title: Psychometric properties of the Persian version of the "Hospital Ethical Climate Survey".
abstract: In order to improve the ethical climate in health care organizations, it is important to apply a valid measure. This study aimed to investigate the psychometric properties of the Persian version of the Hospital Ethical Climate Survey (HECS) and to assess nurses' perceptions of the ethical climate in teaching hospitals of Iran. A cross-sectional study of randomly selected nurses (n = 187) was conducted in three teaching general hospitals of Tehran, capital of Iran. Olson's Hospital Ethical Climate Survey (HECS), a self-administered questionnaire, was used to assess the nurses' perceptions of the hospital ethical climate. Descriptive statistics, confirmatory factor analysis (CFA), internal consistency, and correlation were used to analyze the data. CFA showed acceptable model fit: an standardized root mean square residual (SRMR) of 0.064, an non-normalized fit index (NNFI) of 0.96, a comparative fit index (CFI) of 0.96, and an root mean square error of approximation (RMSEA) of 0.075. The Cronbach's alpha values were acceptable and ranging from 0.69 to 0.85. The overall Cronbach's alpha coefficient was 0.94. The factor loadings for all ethical climate items were between 0.50 and 0.80, which revealed good structure of the Persian version of the HECS. Survey findings showed that the "managers" subscale had the highest score and the subscale of "doctors" had the lowest score. This study shows that the Persian version of the HECS is a valid and reliable instrument for measuring nurses' perceptions of the ethical climate in hospitals of Iran.
authors.affiliation: Associate Professor, Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nader
authors.initials: N
authors.lastname: Khalesi
authors.affiliation: PhD Candidate, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Jalal
authors.initials: J
authors.lastname: Arabloo
authors.affiliation: PhD Candidate, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Khosravizadeh
authors.affiliation: Department of Health Services Management, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Taghizadeh
authors.affiliation: Assistant Professor, Research Center for Social Determinants in Health Promotion, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Heyrani
authors.affiliation: PhD Candidate, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbasali
authors.initials: A
authors.lastname: Ebrahimian
keywords: ethical climate; ethics; organizational ethics