護理人員短缺及高的離職率已成為全世界的議題。當然，有許多因素影響護理人員離職率，但是其中以工作滿意度、組織承諾及組織公民行為等經常作為預測離職傾向的前因變數。許多研究顯示，組織如果能創造一個強烈的倫理氣候，對於預防員工不倫理的行為是很重要的。但是，先前文獻探討不同倫理氣候類型與工作滿意度、組織承諾及組織公民行為各構面之之關係的文獻卻相當有限。因此，本研究將探討台灣醫療機構不同的倫理氣候對工作滿意度之影響，及不同類型的倫理氣候與工作滿意度各構面對組織承諾三種成份之影響，最後探討不同類型的倫理氣候、工作滿意度各構面及組織承諾三種成份對三種組織公民行為之影響，以多構面性地瞭解醫療機構管理當局應該增進或避免何種類型的倫理氣候以強化員工的不同構面的工作滿意度、組織承諾及組織公民行為。
首先，以結構方程模式（SEM）探討整體性的倫理氣候、工作滿意度、組織承諾及組織公民行各變項之關係，並瞭解模式之配適程度。此外，以階層迴歸探討不同的倫理氣候（關懷型、獨立型、法律與規範型、規則型及獨立型）對五種不同構面之工作滿意度（主管、同事、薪資、升遷及工作本身）之影響，及探討不同的倫理氣候與不同構面的工作滿意度對組織承諾三種成份（情感性承諾、持續性承諾及規範性承諾）的影響，最後探討五種倫理氣候、不同構面之工作滿意度及組織承諾三種成份對三種組織公民行為(角色內行為、人際利他行為及組織公益行為)之影響。本研究主要研究的對象為台灣地區醫院的護理人員，有效問卷為310份。主要的分析方法為描述性統計、變異數分析、信度分析、相關分析、結構方程模式及階層迴歸分析等。
主要研究發現為從整體模式可發現，倫理氣候對工作滿意度與組織公民行為有顯著正向影響，工作滿意度與組織承諾對組織公民行為也有顯著正向之影響，工作滿意度對組織承諾有顯著正向之影響，唯倫理氣候需透過工作滿意度來影響組織承諾，即工作滿意度對於倫理氣候與組織承諾具有中介效果。另外，醫院可藉由塑造組織不同的倫理氣候來影響護理人員不同構面的工作滿意度、組織承諾及組織公民行為，尤其以促進關懷型倫理氣候並避免功利型倫理氣候最為重要。因此，醫療機構可以加強護理人員的主管、同事及工作本身的工作滿意度，對促進員工的情感性、規範性承諾及人際利他行為是很重要的。最後，醫院應增加護理人員的情感性及規範性承諾，並避免持續性承諾，以發展員工的角色內行為、人際利他行為及組織公益行為。

The high turnover of nurses has become a global problem. Several studies have proposed that nurses’ perceptions of the ethical climate of their organization are related to higher job satisfaction, organizational commitment, and organizational citizenship behaviors, and thus lead to lower turnover. However, there is limited empirical evidence supporting a relationship among different types of ethical climate within organizations, facets of job satisfaction, the three components of organizational commitment, and organizational citizenship behavior types.
This study attempts to explore the different types of ethical climate that exist in hospitals, and the degree of job satisfaction, organizational commitment, and organizational citizenship behaviors of nurses in Taiwan. It uses SEM to understand the relationship among overall ethical climate, overall job satisfaction, overall organizational commitment, and overall organizational citizenship behaviors. The study uses hierarchical multiple regression to examine the relationship between ethical climate and facets of job satisfaction. It also examines the impact of different types of ethical climate and facets of job satisfaction on the three components of organizational commitment, and the impact of different types of ethical climate, facets of job satisfaction, and the three components of organizational commitment on three types of organizational citizenship behaviors.
Questionnaires were distributed to 310 nurses. The relationships among variables were assessed by confirmatory factor analysis (CFA), reliability, descriptive statistics, correlations, one-way ANOVA, SEM, and hierarchical multiple regression.
The important conclusion is that hospitals can increase job satisfaction, organizational commitment, and organizational citizenship behaviors by influencing an organization’s ethical climate. Hospital administrators can foster within organizations the climate types of caring, independent, and rules climate that increase satisfaction, while preventing organizations from developing the type of instrumental climate that decreases it. Furthermore, hospital administrators can foster the satisfaction of supervisors, co-workers, and work itself that increases affective and normative commitment. Finally, hospital administrators can foster affective and normative commitment that increase three types of organizational citizenship behaviors, and decrease continuous commitment.

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