Ethical climate perception and sustainability attitude among nurses: The mediating role of professional self-efficacy<sup></sup>

This study aimed to examine the relationships among ethical climate perception, professional self-efficacy, and sustainability attitudes among nurses and to investigate the mediating role of professional self-efficacy. The study used a cross-sectional design with 257 nurses from a public hospital. Data were collected using the Ethical Climate Scale, the Professional Self-Efficacy Scale, and the Sustainability Attitude Scale. Descriptive statistics, correlation analysis, regression analysis, and mediation analysis using Hayes' PROCESS Model 4 were performed. The findings revealed significant positive relationships among ethical climate perception, professional self-efficacy, and sustainability attitudes (p < 0.01). While professional self-efficacy significantly predicted sustainability attitudes, ethical climate perception did not have a significant direct effect on sustainability attitudes. The mediation analysis demonstrated that professional self-efficacy played a significant mediating role in the relationship between ethical climate perception and sustainability attitudes (95% Bootstrap CI: 0.096–0.267). These findings indicate that ethical climate indirectly strengthens nurses' sustainability attitudes through professional self-efficacy. Therefore, fostering ethical work environments and enhancing nurses' professional self-efficacy may promote sustainability in healthcare services.