title: The workers opinions have a value in the Code of Ethics: Analysis of the contributions of workers in virtual Forum Catalan Institute of Health.
abstract: BACKGROUND
  The Catalan Institute of Health (CIH) is the largest health services public provider in Catalonia. "CIH Code of Ethics Virtual Forum" (CEVF), was created within the Intranet of the CIH to facilitate participation among their employees. The current study aims to: a) Analyse the CIH workers' assessment of their own, their colleagues' and the organization's observance of ethical values; b) Identify the opinions, attitudes, experiences and practices related to the ethical values from the discourse of the workers that contributed voluntarily to the CEVF.
  
  
  METHODS
  Mixed methods study with convergent parallel design: 1. Cross sectional study by means of a self-administered, ad hoc, anonymous questionnaire to assess the observance of the ethical values of the CIH according to the participants. A total of 712 workers responded to the questionnaire. A descriptive, bivariate analysis of the results was carried out. 2. Qualitative study to determine the meaning for the workers of the ethical values put forward by the organization. Their individual opinions and experiences were explored by means of a thematic contents analysis of 225 comments posted in the CEVF. The study was conducted between May and December 2008.
  
  
  RESULTS
  The average score for observance of the CE by the respondents themselves was high (over 4/5), between 3.5-4/5 for the observance by their colleagues and close to 3/5 for the CIH management. These results do not change when we compare by gender, age group and professional discipline. The comments on the values are information-rich, they mirror the ethical environment of the institution and show various ethical dilemmas and suggestions.
  
  
  CONCLUSIONS
  Results show that it is feasible for a publicly funded health care organization to develop a CE with the participation of employees and the support of the management. Results underscore the relevance of this strategy for the implementation, improvement and update of the CE as a responsibility shared by all workers. Practices consistent with ethical values are rewarded by social approval, enhance employee's confidence and coherence in decision-making and improve public engagement and institutional policies.
authors.affiliation: Centre d'Atenció Primària El Castell. Carrer de Guillermo Marconi, 9, 08860 Castelldefels, Àmbit d'Atenció Primària Metropolitana Sud. Institut Català de la Salut, Barcelona, Spain. evapeguero@me.com.
authors.forename: Eva
authors.initials: E
authors.lastname: Peguero
authors.affiliation: Unitat de recerca del Institut Universitari d'investigació en Atenció Primària Jordi Gol (IDIAP- Jordi Gol), Gran Via de les Corts Catalanes, 587, àtic, Barcelona, 08007, Spain. aberenguera@idiapjgol.org.|Universitat Autònoma de Barcelona, Edifici A. Rectorat, Bellaterra (Cerdanyola del Vallès), 08193, Spain. aberenguera@idiapjgol.org.
authors.forename: Anna
authors.initials: A
authors.lastname: Berenguera
authors.affiliation: Unitat de recerca del Institut Universitari d'investigació en Atenció Primària Jordi Gol (IDIAP- Jordi Gol), Gran Via de les Corts Catalanes, 587, àtic, Barcelona, 08007, Spain. epujol@idiapjgol.org.|Universitat Autònoma de Barcelona, Edifici A. Rectorat, Bellaterra (Cerdanyola del Vallès), 08193, Spain. epujol@idiapjgol.org.|Gerència d'Àmbit d'Atenció Primària, Balmes, 22, 3ª planta, Barcelona, 08007, Spain. epujol@idiapjgol.org.
authors.forename: Enriqueta
authors.initials: E
authors.lastname: Pujol-Ribera
authors.affiliation: Facultat de Filosofia, Universitat de Barcelona, Edifici B, Campus UAB, Bellaterra, (Cerdanyola del Vallès), 08193, Spain. broman@ub.edu.
authors.forename: Begoña
authors.initials: B
authors.lastname: Roman
authors.affiliation: Centre d'Atenció Primària El Plà, Plaça Felip Alcantara s/n, 08980 Sant Feliu de Llobregat. Àmbit d'Atenció Primària Metropolitana Sud. Institut Català de la Salut, Barcelona, Spain. 25854cpv@comb.cat.
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Prieto
authors.affiliation: Institut Borja de Bioètica, Santa Ros, 39-57, 3ª Planta, Esplugues de Llobregat, Barcelona, 08950, Spain. nterribas@ibb.hsjdbcn.org.
authors.forename: Núria
authors.initials: N
authors.lastname: Terribas
mesh_terms: D000047:Academies and Institutes / Q000941:ethics*; D000328:Adult; D032781:Codes of Ethics / Q000639:trends*; D003430:Cross-Sectional Studies; D003657:Decision Making / Q000941:ethics; D004991:Ethics, Institutional; D005260:Female; D006262:Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013030:Spain; D011795:Surveys and Questionnaires