Organizational determinants of professional ethics among healthcare workers: implications for health system...

Professional ethics is a critical component of healthcare workforce performance and plays an essential role in patient safety, service quality, and organizational accountability. However, professional ethics may be influenced by workplace conditions and individual competencies. This study aimed to evaluate the predictive role of occupational stress and information literacy on professional ethics among healthcare employees while accounting for the potential confounding effects of sociodemographic characteristics.

This cross-sectional study was conducted among 336 staff members of Sarab University of Medical Sciences selected through multi-stage cluster random sampling (April-August 2024). Data were collected using standardized instruments: the Cadozier Professional Ethics Questionnaire, the Information Literacy Scale, and the HSE Job Stress Questionnaire. After applying rank-based inverse normal transformation to non-normal variables, analyses included descriptive statistics, independent t-tests, ANOVA, Pearson correlations, and hierarchical multiple regression to assess predictive factors.

Professional ethics was strongly correlated with information literacy (r = 0.702, p < 0.001) and with higher HSE job stress scores, indicating lower levels of occupational stress (r = 0.543, p < 0.001), whereas demographic characteristics showed no significant associations except income (p < 0.001). In the final regression model, information literacy was the strongest predictor of professional ethics (β = 0.561, p < 0.001), followed by lower occupational stress (β = 0.213, p < 0.001). Demographic factors accounted for only a small portion of the variance (R² = 0.135), while the full model explained 55.6% of the variance in professional ethics scores.

Professional ethics among healthcare employees is shaped not only by individual values but also by workplace stressors and cognitive competencies. Interventions aimed at reducing occupational stress and strengthening information literacy may enhance professional ethics, improve workforce performance, and contribute to health system quality improvement. Future research should explore causal mechanisms and evaluate targeted organizational interventions.