Ethical behaviour in clinical practice: a multidimensional Rasch analysis from a survey of primary health care professionals of Barcelona (Catalonia, Spain)

Purpose Normative ethics includes ethical behaviour health care professionals should uphold in daily practice. This study assessed the degree to which primary health care (PHC) professionals endorse a set of ethical standards from these norms. Methods Health care professionals from an urban area par...

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Bibliographic Details
Published in:Quality of life research 2014-12, Vol.23 (10), p.2681-2691
Main Authors: Paz, Luis González-de, Kostov, Belchin, López-Pina, Jose A., Zabalegui-Yárnoz, Adelaida, Navarro-Rubio, M. Dolores, Sisó-Almirall, Antoni
Format: Article
Language:English
Subjects:
Adult
Aged
Attitude of Health Personnel
Charters
Clinical medicine
Communication
Cross-Sectional Studies
Data collection
Disease prevention
Ethical behavior
Ethical codes
Ethics, Clinical
Family physicians
Female
Health care
Health Personnel - ethics
Humans
Knowledge
Male
Medical ethics
Medical personnel
Medical records
Medicine
Medicine & Public Health
Middle Aged
Normative ethics
Nurses
Parametric models
Patient-centered care
Patient-Centered Care - ethics
Patients rights
Physicians
Polls & surveys
Primary care
Primary health care
Professional communication
Professional ethics
Professionals
Professions
Public Health
Quality of Life
Quality of Life Research
Questionnaires
Social ethics
Social workers
Sociology
Spain
Surveys and Questionnaires
Urban areas
Values
Young Adult
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Summary:Purpose Normative ethics includes ethical behaviour health care professionals should uphold in daily practice. This study assessed the degree to which primary health care (PHC) professionals endorse a set of ethical standards from these norms. Methods Health care professionals from an urban area participated in a cross-sectional study. Data were collected using an anonymous, self-administered questionnaire. We examined the level of ethical endorsement of the items and the ethical performance of health care professionals using a Rasch multidimensional model. We analysed differences in ethical performance between groups according to sex, profession and knowledge of ethical norms. Results A total of 452 Professionals from 56 PHC centres participated. The level of ethical performance was lower in items related to patient autonomy and respecting patient choices. The item estimate across all dimensions showed that professionals found it most difficult to endorse avoiding interruptions when seeing patients. We found significant differences in two groups: nurses had greater ethical performance than family physicians (p < 0.05), and professionals who reported having effective knowledge of ethical norms had a higher level of ethical performance (p < 0.01). Conclusions Paternalistic behaviour persists in PHC. Lesser endorsement of items suggests that patient-centred care and patient autonomy are not fully considered by professionals. Ethical sensitivity could improve if patients are cared for by multidisciplinary teams.
ISSN:0962-9343
1573-2649
DOI:10.1007/s11136-014-0720-x