International journal of older people nursing · 2026
Nurses' Ethical Competence, Perceived Ethical Climate and Stereotypes of Older Adults: A Cross Sectional Survey.
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Arjama Anna-Liisa, Kangasniemi Mari, Suhonen Riitta
Аннотация
INTRODUCTION: Nurses' ethical competence and the ethical climate of healthcare settings are critical in promoting high-quality and individualised care. However, these factors may also contribute to various stereotypes that healthcare professionals hold towards older adults, potentially hindering the recognition of patients' individuality. The aim of this study was to investigate possible associations between nurses' characteristics, ethical competence, perceived ethical climate and stereotypes towards older adults in long-term care settings.
METHODS: This was a cross sectional survey study. Nurses working in long-term care settings for older adults in Finland participated in the study between 2024 and 2025. The survey included three self-administered instruments: the Ethical Competence Questionnaire, [Hospital] Ethical Climate Survey and Stereotype Content and Strength Survey. The data were analysed using multiple regression models to identify associations between nurses' characteristics, ethical competence, perceived ethical climate and stereotypes regarding older adults.
RESULTS: A total of 409 nurses participated. The participants rated their ethical competence and perceived ethical climate of their workplace as moderate or good. Both factors were statistically significantly associated with positive stereotypes towards older adults but not with negative stereotypes. Most participants (89%) held employee positions and had vocational degrees (65%). Younger age was associated with stronger stereotypes. When the independent variables of ethical competence and ethical climate were tested together, ethical competence alone no longer explained positive stereotypes, but ethical climate did, even after adjusting for age.
CONCLUSION: This study confirms that nurses' ethical competence and perceived ethical climate support each other. Strengthening these elements can help alleviate stereotypes about the residents in long-term care settings. Maintaining and developing these factors can promote the delivery of high-quality, individualised care. To mitigate stereotypes regarding LTCS residents, the nurse manager can create structures that strengthen ethical competence and support an ethical climate. Further research is needed to clarify the determinants that inform nurses' assessments of stereotypes towards older adults in long-term care settings.
IMPLICATIONS FOR PRACTICE: Ethical climate is associated with the content and strength of stereotypes that nurses have towards older adults. Therefore, maintaining and developing an ethical climate is important. Every nurse can promote an ethical climate by improving their ethical competence and promoting positive relationships with different stakeholders. In addition, it is worth creating structures in organizations that strengthen nurses' ethical competence and ethical climate.
METHODS: This was a cross sectional survey study. Nurses working in long-term care settings for older adults in Finland participated in the study between 2024 and 2025. The survey included three self-administered instruments: the Ethical Competence Questionnaire, [Hospital] Ethical Climate Survey and Stereotype Content and Strength Survey. The data were analysed using multiple regression models to identify associations between nurses' characteristics, ethical competence, perceived ethical climate and stereotypes regarding older adults.
RESULTS: A total of 409 nurses participated. The participants rated their ethical competence and perceived ethical climate of their workplace as moderate or good. Both factors were statistically significantly associated with positive stereotypes towards older adults but not with negative stereotypes. Most participants (89%) held employee positions and had vocational degrees (65%). Younger age was associated with stronger stereotypes. When the independent variables of ethical competence and ethical climate were tested together, ethical competence alone no longer explained positive stereotypes, but ethical climate did, even after adjusting for age.
CONCLUSION: This study confirms that nurses' ethical competence and perceived ethical climate support each other. Strengthening these elements can help alleviate stereotypes about the residents in long-term care settings. Maintaining and developing these factors can promote the delivery of high-quality, individualised care. To mitigate stereotypes regarding LTCS residents, the nurse manager can create structures that strengthen ethical competence and support an ethical climate. Further research is needed to clarify the determinants that inform nurses' assessments of stereotypes towards older adults in long-term care settings.
IMPLICATIONS FOR PRACTICE: Ethical climate is associated with the content and strength of stereotypes that nurses have towards older adults. Therefore, maintaining and developing an ethical climate is important. Every nurse can promote an ethical climate by improving their ethical competence and promoting positive relationships with different stakeholders. In addition, it is worth creating structures in organizations that strengthen nurses' ethical competence and ethical climate.