title: Public and private hospital nurses' perceptions of the ethical climate in their work settings, sari city, 2011.
abstract: BACKGROUND
  Nurses' perceptions of ethical climate patterns have certain undeniable effects on hospitals. There is little evidence of possible differences in this element between public and private hospitals and contributing factors.
  
  
  OBJECTIVE
  This study investigated whether the perceptions of the ethical climate in nurses' working in public hospitals differ from that of nurses in private hospitals, and which factors may affect nurses' perceptions.
  
  
  METHODS
  A cross-sectional study of randomly selected registered nurses (n = 235), working in four public hospitals affiliated to Mazandaran University of Medical Sciences, and three private hospitals, was conducted in Sari City, Iran. A self-administered questionnaire, containing demographic characteristics and the Hospital Ethical Climate Survey (HECS), were used to assess registered nurses' perceptions of public and private hospitals ethical climate. An independent t-test and one-way ANOVA were used to analyze the data.
  
  
  RESULTS
  Across the five factors of HECS, the highest and lowest mean scores pertained to managers and physicians, respectively, in both public and private hospitals. Nurses who had a conditional employment situation and those working in pediatric intensive care units showed significantly more positive perceptions of the ethical work climate when compared to their peers (P < 0.05). Although the mean score of ethical work climate in private hospitals (3.82 ± 0.61) was higher than that in public hospitals (3.76 ± 0.54), no significant difference was found (P = 0.44).
  
  
  CONCLUSIONS
  Hospital managers need to discover better ways to promote safety and health programs for their staff according to nurses' area of work and their type of units. They should also encourage greater levels of participation in safety-enhancing initiatives in the hospital's ethical climate, especially in the areas of nurses' perceptions of their physician colleagues, and for nurses with a conditional employment situation.
authors.affiliation: Deputy of Education, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Ali Asghar
authors.initials: AA
authors.lastname: Ghorbani
authors.affiliation: Community Health Nursing Group, Nasibeh Nursing and Midwifery School, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Hesamzadeh
authors.affiliation: Social Medicine Group, Sari Medical School, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Khademloo
authors.affiliation: Nursing Office,Valiaser Hospital, Qaemshahr, IR Iran.
authors.forename: Salimeh
authors.initials: S
authors.lastname: Khalili
authors.affiliation: Statistics and Technology Office,Welfare Organization, Sari, IR Iran.
authors.forename: Shamim
authors.initials: S
authors.lastname: Hesamzadeh
authors.affiliation: Nursing Department, Lone Star College, Houston, Texas, The USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Berger
keywords: Hospitals, Private; Hospitals, Public; Nurses