How Competitive Orientation Influences Unethical Decision-making in Clinical Practices?

Purpose: This study aims to investigate how competitive orientation influences unethical decision-making (UDM) through relationship conflict and the moderating effect of hostile attribution bias. Methods: This study was conducted using a self-report questionnaire. Data were collected from 727 employees in Chinese hospitals. For each variable, measures were adopted or adapted from existing literature. Data were analyzed using descriptive statistics, correlation analysis, confirmatory factor analysis, and hierarchical regression analysis. Common method variance was established using Harman's single-factor test. Results: Competitive orientation is significantly and positively associated with relationship conflict (beta = .36, p < .001) and UDM (beta = .35, p < .001). Relationship conflict is significantly and positively associated with UDM (beta = .51, p < .001). Relationship conflict partially mediates the relationship between competitive orientation and UDM. In addition, hostile attribution bias strengthens the positive relationship between competitive orientation and UDM through relationship conflict. Conclusion: This study provides some implications for hospital employees to deal with ethical dilemmas in decision-making. Hospital employees including nurses, physicians, and other health-care professionals should raise awareness of competitive orientation and adopt a cooperative approach to human relations. Effective training programs should be utilized to direct all hospital employees to depress hostile attribution bias whenever possible to everything in clinical practice. (C) 2018 Korean Society of Nursing Science, Published by Elsevier Korea LLC.