wrong; in other words, people are guided by their own personal ethics.2
Instrumental. This dimension is associated with the egoistic criterion, and its primary goal is to provide
personal benefits. In this climate, people protect their own interests above all else and are mostly out for
themselves.9
Victor and Cullen’s studies do suggest that one dominant criterion (egoism, utilitarianism, and deontology) will emerge in an organization and ultimately define the organization’s ethical climate. In addition,
different dimensions of ethical climates may also exist within organizational departments.
Hypothesis 1: The ethical climate types of ‘‘caring,’’ ‘‘independent,’’ ‘‘professionalism,’’ and
‘‘rules’’ have significant positive influences on affective commitment, but the ethical climate type
of ‘‘instrumental’’ has a significant negative influence.
Hypothesis 2: The ethical climate types of ‘‘caring,’’ ‘‘independent,’’ ‘‘professionalism,’’ and
‘‘rules,’’ have a significant positive influence on normative commitment, but the ethical climate type
of ‘‘instrumental’’ has a significant negative influence.
Hypothesis 3: The ethical climate types of ‘‘caring,’’ ‘‘independent,’’ ‘‘professionalism,’’ and
‘‘rules’’ have significant negative influences on continuance commitment, but the ethical climate type
of ‘‘instrumental’’ has a significant positive influence.
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Nursing Ethics 21(3)
Method
This is a descriptive analytical study carried out in 2011. The sample size was calculated to be 88 people, considering a ¼ 5% and the correlation coefficient between ethical climate and organizational commitment was
0.18. Due to modeling and examination of intervening factors, and maximum 5 variables in the final model,
the sample size was upgraded to 185 people. To eliminate the effect of clustering, design effect ¼ 1.5 was
considered and the final sample size was obtained to be 300 people. The statistical population under study
was chosen out of nurses employed at various hospitals in the southeastern region of Iran who were selected
randomly on a quota basis. This quota was determined according to the number of nurses in each ward and the
number required. The study’s inclusion criteria were as follows: having a Bachelor or Master of Science
degree in nursing and having been working as a nurse for more than 6 months on their present ward.
Participation was on a voluntary basis, and it was explained to nurses that they did not have to write down
their names on the questionnaire and that all the information obtained would remain confidential. After obtaining university ethical committee (ethical committee code K/90/522) and head nurse approval, 300 questionnaires were distributed to the four hospitals which had agreed to participate, and a total of 280 completed
questionnaires were received. After deleting the missing cases, 275 questionnaires remained and constituted
the sample for this study. The 275 questionnaires were personally completed by nurses. For the collection of
data, Victor and Cullen’s Ethical Climate Questionnaire (ECQ) and Meyer and Allen’s Organizational Commitment Questionnaire (OCQ) were used.4,16 The ECQ contains 26 items that investigate 5 types of ethical
climates, namely, caring (items 1, 5, 7, 9, 15, 19), rule (items 2, 8, 10, 22), instrumental (items 6, 14, 16,
18, 20, 23, 25), professionalism (4, 12, 17, 24), and independence (3, 11, 13, 21), which are based on a 5point Likert scale from 0 (completely false) to 5 (completely true). In each dimension, the answers were scored
as follows: 0 (completely false), 1 (mostly false), 2 (sometimes false), 3 (sometimes true), 4 (mostly true), and
5 (completely true). The OCQ also contains 18 items, including three components of affective commitment
(items 1 to 6), normative commitment (items 7 to 12), and continuance commitment (items 13 to 18), with
every 6 questions measuring one of the three dimensions and based on a 7-point Likert scale from 1 (totally
disagree) to 7 (totally agree). Each item was scored 1 for totally disagree, 2 for relatively disagree, 3 for disagree, 4 for no comment, 5 for relatively agree, 6 for agree, and 7 for totally agree. In order to have a more
reasonable score, we computed the score means in the subscale question, which was a number between 1 and 5
for the ECQ and 1–7 for the OCQ, and then the range was converted to 0–20.
These questionnaires were first translated to Farsi, they were translated back to English, and consistency
of the two English copies was examined. Their content validity was reviewed using the opinions of 10
faculty members specializing in ethics and management. Although the internal consistency of the ECQ has
been investigated in previous studies (a ¼ 0.86–0.92) (12), we examined the reliability of the translated
scale using alpha coefficients for each of the domain scores. A Cronbach’s alpha higher than 0.70 indicated
internal consistency: caring (0.747), instrumental (0.725), independence (0.711), professionalism (0.754),
and rules (0.758). The Cronbach’s coefficients for affective commitment, normative commitment, and
continuance commitment components of commitment were 0.869, 0.854, and 0.728, respectively.
Data obtained from the questionnaires were analyzed by Statistical Package for Social Science (SPSS)
software, version 16, using descriptive statistics (mean and standard deviation), and inferential statistics
(Pearson’s correlation and independent t-test), to achieve the study objectives.
Results
Some 275 nurses from city hospitals in the southeastern region of Iran participated in this study. These included
four teaching hospitals of A (28.7%), B (35.6%), C (27.3%), and D (8.4%), and nonsurgical wards (internal,
pediatrics, infectious diseases, oncology, and orthopedics, 39.3%), surgical wards (21.5%), special care units
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Borhani et al.
Table 1. The mean and standard deviations (SDs) for ethical climate dimensions.
Rank
SD
Mean
Ethical climate
1
2
3
4
5
3.68
4.01
3.95
3.88
2.95
13.45
13.41
12.92
11.35
8.93
Professionalism
Rules
Caring
Independence
Instrumental
Means and SDs ranged between 0 and 20.
Table 2. The means and standard deviations (SDs) for components of organizational commitment dimensions.
Rank
SD
Mean
Organizational commitment
1
2
3
4
2.68
3.50
3.28
2.29
10.35
10.09
9.84
10.09
Affective commitment
Normative commitment
Continuance commitment
Overall organizational commitment
Means and standard deviations ranged between 0 and 20.
(19.6%), and emergency wards (19.6%). A total of 21% of the participants worked in nonsurgical wards, 10.5%
in surgical wards, 16.1% in special care units, and 6.9% in emergency wards. There were 69.9% participants
who had less than 10 years of work experience, and 37.1% had over 10 years of experience. The mean age of the
participants was 32.7 years, where a total of 82.2% were female and 53.6% were married.
To investigate the ethical climate according to Victor and Cullen’s16 perspective, scores of the questionnaire, summary, and results obtained were reported in tables. Accordingly, Table 1 shows mean, standard
deviation, and rank of ethical climate governing hospitals under study from the nurses’ perspective. The
ethical climate of professionalism scored the highest level of governing climate, and the least in the opinion
of nurses was the instrumental climate.
Table 2 presents the mean and standard deviation of dimensions of organizational commitment of participating nurses, with the highest level of commitment associated with affective commitment and least
level of commitment of nurses associated with continuance commitment.
Table 3 indicates that ethical climate has an impact on organizational commitment of nurses employed at
Kerman University of Medical Sciences Hospitals in such a way that the more ethical the hospital climate is,
the higher the organizational commitment of its personnel would become. According to these results, the
climate of professionalism has a direct correlation with affective and normative commitments. The rule
climate has a direct and significant correlation with only affective commitment, and caring climate too has
a direct and significant correlation with affective and normative commitments and the same applies to independence climate. Finally, instrumental climate has no significant correlation with affective commitment. It
must be noted that other than instrumental climate, none of the other four climates has any significant
correlation with continuance commitment.
Discussion
Given the objectives of this study that was to determine the correlation between ethical climate and
organizational commitment, results indicated that in general, there is a correlation between the two. This
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Nursing Ethics 21(3)
Table 3. The relationship among ethical climate types and components of organizational commitment.
Variables
Professionalism
Rules
Caring
Independence
Instrumental
Affective commitment
Normative commitment
Continuance commitment
1
1.000
0.749
>0.001**
0.691
>0.001**
0.114
0.062
0.387
>0.001**
0.160
0.008**
0.105
0.08*
0.054
0.37
2
3
4
5
6
7
8
1.000
0.727
>0.001**
0.009
0.880
0.284
>0.001**
0.176
0.003**
0.051
0.40
0.80
0.18
1.000
0.126
0.037*
0.217
>0.001**
0.260
>0.001**
0.119
0.04*
0.12
0.074
1.000
0.440
>0.001**
0.266
>0.001**
0.164
0.006
0.075
0.21
1.000
0.097
0.110
0.130
0.13
0.221
>0.001**
1.000
0.293
>0.001**
0.199
0.001**
1.000
0.341
>0.001**
1.000
Under each correlation coefficient, its p-value is given.
*Correlation is significant at the 0.05 level.
**Correlation is significant at the 0.01 level.
finding concurs with results of studies in which there is a positive and significant correlation between organizational commitment and individuals’ understanding of ethical climate, which means that the more ethical a hospital’s climate, the higher the organizational commitment could be expected of nurses.2,12,18–20 Employees
regard relationships and interactions within their organization as just if they feel the workplace climate is ethical, and this makes for workers’ increased satisfaction and commitment. In addition, organizations with
ethical climates endeavor not to use misleading methods and practices. Thus, ethical climate causes
employees to have a positive outlook on their jobs and stay longer with their organizations and think less
about leaving. Accordingly, Schwepker21 believes a desirable ethical climate could play a role in increased
job satisfaction and organizational commitment, and in contrast, it could reduce leaving intentions. Mulki
et al.22 found that ethical climate has a positive correlation with job satisfaction, and this leads to a reduction in tendency to leave service and increased organizational commitment and job performance.
The findings of this study showed that from the nurses’ perspective, the city of Kerman teaching hospitals climates are of the ‘‘professionalism’’ kind, followed by other climates of ‘‘rule,’’ ‘‘caring,’’ ‘‘independence,’’ and ‘‘instrumental’’ in order. Given that the mean scores of ethical climates of ‘‘professionalism’’
and ‘‘rule’’ are quite close (13.45 for professionalism and 13.41 for rules), it appears that in these hospitals,
obeying the rules and professional standards and also practical requirement for adherence to the rules and
organizational procedures are highly important. In similar studies, the first priority of nurses in identification of ethical climates in nursing has been professionalism. Similar results were observed in a Taiwanese
study2 and in another study in Russia investigating the ethical climate in an organization, where the most
common climate governing the organization was found to be climate of professionalism.23
Existence of ethical climate of professionalism as the climate governing hospitals under study from the
nurses’ perspective indicates that professional principles based on ethical codes and attention to professional ideals, which are those of health improvement, are the first driving factor in development of ethical
climate in hospitals. Considering scientific development of various subjects of health sciences, especially
nursing in Iran and also development of complementary education, it is expected to see its effects in
hospitals in the shape of impact on ethical climate and rule of professional principles.
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According to the results of this study, rule climate is the second climate determined by nurses. This
finding is in accordance with Tsai and Huang’s2 study. Rule climate describes rule of legal guidelines
on behaviors of health professionals. In ethics, adherence to rules and regulations of the hospital is highly
important, and lack of these could affect personnel’s understanding of method of care and treatment and
cause disharmony in care for the patients.24 It has been observed in some studies that rule of law and
regulations have increased nurses’ job satisfaction and have induced the feeling that the organization pays
attention to them.23 Lawfulness does not imply that the organization is rigidly inflexible, but means loyalty
to principles. Successful and ambitious organizations are adamantly loyal to their values and rarely change
them, but equally seek improvement and progress. Responsibility is rooted in law and adherence to ethical
principles. It is worth noting that reliance on law alone does not increase employees’ accountability much, it
is those principles and beliefs institutionalized in a person that can increase his or her sense of responsibility.
On the contrary, lawfulness cannot be equated to ethics. Therefore, legal commitment and doing the work
only because of legal requirements are the basic and the least degree of professional ethics. What is more
valuable to us than just attention to professional rules and regulations is human values and those interpersonal relationships that are the basis for benevolence. All these values are manifested in the climate of interest. In this study, the third climate reported by nurses is caring climate that causes identification of personnel
with the organization and all associated subjects. It is in appropriate interpersonal relationships that one
would expect better teamwork in care for patients. Adherence to rules alone cannot guarantee strong interpersonal relationships. It was thought that after attention to professional problems (professional climate),
nurses pay more attention to interpersonal relationships (caring climate). Although in some studies, such
as those of Cullen et al.12 and Koh and Boo,25 caring climate has been reported as the first of ethical climates
and in Tsai and Huang’s2 study it ranked last, in our study, caring climate ranked higher than independence
and instrumental climates.
Another climate according to the perspective of nurses is independence climate. In this climate, people
behave according to their own beliefs and interests, but try not to be in conflict with the rules and regulations
of the organization. In other words, their interests are a collection of moral principles. Even though in the
independence climate adherence to the rules is somewhat observed, following personal interests can cause
dysfunction of the rules and regulations, and as this climate ranked fourth from nurses’ perspective, it shows
that personal interests are not the guidance nurses would use for their work in hospitals. Therefore, it can be
expected that activities would be in accordance with professional objectives and adherence to the rules. This
result is mentioned in various studies in different forms so that the independence climate ranks third in Tsai
and Huang’s2 study, and in Filipova’s9 study, it ranks last.
The last climate governing the hospitals in the study is the instrumental climate, according to nurses.
Considering that in instrumental climate people only think of their own advantage and prefer personal
interests over organizational interests, the finding that such climate is least prioritized is encouraging. This
finding concurs with Filipova’s9 results, but disagrees with the results of Tsai and Huang2 in which instrumental climate was fourth.
This study reports a medium level of organizational commitment by nurses. As organizational commitment of nurses is an important factor in quality of care of patients,9 it appears that a medium level of
organizational commitment of nurses, due to sensitivity of the job they do, would not be adequate or
satisfactory.
In this study, organizational commitment of nurses is of the affective commitment kind followed by
normative and continuance commitments. This finding is in agreement with a study by Jahangir and
Shokrpour10 in Iran and a study by Vacharakiat26 in the United States, which report the highest level of
commitment of nurses to be affective.
In addition, in this research, evidence has been found that confirms a correlation between aspects of
ethical climate and organizational commitment, so that there is a positive and significant correlation
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between climates of ‘‘professionalism,’’ ‘‘rule,’’ ‘‘caring,’’ and ‘‘independence’’ and organizational commitment, while instrumental climate has no correlation with affective commitment. Affective commitment
indicates the employee’s emotional dependence, determines identity and his or her level of involvement with
the organization, and has a positive correlation with moral and occupational values of the employees27 and
their higher needs.28 Therefore, as moral values find manifestation in the four ethical climates mentioned earlier, they lead to nurses’ increased organizational commitment. In explaining the correlation between ‘‘professionalism’’ and ‘‘rule’’ commitments and affective commitment, it could be reasoned that the
correlation between ethical climate based on rules and organizational commitment of people can only be
observed in specific occasions, so that whenever employees of an organization are committed to principles
of professionalism and regulations of hospital and feel that the organization’s conduct is also wholly in accordance with rules and regulations, their commitment to their organization increases.14 Therefore, with importance of hospital rules and professionalism in hospital, organizational commitment of employees increases.
Thus, given that predominant climate of the hospitals in the study is of the professionalism and rule kind, the
correlation between professionalism and rule climates and affective commitment seems logical. When there is
a climate of interest in hospital, nurses are benevolent and consideration for one another becomes a priority. It
is imperative that whenever there is such a climate in hospital, employees identify themselves with their hospital and feel emotionally committed to their colleagues, leading to desire to stay with their organization and
be committed to it. Additionally, climate of caring encourages better understanding of organizational supports
by employees. Consequently, they regard their organization as if it considers them its top priority.9 This most
probably causes a positive work experience for the employee, and to make up for it, he or she becomes more
committed to the organization. This positive correlation between affective commitment and the understood
organizational support by the employees has been proved in past studies.29
In independence climate, employees behave according to their own beliefs and moral values, which are
based on a series of fair principles. Whenever employees feel that in their organization moral values are taken
into account at the time of decision making, their tendency to remain with the organization increases. This
occurs more when staff feel their personal moral values are compatible with those of the organization.21,30
Various studies show that the ethical ideology (personal ethics) could be used as an alternative to external
financial incentives (rewards), and this helps increase organizational commitment.19 Accordingly, it is
imperative that in an independence climate, organizational commitment of personnel increases due to the fact
that they make their own decisions based on personal beliefs and moral values. In addition, data analysis indicates that instrumental climate has no correlation with affective commitment. Whenever employees focus on
maximizing self-interest, affective commitment decreases. In a climate of instrumentalism, tendency toward
candid and righteous behaviors is less seen, which causes employees to identify less with the organization.12
The results of this study indicate that there is a significant and positive correlation between caring and
professionalism climates and normative commitment. The construct of normative commitment is in fact
indicative of a kind of ethical commitment that a person feels about organization’s investment in him.
This feeling is created in him when organization has spent time and/or money so that he can perform his
duties better. He would feel indebted, and thus stays with the organization. In the Iranian culture, people
feel indebted to others for their goodness and graces and endeavor to recompense them. The results of this
study also indicate that this culture is inbred in Iranian nurses.
Our study showed that there is a positive and significant correlation between instrumental climate and continuance commitment that concurs with the results of past studies of Tsai and Huang2 in Taiwan, Cullen et al.12
in the United States, Kaplan et al. in Turkey.2,12,31 Continuance commitment is a form of psychological attachment of a person to his organization, which is rooted in the person’s understanding of what he might lose if he
left the company. It is evident that in this type of commitment, a kind of egoism and self-interest can be seen.
Therefore, in organizations with instrumental climate, where personal advantage and self-interest take priority
at the time of decision making, increased continuance commitment is observed.
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Limitations of the study
In this study, we did not have access to the demographic variables; in addition, we used self-reported data,
which is one of the limitations of surveys. In order to minimize the impact of this error, subjects were
approached by expert interviewers in a very friendly environment.
Conclusion
In general, results of this study showed that there is a positive and significant correlation between hospital
climates and organizational commitment of nurses. Climate of professionalism was the predominant
climate in hospitals, and climate of instrumentalism had the least priority.
Organizational commitment of participating nurses was at a medium level. There was a positive correlation between different types of ethical climate and some aspects of organizational commitment, and in some
cases, there was no correlation. There was a positive correlation between professional, rule, caring, and
independence climates and affective commitment. Results indicate the more enhanced and favorable ethical
climate (caring, independence, professionalism, and rule) is, the more improved the organizational commitment (affective, normative).
Results of this study are a guideline for researchers and managers alike who endeavor to improve
organizational commitment. Nursing managers ought to pay attention to factors that enhance ethical
climate. Thus, it is recommended that future research examine factors affecting ethical climate.
Acknowledgments
The authors express their gratitude to all those nurses who sincerely helped this research by completing
questionnaires.
Funding
The authors extend their thanks to the Research Deputy of Kerman University of Medical Sciences for the
financial support provided for this study.
Conflict of interest
The authors declare that there is no conflict of interest.
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