Causal relationships among antecedent variables, work stress, and ethical decision-making.

Abstract

The present study explored the causal relationships among nurses' autonomy, st and ardization, individual traits (locus of control, age, experience, education), nursing role conception, moral reasoning, work stress, and ethical decision making by constructing and testing a theoretical framework. Based on Kahn, Wolfe, Quinn, and Snoek's (1964) theory of stress and Kohlberg's (1978) theory of moral development, nurses' work stress and ethical decision making were conceived of as outcomes of the interplay between personal characteristics and work environment. Personal aspects associated with work stress and ethical decision making included locus of control, education, age, experience, nursing role conception, and moral reasoning. The work environment factors involved autonomy and st and ardization. Using the data which were collected for the study titled "Professional and bureaucratic role conceptions and moral behavior of nurses" conducted by Ketefian (1985), the present study tested a series of hypotheses and a conceptual model. The total sample for the study included 224 registered nurses. Basically two kinds of research methodologies were employed to examine the hypotheses. First, the linear structural relations (LISREL) technique was used to test the fit of the proposed conceptual model to the data and examine the causal relationships among the variables. Second, correlational analyses were executed to check for the moderating effects of demographic variables (i.e., age, experience, and education) on particular relationships between two variables. The results showed that all the developed six models fit the data moderately, revealing considerable explanatory power for each of the endogenous variables. In predicting nurses' work stress and ethical decision making, the findings of this study clearly demonstrated that autonomy as an environmental factor might be much more important than personal factors. Also, professional and service role conceptions were found to be the most important factors in predicting nurses' ethical decision making. The results were discussed noting the limitations of the study. Practical implications drawn from the research were suggested. Finally, directions for future research were presented.