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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
  1. Francis Maisonneuve1,
  2. Patrick Groulx2,
  3. Denis Chênevert1,
  4. Colleen Grady3,
  5. Angela Coderre-Ball3
  1. 1 Human Resource Management, HEC Montreal, Montreal, Quebec, Canada
  2. 2 Management, HEC Montreal, Montreal, Quebec, Canada
  3. 3 Family Medecine, Queen's University, Kingston, Ontario, Canada
  1. Correspondence to Francis Maisonneuve, Human Resource Management, HEC Montreal, Montreal, QC H3T 2A7, Canada; francis.maisonneuve{at}hec.ca

Abstract

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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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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Footnotes

  • Contributors FM and DC developed the questionnaire. FM, CG and AC-B participated in the distribution of the questionnaire and data collection. FM and PG conducted the data cleaning, initial analyses and theorisation. FM and PG proceeded with the redaction of the first version of the article. DC revised the theorisation and statistical analyses of the first version. CG and AC-B revised the first version regarding wording and syntax. FM submitted the manuscript. FM and PG addressed the comments and rewrote the manuscript. FM completed the revision responses to the editors and reviewers. DC, CG and AC-B revised the new version of the manuscript. Karen Sherman completed the linguistic review of the manuscript (non-author contributor). FM completed the RnR. FM acts as guarantor.

  • Funding This study was funded by Mental Health Commission of Canada (no grant number).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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