title: Nurses' adherence to ethical codes: The viewpoints of patients, nurses, and managers.
abstract: BACKGROUND
  Ethical codes are guidelines that orient nurses and ensure that their decisions are in accordance with the values of the professional system. These codes show that there is a connection among values, patients' rights, and nurses' duties.
  
  
  OBJECTIVE
  This study aimed to compare the viewpoints of patients, nurses, and nurse managers regarding the extent to which clinical ethical codes are observed.
  
  
  METHODS
  In this descriptive-comparative study, data were collected using three questionnaires based on Iranian nurses' ethical codes with a focus on clinical care. The reliability of the questionnaire was verified by test-retest method (r = 0.9). The patients were interviewed by the researcher, but nurses and managers completed the questionnaires themselves. After all, the data were analyzed using the SPSS statistical software (v 15).
  
  
  METHODS
  In all, 100 patients, 100 nurses, and 30 managers from internal and surgical wards of two major hospitals in Shiraz, Iran, participated in 2014.
  
  
  METHODS
  This research was approved by the Ethics Committee of Shiraz University of Medical Sciences. All the participants signed written informed consents.
  
  
  RESULTS
  According to the results, 70% of the patients, 86% of the nurses, and 53.3% of the nurse managers rated nurses' adherence to ethical codes as satisfactory. The mean scores (standard deviation) of the level of adherence to ethical codes were 38.44 (6.91) in the patients, 41.08 (4.82) in the nurses, and 37.83 (6.98) in the nurse managers. The results of analysis of variance revealed a significant difference between the attitudes of the nurses and the other two groups (p = 0.001).
  
  
  CONCLUSIONS
  Nurses' adherence to ethical codes was satisfactory in all three groups. Accordingly, our findings agree with the results of some national and international studies, although there are still controversies in this regard.
  
  
  CONCLUSIONS
  Although the nurses rated their performance in certain fields more satisfactory compared to the patients and managers, all the three groups agreed that clinical ethical codes were properly observed in the internal and surgical wards. Nurses can improve the quality of care by considering the viewpoints of patients and managers about their ethical performance.
authors.affiliation: Shiraz University of Medical Sciences, Shiraz, Iran momennasab@sums.ac.ir.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Momennasab
authors.affiliation: Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Afifeh Rahmanin
authors.initials: AR
authors.lastname: Koshkaki
authors.affiliation: Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Camellia
authors.initials: C
authors.lastname: Torabizadeh
authors.affiliation: Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Ziaeddin
authors.initials: SZ
authors.lastname: Tabei
mesh_terms: D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D032781:Codes of Ethics; D004993:Ethics, Nursing; D006801:Humans; D007492:Iran; D009718:Nurse Administrators / Q000941:ethics*; D009741:Nursing Staff, Hospital / Q000941:ethics*; D010361:Patients; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Adherence; ethical codes; nurse managers; nurses; patients; viewpoints