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Effects of ethical climate in association with tenure on work addiction, quality of care and staff retention: a cross-sectional study


Objectives Work addiction is not contingent on personality alone; it is also impacted by social contextual factors. Work addiction influences the perceived quality of care and intention to remain in healthcare sector. The current study seeks to understand the role of ethical climate as a potential organisational lever to reduce such addiction, especially among newcomers.

Design We contacted a sample of Canadian healthcare organisations to collect quantitative data using an online questionnaire from November 2021 to February 2022. All constructs (ethical climate, work addiction, perceived quality of care, intention to quit the profession) were measured using validated psychometric scales. 860 respondents provided complete questionnaires. We analysed the data using structural equation modelling and regression analysis.

Results Work addiction mediated the indirect relationship between ethical climate and the intention to quit the profession (β=−0.053; 95% CI (−0.083 to –0.029); p<0.001) and with quality of care (β=0.049; 95% CI (0.028, 0.077); p<0.001). For each increase of 1 SD of ethical climate, the total effects regarding the variations in the outcomes were more important at low rather than high levels of tenure for work addiction (−11%, −2%), perceived quality of care (23%, 11%) and intention to quit the profession (−30%, −23%), respectively.

Conclusion Ethical climate in healthcare organisations has a significant and beneficial relationship with healthcare workers’ (HCWs) work addiction behaviours. In turn, this relationship is related to greater perceived quality of care and higher intention to remain, especially for HCWs with lower tenure.

  • Health policy
  • Surveys
  • Social sciences
  • Management
  • Attitudes

Data availability statement

Data are available upon reasonable request. Data include deidentified participant data in the form of answers to all used items and demographics questions used in the presented study. Data are available from the first author (ORCID ID 0000-0002-6708-0258), upon reasonable request to replicate or add the data to a meta-analysis research project.

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