Analysis of the Current Status and Influencing Factors of ICU Nurses' Ethical Behaviour: A Multicentre Cross‐Sectional Study

ABSTRACT Background The ethical behaviour of ICU nurses is closely related to their own psychological health, patient safety and quality of care. Current research shows that the practice of ethical behaviour of nurses faces serious challenges, the level of practice needs to be improved and few scholars pay attention to the special group of ICU nurses. Therefore, it is necessary to conduct an in‐depth study on the ethical behaviour of ICU nurses. Aim We aimed to understand the current status of ethical behaviour among ICU nurses and analyse its influencing factors. Study Design A multicentre cross‐sectional study was conducted using the cluster sampling method. Between February and June 2025, ICU nurses from 10 tertiary Grade A hospitals in Guizhou Province, China, were selected. We used general information questionnaires, the Ethical Behaviour Scale for Nurses‐Revise, the Moral Sensitivity Questionnaire‐Revised Version into Chinese, the Rushton Moral Resilience Scale and the Ethical Leadership at Work Questionnaire for the investigation. Descriptive analysis, t ‐tests, ANOVA, correlation analysis and multiple linear regression analysis were used to analyse the results. Results A total of 405 ICU nurses were included, and the ethical behaviour score of ICU nurses was 62.32 ± 5.95 (range 15–90), with the highest score of 22.33 ± 2.32 for the risk prevention dimension and the lowest score of 19.05 ± 2.70 for the fair nursing dimension. The results of multiple linear regression analysis revealed that position ( β = 2.266, p = 0.009), whether ethics‐related training has been received ( β = 1.540, p = 0.004), moral sensitivity ( β = 0.326, p < 0.001), moral resilience ( β = 0.109, p < 0.001), and ethical leadership ( β = 0.196, p < 0.001) were the factors influencing the ethical behaviour of ICU nurses. Conclusions The ethical behaviour of ICU nurses is at a moderate level and needs to be further improved, with position, whether ethics‐related training has been received, moral sensitivity, moral resilience and ethical leadership confirmed as significant influences. Relevance to Clinical Practice We identified key intervenable factors to enhance the ethical behaviour of ICU nurses. In future practice, healthcare organisations and nursing administrators should focus on strengthening ethical leadership, ensuring full coverage of ethical training and enhancing the moral sensitivity and resilience of ICU nurses, so as to effectively promote the practice of ethical behaviour.