Associação entre a advocacia do paciente e o clima ético na enfermagem
Keywords:
Health advocacy, Nursing Ethics, Nursing team, Primary health careAbstract
Objective: To evaluate the association between patient advocacy and the ethical climate in nursing. Materials e Methods: This is a cross-sectional study, through which it is possible to investigate a certain population at a particular moment, providing a portrait of how the variables are related, which was carried out in Primary Health Care in which all nursing professionals who are working in their sectors were invited to participate. The Data Confidentiality Agreement and the Free and Informed Confidentiality Agreement were signed. The questionnaire for sociodemographic and labor characterization and the validated instruments were applied in a virtual environment, using Google Forms®, an electronic research form. All precepts of Resolution 466/2012 were respected. Results: 112 nursing professionals participated, where the ethical climate was evaluated as positive (M=3.82; SD=0.96) and patient advocacy was shown to be adequate (M=3.29; SD=1.39). Patient advocacy is associated with the ethical climate (p<0.05). Conclusion: The association between patient advocacy and the ethical climate was highlighted as it is essential to guarantee the quality of care and patient safety. A healthy ethical climate promotes an environment where professionals feel encouraged and empowered to act for the benefit of patients, respecting their rights, autonomy and dignity.
References
Cosmo KO, Villagran CA, Lanes TC. Adaptação da protective nursing advocacy scale para a enfermagem na atenção primária à saúde: evidências de validade. Trabalho de conclusão de curso. Graduação em enfermagem. Universidade do Rio Verde, RV,Goiás, 2024.
Ibrahim AM. Nurses’ ethical responsibilities: Whistleblowing and advocacy in patient safety. Nursing Ethics. 2024; 31(7):1289-1314.
Hanks RG. Development and testing of an instrument to measure protective nursing advocacy. Nurs Ethics. 2010;17(2):255-67.
Ramsay A, Hartin P, McBain-Rigg K, Birks M. Advocating for patient safety: Power dynamics in nurse advocacy practice in Australia—An integrative review. Collegian.2025; 32:84–99.
Schutz TC, Lanes TC, Villagran CA, Bernardi CMS, Dalmolin GL. Fatores associados ao clima ético em ambiente hospitalar. Res Soc Dev. 2021 Feb18;10(2).
Dalmolin GL, Lanes TC, Bernardi CMS, Ramos FRS. Conceptual framework for the ethical climate in health professionals. Nurs Ethics. 2022;29(5):1174-85.
Lanes TC, Magnago ACS, Schutz TC, Carneiro AS, Morais BX, Dalmolin GL. Avaliação do clima ético nos serviços de saúde: revisão sistemática. Rev Bras Enferm. 2020;73(1):e20190054.
Martins MEP, Villagran CA, Lanes TC. Evidências de validade do hospital ethical climate survey -versão brasileira para atenção primária à saúde. Trabalho de conclusão de curso. Graduação em enfermagem. Universidade do Rio Verde, RV,Goiás, 2024.
Lanes, TC, Schutz TC, Pompeu KC, Pereira LA, Morais FS, Dalmolin GL. Associação do clima ético e variáveis laborais entre enfermeiros hospitalares. Reufsm.2023; 13:e49.
Fisher ML, Rosaneli CF, Farias MK, Martins GZ. E-caminho do diálogo: ambientes virtuais como espaço coletivo de construção ético. Rev Bioética. 2021;30(2):258-71.
Abadiga M, Nemera G, Hailu E, Mosisa G. Relationship between nurses’ perception of ethical climates and job satisfaction in Jimma University Specialized Hospital, Oromia region, south west Ethiopia. BMC Enferm. 2019;18(39).
Rivaz M, Asadi F, Mansouri P. Assessment of the Relationship between Nurses' Perception of Ethical Climate and Job Burnout in Intensive Care Units. Invest Educ Enferm. 2020 Oct;38(3):e12.
Pereira, M. G. Epidemiologia: Teoria e Prática. [9° reimpr.]. Rio de Janeiro: Guanabara Koogan, 2015.
Bolfarine H, Bussab W. O. Elementos de amostragem. São Paulo: Blucher; 2005
Toschewski-Barlem JG, Lunardi VL, Barlem ELD, Silveira RS, Dalmolin GL, Ramos AM. Adaptação transcultural e validação do instrumento Protective Nursing Advocacy Scalepara enfermeiros brasileiros. Rev. Latino-Am. Enfermagem jul.-ago. 2015;23(4):669-76. Doi: 10.1590/0104-1169.0214.2602
Olson LL. Hospital Nurses’ Perceptions of the Ethical Climate of Their Work Setting. J Nurs Scholarsh. 1998;30(43):345-349.
Lanes TC, Dalmolin GL, Silva AM, Ramos FRS, Olson LL. Cross-Cultural Adaptation of the Hospital Ethical Climate Survey to Brazil. J Nurs Meas. 2022; 2;31.
Cohen J. Weighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit. Psychological Bulletin, 70, 213-220, 1988
Brasil. Ministério da Saúde (BR). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Auto avaliação para a Melhoria do Acesso e da Qualidade da Atenção Básica: AMAQ 2012. Brasília: Ministério da Saúde, 2012.
Andrée, le, May. Commentary: Nurses’ assessment of the ethical climate of a university hospital in the South of Brazil. Journal of Research in Nursing, 2023. doi: 10.1177/17449871231154005.
Ramos AM, Barlem ELD, Barlem JGT, Rocha LP, Mattos LM. Preditores da advocacia em saúde identificados por enfermeiros no contexto hospitalar. Aquichan. 2018; 18(3):355-365. doi: 10.5294/AQUI.2018.18.3.9.
Vargas CP, Vargas MAO, Ramos FRS, Brito MJM, Barth PO, Caram CS. Advocacia do paciente por enfermeiros brasileiros no contexto da terapia intensiva. Revista Recien, 2022; 12(37):45–56. Doi: 10.24276/rrecien2022.12.37.45-56.
Ito AS, Andrade MBT, Leite EPRC, Terra FS, Silveira-Monteiro, CA. Exercício pelo enfermeiro da advocacia em saúde em defesa do paciente: revisão integrativa. Research, Society and Development. 2021; 10(10): e525101018956.doi: 10.33448/rsd-v10i10.18956.
Hatefimoadab N, Cheraghi MA, Benton DC, Pashaeypoor S. Ethical advocacy in the end-of-life nursing care: A concept analysis. Nursing Forum. 2021; 57(1):127-135. doi: 10.1111/nuf.12656
Mrayyan1 MT, Abunab HY, Khait1 AA, Rababa MJ, Al-Rawashdeh1 S, Algunmeeyn A, Saraya AA. Competency in nursing practice: a concept analysis BMJ Open. 2023; 13:e067352. doi:10.1136/bmjopen-2022-067352.
Essex R, Thompson T, Evans TR, Fortune V, Kalocsányiová E, Miller D, Markowski M, Elliott H. Ethical climate in healthcare: A systematic review and meta-analysis. Nursing ethics. 2023;30(7-8):9697330231177419. doi: 10.1177/09697330231177419.
Dziurka M, Ozdoba P, Olson L, Jedynak A, Ozga D, Jurek K, Dobrowolska B. Hospital ethical climate survey - selected psychometric properties of the scale and results among polish nurses and midwives. BMC Nursing. 2022; 21:295. doi: 10.1186/s12912-022-01067-x.
Okumoto A, Yoneyama S, Miyata C, Kinoshita A. The relationship between hospital ethical climate and continuing education in nursing ethics. PLOS ONE. 2022; 17(7). doi: 10.1371/journal.pone.0269034.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Revista de Divulgação Científica Sena Aires

This work is licensed under a Creative Commons Attribution 4.0 International License.
-
Atribuição — Você deve dar o crédito apropriado, prover um link para a licença e indicar se mudanças foram feitas. Você deve fazê-lo em qualquer circunstância razoável, mas de nenhuma maneira que sugira que o licenciante apoia você ou o seu uso.
- Sem restrições adicionais — Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita.
