Level of knowledge on ethical principles in nursing professionals and their relationship with dilemmas in care practice: cross-sectional study in a teaching hospital in Santiago de Cuba

Abstract

Introduction: Ethical competence is essential in nursing practice; however, Cuban studies assessing knowledge of ethical principles and its relationship with ethical dilemmas in hospital settings remain limited. Objective: To characterize the level of knowledge of ethical and moral principles among nursing professionals and to analyze its relationship with sociodemographic and occupational variables, as well as the presence of ethical dilemmas in clinical practice. Methods: An observational, descriptive, cross-sectional study with an analytical component was conducted at Roberto Infante Pascual Teaching Hospital, Santiago de Cuba, between 2024 and 2025. All 54 nursing professionals working at the institution were included. Data were collected using a researcher-developed questionnaire with satisfactory content validity (Content Validity Index=0.94) and internal consistency (Cronbach’s alpha=0.86). Descriptive statistics and Fisher’s exact test were used to assess associations, with a significance level of p<0.05. Results: Female participants (90.7%) and those aged 35–45 years (43.9%) predominated. Overall, 66.7% of participants showed an inadequate level of knowledge of ethical and moral principles. No significant associations were found between knowledge level and professional qualification (p=0.083) or hospital department (p=0.697). A statistically significant association was identified between the presence of ethical dilemmas and the level of knowledge (p=0.030). Conclusions: An inadequate level of knowledge predominated. The association between ethical dilemmas and knowledge level highlights the need to strengthen bioethics education among nursing professionals.