Ethical culture and climate in nursing: A bibliometric review

Ethical culture and climate are key factors that shape the quality of nursing care in healthcare settings. Together, these constructs provide a framework for tackling moral dilemmas and supporting nurses as they navigate ethical challenges in patient care. Despite progress in understanding these concepts, systemic issues remain. The increasing number of studies on this topic in recent years highlights the importance of issues related to ethical culture and climate in healthcare settings. The present study employs a bibliometric method to analyze and examine 251 documents published in the Web of Science database, aiming to provide a comprehensive review of the literature and science mapping of the field of ethical culture. It also seeks to identify historical and contemporary research streams and analyze the evolutionary trends in this domain. The results indicate that two historical research streams in the field of ethical culture have evolved into four contemporary streams, with topics such as ethical leadership, professional ethics, and resilience gaining increased significance. We have also identified and introduced the most influential authors, documents, and sources in the field of ethical culture. Finally, the study examines potential future research directions in this domain. Recommendations include strengthening ethical leadership, using reflective practices such as ethics rounds, and encouraging cross-cultural research to address diverse healthcare environments. By addressing moral distress and improving organizational support, healthcare facilities can retain nurses, enhance patient care, and advance ethical nursing practices.