Caring behaviors and its associated factors among nurses and midwives working at public health hospitals in Ethiopia: a systematic review and meta-analysis

Abstract

BACKGROUND: Caring behaviors among nurses and midwives are essential for quality patient care, yet factors influencing these behaviors in Ethiopian public hospitals remain poorly understood. This systematic review and meta-analysis aimed to determine the prevalence of caring behaviors and identify associated factors among Ethiopian nurses and midwives. METHODS: We searched five electronic databases (MEDLINE, Scopus, Web of Science, Cochrane Library, Hinari) and grey literature sources. Studies were included if they examined caring behaviors among nurses/midwives in Ethiopian public hospitals. Two independent reviewers were involved in the study selection, data extraction, and quality assessment, resolving discrepancies by the inclusion of a third reviewer. Meta-analysis was conducted using random-effects models, with heterogeneity assessed using I² statistics. RESULTS: Seven cross-sectional studies involving 2,410 nurses and midwives across four Ethiopian regions(List the regions) were included. The pooled proportion of caring behaviors was 66.14% (95% CI: 58.26-74.01%) with substantial heterogeneity (I² = 94.45%). Job satisfaction (AOR = 1.84, 95% CI: 1.48-2.21), positive coworker relationships (AOR = 2.98, 95% CI: 1.80-4.17), and manageable workloads (AOR = 2.73, 95% CI: 1.44-4.02) were significantly associated with caring behaviors. CONCLUSION: Approximately two-thirds of Ethiopian nurses and midwives demonstrate caring behaviors, with significant variation between studies. Workplace factors including job satisfaction, collegial relationships, and workload management appear important for caring behavior. However, the limited evidence base and high heterogeneity indicate need for more comprehensive research before definitive policy recommendations. PROTOCOL REGISTRATION: CRD42024614975.