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Azizi Z, Naghizadeh MM, Bijani M. The relationship between moral courage, team work, and safe nursing care in clinical nurses: a multicenter cross-sectional study in Iran. BMC Nurs 2024; 23:411. [PMID: 38898506 PMCID: PMC11186086 DOI: 10.1186/s12912-024-02097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Moral courage and team work are the most important aspects of professional competence in clinical nurses; nurses with moral courage and team work are thought to be able to deliver safe nursing care to patients. The present study aimed to investigate whether moral courage and teamwork correlate with safe nursing care among clinical nurses. METHODS This descriptive cross-sectional multicenter study was carried out from December 2023 to February 2024. A total of 375 nurses who were practicing in four hospitals in the south of Iran were enrolled in this study using convenience sampling. The data collection tools used consisted of a demographics survey, Moral Courage Questionnaire (MCQ), Team STEPPS Team Perception Questionnaire (T-TPQ), and the Assessment of Safe Nursing Care Questionnaire (ASNCQ). The data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson's correlation coefficient. SPSS version 22 was used to analyze the data. RESULTS The participants' mean age was 32.66 ± 6.63 years, and their work experience was 8.56 ± 6.22 years. The total mean scores for moral courage, teamwork, and safe care were 422.37 ± 52.92, 144.09 ± 18.43, 315.84 ± 41.95, respectively. A statistically significant positive correlation was found between teamwork and safe care (r = 0.57, p < 0.001), teamwork and moral courage (r = 0.49, p = 0.002), and moral courage and safe nursing care (r = 0.59 p < 0.001). According to the results, work experience, moral courage, and teamwork explained 44.4% of the variance in safe nursing care (R2 = 0.44, p < 0.001). CONCLUSION The results indicated that the moral courage and teamwork of nurses were positively and significantly correlated with the participants' safe nursing care. Accordingly, since moral courage and teamwork are the qualities that can contribute to improving the quality of care and ensuring safe nursing care, it is recommended that nursing managers pay special attention to these factors.
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Affiliation(s)
- Zahra Azizi
- Student Research Committee, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, 81936-13119, Iran.
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Ruixin Z, Shan H, Yongli T, Chen J, Qianzhu C, Xue W. The influence of psychological resilience and nursing practice environment on nurses' moral courage: A cross-sectional study. Nurs Open 2024; 11:e2163. [PMID: 38642075 PMCID: PMC11032114 DOI: 10.1002/nop2.2163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/08/2024] [Accepted: 03/26/2024] [Indexed: 04/22/2024] Open
Abstract
AIM To determine the relationship between psychological resilience, nursing practice environment, and moral courage of clinical nurses and also the factors influencing moral courage. DESIGN Cross-sectional study. METHODS 586 nurses from a general hospital were selected by convenience sampling method in January 2023. The general information questionnaire, Nurses' Moral Courage Scale (NMCS), Resilience Scale, and Practice Environment Scale (PES) were measured. Hierarchical linear regression analysis was used to explore the influencing factors of clinical nurses' moral courage. RESULTS Nurses' average moral courage score was 79.00 (69.00, 91.00). The nurses' moral courage was positively correlated with psychological resilience and nursing practice environment. Multivariate linear regression analysis showed that psychological resilience and nursing practice environment entered the regression equation, accounting for 23.4% of the total variation. Psychological resilience and nursing practice environment are the main factors affecting the moral courage of clinical nurses. Nursing managers should conduct moral courage training, develop a decent nursing practice environment, pay attention to the psychological emotions of nurses, and actively build a safe, open, and supportive atmosphere for moral behaviour.
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Affiliation(s)
- Zhang Ruixin
- Department of OrthopaedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- Orthopedic Laboratory of Chongqing Medical UniversityChongqingChina
| | - He Shan
- School of NursingChongqing Medical UniversityChongqingChina
| | - Tang Yongli
- Department of OrthopaedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jie Chen
- Department of OrthopaedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Chen Qianzhu
- Department of OrthopaedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Wang Xue
- Department of OrthopaedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- Orthopedic Laboratory of Chongqing Medical UniversityChongqingChina
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Tiryaki Şen H, Polat Ş, Afşar Doğrusöz L. The relationship between subjective compliance with isolation precautions and moral sensitivity in novice nurses: cross-sectional study. BMC Nurs 2024; 23:69. [PMID: 38267937 PMCID: PMC10809565 DOI: 10.1186/s12912-024-01735-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/14/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Increasing compliance with isolation precautions is important in reducing hospital-acquired infections and their consequences. It is not possible to achieve and maintain nurse compliance through supervision, control, pressure, or training. Therefore, nurses must personally demand compliance with isolation precautions. This study aimed to determine the relationship between compliance with isolation precautions and the moral sensitivity levels of nurses who have just started working. METHODS This study employed a descriptive and cross-sectional research design. The study population consisted of 456 new nurses recruited during the pandemic. All of the new nurses who volunteered to participate in the study and completed the questionnaires completely were included in the study and 398 nurses constituted the sample of the study. Data were collected from 398 out of 456 novice nurses who agreed to participate in the study. The population coverage rate was 87.28%. Participants were selected using convenience sampling method. The data collection tools included an Introductory Information Form, The Isolation Compliance Precautions Scale (TIPCS), and the Moral Sensitivity Questionnaire (MSQ). Descriptive statistics, correlation analyses, and regression models were used to analyze data. FINDINGS The mean score of the MSQ was high (mean ± SD = 90.49 ± 25.94; median (P25-P75) = 84 (range, 74-97), and the score for TIPCS was high (mean ± SD = 79.29 ± 7.68; median (P25-P75) = 82 (range, 76-85)). No correlation was found between MSQ and TIPCS (p > 0.05). According to the regression analysis, although the MSQ did not correlate with TIPCS, compliance with isolation measures was found to increase as the conflict subscale of moral sensitivity increased (β= -0.36, CI= -0.55 to -0.16; p < 0.001). Choosing the profession willingly had a positive correlation with compliance with isolation measures (β = 5.3, CI = 2.4 to 8.3; p < 0.001). In addition, starting the profession at an early age had a positive correlation with compliance with isolation measures (β= -0.49, CI= -0.8 to -0.17; p = 0.002). CONCLUSION The conflict sub-dimension of moral sensitivity is an important factor in nurses' compliance with isolation measures, and conducting necessary training and other studies to improve nurses' moral sensitivity may increase their compliance with isolation measures.
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Affiliation(s)
- Hanife Tiryaki Şen
- Training Nurse, Istanbul Health Directorate, Fatih, Istanbul, Türkiye, Turkey.
| | - Şehrinaz Polat
- Faculty of Nursing, Istanbul University, Fatih, İstanbul, Turkey
| | - Leyla Afşar Doğrusöz
- Istanbul Faculty of Medicine, Istanbul University, Quality Coordinator, Istanbul, Türkiye, Turkey
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Huang ZE, Qiu X, Yan J, Liao DD, Huang H, Fu YQ, Liu BR, Zhu SC, Yi QF. Structural equation modeling for associated factors with patient safety behaviors among nursing interns: A cross-sectional study based on the capability opportunity motivation-behavior model. NURSE EDUCATION TODAY 2024; 132:105992. [PMID: 37890194 DOI: 10.1016/j.nedt.2023.105992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/22/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Nursing interns are one of the most crucial providers of nursing services. Their safety behaviors are closely associated with adverse events. Therefore, it is vital to explore the factors influencing nursing intern safety behavior to improve patient safety. OBJECTIVE To evaluate patient safety behavior among nursing interns and explore latent influencing mechanisms based on the capability opportunity motivation-behavior (COMB) model. DESIGN A cross-sectional study SETTINGS AND PARTICIPANTS: The participants were 422 nursing interns recruited through convenience sampling from a comprehensive teaching hospital. METHODS Data on general information, nursing interns' patient safety behavior, metacognitive ability, clinical internship environment, and moral sensitivity were collected. Nursing interns' patient safety behavior was described with means and standard deviations. The independent sample t-test, ANOVA, Pearson's correlation, and SEM were used to determine contributing factors to nursing interns' patient safety behavior. RESULTS The mean total score for patient safety behavior was 53.08 ± 6.22. The results indicated that metacognitive ability not only directly affects the patient safety behavior of nursing interns (β = 0.554, P < 0.001, 95 % CI = [0.446, 0.637]) but indirectly affects interns' safety behavior through professional identity (β = 0.009, P = 0.031, 95 % CI = [0.001, 0.019]). The clinical internship environment also has both direct (β = 0.258, P = 0.001, 95 % CI = [0.166, 0.349]) and indirect (β = 0.007, P = 0.029, 95 % CI = [0.001, 0.015]) effects on the patient safety behavior of nursing interns. CONCLUSION There are some specific areas where nursing interns' safety behaviors need to be improved. This study reveals that strong metacognitive ability and a clinical internship environment with rich opportunities might be essential for the development of patient safety behaviors. To promote nursing interns' patient safety behaviors, clinical teachers could use reflective teaching methods and provide a supportive clinical environment to nurture nursing interns' professional identities and patient safety behaviors.
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Affiliation(s)
- Zhuo-Er Huang
- Department of Nursing Teaching and Research, the Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China
| | - Xing Qiu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Jin Yan
- Xiangya Nursing School, Central South University, Changsha, China; Department of Nursing, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Dan-Dan Liao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hui Huang
- Department of Nursing Teaching and Research, the Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China
| | - Ya-Qian Fu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Bi-Rong Liu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Su-Cui Zhu
- Department of Pulmonary and Critical Care Medicine, the Third Xiangya Hospital, Central South University, Changsha, China.
| | - Qi-Feng Yi
- Department of Nursing Teaching and Research, the Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China.
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Yang Q, Zheng Z, Ge L, Huang BX, Liu J, Wang J, Lu K, Huang Y, Zhang J. The impact of resilience on clinical nurses' moral courage during COVID-19: A moderated mediation model of ethical climate and moral distress. Int Nurs Rev 2023; 70:518-526. [PMID: 37584307 DOI: 10.1111/inr.12871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 07/23/2023] [Indexed: 08/17/2023]
Abstract
AIM The purpose of this study was to explore whether clinical ethical climate mediates the relationship between resilience and moral courage in a population of clinical nurses during COVID-19, and if moral distress faced by nurses is a moderating factor. BACKGROUND Resilience can help nurses maintain their personal health during COVID-19 when they face great physical and psychological shock and are prone to health problems. Moral courage, as an ethical competency, helps nursing staff in adhering to the principles and values of professional ethics. There is a strong correlation between resilience and moral courage, but the mechanism by which resilience contributes to moral courage is unclear. METHOD A cross-sectional study research is designed. Three hundred thirty clinical nurses from six hospitals in Beijing, Sichuan, and Fujian of China were included between August 2021 and March 2022. The survey instruments include the Nurses' Moral Courage Scale (NMCS), Connor-Davidson Resilience Scale (CD-RISC), Moral Distress Scale-Revised (MDS-R), and Hospital Ethical Climate Scale (HECS). RESULTS Ethical climate mediates 15% of the relationship between resilience and moral courage. The association between resilience and ethical climate, as well as the indirect relationship between resilience and moral courage, was modified by moral distress. DISCUSSION This study investigated the mechanisms by which resilience affects moral courage in clinical nurses in the context of COVID-19, suggesting that moral courage can be increased by alleviating moral distress and increasing ethical climate. IMPLICATIONS FOR NURSING AND HEALTH POLICY This study confirms the mediating effect of moral climate on the relationship between resilience and moral courage, as well as the moderating effect of moral distress. Hospital policymakers should value nurses' psychological resilience and moral courage, develop effective policies to prevent and manage stressors, build social support systems, and create a positive ethical climate.
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Affiliation(s)
- Qingqing Yang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Zhihui Zheng
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Li Ge
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Bi Xia Huang
- Department of Nursing, The Third People's Hospital of Fujian Province, Fujian, China
| | - Jujuan Liu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Jie Wang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Kangyuan Lu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Yufeng Huang
- Department of Neonatology, Xiamen Maternal and Child Health Hospital, Fujian, China
| | - Jiahui Zhang
- Department of Health Management, Fujian Vocational College of Bioengineering, Fujian, China
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Hong N, Qichao N, Dong C, Chunling T, Dong P, Xinyu L, Yu S, Shilong L, Yuhuan Z. A study on different types of moral courage and coping styles of clinical nurses: based on potential profile analysis. BMC Nurs 2023; 22:418. [PMID: 37940968 PMCID: PMC10633898 DOI: 10.1186/s12912-023-01590-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND In professional ethics-related events, there are various unpleasant and complex ethical issues that require strong moral courage. Our aim is to identify and describe the potential categories of moral courage among nurses and to clarify the coping styles of nurses under different categories. METHOD A cross-sectional study was conducted using three data collection tools: a self-designed general information questionnaire, a Chinese version of the Moral Courage Scale, and a Trait Coping Style Questionnaire. Three hundred fourteen nurses from a tertiary hospital in Heilongjiang Province, China, were analysed using potential profile analysis, descriptive analysis, and Mann-Whitney U test data. RESULT The latent profile analysis (LPA) results indicate that the two-profile model is the most suitable and supports the existence of two different moral courage profiles: the low moral courage group (60.51%) and the high moral courage group (39.49%), with a high relative entropy value (0.922). The results point to a good profile solution, and there are significant differences between the two profiles. The Mann-Whitney U-test results showed that the positive coping scores of the high moral courage group were significantly higher than those of the low moral courage group, and the negative coping scores of the high moral courage group were significantly lower than those of the low moral courage group. CONCLUSION Our results reveal the heterogeneity of moral courage in the nurse sample and indicate that nurses in the high moral courage group tend to choose positive coping styles, while nurses in the low moral courage group are more likely to develop negative coping emotions. This provides important significance and reference value for nursing managers, who can propose customised management plans based on the types of moral courage of the nursing community and the coping styles under different categories.
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Affiliation(s)
- Nian Hong
- Cancer Radiotherapy Department, Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China
| | - Niu Qichao
- Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China
| | - Chen Dong
- Heilongjiang Higher Nursing School, Harbin City, 150000, Heilongjiang Province, China
| | - Tai Chunling
- Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China
| | - Pang Dong
- Department of Neurology, Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China
| | - Lv Xinyu
- Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China
| | - Su Yu
- Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China
| | - Liu Shilong
- Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China
| | - Zhang Yuhuan
- Second Affiliated Hospital of Harbin Medical University, Harbin City, 150000, Heilongjiang Province, China.
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Alshammari MH, Alboliteeh M. Moral courage, burnout, professional competence, and compassion fatigue among nurses. Nurs Ethics 2023; 30:1068-1082. [PMID: 37192753 DOI: 10.1177/09697330231176032] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses. AIM This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses. RESEARCH DESIGN Correlational, cross-sectional design following the STROBE guidelines. PARTICIPANTS AND RESEARCH CONTEXT Convenience sampling was used to recruit nurses (n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses' Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data. ETHICAL CONSIDERATIONS The ethics review committee of a government university in Ha'il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured. RESULTS The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue. CONCLUSION Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses.
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Affiliation(s)
| | - Mohammad Alboliteeh
- Mental Health Nursing Department, College of Nursing, University of Ha'il, Ha'il City, KSA
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Yu Q, Wang H, Tian Y, Wang Q, Yang L, Liu Q, Li Y. Moral courage, job-esteem, and social responsibility in disaster relief nurses. Nurs Ethics 2023; 30:1051-1067. [PMID: 37192663 DOI: 10.1177/09697330231174540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Social responsibility can motivate disaster relief nurses to devote themselves to safeguarding rights and interests of people when facing challenges that threaten public health. However, few studies focused on the relationship of moral courage, job-esteem, and social responsibility among disaster relief nurses. OBJECTIVE To explore the influence of moral courage and job-esteem on the social responsibility in disaster relief nurses and clarify the relationship model between them. METHODS A cross-sectional study was conducted among 716 disaster relief nurses from 14 hospitals in central China through an online survey, including moral courage scale, job-esteem scale, and social responsibility questionnaire. The data were analyzed by Pearson's correlation, and the mechanism of the effect of moral courage and job-esteem on social responsibility was completed. ETHICAL CONSIDERATIONS This study was approved by the Medical Ethics Committee of the Second Xiangya Hospital of Central South University (Approval Number: 2019016). RESULTS Disaster relief nurses' moral courage positively impacted social responsibility (r = 0.677, p < 0.01), and moral courage could affect social responsibility through the mediating role of job-esteem. CONCLUSION Job-esteem mediated between moral courage and social responsibility among disaster relief nurses. Nursing managers regular assessment of nurses' moral courage and interventions such as meetings and workshops can reduce moral distress, foster morally courageous behavior, enhance job-esteem, and improve social responsibility performance among disaster relief nurses.
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Affiliation(s)
- Qiang Yu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Neurosurgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Huaqin Wang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qin Wang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Li Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiaomei Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
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Kashani M, Bozorgzad P, Masror Roudsary D, Janani L, Asghari H, Asgari MR, Babamohamadi H. The relationship between moral courage and providing safe care in nurses: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:352. [PMID: 38144009 PMCID: PMC10743858 DOI: 10.4103/jehp.jehp_977_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/01/2022] [Indexed: 12/26/2023]
Abstract
BACKGROUND Moral courage is one of the moral virtues, which can have a great impact on the provision of safe care for patients. Providing safe care is one of the most significant and fundamental principles of healthcare. This study aimed to determine the relationship between moral courage and safe care among nurses and explain the factors predicting safe care. MATERIALS AND METHODS This is a cross-sectional study conducted on 172 nurses who worked in selected hospitals affiliated with the Iran University of Medical Sciences in 2019. For this purpose, self-report questionnaires on moral courage and safe nursing care were used. The collected data were analyzed in the Statistical Package for Social Sciences (SPSS) version 23.0 using descriptive (mean, standard deviation, percentage, and frequency) and inferential (Pearson's correlation coefficient and multiple linear regression) statistics. P values less than 0.05 were considered statistically significant. RESULTS Mean scores of nurses' moral courage and safe care were desirable (407.57 ± 53.97) and satisfactory (311.31 ± 39.48), respectively. There was a significant correlation between the scores of nursing safe care and moral courage (r = 0.69, P < 0.001). Moral courage, gender, and work experience explained 54% of the variance of nursing safe care. CONCLUSION The results showed that there is a positive and significant relationship between safety care and moral courage. It seems that increasing nurses' awareness of ethical principles leads to their courageous ethical behaviors, and safety and high-quality care should be one of the goals of all healthcare professionals. Also, the results of this study support the need to improve the knowledge and awareness of nurses and nurse managers regarding the importance of moral courage in providing safe nursing care and improving patient safety.
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Affiliation(s)
- Maryam Kashani
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Parisa Bozorgzad
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Daryadokht Masror Roudsary
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Health, Iran University of Medical Science, Tehran, Iran
| | - Hosein Asghari
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Mohammad Reza Asgari
- Department of Critical Care Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
| | - Hassan Babamohamadi
- Department of Medical-Surgical Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
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Lotfi-Bejestani S, Atashzadeh-Shoorideh F, Ghafouri R, Nasiri M, Ohnishi K, Ghadirian F. Is there any relationship between nurses' perceived organizational justice, moral sensitivity, moral courage, moral distress and burnout? BMC Nurs 2023; 22:368. [PMID: 37803416 PMCID: PMC10559416 DOI: 10.1186/s12912-023-01536-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
AIM The present study is an attempt to investigate the relationship between Corley's model variables in mental health nurses. BACKGROUND Based on Corley's model, burnout and moral distress in nurses are, in retrospect, the consequences of the interplay of organizational and individual factors such as perceived organizational justice, moral sensitivity, and moral courage. The relationship between two variables or three variables of Corley's moral distress model has been investigated, but the test of Corley's moral distress model with more variables has not been done. Therefore, this research was proposed with the aim of investigating the relationship between the variables of moral courage and moral sensitivity (as characteristics of nurses), perceived organizational justice (as an antecedent), moral distress, and job burnout (as consequences of moral distress). METHODS The study was conducted as a descriptive correlational study involving 500 nurses working in the mental health wards of hospitals. Data collection was conducted using perceived organizational justice scale, moral sensitivity scale, moral courage scale, moral distress scale, and burnout inventory. RESULTS The results showed a significant relationship between perceived organizational justice, moral sensitivity, moral courage, and moral distress (< 0.05). Moreover, perceived organizational justice and moral distress had an inverse relationship. Moral sensitivity and moral courage had a direct relationship with moral distress (< 0.05). Furthermore, the results showed inadequate model fitness. CONCLUSIONS This study adds to the existing knowledge about the experiences of mental health nurses and their interactions with both organizational and individual factors. It highlights that the connections between perceived organizational justice, moral sensitivity, moral courage, moral distress, and burnout are intricate and multifaceted. As we deepen our understanding of these relationships, it opens the door for the development of interventions and strategies to enhance nurses' well-being and the quality of care they deliver in mental health settings. Moreover, future research and ongoing refinement and expansion of Corley's model will be crucial in addressing the complex challenges within the healthcare sector.
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Affiliation(s)
- Sara Lotfi-Bejestani
- Master of Science in psychiatric nursing student, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Department of Psychiatric Nursing & Management, School of Nursing and midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Raziyeh Ghafouri
- Medical-Surgical Nursing Department, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kayoko Ohnishi
- Graduate School of Nursing, Nagoya City University, Nagoya, Japan
| | - Fataneh Ghadirian
- Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Andina-Díaz E, Siles-González J, Gutiérrez-García AI, Solano-Ruiz MC. Perception of care from the perspective of nursing students: A study using photovoice, storytelling and poetry. Nurse Educ Pract 2023; 72:103791. [PMID: 37774427 DOI: 10.1016/j.nepr.2023.103791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/01/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The Higher Education in Nursing requires providing students with skills such as critical and reflective thinking about the actions to be carried out so that they are capable of providing humanised and quality care in an increasingly complex and technified society. Participatory teaching methodologies promote the development of these skills. OBJECTIVES to explore the potential of photovoice, storytelling and poetry as instruments capable of encouraging reflection. To identify through images (photovoice) and poetic narratives (storytelling and poetry) the perception that students of the nursing degree express about nursing care. DESIGN qualitative study in the framework of the socio-critical paradigm, using photovoice, storytelling and poetry in the field of care. PARTICIPANTS first-year undergraduate nursing students at two Spanish universities in the academic year 2021-2022. METHODOLOGY 48 images were shown and students were asked to select one, write a narrative and generate a short poem connected to the image. Subsequently, a content analysis was conducted of those poems evoked by the five photographs most chosen by the students. The analysis was supported by qualitative data analysis software. A total of 67 contributions from 67 students were analysed. RESULTS the concepts addressed in the poems and the compositions generated reveal how critical humanist thinking and reflection on the subject of care developed. The topics identified were care, accompaniment throughout the life cycle, working on the basis of values and caring for small details as subcategories of nursing care. CONCLUSION The combination of different tools in university education has encouraged reflection and enabled students to identify for themselves the importance of humanised care. Working on the theoretical foundation in an active way can reduce the gap between theory and practice and foster the empowerment of the nursing identity.
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Affiliation(s)
- Elena Andina-Díaz
- Department of Nursing and Physiotherapy, University of León, Vegazana Campus, 24170 Leon, Spain; SALBIS Research Group, University of León, Spain; EYCC Research Group, University of Alicante, Spain
| | - José Siles-González
- EYCC Research Group, University of Alicante, Spain; Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig, s/n, 03690 San Vicente del Raspeig, Spain
| | - Ana Isabel Gutiérrez-García
- EYCC Research Group, University of Alicante, Spain; Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig, s/n, 03690 San Vicente del Raspeig, Spain.
| | - MCarmen Solano-Ruiz
- EYCC Research Group, University of Alicante, Spain; Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig, s/n, 03690 San Vicente del Raspeig, Spain
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12
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Aydin Dogan R. Compassion fatigue and moral sensitivity in midwives in COVID-19. Nurs Ethics 2023; 30:776-788. [PMID: 36927231 PMCID: PMC10028444 DOI: 10.1177/09697330221146224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND The Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies involving health workers such as nurses and physicians affected by the pandemic's compassion fatigue, few studies include midwives. RESEARCH OBJECTIVE The present study seeks to investigate the effects of compassion fatigue experienced by midwives working under intense stress during the third wave of the COVID-19 pandemic on the level of moral sensitivity. RESEARCH DESIGN This is a descriptive-correlation study. PARTICIPANTS The statistical population consisted of all the midwives in Türkiye hospitals in 2021. This cross-sectional study was collected through a questionnaire using convenience sampling. Three hundred and ten midwives working in different units of the country participated in the study. ETHICAL CONSIDERATIONS Approval from the researcher's university Institutional Review Board for ethical review was obtained with the code of IRB 20/510. FINDINGS The average age of the midwives is 34.29 ± 8.39. It has been noticed that 43.5% of the midwives work in public hospitals and 38.1% in family health and community health centers. Midwives' mean MR-CS score is 67.11 ± 25.13, secondary trauma sub-dimension average 15.77 ± 6.23, and occupational burnout sub-dimension 40.69 ± 16.35. The mean moral sensitivity questionnaire score is determined as 93.86 ± 19.51. It has been observed that the working style and working time are effective on compassion fatigue. In the linear regression model, 98% of compassion fatigue was explained. Age, secondary trauma, and occupational burnout sub-dimensions affect the model. DISCUSSION Working year, working style, second trauma, age, and occupational burnout parameters may help explain some of the links between midwives' symptoms of compassion fatigue. CONCLUSION The pandemic affects the compassion fatigue of midwives. It is crucial to provide social support to midwives and health workers to prevent compassion fatigue and examine and control groups at risk in mental health.
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Affiliation(s)
- Reyhan Aydin Dogan
- Department of Midwifery, Faculty of Health
Sciences, Karabuk University, Turkey
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13
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Luo Z, Tao L, Wang CC, Zheng N, Ma X, Quan Y, Zhou J, Zeng Z, Chen L, Chang Y. Correlations between moral courage, moral sensitivity, and ethical decision-making by nurse interns: a cross-sectional study. BMC Nurs 2023; 22:260. [PMID: 37553653 PMCID: PMC10408053 DOI: 10.1186/s12912-023-01428-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/01/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Clinical decision-making involves ethical issues that become more and more complex. Nurse interns must be more skilled in making rational and timely decisions when facing ethical dilemmas. The contributing factors and their relationships that challenge ethical decision-making among nurse interns must be fully understood, as this level of knowledge can support the development of strategies and interventions that improve the ethical decision-making ability of nurse interns. OBJECTIVE This study examined the relationships between moral courage, moral sensitivity, and ethical decision-making by nurse interns. In addition, we investigated whether moral sensitivity mediates the relationship between moral courage and ethical decision-making. DESIGN A descriptive cross-sectional study using an online questionnaire. SETTING The study sampled nurse interns from Class iii Grade A general hospitals in Sichuan Province, China. PARTICIPANTS A convenience sampling method was used to select 1334 nurse interns from March 2022 to May 2022. METHODS A general information questionnaire, the Nurses' Moral Courage Scale (NMCS), the Chinese Moral Sensitivity Questionnaire (MSQ), and the Judgement About Nursing Decision (JAND) were used for data collection. Data was processed and analysed using SPSS 26.0 and Amos 28.0. Data analysis included descriptive statistics, Pearson correlation analysis, and structural equation modelling. RESULTS Moral courage was found to be positively correlated with ethical decision-making (P < 0.01). Moral sensitivity was also positively correlated with ethical decision-making (P < 0.01) and had a mediating effect on the relationship between moral courage and ethical decision-making (P < 0.01). CONCLUSIONS The moral courage and moral sensitivity of nurse interns are positively correlated with ethical decision-making ability. Moral sensitivity significantly mediates the relationship between moral courage and ethical decision-making ability. The knowledge gained from this study can inform educational strategies and interventions in supporting the development of nurse interns' ethical decision-making ability.
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Affiliation(s)
- Zongting Luo
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
| | - Lan Tao
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
| | - Carol Chunfeng Wang
- Australasian Academy of Cosmetic Dermal Science (AACDS), The University of Notre Dame Australia AU, Perth, Australia
| | - Nan Zheng
- School of Nursing, Leshan Vocational and Technical College, Leshan, China
| | - Xiaolin Ma
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
| | - Yi Quan
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
| | - Jian Zhou
- Department of Rheumatology and immunology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
| | - Zhen Zeng
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
| | - Lijuan Chen
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
| | - Yue Chang
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
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14
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Erel M, Marcus EL, DeKeyser Ganz F. Cognitive biases and moral characteristics of healthcare workers and their treatment approach for persons with advanced dementia in acute care settings. Front Med (Lausanne) 2023; 10:1145142. [PMID: 37425320 PMCID: PMC10325688 DOI: 10.3389/fmed.2023.1145142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Palliative care (PC) delivery for persons with advanced dementia (AD) remains low, particularly in acute-care settings. Studies have shown that cognitive biases and moral characteristics can influence patient care through their effect on the thinking patterns of healthcare workers (HCWs). This study aimed to determine whether cognitive biases, including representativeness, availability, and anchoring, are associated with treatment approaches, ranging from palliative to aggressive care in acute medical situations, for persons with AD. Methods Three hundred fifteen HCWs participated in this study: 159 physicians and 156 nurses from medical and surgical wards in two hospitals. The following questionnaires were administered: a socio-demographic questionnaire; the Moral Sensitivity Questionnaire; the Professional Moral Courage Scale; a case scenario of a person with AD presenting with pneumonia, with six possible interventions ranging from PC to aggressive care (referring to life-prolonging interventions), each given a score from (-1) (palliative) to 3 (aggressive), the sum of which is the "Treatment Approach Score;" and 12 items assessing perceptions regarding PC for dementia. Those items, the moral scores, and professional orientation (medical/surgical) were classified into the three cognitive biases. Results The following aspects of cognitive biases were associated with the Treatment Approach Score: representativeness-agreement with the definition of dementia as a terminal disease and appropriateness of PC for dementia; availability-perceived organizational support for PC decisions, apprehension regarding response to PC decisions by seniors or family, and apprehension regarding a lawsuit following PC; and anchoring-perceived PC appropriateness by colleagues, comfort with end-of-life conversations, guilt feelings following the death of a patient, stress, and avoidance accompanying care. No association was found between moral characteristics and the treatment approach. In a multivariate analysis, the predictors of the care approach were: guilt feelings about the death of a patient, apprehension regarding senior-level response, and PC appropriateness for dementia. Conclusion Cognitive biases were associated with the care decisions for persons with AD in acute medical conditions. These findings provide insight into the potential effects of cognitive biases on clinical decisions, which may explain the disparity between treatment guidelines and the deficiency in the implementation of palliation for this population.
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Affiliation(s)
- Meira Erel
- Henrietta Szold Hadassah-Hebrew University School of Nursing, Jerusalem, Israel
| | | | - Freda DeKeyser Ganz
- Henrietta Szold Hadassah-Hebrew University School of Nursing, Jerusalem, Israel
- Faculty of Health and Life Sciences, Jerusalem College of Technology, Jerusalem, Israel
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15
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Goktas S, Aktug C, Gezginci E. Evaluation of moral sensitivity and moral courage in intensive care nurses in Turkey during the COVID-19 pandemic. Nurs Crit Care 2023; 28:261-271. [PMID: 35821613 PMCID: PMC9350110 DOI: 10.1111/nicc.12820] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, intensive care nurses may experience ethical issues related to fear of transmission, limited resources, and increased workload. Nurses' moral sensitivity and courage may have a role in dealing with these problems. AIM The purpose of this study was to assess intensive care nurses' moral sensitivity and moral courage during the COVID-19 pandemic. DESIGN Descriptive cross-sectional survey. METHODS A total of 362 nurses working in the intensive care units of pandemic hospitals in Turkey participated in the study between January and March 2021. Data were obtained using a personal information form, the Moral Sensitivity Questionnaire, and the Nurses' Moral Courage Scale. A link to the online data collection tools was sent to the management of participating institutions, who forwarded it to nurses. Reporting followed the CHERRIES guidelines. RESULTS In this study, the response rate of nurses was 89%. The nurses' total mean moral sensitivity score was 90.70 ± 28.89 and their mean moral courage score was 82.08 ± 13.51. A weak inverse correlation was found between the nurses' moral sensitivity and moral courage scores (r = -.176, p = .001). Total moral sensitivity score differed significantly according to years of Intensive care unit (ICU) experience (p = .007). Total moral courage scores increased significantly with education level (p = .012), years of nursing experience (p = .016), and willingness to work in the ICU (p < .001). CONCLUSION The study suggests that nurses working in the intensive care unit during the pandemic had moderate moral sensitivity and high levels of moral courage. Nurses' sociodemographic characteristics and ICU work conditions may affect their moral sensitivity and moral courage. RELEVANCE TO CLINICAL PRACTICE The results of this study can help guide efforts to improve moral courage and sensitivity and address ethical issues among ICU nurses.
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Affiliation(s)
- Sonay Goktas
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
| | - Cemile Aktug
- Faculty of Health Sciences, Department of Nursing, Gümüşhane University, Gumushane, Turkey
| | - Elif Gezginci
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
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16
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Huang M, Dong W, Zhao Q, Mo N. Factors associated with the moral courage of nurses in China: A cross-sectional study. Nurs Open 2023. [PMID: 36811339 DOI: 10.1002/nop2.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/12/2022] [Accepted: 02/04/2023] [Indexed: 02/24/2023] Open
Abstract
AIM The purpose of this study was to assess the level of moral courage among nurses in China, and to explore related influential factors, to help nursing managers take measures to improve nurses' moral courage. DESIGN A cross-sectional study. METHODS The data adopted a convenient sampling method. From September to December 2021, 583 nurses from five hospitals in Fujian Province completed the Chinese version of the Nurses' Moral Courage Scale (NMCS). Data were analysed using descriptive statistics, chi-square test, T-test, Pearson correlation analysis and multiple regression analysis. RESULTS The Chinese nurses perceived themselves, on average, as morally courageous. The mean NMCS score was 3.64 ± 0.692. The six factors showed statistically significant correlations (p < 0.05) with moral courage. Regression analysis showed that the main factors influencing nurses' moral courage were active learning of ethics knowledge and nursing was a career goal. CONCLUSION This study provides the self-evaluation level and related influencing factors of Chinese nurses' moral courage. There is no doubt that nurses still need strong moral courage to face unknown ethical problems and challenges in the future. Nursing managers should pay attention to the cultivation of nurses' moral courage, using various forms of educational activities to help nurses alleviate moral problems and improve their moral courage, to maintain patients' access to high-quality nursing.
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Affiliation(s)
- Mingtao Huang
- School of Health Management, Fujian Medical University, Fuzhou, China.,Research Centre for Medical Humanities, Fujian Medical University, Fuzhou, China
| | - Wenhong Dong
- School of Health Management, Fujian Medical University, Fuzhou, China.,Research Centre for Medical Humanities, Fujian Medical University, Fuzhou, China
| | - Qianqian Zhao
- School of Health Management, Fujian Medical University, Fuzhou, China.,Research Centre for Medical Humanities, Fujian Medical University, Fuzhou, China
| | - Nan Mo
- Research Centre for Medical Humanities, Fujian Medical University, Fuzhou, China.,School of Marxism, Fujian Medical University, Fuzhou, China
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17
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Whiteing N, Massey D, Rafferty R, Penman O, Samios C, Bowen K, Stephens A, Aggar C. Australian nurses' and midwives' perceptions of their workplace environment during the COVID-19 pandemic. Collegian 2023; 30:39-46. [PMID: 35765377 PMCID: PMC9226292 DOI: 10.1016/j.colegn.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/24/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
Abstract
Background Working as a front-line worker during a pandemic is a unique situation that requires a supportive work environment. An informed understanding of nurses' and midwives' workplace experiences during a pandemic, such as COVID-19, may enable better preparation and targeted support for future pandemics at an individual, organisational, and policy level. Aim The aim of this study was to explore nurses' and midwives' workplace experiences during the COVID-19 pandemic response. Methods A cross-sectional online survey consisting of open-ended questions was conducted with a convenience sample of nurses and midwives (n = 1003) working in New South Wales Health hospital settings, in Australia. Open-ended questions were analysed using content analysis. Results Five themes were identified; 'organisational communication', 'workplace support', 'availability of personal protective equipment', 'flexible working', and 'new ways of working'. Nurses' and midwives' workplace experiences during COVID-19 were influenced by leaders who were perceived to be adaptive, authentic, responsive, transparent, and visible. While many expressed a number of workplace challenges, including access to personal protective equipment, there was opportunity to explore, develop, and evaluate new and alternate models of care and working arrangements. Conclusion It is important that nurses and midwives are supported and well prepared to cope during pandemics in the workplace. Organisational leadership and timely dissemination of transparent pandemic plans may support nurses' adaptive workplace experiences.
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Affiliation(s)
- Nicola Whiteing
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
| | - Deb Massey
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
| | - Rae Rafferty
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
| | - Olivia Penman
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
| | - Christina Samios
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
- Australian College of Applied Psychology, 255 Elizabeth Street, Sydney, NSW, Australia
| | - Karen Bowen
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
| | - Alexandre Stephens
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
| | - Christina Aggar
- Southern Cross University, Faculty of Health, Southern Cross Drive, Bilinga, QLD, Australia
- Northern New South Wales Local Health District, 89 Tamar St, Ballina, NSW, Australia
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18
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Jantara RD, Barlem JGT, Jantara A, Rocha LP, Rocha SSD, Stigger DADS. Analysis of moral courage and related factors among undergraduate nursing students: a scoping review. Rev Bras Enferm 2023; 76Suppl 3:e20220225. [PMID: 37042930 PMCID: PMC10084776 DOI: 10.1590/0034-7167-2022-0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/10/2022] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVE to analyze scientific evidence on moral courage and related factors among nursing undergraduate students. METHOD the protocol of this scoping review was registered on Open Science Framework. A search was performed in five databases, according to the method provided by Joanna Briggs Institute Reviewers, the mnemonic strategy Population, Concept and Context, and a specific checklist. RESULTS a total of 2,812 results were identified, but only nine studies were eligible and presented three thematic approaches: Moral courage from the perspective of nursing students; Moral courage and related factors; and The teaching of moral courage in the training of nursing students. The factors related to moral courage include moral distress, moral sensitivity, age, and having a previous degree in the health field. FINAL CONSIDERATIONS few studies were found with a low evidence level. Most were performed in developed countries, indicating some gaps that need to be addressed in the future.
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Affiliation(s)
| | | | - Adrieli Jantara
- Universidade Federal do Rio Grande. Rio Grande, Rio Grande do Sul, Brazil
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19
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Peng M, Saito S, Guan H, Ma X. Moral distress, moral courage, and career identity among nurses: A cross-sectional study. Nurs Ethics 2022; 30:358-369. [PMID: 36545793 DOI: 10.1177/09697330221140512] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The concept of career identity is integral to nursing practices and forms the basis of the nursing professions. Positive career identity is essential for providing high-quality care, optimizing patient outcomes, and enhancing the retention of health professionals. Therefore, there is a need to explore potential influencing variables, thereby developing effective interventions to improve career identity. Objectives To investigate the relationship between moral distress, moral courage, and career identity, and explore the mediating role of moral courage between moral distress and career identity among nurses. Design A quantitative, cross-sectional study. Methods A convenient sample of 800 nurses was recruited from two tertiary care hospitals between February and March 2022. Participants were assessed using the Moral Distress Scale-revised, Nurses’ Moral Courage Scale, and Nursing Career Identity Scale. This study was described in accordance with the STROBE statement. Ethical consideration Research ethics approval was obtained from the researcher’s university and hospital where this study was conducted prior to data collection. Findings Moral distress is negatively associated while moral courage is positively associated with career identity among nurses. Moral courage partially mediates the relationship between moral distress and career identity ( β = −0.230 to −0.163, p < 0.01). Discussion The findings reveal a relationship between moral distress, moral courage, and career identity among nurses. Conclusion By paying attention to nurses’ moral distress and courage, healthcare providers can contribute to the development of effective interventions to improve career identity, and subsequently performance, among nurses.
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Affiliation(s)
- Mengyun Peng
- Graduate School of Health Sciences, Okayama University, Japan
| | - Shinya Saito
- Graduate School of Health Sciences, Okayama University, Japan
| | - Hong Guan
- Department of Nursing, The Second Hospital of Dalian Medical University, China
| | - Xiaohuan Ma
- Department of Nursing, The Second People's Hospital of Dalian, China
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20
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Hu K, Liu J, Zhu L, Zhou Y. Clinical nurses' moral courage and related factors: an empowerment perspective. BMC Nurs 2022; 21:321. [PMID: 36419129 PMCID: PMC9685865 DOI: 10.1186/s12912-022-01093-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Moral courage as part of the moral competence of nurses has received increasing attention. Determination of the factors affecting moral courage is important in improving the quality of care. The purpose of this study was to investigate moral courage and related factors among frontline nurses from an empowerment perspective. METHODS A cross-sectional study was conducted using data collection instruments comprising four main parts: the self-designed form of demographic characteristics, Conditions for Work Effectiveness II (CWEQ-II), Spreitzer's Psychological Empowerment Scale (PES) and Nurses' Moral Courage Scale (NMCS). Data were collected from 226 nurses in a tertiary hospital between February and March 2022 in Wuhan, the capital city of Hubei Province in central China. Descriptive statistics and multiple linear regression were used to analyze the data. RESULTS The means of the total scores for the CWEQ-II, PES and the NMCS were 3.52 (SD = 0.69), 3.85 (SD = 0.53) and 3.90 (SD = 0.67), respectively. All the dimensions and the total scores of the CWEQ-II and PES were significantly correlated with the NMCS (p < 0.001). According to the multivariate stepwise regression analysis, CWEQ-II and PES were determined to be factors affecting NMCS. These variables explained 35.9% of the total variance in the moral courage scores of nurses. CONCLUSION The level of moral courage among nurses is above average. Structural empowerment and psychological empowerment were the key factors affecting the promotion of moral courage. Hospital and organizational administrations should be conscious of the role of attach structural empowerment and psychological empowerment in the nursing workplace in increasing moral courage.
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Affiliation(s)
- Kaili Hu
- grid.33199.310000 0004 0368 7223Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Hankou Wuhan, 430030 P.R. China
| | - Juan Liu
- grid.33199.310000 0004 0368 7223Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Hankou Wuhan, 430030 P.R. China
| | - Lisi Zhu
- grid.33199.310000 0004 0368 7223Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Hankou Wuhan, 430030 P.R. China
| | - Yanrong Zhou
- grid.33199.310000 0004 0368 7223Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Hankou Wuhan, 430030 P.R. China
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21
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Grande RAN, Berdida DJE, Villagracia HN, Raguindin SM, Cornejo LTO, Reshidi NMA, Alshammari AT, Aljebari BJ, AlAbd AMA. The moderating effect of burnout on professionalism, values, and competence of nurses in Saudi Arabia amidst the COVID-19 pandemic: A structural equation modeling approach. J Nurs Manag 2022; 30:2523-2536. [PMID: 35941714 PMCID: PMC9538538 DOI: 10.1111/jonm.13754] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022]
Abstract
Aim To examine the moderating effect of burnout on the relationship between nurses' competence, professional competence and professional values. Background There is a preponderance of burnout studies of nurses before and during the COVID‐19 pandemic. However, little is known about burnout's moderating influence on nurses' professionalism, competence and values during the ongoing pandemic. Methods This study used a correlational, cross‐sectional design and convenience sampling to recruit 809 Saudi nurses employed in four government hospitals. Four self‐report instruments were used to collect data from August 2021 to March 2022. Spearman Rho, structural equation modelling and multi‐group moderation analysis were used to analyse the data. Results Most of the participants had high burnout. There was a moderate to high correlation between the dimensions of professional competence, nurse professional values, burnout and nurse competence. Both professional competence and nurse professional values significantly affected nurse competence. Nurse professional values also had a direct effect on professional competence. Professional competence and nurse professional values on nurse competence may vary among those with low, moderate and high levels of burnout, suggesting the moderating effect of burnout. Conclusions The positive impacts of nurse professional values and professional competence on nursing competence were validated in this study, as was the evidence of burnout's moderating effect on the studied connections. To avoid burnout, it is necessary to increase organizational knowledge and support for nurses, their working conditions and the environment through strategies that promote well‐being and empowerment. Implications for nursing management Nurse managers can implement policies to help nurses minimize burnout and improve their professional values and competence. Management policies may be considered include increased staffing, opportunities to improve technical abilities through education and vocational training programs, and increased diversity of job assignments.
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Affiliation(s)
- Rizal Angelo N Grande
- Mental Health Nursing Department, College of Nursing, University of Ha'il, Ha'il City, KSA
| | | | - Hazel N Villagracia
- Medical-Surgical Nursing Department, College of Nursing, University of Ha'il, Ha'il City, KSA
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22
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A Study of How Moral Courage and Moral Sensitivity Correlate with Safe Care in Special Care Nursing. ScientificWorldJournal 2022; 2022:9097995. [PMID: 35874846 PMCID: PMC9300363 DOI: 10.1155/2022/9097995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Nursing is a caring profession, and nurses who have moral sensitivity and moral courage presumably can provide safe and better care for patients. This study aims at investigating how moral courage and moral sensitivity correlate with safe care in special care nursing. Methods This study is a descriptive work of research. The participants consisted of 524 nurses who were in practice in the ICU (intensive care unit), CCU (C\coronary care unit), post-CCU (postcoronary care unit), and dialysis of four hospitals located in the south of Iran selected via census sampling. Data were collected from April to September 2020 using the moral sensitivity questionnaire (MSQ), professional moral courage questionnaire (PMCQ), and the assessment of safe nursing care questionnaire (ASNCQ). The collected data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson's correlation coefficient in SPSS v. 22. Results The mean ± SD of the nurses' age was 33.89 ± 6.91 years, and the mean ± SD of their work experience was 9.16 ± 4.67 years. The total mean score ± SD of the nurses' moral sensitivity was found to be 93.41 ± 2.68, the total mean score ± SD of their moral courage was found to be 96.38 ± 3.63, and the total mean score ± SD of their safe care scores was found to be 321.80 ± 9.76. The values of Pearson's correlation coefficients showed significant correlations between moral courage and safe care (r = 0.54, p < 0.001), moral sensitivity and safe care (r = 0.59, p < 0.001), and moral sensitivity and moral courage (r = 0.52, p < 0.001). Conclusion There is a positive correlation between moral sensitivity and moral courage. Both positively correlated with special care nursing. Accordingly, through effective planning, education, and giving their support, nurse administrators can promote the abovementioned ethical virtues in the nursing staff, thereby improving the quality of care.
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Ali Awad NH, Al-Anwer Ashour HM. Crisis, ethical leadership and moral courage: Ethical climate during COVID-19. Nurs Ethics 2022; 29:1441-1456. [PMID: 35724327 PMCID: PMC9209857 DOI: 10.1177/09697330221105636] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background The global COVID-19 pandemic has challenged nurse leaders in ways that one
could not imagine. Along with ongoing priorities of providing high quality,
cost-effective and safe care, nurse leaders are also committed to promote an
ethical climate that support nurses’ moral courage for sustaining excellence
in patient and family care. Aim This study is directed to develop a structure equation model of crisis,
ethical leadership and nurses’ moral courage: mediating effect of ethical
climate during COVID-19. Ethical consideration Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria
University, Egypt. Methods A cross-sectional design was used to conduct this study using validated
scales to measure the study variables. It was conducted in all units of two
isolated hospitals in Damanhur, Egypt. A convenient sample of 235 nurses was
recruited to be involved in this study. Results This study revealed that nurses perceived a moderate mean percent (55.49 ±
3.46) of overall crisis leadership, high mean percent (74.69 ± 6.15) of
overall ethical leadership, high mean percent (72.09 ± 7.73) of their moral
courage, and moderate mean percent of overall ethical climate (65.67 ±
12.04). Additionally, this study declared a strong positive statistical
significant correlation between all study variables and indicated that the
independent variable (crisis and ethical leadership) can predict a 0.96,
0.6, respectively, increasing in the dependent variable (nurses’ moral
courage) through the mediating impact of ethical climate. Conclusion Nursing administrators should be conscious of the importance of crisis,
ethical leadership competencies and the role of ethical climate to enhance
nurses’ moral courage especially during pandemic. Therefore, these findings
have significant contributions that support healthcare organizations to
develop strategies that provide a supportive ethical climate. Develop
ethical and crisis leadership competencies in order to improve nurses' moral
courage by holding meetings, workshops, and allowing open dialogue with
nurses to assess their moral courage.
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Mohammadi F, Masoumi Z, Oshvandi K, Khazaei S, Bijani M. Death anxiety, moral courage, and resilience in nursing students who care for COVID-19 patients: a cross-sectional study. BMC Nurs 2022; 21:150. [PMID: 35698221 PMCID: PMC9189788 DOI: 10.1186/s12912-022-00931-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/03/2022] [Indexed: 12/15/2022] Open
Abstract
Background Being on the frontline of the battle against COVID-19, nurses and nursing students have been under considerable psychological stress and pressure. The present study is done to explore death anxiety, moral courage, and resilience in nursing students caring for COVID-19 patients in the south of Iran. Methods The present study is cross-sectional research conducted between September and December 2021. A total of 420 senior nursing students (nursing interns) who were undergoing their clinical training courses were invited to participate in the study by convenience sampling method from three hospitals affiliated with the University of Medical Sciences of Southern Iran. Data were collected using a demographics survey, Nurses’ Moral Courage Questionnaire, Connor-Davidson Resilience Scale, and Templer’s Death Anxiety Scale. Results The nursing students participating in this study had a death anxiety mean score of 12.78 ± 1.17. The results showed that there was a significant and indirect correlation between death anxiety on the one hand and moral courage (r = -0.91, p < 0.001) and resilience (r = -0.89, p < 0.001) on the other in nursing students caring for patients with COVID-19. Also, it was found that there was a significant and direct correlation between the students’ resilience and moral courage scores (r = 0.91, p < 0.001). Conclusion The nursing students caring for COVID-19 patients had experienced high levels of death anxiety in the past few months. Considering the persistence of the COVID-19 crisis in Iran and other countries, there is an urgent need for measures to preserve and improve the physical, mental, and spiritual health of nursing students, enhance their moral courage and resilience and reduce their death anxiety.
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Affiliation(s)
- Fateme Mohammadi
- Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Masoumi
- Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, School of Health , Health Sciences Research Center, Health Sciences & Technology Research Institue, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran.
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Pirdelkhosh M, Mohsenipouya H, Mousavinasab N, Sangani A, Mamun MA. Happiness and Moral Courage Among Iranian Nurses During the COVID-19 Pandemic: The Role of Workplace Social Capital. Front Psychiatry 2022; 13:844901. [PMID: 35711599 PMCID: PMC9197335 DOI: 10.3389/fpsyt.2022.844901] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/04/2022] [Indexed: 11/28/2022] Open
Abstract
Background COVID-19 has become a major global health problem, and healthcare professionals are facing lot of pressure and stress. Accumulated resources and energy obtained via interpersonal relationships is called social capital, which can reduce the negative effects of pressure and stress related to the workplace by impacting happiness and moral courage. This study explored the effect of workplace social capital on moral courage and happiness in nurses working in the COVID-19 wards. Methods In this cross-sectional study, using a random sampling method, 169 nurses from three hospitals in East Mazandaran province, Iran, participated who worked in COVID-19 wards. The Onyx and Bullen Social Capital Questionnaire, the Sekerka's Moral Courage Scale, and the Oxford Happiness Inventory were used in this study. Descriptive analysis, Pearson correlation analyses, and stepwise multiple regression were performed for data analysis. Results The mean age of nurses was 31.38 ± 6.82 years. Socio-demographic factors such as age, gender, educational level, and employment status were significant predictors of workplace social capital. Social capital was positively correlated with moral courage (r = 0.29, p < 0.01) and happiness (r = 0.32, p < 0.01). In addition, social capital explained 6.8 and 8.6% variance in predicting moral courage and happiness, respectively. Conclusions Workplace social capital is a vital organizational phenomenon affecting nurses' moral courage and happiness, especially during the COVID-19 pandemic. Thus, hospitals should be aware of the importance of social capital; they should ensure that all the practices and policies are in place to develop and increase it.
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Affiliation(s)
- Maryam Pirdelkhosh
- Faculty of Nursing, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mohsenipouya
- Health Education and Promotion, Faculty of Nursing, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nouraddin Mousavinasab
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Sangani
- Department of Cultural Psychopathology, Farabi, Psychological Sciences Research Center, Mazandaran, Iran
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Dhaka, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
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Evolution of the Public-Health Response to COVID-19 Pandemic in Spain: A Descriptive Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073824. [PMID: 35409509 PMCID: PMC8997787 DOI: 10.3390/ijerph19073824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022]
Abstract
The capacity of hospitals and primary care centres has, rightfully, been at the centre of public and political debate on resource availability and control measures during the outbreak of COVID-19 and lockdown. Thus, the aim of this study is to describe the public and professional perceptions towards the evolution of the COVID-19 public-health response, in order to analyse and learn lessons for future health policies in similar situations in the future. A descriptive qualitative study was conducted through 41 in-depth interviews between January and June 2021. Twenty-one healthcare professionals and twenty service users participated in our study. The participants were recruited using purposive sampling. After our data analysis, three main themes emerged: (i) experiences during an unprecedented public health threat: the impact and challenges of early control measures, and outcomes for the public image of nursing; (ii) overcoming the impact of the outbreak on the healthcare system: professional coping strategies in the context of the pandemic, and institutional considerations in hospitals and primary care; and (iii) the efficiency of resource management during the outbreak: perceptions of professionals and healthcare users. Health providers and service users demand structural and organisational changes, as well as resource-optimisation strategies for front-line workers. Nurses need to be involved in decision making in order to provide evidence-based guidelines and ensure well-resourced and supported care practice.
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Jang SJ, Kim EH, Lee H. Moral sensitivity and person-centered care among mental health nurses in South Korea: A cross-sectional study. J Nurs Manag 2022; 30:2227-2235. [PMID: 35119156 DOI: 10.1111/jonm.13554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/27/2022]
Abstract
AIM To identify the predictors of mental health nurses' person-centered care, including moral sensitivity. BACKGROUND Person-centered care meets patients' ethical needs by protecting their autonomy and dignity, and respecting their choices; it is essential to enhance patient outcomes. Therefore, it is important to identify the predictors of the practice of advocating patients' rights and dignity, and providing person-centered care among mental health nurses to foster competency and ensure the highest quality of care. METHODS This cross-sectional study included 220 mental health nurses in South Korea. It measured their general and work-related characteristics, moral sensitivity, and person-centered care. Multiple regression analysis was conducted to identify the person-centered care predictors. RESULTS The most potent person-centered care predictor was moral sensitivity (β=.35, p<.001). Other predictors included prior biomedical ethics education (β=.15, p=.013) and marital status (β=.14, p=.025). The regression model had 28.0% explanatory power. CONCLUSIONS Mental health nurses' moral sensitivity must be increased to improve their person-centered care. IMPLICATIONS FOR NURSING MANAGEMENT Nurses should receive continuous education to remain aware of and maintain a high level of moral sensitivity and be encouraged to continue the person-centered practice. Organizational and policy support is needed to promote the practice of person-centered care in the workplace.
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Affiliation(s)
- Sun Joo Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Eun Hye Kim
- Dawongongdongche, Mental Rehabilitation Facilities, Daejeon, Republic of Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
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Khodaveisi M, Oshvandi K, Bashirian S, Khazaei S, Gillespie M, Masoumi SZ, Mohammadi F. Moral courage, moral sensitivity and safe nursing care in nurses caring of patients with COVID-19. Nurs Open 2021; 8:3538-3546. [PMID: 33945661 PMCID: PMC8242869 DOI: 10.1002/nop2.903] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/10/2021] [Accepted: 02/28/2021] [Indexed: 12/28/2022] Open
Abstract
AIM Evaluation the moral courage, moral sensitivity and safe nursing care in nurses caring of infected patients by the COVID-19. DESIGN This study employed cross-sectional research. METHODS 520 nurses caring for COVID-19 patients in 5 hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. RESULTS Findings showed that moral courage has a strong and direct correlation with moral sensitivity (p < .001, r = 0-.70) and safe nursing care (p < .001, r = 0-.74). Variables of moral sensitivity, safe nursing care, work experience, age and employment status can predict 64.76% of the variance in moral courage in these nurses. Nursing care of patients with COVID-19 have reported high moral courage in recent months, and in spite of the numerous tensions and stresses in terms of caring these patients during this relative long period, they are still diligent in providing safe and high sensitive care to these patients.
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Affiliation(s)
- Masoud Khodaveisi
- Department of Community Health NursingSchool of Nursing and MidwiferyChronic Diseases (Homecare) Research CenterHamadan University of Medical SciencesHamadanIran
| | - Khodayar Oshvandi
- Department of Medical Surgical NursingSchool of Nursing and MidwiferyMother and Child Care Research CenterHamadan University of Medical SciencesHamadanIran
| | - Saeid Bashirian
- Department of Public Health, Social Determinants of Health Research CenterHamedan University of Medical SciencesHamadanIran
| | - Salman Khazaei
- Department of Epidemiology, School of Public HealthHamadan University of Medical SciencesHamadanIran
| | - Mark Gillespie
- School of Health Nursing and MidwiferyUniversity of the West of ScotlandPaisleyScotland
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and MidwiferyHamadan University of Medical SciencesHamadanIran
| | - Fateme Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Autism Spectrum Disorders Research CenterHamadan University of Medical SciencesHamadanIran
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