Interventions for the promotion of the ethical environment among health professionals: Scoping review.

Abstract

Background: Education is a tool for the promotion of ethical skills that ensure the principles of conduct and the quality of care provided. The literature is still incipient in this theme; however, some studies point to education and ethical consultations as strategies to promote an ethical environment.

Objective: To map the interventions that aim to prospect the ethical environment in health services.

Method: Scoping review to answer the question "What interventions are being used by health professionals to prospect an ethical environment in health services?" It occurred in the Medline (PubMed), CINAHL with Full Text (EBSCO), Scopus, Embase (Elsevier), and Web of Science databases in January 2023 by two reviewers, via the Rayyan platform. Articles with health professionals addressing interventions to prospect the ethical environment in any health service were included, without time frame. A form was used for data extraction and analysis occurred via Bardin content analysis. The review protocol was registered in the Open Science Framework.

Results: 2429 records were found; however, only 12 articles were included for analysis, these being randomized, cross-sectional, descriptive, and qualitative studies. Among the interventions, it was noticed that 58.3% (n = 7) is about ethical education, 16.7% (n = 2) about ethical guidelines and codes, 16.7% (n = 2) about ethical reflection and leadership, and 8.3% (n = 1) of ethical consultations. A theoretical map was elaborated, and four types of interventions were identified, based on ethical consultation, ethical education, guidelines and codes of ethics, reflection, and ethical leadership.

Conclusions: The interventions were considered effective to prospect the ethical environment in health services, and their effectiveness was evaluated by validated instruments, as well as through interviews and focus groups.