Determinants of ethical care provision among nurses working in public hospitals of Wolaita Zone, South Ethiopia

Abstract

BACKGROUND: Ethical care provision among nurses refers to the provision of care that is in line with ethical principles, which include autonomy, beneficence, non-maleficence, and justice. Ethical care is fundamental to effective and safe care. Violations of ethics can result in negative outcomes for patients and erode trust in healthcare providers. There are gaps between accepted ethical principles and ethical care provision in Ethiopia. Therefore, this study aimed to assess the ethical care provision and its determinants among nurses. METHODS: An institution-based cross-sectional study was conducted among 411 nurses in public hospitals of the Wolaita Zone, South Ethiopia, from August 1 to 30, 2023. The study comprised two components: a self-administered survey (n = 411) and an embedded overt observational component. Of the total participants, 354 nurses were selected for observation, with 322 successfully completing the component. A simple random sampling method was used to select study participants from selected hospitals. The data were entered into EpiData version 4.6, and analysis was done using SPSS version 25. Bivariate and multivariate logistic regression were used to identify associated factors. Significance was considered at a P-value < 0.05 in the multivariate analysis. RESULTS: The prevalence of self-reported good ethical care provision was 64.5%, while observed practice was 59.9%. Nurses who had good knowledge of the ethical care principles (AOR 5.23; 95% CI 2.27, 12.03), nurses who had good communication skills (AOR 2.32; 95% CI 1.07, 5.00), nurses who were satisfied with their jobs (AOR 9.53; 95% CI 4.54, 20.02), nurses who had training in the nursing code of ethics (AOR 5.68; 95% CI 2.56, 12.59), and nurses who had favorable attitudes (AOR 4.42; 95% CI 2.09, 9.40) were significantly associated with ethical care provision. CONCLUSION: The ethical care provision in this study was suboptimal. Knowledge, attitude, communication skills, training, and job satisfaction were the predictors of ethical care provision. Therefore, providing in-service training for nurses to improve their skills in the ethical care provision and communication was recommended to maximize the ethical care provision. In addition, nurses should engage in continuous professional development to enhance their knowledge and skills in ethical care. CLINICAL TRIAL NUMBER: Not applicable.