title: Organisational and individual support for nurses' ethical competence: A cross-sectional survey.
abstract: BACKGROUND
  Nurses' ethical competence has been identified as a significant factor governing high quality of care. However, nurses lack support in dealing with ethical problems, and therefore managerial support for nurses' ethical competence is needed.
  
  
  OBJECTIVE
  This study aimed to analyse, from the perspective of nurse and nurse leaders, the level of nurses' and nurse leaders' ethical competence, perceptions of support for nurses' ethical competence at the organisational and individual levels and background factors associated with this support.
  
  
  METHODS
  A descriptive, cross-sectional study design was employed. The Ethical Competence and Ethical Competence Support questionnaires were used to measure the main components. Descriptive statistics and multifactor analysis of variance were used for data analysis.
  
  
  METHODS
  The participants were 298 nurses and 193 nurse leaders working in specialised (48%/52%), primary (43%/36%) or private healthcare (5%/7%) in Finland. Ethical considerations: Ethical approval was obtained from the university ethics committee.
  
  
  RESULTS
  Nurses estimated their own ethical competence to be at an average level, whereas nurse leaders estimated their own competence at a high level. Nurses' and nurse leaders' perceptions of provided support for nurses' ethical competence was not at a high level. The positive agreement percentage related to organisational support was 44% among nurses and 51% among nurse leaders. The positive agreement percentage related to individual support was lower, that is, 38% among nurses and 61% among nurse leaders. University education had a positive association with some items of individual support.
  
  
  CONCLUSIONS
  Despite the findings that ethical competence was estimated at a high level among nurse leaders, perceptions of support for nurses' ethical competence were not at a satisfactory level. At the organisational level, nurse leaders need to inform of ethical procedures and practices in orientation; encourage multidisciplinary ethics discussions and collaboration; and support nurses at an individual level to participate in ethics education, multidisciplinary ethics discussions and in solving ethical problems.
authors.forename: Tarja
authors.initials: T
authors.lastname: Poikkeus
authors.forename: Riitta
authors.initials: R
authors.lastname: Suhonen
authors.affiliation: University of Turku, Finland.
authors.forename: Jouko
authors.initials: J
authors.lastname: Katajisto
authors.affiliation: University of Turku, Finland; Turku University Hospital, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004993:Ethics, Nursing / Q000193:education*; D005260:Female; D005387:Finland; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators / Q000523:psychology / Q000592:standards; D009726:Nurses / Q000523:psychology* / Q000592:standards; D016134:Organizational Policy; D010465:Perception; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Cross-sectional survey; ethical competence; individual support; nurse leaders; nurses; organisational support