Scale validation and associated factors with ethical climate in health services
methodological study
DOI:
https://doi.org/10.47456/rbps.v27i1.47346Keywords:
Institutional ethics, Validation study, Health Care Professionals, Health servicesAbstract
Introduction: Organizational ethical climate is an important indicator of working conditions in healthcare, influencing professionals' well-being, quality of care, and organizational outcomes. However, no validation studies of the Hospital Ethics Climate Survey (HECS) were identified for the Brazilian context. Objective: To seek evidence of internal structure validity and reliability of an organizational ethical climate scale through its translation, adaptation, and application for nurses and physicians in primary and hospital care services. Methods: This methodological study involved the translation, adaptation, and validation of the HECS instrument. Participants included 5 researchers, 4 translators, and 20 experts in the translation and adaptation process, 41 healthcare professionals in the pre-test, and 134 professionals in the validation phase, conducted in southern Brazil between 2021 and 2022. Statistical analyses included exploratory and confirmatory factor analysis, Cronbach’s Alpha, McDonald’s Omega, Pearson’s chi-square test, and Student’s t-test. Results: Exploratory analysis showed KMO=0.892, Bartlett p<0.001, and factor loadings from 0.42 to 0.86. Cronbach's Alpha was 0.93, McDonald’s Omega was 0.95, and variance explained was 66.1%. Confirmatory analysis presented RMSEA 0.05, CFI 0.95, TLI 0.95, and SRMR 0.06. The mean ethical climate score was 3.87 (SD 0.68), with higher scores associated with postgraduate education (p=0.037) and primary care (p<0.001). Conclusion: The scale demonstrated validity and reliability. This instrument enables monitoring of the ethical climate, guiding actions to promote healthy work environments and positively impacting worker health.
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