The mediating role of ethical culture and psychological safety in determining the effects of health professionals' perceptions of organizational trust and organizational support on their whistleblowing tendency

The aim of this study is to reveal the mediating role of psychological security and ethical organizational culture perceptions in the effect of organizational trust and organizational support perceptions in the whistleblowing tendencies of health workers against ethical/illegal events that occur in health institutions. For this purpose, a model was created and it was planned to determine the direct and indirect interactions of the study variables and to develop models with confirmatory character. Quantitative research method was used in the study and the data were generally obtained through online, partially face-to-face surveys. The universe of the study consists of 12,669 employees working in 18 hospitals with JCI quality and accreditation certificates serving in the province of Istanbul. The sample of the study consists of 589 employees, who were easily reached by sampling technique. Many analysis techniques were used in the study. These, respectively, were descriptive statistics, exploratory factor analyses, difference analyses, confirmatory factor analysis, path analysis and mediation analysis. Data analysis was carried out using Microsoft Excel, IBM SPSS 25 and AMOS 24 package programs. The findings and results obtained in the study generally include the perspectives of the health professionals who perform their profession in private hospitals that have the JCI Quality and Accreditation certificate. As a result of the exploratory factor analysis, it was seen that whistleblowing was divided into three dimensions and internal whistleblowing was the dimension that best represented whistleblowing. It has been seen that organizational trust is divided into three dimensions and emotional trust is the dimension that best represents organizational trust. It has been seen that the perception of organizational support is divided into two dimensions and that institutional support is the dimension that best represents organizational support. It has been seen that ethical organizational culture is divided into two dimensions and openness is the dimension that best represents ethical organizational culture. It has been observed that psychological safety is one-dimensional. According to the results of the confirmatory factor analysis, it was seen that the CR, AVE and Cronbach Alpha values of the variables were above the threshold values and the model fit values were sufficient. According to the results of the path analysis, it was seen that the variables in the model of the study had a significant relationship and the model fit values were found to be at a sufficient level. In other words, it was seen that the study model was generally confirmed. In the model, it was observed that the perception of career support did not have an effect on any dependent or mediator variable and was excluded from the model. According to the results of the mediation analyzes conducted in the study, it was seen that openness and applicability, which are the sub-dimensions of ethical culture, were mediating variables in the effect of organizational trust and organizational support sub-dimensions on the perceptions of internal whistleblowing and indifference. Since the independent variables did not have an effect on the perception of external whistleblowing, mediation analyzes were not performed and the relevant hypotheses were rejected. It has been observed that the perception of psychological security is a mediating variable on organizational support, internal whistleblowing and indifference. In the analysis conducted using latent variables, it was found that ethical culture acts as a complete mediator in the relationship between organizational trust and support perception and its impact on whistleblowing, whereas the mediating effect of psychological safety was not observed. Accordingly, it is predicted that it will provide great benefits in the functioning of the whistleblowing mechanism, with the increase in ethical culture and psychological security perception, as well as organizational support and organizational trust in health institutions.