Community Nurses' Perception of Factors Influencing Knowledge and Understanding of Code of Ethics and Professional Conduct


  • Nurul Nazurah Julaini PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam
  • Hamidun Sanif Ministry of Health, Brunei Darussalam
  • Yusrita Zolkefli PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam.



Code of Ethics, Professional Conduct, Community, Nurses, Knowledge, Understanding


Background: Nurses play a significant role in health care and have the most direct contact with patients, making them the most likely to encounter ethical questions regularly. Therefore, their knowledge and understanding of the code of ethics and professional conduct are essential. In Brunei Darussalam, these codes were developed in 2010 by the Nursing Board for Brunei, Ministry of Health. However, factors influencing nurses' knowledge and understanding of these codes have not yet been studied.  Objectives: The purpose of this study was to examine community nurses' perception of factors influencing knowledge and understanding of the codes. Methods: A qualitative research approach was used as the study design. The data were collected through individual and group semi-structured interviews and analysed using the qualitative thematic analysis method. This study was conducted on community nurses who hold managerial responsibility in four health centres in Brunei. Findings: Three factors were identified to influence Bruneian nurses' knowledge and understanding of the codes. These factors were "a lack of reinforcement", "nurses' attitude", and "work environment". Conclusion: The knowledge of the codes by community nurses is deemed to be adequate. The findings, however, highlight the need for nurses to have an enhanced understanding of the codes.


Koshy P. A study to assess the knowledge regarding legal and ethical concepts in the care of

children among staff nurses in selected hospital in M.P. International Journal of Science and Research (IJSR). 2016; 5(9):1454-1457.

Momennasab M, Koshkaki AR, Torabizadeh, C, Tabei SZ. Nurses' adherence to ethical

Codes: The viewpoints of patients, nurses, and managers. Nursing Ethics. 2015; 23(7):794-803.

Oguisso, T, Takashi, MH, de Freitas GF, Bonini BB, da Silva TA. First international code of ethics for nurses. Texto Contexto Enferm. 2018; 28.

De Casterle BD, Izumi S, Godfrey NS, Denhaerynck K. Nurses' responses to ethical dilemmas in nursing practice: a meta-analysis. Jan Review Paper. 2008; 63(6):540-549.

White J, Phakoe M, Rispel LC. 'Practice what you preach': Nurses' perspectives on the Code of Ethics and Service Pledge in five South African hospitals. Global Health Action Journal. 2015; 8(1).

Jane D. Development of an individual's ethical behaviour. 2011. Available from: Http://nursingcrib/nursing_notes_reviewer_fundamental.nursing/ethical_behavior.

Butts JB, Rich KL. Nursing ethics: across the curriculum and into practice. Jones & Bartlett Learning. 2013:146-149.

Corley M. Nurse moral distress: a proposed theory and research agenda. Nursing Ethics. 2002; 9(6):636-650.

Joolaee S, Joolaei A, Tschudin V. Caring relationship: the core component of patients' rights practice as experienced by patients and their companions. J Med Ethics Hist Med. 2010; 3(4).

Jane D. Fundamental ethical issues. 2010. Available from: Http://

Aitamaa E, Leino-Kilpi H, Puukka, P. Ethical problems in nursing management: the role of code of ethics. Nursing Ethics. 2010; 17(4):469-482.

Hafez FE, Mohamed HA, Eltabey Sobeh D. Assessment of nurses' knowledge and practice regarding professional ethics in outpatient clinics at Mansoura University Hospital. IOSR Journal of Nursing and Health Science. 2016; 5(6):20-28.

Timilsina A, Bhagawati KC. Level of knowledge and practice of patient care ethics among nurses in Pokhara. Janapriya Journal of Interdisciplinary Studies. 2017; 6:17-28.

Humphries A, Woods MA. Study of nurses' ethical climate perceptions: Compromising in an uncompromising environment. Nursing Ethics. 2015:1-12.

Chau JPC, Lam LW, Lui MHL, Ip, WY, Chien WT, Lee IFK, Thompson DR. A survey of registered nurses' perceptions of the code of professional conduct in Hong Kong. Journal of Clinical Nursing. 2010; 19:23-24.

Nursing Board for Brunei. Code of Ethics for Registered Nurses and Midwives in Brunei Darussalam. Ministry of Health, Brunei Darussalam; 2010.

Nursing Board for Brunei. Code of Professional Conduct for Registered Nurses and Midwives in Brunei Darussalam. Ministry of Health, Brunei Darussalam; 2010.

Braun V, Clarke V. Thematic analysis: A practical guide. London: Sage; 2020.

Duchscher JE. Catching the wave, understanding the concept of critical thinking. Journal of Advanced Nursing. 1999; 29(3):577-583.

Shrestha S, Jose P. Knowledge & practice of nursing ethics and laws. Journal of Universal College of Medical Sciences. 2014; 2(7):30-33.

Adams D, Miller B. Professionalism in nursing behaviours of nurse practitioners. J Prof Nurs. 2001; 17(4):203-210.

Aliyu D. Knowledge, attitude and practice of nursing ethics and law among nurses at Federal Medical Centre, Bida. American Journal of Health Research. 2015; 3(1):32.

Hariharan S, Jonnalagadda R, Walrond E, Moseley H. Knowledge, attitudes and practice of healthcare ethics and law among doctors and nurses in Barbados. BMC Medical Ethics. 2006; 7(1).

Aghdam AM, Hassankhani H, Zamanzadeh V. Knowledge and performance about nursing ethic codes from nurses' and patients' perspective in Tabriz teaching hospitals, Iran. Scandinavian Journal of Caring Sciences. 2013; 2(3):219-227.

Dehghani A, Mosalanejad L, Dehghan-Nayeri N. Factors affecting professional ethics in nursing practice in Iran: a qualitative study. BMC Medical Ethics. 2015; 16(1).

Adib HM, Salsali M, Ahmadi F. A qualitative study of Iranian nurses' understanding and experiences of professional power. Hum Resour Health. 2004; 2(1):9–11.

Gastmans C, Verpeet, E. 30th anniversary commentary on Esterhuizen: is the professional code still the cornerstone of clinical nursing practice? J Adv Nurs. 2006; 53(1):111–112.

Nasrabadi AN, Emami A, Yekta ZP. Nursing experience in Iran. Int J NursPract. 2003; 9(2):78–86.

Harrowing JN, Mill J. Moral distress among Ugandan nurses providing HIV care, a critical ethnography. Int J Nurs Stud. 2010; 47(6):723–731.




How to Cite

Julaini , N. N. ., Sanif , H. ., & Zolkefli, Y. (2021). Community Nurses’ Perception of Factors Influencing Knowledge and Understanding of Code of Ethics and Professional Conduct . INTERNATIONAL JOURNAL OF CARE SCHOLARS, 4(Supp1), 79–85.




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