Abstract
OBJECTIVE: This study aimed to investigate the relationship between role clarity and ethical behaviour and to identify the primary factors influencing nurses' ethical conduct. DESIGN: A cross-sectional survey was conducted. SETTING, PARTICIPANTS AND METHODS: A questionnaire survey was conducted from March to April 2024, involving 315 orthopaedic nurses from six tertiary hospitals in Hunan Province, China. The survey employed a general information questionnaire, the Role Clarity Scale and the Ethical Behaviour Scale for Nurses-Revise. Data were analysed using IBM SPSS V.26.0. Pearson's correlation analysis was performed to examine the relationship between role clarity and ethical behaviour, followed by multiple stepwise linear regression analysis to determine the factors influencing ethical behaviour. PRIMARY OUTCOME: The scores of ethical behaviour and role clarity among orthopaedic nurses were analysed, along with the key factors affecting their ethical behaviour. RESULTS: The average item scores for role clarity and ethical behaviour among the 315 nurses were 3.85±0.77 and 3.68±0.44, respectively. A positive correlation was observed between role clarity and ethical behaviour (r=0.444, p<0.001). Stepwise multiple linear regression analysis indicated that role clarity (95% CI 0.243 to 0.357, β=0.496, p<0.001) and the degree of affection for the nursing profession (95% CI 0.018 to 0.127, β=0.125, p<0.05) were significant factors influencing ethical behaviour. Together, these factors accounted for 28.0% of the variance in nurses' ethical behaviour (R²=0.280, F=31.581, p<0.001). CONCLUSIONS: The findings indicated that role clarity and ethical behaviour among orthopaedic nurses were at a moderate level. Nursing managers can enhance nurses' ethical conduct by fostering accurate role perceptions and cultivating a supportive ethical environment within hospitals.