Of courage and leaving safe harbors

Moral courage of nursing: Bibliometric analysis

BACKGROUND

Moral courage is a recognized virtue. Researchers have focused on various aspects of nursing moral courage, such as its conceptualization and influencing factors. Within these studies, various literature reviews have been conducted, but to our knowledge, bibliometric mapping has not been utilized.

AIM

This article aims to analyze the production of literature within nursing moral courage research.

RESEARCH DESIGN

To investigate publication patterns, we employed VOSviewer and CiteSpace software, focusing on publication dynamics, prolific research entities, and most cited articles. Additionally, we forecasted future research trends.

ETHICAL CONSIDERATIONS

In our study, ethical review was not required.

RESULTS

A total of 105 information sources were identified in the WoS database. Overall, there has been a significant increase in research volume after 2020. The most prolific countries are the United States, Finland, and China, while the most prolific source title is "Nursing Ethics." Keywords are also related to moral dilemmas and ethics. However, there are further improvements needed in international cooperation.

CONCLUSIONS

The results proposed in this paper can serve as a starting point for comprehensive or systematic literature reviews and seek more detailed data, information, and knowledge in the field of nursing moral courage. It can enable outsiders to quickly understand research on nursing moral courage, whether for in-depth exploration or simply to facilitate more effective collaboration with nursing ethics experts.

Moral courage in nursing: A concept analysis

BACKGROUND

Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one's moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous.

OBJECTIVE

This article is an analysis of the concept of moral courage in nursing.

DESIGN

Rodgers' evolutionary method of concept analysis provided the framework to conduct the analysis.

DATA SOURCES

The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher's Index. The following key words were used: "moral" OR "ethical" AND "courage" OR "strength" AND "nurs*" with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines.

RESULTS

Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment.

DISCUSSION AND CONCLUSION

This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice.

Nursing's role in courage development in patients facing complications of diabetes

The purpose of this study was to explore the experience of nurses in relation to courage development in patients with disabling complications of diabetes. The phenomenon of courage has been explored in philosophy, theology, literature, and other fields of inquiry rooted in the humanities. Nursing inquiry has not often been directed toward an exploration of courage, although coping, compassion, caring, and other experiences integral to the nurse-patient relationship have been examined. The holistic view of the cascading effect of complications on the individual patient is often overlooked. This qualitative study used phenomenological inquiry and included face-to-face interviews of nurses to explore their experience in assisting patients in the development of courage. The experience of courage is investigated as it relates to a specific group of patients who have complications of diabetes. Four categories representing the unique opportunities for courage development by nurses were generated. These categories included education, advocacy, relationship building, and humanization. Each category described nursing intentions and actions and taken together formed an essential structure of courage development. Conclusions indicated that nurses recognize and are able to describe their role in courage development. Implications for improved health through deliberate caring nursing interventions, aimed at courage development, are presented.