Evidence map›Paper›PMID 40713613›Full record

Trial reportBMC medical ethics2025

Effects of ethics communication in health care: a cluster randomised controlled trial.

Brännström Margareta, Isaksson Ulf, Fischer Grönlund C

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medical ethics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05146102 (Ethics Communication in Groups Among Healthcare Professionals), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05146102 naunknown statusnot on this map

Ethics Communication in Groups Among Healthcare Professionals (The Ethics-com Study).

TypeinterventionalSponsorUmeå UniversityRan2021 to 2022Enrolled100ConditionsEthics SupportArmsethics communication in group, in line with "the one to five-step method"
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Workplace Mental Health Programs for Healthcare Workers: A Systematic Review.International journal of environmental research and public health · 2026
    Pooled it
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Brännström MargaretaDepartment of Nursing, Umeå University, Umeå, Sweden. margareta.brannstrom@umu.se.
Isaksson UlfDepartment of Nursing, Umeå University, Umeå, Sweden.
Fischer Grönlund CDepartment of Nursing, Umeå University, Umeå, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies show that healthcare professionals encounter ethically difficult situations in everyday clinical practice, and there is a need for interprofessional communication in organised forms. Ethics communication in groups (ECG), based on Habermas's theory of communicative actions, is a form of support for interprofessional communications about ethical issues. The 'one to five method' is a practical tool for healthcare professionals with education in ethics to facilitate ECG in everyday clinical practice. RESEARCH

aimTo evaluate the effects of organised ECG using the 'one to five' method for health care professionals concerning moral distress and ethical climate at wards with round-the-clock care compared with a control group. RESEARCH

designThis was a prospective cluster randomised study with an open, non-blinded design.

methodsNine wards with different medical specialisations at one university hospital were purposefully and then randomly allocated to an intervention group (IG) (n = 5) and a control group (CG) (n = 4). An ECG was performed monthly for six months in the intervention group. Prospective assessments were made at 3 and 6 months using the Measure of Moral Distress-Healthcare Professionals (MMD-HP), Moral Distress Thermometer (MDT), and the Swedish Ethical Climate Questionnaire (SwECQ).

resultBetween-group analyses showed no significant differences in moral distress over time. Within-group analysis revealed that the intervention group scored lower moral distress concerning clinical causes at the patient level at the 3-month measurement point but returned to the same level as the control group at six months. The ethical climate was rated higher in the intervention group at 3 and 6 months.

conclusionParticipation in ECG likely fosters shared values and an enhanced ethical climate, though no significant differences in moral distress were observed. Moral distress may persist despite interventions, but open dialogue and professional growth can foster moral resilience. This study found a positive relationship between an ethical climate and participation in ethics communication groups (ECG) using the 'one to five method.' However, the small sample size limited statistical power. Future research should include larger-scale, multicentre studies and qualitative research to explore experiences with ECG.

trial registrationClinicalTrials.gov : NCT05146102 (2021-11-05).

Indexed as

CommunicationDelivery of Health CareHealth PersonnelAdultAttitude of Health PersonnelFemaleHumansMaleMiddle AgedMoralsProspective StudiesSurveys and QuestionnairesSwedenCESClinical ethics supportCluster randomised studyEthical climateEthics communication in groupsEthics com studyInterventionMoral distress

Identifiers

PMID40713613
PMCPMC12297816

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.