The Ethical Behaviour of Registered nurses: A Comparison between Registered nurses’ and Clients’ Perceptions in a Private Hospital
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Abstract
OBJECTIVES: This descriptive study aimed to examine and compare the ethical behaviours of registered nurses based on the perceptions of both nurses and their clients in an inpatient hospital setting.
MATERIALS AND METHODS: A total of 465 participants were recruited using purposive sampling, comprising 90 registered nurses and 375 clients. The research instrument was a validated ethical nursing behaviour questionnaire with a reliability coefficient (Cronbach’s alpha) of 0.98. Data were collected via self-administered questionnaires from March 1 to July 31, 2023. Data were analyzed using descriptive statistics, independent t-tests, and Chi-square tests.
RESULTS: The overall mean score of ethical behavior as perceived by registered nurses was at a very good level (4.54 ± 0.52), while clients rated it at an excellent level (4.71 ± 0.44). The comparison revealed that clients’ perceptions of nurses’ ethical behaviors were significantly higher than those of the nurses themselves (t = 2.947, p < .05). However, no statistically significant difference was found in the domain of respect for individual rights (t = 1.920, p = .057).
CONCLUSION: Clients perceived the ethical behaviour of registered nurses more favourably than the nurses’ self-assessments. Enhancing ethics education and fostering adherence to professional ethical standards are essential for improving the quality of nursing care and increasing client satisfaction in hospital settings.
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References
Kenny DJ, Treyball MP. The Code of Ethics for Nurses— Implications for Nursing Faculty. J Nurs Educ 2025;64(3):143 4. doi: 10.3928/01484834-20250212-01
Thongjam R. Ethics in nursing practice. J Graduate MCU KhonKaen Campus. 2020;7(1):29-44. (Accessed on December 16, 2023 at https://so02.tci-thaijo.org/index.php/jg-mcukk/article/view/235685 ).
Thailand Nursing and Midwifery Council. Notification of Thailand Nursing and Midwifery Council on Policy of the Thailand Nursing and Midwifery Council on the promotion of professionals, November 16, 2015. (Accessed on December 16, 2023 at, https://www.tnmc.or.th/images/userfiles/files/tcne2.pdf ).
Patchetphokin K, Prayong M, Chinuntdej N, et al. The influence of knowledge management, safety climate, and information technology capabilities on a smart emergency logistics system: a study of BDMS emergency services. BKK Med J 2023;19(2):74-84. doi: 10.31524/bkkmedj.2023.21.002
Sirilai S. Ethics for nurses. 13th ed. Bangkok: Chulalongkorn Press; 2013. Thai.
Atsawaponwiput W. Standards of Nursing Care: Nursing process and professional ethics. PH.PL [internet] 2016; 2(3): 393-400. (Accessed on December 16, 2023 at, https://so05.tci-thaijo.org/index.php/journal_law/article/view/162546).
Chumpradit S. Ethical behaviors among professional nurses at outpatient department, Maharaj Nakorn Chiang Mai Hos pital [master’s thesis]. Chiang Mai: Chiang Mai University, Graduate School; 2006. Thai.
Tikham N, Chitpakdee B, Sirakamol S. Ethical climate as perceived by nurses, Maharaj Nakorn Chiang Mai Hospital. J Nurs Health Care 2022;40(1):54-63. Thai.
Chaiwatthanakorn S, Sirakamon S, Sanluang C. Work ethic, perceived organizational support and proactive work behaviors among nurses in health promotion hospitals under the Department of Health. Nurs J CMU 2025;52(1):228-43.
Thamnarak Y, Chitpakdee B, Akkadechanunt T. Ethical be haviors of nurses as perceived by clients in a university hospital. J Nurs Public Health Educ 2020;21(2):132-43. 108 The Bangkok Medical Journal Vol. 21, No.2; September 2025 ISSN 2287-0237 (online)/ 2228-9674 (print)
Utthawang P, Jaikarn T. Ethical behaviors and nursing service behaviors of registered nurses of Pong Hospital, Phayao Province. J Nurs Public Health Educ 2013;14(2):43-51.
Zhang N, Li J, Bu X, et al. The relationship between ethical climate and nursing service behavior in public and private hospitals: a cross-sectional study in China. BMC Nurs 2021;20:136. doi:10.1186/s12912-021-00655-7.
Fry ST, Johnstone MJ, Fletcher M. Ethics in nursing practice: a guide to ethical decision making. Can Nurs2003;99(4):20.
Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas 1970;30(3):607-10. doi:10.1177/001316447003000308.
Muangprasert S. Head nurses’ moral actions perceived and experienced by head nurses and nurse subordinates in regional hospital, Southern Thailand [master’s thesis]. Songkhla: Prince of Songkla University; 2010. Thai.
Beauchamp T, Childress J. Principles of biomedical ethics: marking its fortieth anniversary. Am J Bioeth 2019;19(11):9 12. doi:10.1080/15265161.2019.1665402
Chaowalit A, Khampalikit S, Thanasil S. Ethics promotion handbook for nursing organizations: mechanism and practice. 1st revised ed. Bangkok: Thailand Nursing and Midwifery Council, Judthong; 2021. Thai.
Ayala B. Ethical and legal implications of healthcare worker shortages. J Healthc Ethics Adm 2025;11(1):1-6. doi:10.22461/ jhea.1.71649.
Güllü A, Kanadlı KA. Nurses’ perceptions of professional values and ethics: a cross-sectional study in university hospital. J Radiol Nurs 2025;44:105-10.
Songmuang K, Thungjaroenkul P, Nantsupawat A. Ethical leadership of head nurses and organizational citizenship behaviors as perceived by nurses in regional hospitals. Nurs J CMU. 2022;49(3):352-63.
