The Effects of Professional Autonomy on Employees' Perception of Its Ethical Climate and Job Satisfaction

Background: It is a global understanding to improve nurses’ professional autonomy is crucial to provide excellent nursing care. However, it is also clear, that the more professional autonomy grows, the more the conflict to the organizational custom is enlarged. The number of studies pertaining to the relationship between professional autonomy and the organizational climates is quite a few. This study aims to investigate how professional autonomy influences to perception of the ethical climate, as the result, to job satisfaction.

Methods: The candidates were gathered from nurses who working in two hospitals which have more than 300 beds-sized by a convenient sampling methodology. Following ethical guidelines of nursing research, the survey was performed by the mail returned- questionnaire in terms of professional autonomy, perception of its ethical climate, the preference of its ethical climate, and job satisfaction. As the measurement tool, DPBS (Dempster, 1990), ECS (Victor & Cullen, 1988) and MSQ (Weiss et.al, 1967) were adopted. DPBS has 4 subscales; Actualization, Empowerment, Readiness and Valuation. ECS has 7 categories; Egoism-Individual, Egoism-Local, Egoism-Cosmopolitan, Benevolence, Principle-Individual, Principle-Local, Principle-Cosmopolitan. MSQ has 3 categories; Intrinsic, Extrinsic, and Social. Each item was calculated by Likert scale.

Results: The number of eligible data was 310. The ratio of sex was 9:1(women:men).  The composition of population was 20s(45.3%), 30s(29.0%), 40s(15.1%), 50s(8.9%), 60s(1.7%). As the results of Pearson correlation analysis, every category of DPBS score was positively correlated with job satisfaction score (0.21<r<0.47, p<0.001). On the contrary, as for perception of .its ethical climate, Egoism-Individual and Egoism-Local climates score were negatively correlated to all categories of job satisfaction score (-0.34<r<-0.17, p<0.001). Spontaneously, Empowerment and Valuation, subscales of DPBS were negatively correlated to perception of Egoism climates (-0.19<r<-0.12, p<0.05). In order to demonstrate Structural Equation Model, ethical climate categories were divided into 3groups: Egoism, Benevolence, and Principle. At Egoism group, negative affection model was depicted (DPBS->JS 0.40*, Ego->JS -0.40*, CFI=0.93). At Benevolence group, model was not depicted. At Principle group, positive affection model was depicted but there was slight relationship (DPBS->JS 0.31*, Principle->JS 0.07. CFI=0.94). To determine the relationship with the preference of ethical climates, pass analysis was implemented. There was a positive effect in both Egoism and Principles groups (DPBS->Ego0.18*, Ego->JS0.38*, DPBS->JS0.36*, CFI=0.95; DPBS->Principle0.24*, Principle->JS 0.48*, DPBS->JS0.31* CFI=0.93). As a result, total effects of DPBS was 0.42(Egoism) and 0.42(Principle) each.

Discussion: DPBS score highly affected to nurses’ job satisfaction. However, the perception of ethical climate also influenced to their job satisfaction. Especially, Egoism-climates are characteristically negative affection to their job satisfaction.According to the depicted pass models, there was no different influence between job satisfaction and culture preference. It means DPBS originally affect to JS no matter with cultural preference, only with the perception to the cultural aspects.　 It should be encouraged for nursing managers to establish principle based culture to foster professional autonomy and improve job satisfaction although high automated nurses prefer egoism based culture.