Hospital ethical climate associated with the professional quality of life among nurses during the early stage of COVID-19 pandemic in Wuhan, China: A cross-sectional study

Abstract

Objectives To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight in Wuhan and especially examine whether the hospital ethical climate was independently associated with nurses’ professional quality of life. Methods A cross-sectional online survey was conducted from March 2020 to April 2020. The nurses working in Wuhan from the other parts of China were the target population. The Professional Quality of Life Scale version 5, the Hospital Ethical Climate Survey, and a basic information sheet were used to collect data. Descriptive statistics, t -test, ANOVA, Pearson correlation, and multiple linear regression analysis were used to analyze the data. Results In total, 236 nurses participated in this study, and 219 valid questionnaires were analyzed. The average age of the participants was 31.2 ± 5.0 years. Most nurses were female (176/219; 80.4%) and married (145/219; 66.2%). In term of professional quality of life, nurses reported moderate (129/219; 58.9%) to high (90/219; 41.1%) levels of compassion satisfaction, low (119/219; 54.3%) to moderate (100/219; 45.7%) levels of burnout, and low (67/219; 36.0%) to high (10/219; 4.6%) levels of secondary traumatic stress. Regarding hospital ethical climate, nurses reported moderately high hospital ethical climates with an average score of 4.46. After controlling for socio-demographic characteristics, the multiple linear regression models showed that the hospital ethical climate subscale of “relationship with physicians” was independently associated with the compassion satisfaction ( β = 0.533, P < 0.01) and burnout ( β = −0.237, P < 0.05); the hospital ethical climate subscale of “relationship with peers” ( β = −0.191, P < 0.01) was independently associated with the secondary traumatic stress. Conclusions During the early stage of the pandemic, nurses demonstrated moderate to high level of compassion satisfaction, low to moderate level of burnout, and all nurses experienced secondary traumatic stress. Nurses perceived a high level of hospital ethical climate, and the perceived hospital ethical climate played an important role in promoting nurses’ professional quality of life during a life-threatening infectious disease pandemic.

The mental health impact of the COVID-19 pandemic on Canadian critical care nurses

“…Pre-pandemic researchers have found a moderate to high degree of burnout and stress that impacted healthcare providers and CCNs’ ability to provide care (Sacco et al, 2020; Austin, Saylor, Finley, 2017; Mohammadi, Peyrovi, Mahmood, 2017; Monroe, Morse, Price, 2020). While our study reports higher episodes of burnout and secondary trauma symptoms than some other recent studies, the results are not unexpected when considering the work of CCNs in caring for COVID-19 patients ( Inocian et al, 2021 , Jiang et al, 2021 ). It is highly likely that the cumulative mental health toll influenced the CCNs intent to turnover.…”

“…We collected data using four questionnaires: the Impact of Event Scale – Revised (IES - R), the Depression, Anxiety, Stress Scale (DASS – 21), the Professional Quality of Life scale (ProQoL), and the Intent to Turnover scale (Creamer, Bell, Falilla, 2002; Lovibond, Lovibond, 1995; Stamm, 2012 ). These scales have demonstrated strong reliability and validity when used in previous nursing studies, including with CCN participants ( McMahon et al, 2016 , Maunder et al, 2004 , Jiang et al, 2021 ). Previously used to assess the impact of a public health crisis, the IES – R measures the psychological impact of an event, providing a brief snapshot in time of staff response to crisis, and capturing symptoms of post-traumatic stress disorder (PTSD) ( Wang et al, 2020 , McAlonan et al, 2007 , Weiss, 2007 ).…”

The association between perceived hospital ethical climate and self-evaluated care quality for COVID-19 patients: the mediating role of ethical sensitivity among Chinese anti-pandemic nurses

“…However, we should note that these data were collected from March through April 2020, when the nurses had only worked in the isolated wards for a couple of months. Some negative factors such as burnout that affect nurses’ perceptions of hospital ethical climate were likely not yet obvious or severe [ 45 ].…”

Increasing Nurse Professionalism During The COVID-19 Pandemic in Hospital Province Central Sulawesi

“…This is a big challenge for nurses because nurses must be able to adapt to these conditions (Chau et al, 2021). Creating an ethical environment in organizational clinical settings in hospitals can improve the quality of care during the covid-19 pandemic (Jiang et al, 2021) so that the patient's length of stay is reduced, the cost of the health care system decreases and the patient's working time increases, which in turn will affect the economic aspect (Miskir and Emishaw, 2018).…”

“…Hospital ethical climate refers to individual perceptions of the organization that influences attitudes and behavior, as well as being a reference for employee behavior, including nurse relationships with peers, patients, managers, doctors, and hospitals (Jiang et al, 2021;Olson, 1998). During the covid-19 pandemic, some doctors expect nurses to assume some doctor responsibilities, such as checking the patient's condition with lung auscultation and blood gas analysis at the bedside, asking nurses to view patient monitoring parameters via video instead of entering the patient's room.…”