Ethical climate and missed nursing care in cancer care units.
BACKGROUND
Previous research has linked missed nursing care to nurses' work environment. Ethical climate is a part of work environment, but the relationship of missed care to different types of ethical climate is unknown.


OBJECTIVE
To describe the types of ethical climate in adult in-patient cancer care settings, and their relationship to missed nursing care.


METHODS
A descriptive correlation design was used. Data were collected using the Ethical Climate Questionnaire and the MISSCARE survey tool, and analyzed with descriptive statistics, Pearson's correlation and analysis of variance. Participants and research context: All nurses from relevant units in the Republic of Cyprus were invited to participate. Ethical considerations: The research protocol has been approved according to national legislation, all licenses have been obtained, and respondents participated voluntarily after they have received all necessary information.


RESULTS
Response rate was 91.8%. Five types identified were as follows: caring (M = 3.18, standard deviation = 1.39); law and code (M = 3.18, standard deviation = 0.96); rules (M = 3.17, standard deviation = 0.73); instrumental (M = 2.88, standard deviation = 1.34); and independence (M = 2.74, standard deviation = 0.94). Reported overall missed care (range: 1-5) was M = 2.51 (standard deviation = 0.90), and this was positively (p < 0.05) related to instrumental (r = 0.612) and independence (r = 0.461) types and negatively (p < 0.05) related to caring (r = -0.695), rules (r = -0.367), and law and code (r = -0.487).


CONCLUSIONS
The reported levels of missed care and the types of ethical climates present similarities and differences with the relevant literature. All types of ethical climate were related to the reported missed care.


CONCLUSIONS
Efforts to reduce the influence of instrumental and independence types and fostering caring, law and code, and rules types might decrease missed nursing care. However, more robust evidence is needed.
Cyprus University of Technology, Cyprus.
Stavros
S
Vryonides
Cyprus University of Technology, Cyprus.
Evridiki
E
Papastavrou
Cyprus University of Technology, Cyprus.
Andreas
A
Charalambous
Cyprus University of Technology, Cyprus.
Panayiota
P
Andreou
Cyprus University of Technology, Cyprus.
Christos
C
Eleftheriou
Cyprus University of Technology, Cyprus.
Anastasios
A
Merkouris
D000328:Adult; D003535:Cyprus; D004991:Ethics, Institutional; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009732:Nursing Care / Q000941:ethics* / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data; D016522:Oncology Service, Hospital / Q000458:organization & administration*; D015279:Organizational Culture; D055815:Young Adult
Cancer care units; care rationing; hematology; missed nursing care; oncology; types of ethical climate