Factors related to implementation of nursing care ethical principles in Indonesia

  • Ilkafah Ilkafah | ilkafah@vokasi.unair.ac.id Nursing Program, Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia. https://orcid.org/0000-0002-6365-0065
  • Anestesia Pangestu Mei Tyas Nursing Program, Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia.
  • Joni Haryanto Faculty of Nursing, Universitas Airlangga, Surabaya , Indonesia.


Background: The implementation of ethical principles is crucial in carrying out nursing care, since it is part of the 12 basic competencies, that should be possessed by a nurse. This study aims to analyze the factors associated with the implementation of nurses' ethical principles.
Design and Methods: This study used a quantitative research design, with a cross-sectional approach. The participants consisted of 389 nurses, working in the medical ward of the hospitals, in Indonesia. Data were analyzed using the bivariate analysis, t-test, ANOVA and multiple linear regression test.
Results: There were no significant relationships between the demographic factors and the ethical behaviour. There was a relationship between caring behaviour and the application of ethical principles (p=0.000, and a correlation coefficient of 0.602).
Conclusion: Nurse ethical behaviour was improved, by increasing their caring attitude.



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Haddad LM, Geiger RA. Nursing ethical considerations. Treasure Island: StatPearls Publishing; 2020.

Sorrell JM. Errors: Shaping a culture of safety in healthcare. Online J Issues Nurs 2017;22:2.

Schröder-Bäck P, Duncan P, Sherlaw W, et al. Teaching seven principles for public health ethics: Towards a curriculum for a short course on ethics in public health programmes. BMC Med Ethics 2014;15:1‑10. DOI: https://doi.org/10.1186/1472-6939-15-73

Tschudin V. Nursing ethics: The last decade. Nurs Ethics 2010;17:127‑31. DOI: https://doi.org/10.1177/0969733009352408

Marquis BL, Huston CJ, Marquis BL, et al. Leadership roles and management functions in nursing: Theory and application. Philadelphia: Lippincott Williams & Wilkins; 2012.

Peter E. Ethics in healthcare: Nurses respond. Online J Issues Nurs 2018;23.

Mohajjel-Aghdam A, Hassankhani H, Zamanzadeh V, et al. Knowledge and performance about nursing ethic codes from nurses’ and patients’ perspective in Tabriz teaching hospitals, Iran. J Caring Sci 2013;2:219‑27.

Watson J. Assessing and measuring caring in nursing and health sciences. Springer; 2009.

Indonesian National Nurses Association. [Pedoman perilaku sebagai penjabaran kode etik keperawatan (Code of conduct as an elaboration of the nursing code of ethics)].[Book in Indonesian]. Jakarta: DPP PPNI; 2017.

Poikkeus T, Leino-Kilpi H, Katajisto J. Supporting ethical competence of nurses during recruitment and performance reviews - the role of the nurse leader. J Nurs Manag 2014;22:792‑802. DOI: https://doi.org/10.1111/jonm.12033

Suhonen R, Stolt M, Habermann M, et al. Ethical elements in priority setting in nursing care: A scoping review. Int J Nurs Stud 2018:25‑42. DOI: https://doi.org/10.1016/j.ijnurstu.2018.08.006

Safavi F, Ebrahimi H, Namdar Areshtanab H, et al. Relationship between demographic characteristics and ethical reasoning of nurses working in medical wards. J Clin Diagnostic Res 2018;12:LC01‑4. DOI: https://doi.org/10.7860/JCDR/2018/32521.11883

Ministry of Health of the Republic of Indonesia. [Regulation of the Minister of Health of the Republic of Indonesia Number 42 of 2018 concerning the Ethics and Law Committee of Hospitals].[In Indonesian]. 2018.

Dehghani A, Mosalanejad L, Dehghan-Nayeri N. Factors affecting professional ethics in nursing practice in Iran: a qualitative study. BMC Med Ethics 2015;16:1‑7. DOI: https://doi.org/10.1186/s12910-015-0048-2

Zhang N, Li M, Gong Z, et al. Effects of ethical leadership on nurses’ service behaviors. Nurs Ethics 2019;26:1861‑72. DOI: https://doi.org/10.1177/0969733018787220

Özden D, Arslan GG, Ertuğrul B, et al. The effect of nurses’ ethical leadership and ethical climate perceptions on job satisfaction. Nurs Ethics 2019;26:1211‑25. DOI: https://doi.org/10.1177/0969733017736924

Devik SA, Munkeby H, Finnanger M, et al. Nurse managers’ perspectives on working with everyday ethics in long-term care. Nurs Ethics 2020;27:1669‑80. DOI: https://doi.org/10.1177/0969733020935958

Watson J. Nursing science as contex: The philosophy and science of caring. Boulder: University Press of Colorado; 2008.

Milliken A. What it is and why it matters. Online J Issues Nurs 2018;23.

Black BP. Professional nursing concepts & challenges. Elsevier; 2014.

Ozan YD, Okumus H, Lash AA. Implementation of Watson’ s theory of human caring: A case study. Int J Caring Sci 2015;8:25‑35.

Berhe H, Berhe H, Bayray A, et al. Status of caring, respectful and compassionate health care practice in Tigrai Regional State: Patients’ perspective. Int J Caring Sci 2017;10:1118‑28.

Liu J, Mok E, Wong T. Caring in nursing: investigating the meaning of caring from the perspective of cancer patients in Beijing, China. J Clin Nurs 2006:188‑96. DOI: https://doi.org/10.1111/j.1365-2702.2006.01291.x

Linton M, Koonmen J. Self-care as an ethical obligation for nurses. Nurs Ethics 2020;27:1694‑702. DOI: https://doi.org/10.1177/0969733020940371

Al-Breiki M. What influence nurses practice more: Law or ethics. JOJ Nurse Health Care 2017;5:3‑5.

Ethics Approval
This study has been approved by the Health Research Ethics Committee of Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia (No. 2063-KEPK)
Caring, ethical principles, nurses, nursing care
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How to Cite
Ilkafah, I., Mei Tyas, A. P., & Haryanto, J. (2021). Factors related to implementation of nursing care ethical principles in Indonesia. Journal of Public Health Research, 10(2). https://doi.org/10.4081/jphr.2021.2211