Evaluation of Moral Courage in Nurses According to Individual Characteristics
Yıl 2025,
Cilt: 10 Sayı: 1, 1 - 7
Fatma Tanrıkulu
,
Mustafa Demir
,
Rümeysa Demir
Öz
Objective: The study aimed to evaluate the moral courage of the nurses according to their socio-demographic characteristics.
Materials and Methods: This study was cross-sectional and descriptive. A total of 214 volunteer nurses working in a private hospital were included in this study. ‘Individual Characteristics Form’ and ‘Nurses’ Moral Courage Scale’ are the data collection tools of this study.
Results: The median value of the participants' “Moral Courage Scale in Nurses” was 86.0.
In the study, statistical significance was found between the mean ranks of moral courage and nurses' level of education, years of experience in the profession, whether they worked as a clinical or manager nurse, the department they worked in, and whether they received ethics training (p<0.05).
Conclusions: In this study, it was determined that nurses were moderately morally courageous. The fact that moral courage was found to be at a higher level among nurses who had been working for less than a year showed that nurses who were new to the profession possessed a heightened awareness of moral courage. It is thought that it would be useful to evaluate moral courage in nurses and student nurses through prospective and qualitative studies in future studies.
Etik Beyan
The study was approved by the Non-Interventional Clinical Research Ethics Committee from Istanbul Medipol University. (Date: 26/07/2022, decision no: 648). The necessary permissions for the measurement instruments to be used in the study were obtained from the authors by email. The study was conducted in accordance with the Declaration of Helsinki.
Kaynakça
- 1. Şahiner P, Babadağlı B, Ersoy N. Ebelik ve hemşirelik öğrencilerinin ahlaki duyarlılığı. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2019;5(2):86-90. doi:10.30934/kusbed.522406
- 2. Kleemola E, Leino-Kilpi H, Numminen O. Care situations demanding moral courage: content analysis of nurses’ experiences. Nursing Ethics. 2020;27(3):714–25. doi:10.1177/0969733019897780
- 3. Murray JS. Moral courage in healthcare: acting ethically even in the presence of risk. The Online Journal of Issues Nursing. 2010;15(3). doi:10.3912/OJIN.Vol15No03Man02
- 4. Numminen O, Repo H, Leino-Kilpi H. Moral courage in nursing: A concept analysis. Nursing Ethics. 2017;24(8):878–891. doi:10.1177/0969733016634155.
- 5. Barlow NA, Hargreaves J, Gillibrand WP. Nurses‟ contributions to the resolution of ethical dilemmas in practice. Nursing Ethics. 2018;25(2):230-242. doi:10.1177/0969733017703700
- 6. Lamiani G, Borghi L, Argentero P. When healthcare professionals cannot do the right thing: A systematic review of moral distress and its correlates. Journal of Health Psychology. 2017;22(1):51–67. doi:10.1177/1359105315595120
- 7. Hassanzadeh Naeini M, Nasiriani K, Fazljoo SE. Moral courage of the nursing students of Yazd University of Medical Sciences, Iran. Iranian Journal of Nursing. 2020;33(127):35-44. doi:10.29252/ijn.33.127.35
- 8. Hu K, Liu J, Zhu L, Zhou Y. Clinical nurses' moral courage and related factors: An empowerment perspective. BMC Nursing. 2022;21(1):1-7. doi:10.1186/s12912-022-01093-9
- 9. Mohammadi S, Borhani F, Roshanzadeh M. Relationship between moral distress and moral courage in nurses. Journal of Medical Ethics History of Medicine. 2014;7(3):1-10.
- 10. Pajakoski E, Rannikko S, Leino-Kilpi H, Numminen O. Moral courage in nursing – An integrative literature review. Nursing Health Sciences. 2020;23:570–585. doi:10.1111/nhs.12805
- 11. Khoshmehr Z, Barkhordari-Sharifabad M, Nasiriani K, Fallahzadeh H. Moral courage and psychological empowerment among nurses. BMC nursing. 2020. doi:10.1186/s12912-020-00435-9
- 12. 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. Frontiers in Psychiatry. 2022. doi:10.3389/fpsyt.2022.844901
- 13. Amos VK, Epstein E. Moral distress interventions: An integrative literature review. Nursing Ethics. 2022;29(3):582–607. doi:10.1177/09697330211035489
- 14. Taraz Z, Loghmani L, Abbaszadeh A, Ahmadi F, Safavibiat Z, Borhani F. The relationship between ethical climate of hospital and moral courage of nursing staff. Electronic Journal of General Medicine. 2019;16(2):1-6. doi:10.29333/ejgm/93472
- 15. Lachman VD. Moral courage: A virtue in need of development? MedSurg Nursing Journal. 2007;16:131–133.
16. Kleemola E, Leino-Kilpi H, Numminen O. Care situations demanding moral courage: content analysis of nurses' experiences. Nursing Ethics. 2020; 27:714–725. doi:10.1177/0969733019897780
- 17. Pohjanoksa J, Stolt M, Suhonen R, Leino‐Kilpi H. Wrongdoing and whistleblowing in health care. Journal of Advanced Nursing. 2019;75(7):1504–1517. doi: 10.1111/jan.13979
- 18. Khodaveisi M, Oshvandi K, Bashirian S, et al. Moral courage, moral sensitivity and safe nursing care in nurses caring of patients with COVID-19. Nursing Open. 2021;8(6):3538-3546. doi: 10.1002/nop2.903.
- 19. Gallagher A. Moral distress and moral courage in everyday nursing practice. Online Journal of Issues Nursing. 2011;16(2):1-12.
- 20. Elmaoğlu E, Eriş H. Hemşirelerde ahlaki cesaretin otonomiye etkisi. Journal on Mathematic, Engineering and Natural Sciences. 2022. doi:10.5281/zenodo.7221103
- 21. Ayaz E, Akkuş Y. Nurses' Moral Courage Scale:Adaptation, validity and reliability study. Sağlık Bilimlerinde Değer. 2023;13(2):238-44. doi:10.33631/sabd.1142622
- 22. Numminen O, Katajisto J, Leino-Kilpi H. Development and validation of Nurses’ Moral Courage Scale. Nursing Ethics. 2019;26(8):2438-2455. doi:10.1177/0969733018791325
- 23. Goktas S, Aktug C, Gezginci E. Evaluation of moral sensitivity and moral courage in intensive care nurses in Turkey during the COVID-19 pandemic. Nursing in Critical Care. 2023;28(2):261–271. doi: 10.1111/nicc.12820
- 24. Kovancı MS, Hiçdurmaz D. Ahlaki cesaret: Tanımı, ahlaki sıkıntı ve ahlaki duyarlılık ile ilişkisi ve geliştirilmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2021;11(1):96-102. doi:10.33631/duzcesbed.683548
- 25. Konings KJP, Gastmans C, Numminen OH, et al. Measuring nurses’ moral courage: An explorative study. Nursing Ethics. 2022;29(1):114-130. doi: 10.1177/09697330211003211.
- 26. Gibson E, Duke G, Alfred D. Exploring the relationships among moral distress, moral courage, and moral resilience in undergraduate nursing students. Journal of Nursing Education. 2020;59(7):392-395. doi: 10.3928/01484834-20200617-07.
- 27. Huang M, Dong W, Zhao Q, Mo N. Factors associated with the moral courage of nurses in China: A cross‐sectional study. Nursing Open. 2023;10(7):4305-4312. doi:10.1002/nop2.1672
- 28. Hauhio N, Leino-Kilpi H, Katajisto J, Numminen O. Nurses’ self-assessed moral courage and related socio-demographic factors. Nursing Ethics. 2021;28(7–8):1402–1415. doi:10.1177/0969733021999763.
- 29. Moosavi SS, Borhani F, Abbaszadeh A. The moral courage of nurses employed in hospitals affiliated to Shahid Beheshti University of Medical Sciences. Journal of Hayat. 2017;22(4):339‐349.
Hemşirelerde Ahlaki Cesaretin Bireysel Özelliklerine Göre Değerlendirilmesi
Yıl 2025,
Cilt: 10 Sayı: 1, 1 - 7
Fatma Tanrıkulu
,
Mustafa Demir
,
Rümeysa Demir
Öz
Amaç: Araştırmanın amacı hemşirelerin sosyodemografik özelliklerine göre ahlaki cesaretini değerlendirmektir.
Materyal ve Metot: Bu çalışma kesitsel ve tanımlayıcı niteliktedir. Çalışmaya özel bir hastanede görev yapan toplam 214 gönüllü hemşire dahil edilmiştir. ‘Bireysel Özellikler Formu’ ve ‘Hemşirelerde Ahlaki Cesaret Ölçeği’ bu çalışmanın veri toplama araçlarıdır.
Bulgular: Araştırmada “Hemşirelerde Ahlaki Cesaret Ölçeği” median değerinin 86.0 olduğu belirlendi. Hemşirelerin eğitim düzeyi, meslekte çalışma yılı, servis ya da yönetici hemşire olarak çalışma durumu, çalıştıkları klinik türü ve etik-ahlak konularında eğitim alma durumu ile ahlaki cesaret sıra ortalamaları arasında istatistiksel açıdan anlamlı farklılık olduğu belirlendi (p<0,05).
Sonuç: Bu çalışmadan elde edilen veriler doğrultusunda hemşirelerin orta düzeyde ahlaki açıdan cesaretli olduğu belirlendi. Özellikle bir yıl altında çalışan hemşirelerde ahlaki cesaretin daha yüksek düzeyde saptanmış olması mesleğe yeni başlayan hemşirelerin bu kavramın farkında olduklarını ortaya koydu. Bu sonuç hasta bakım kalitesi, hasta savunuculuğu ve hemşirelik mesleği açısından sevindiricidir. Gelecek çalışmalarda hemşirelerde ve öğrenci hemşirelerde ahlaki cesaretin prospektif ve kalitatif çalışmalar ile değerlendirilmesinin yararlı olacağı düşünülmektedir.
Kaynakça
- 1. Şahiner P, Babadağlı B, Ersoy N. Ebelik ve hemşirelik öğrencilerinin ahlaki duyarlılığı. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2019;5(2):86-90. doi:10.30934/kusbed.522406
- 2. Kleemola E, Leino-Kilpi H, Numminen O. Care situations demanding moral courage: content analysis of nurses’ experiences. Nursing Ethics. 2020;27(3):714–25. doi:10.1177/0969733019897780
- 3. Murray JS. Moral courage in healthcare: acting ethically even in the presence of risk. The Online Journal of Issues Nursing. 2010;15(3). doi:10.3912/OJIN.Vol15No03Man02
- 4. Numminen O, Repo H, Leino-Kilpi H. Moral courage in nursing: A concept analysis. Nursing Ethics. 2017;24(8):878–891. doi:10.1177/0969733016634155.
- 5. Barlow NA, Hargreaves J, Gillibrand WP. Nurses‟ contributions to the resolution of ethical dilemmas in practice. Nursing Ethics. 2018;25(2):230-242. doi:10.1177/0969733017703700
- 6. Lamiani G, Borghi L, Argentero P. When healthcare professionals cannot do the right thing: A systematic review of moral distress and its correlates. Journal of Health Psychology. 2017;22(1):51–67. doi:10.1177/1359105315595120
- 7. Hassanzadeh Naeini M, Nasiriani K, Fazljoo SE. Moral courage of the nursing students of Yazd University of Medical Sciences, Iran. Iranian Journal of Nursing. 2020;33(127):35-44. doi:10.29252/ijn.33.127.35
- 8. Hu K, Liu J, Zhu L, Zhou Y. Clinical nurses' moral courage and related factors: An empowerment perspective. BMC Nursing. 2022;21(1):1-7. doi:10.1186/s12912-022-01093-9
- 9. Mohammadi S, Borhani F, Roshanzadeh M. Relationship between moral distress and moral courage in nurses. Journal of Medical Ethics History of Medicine. 2014;7(3):1-10.
- 10. Pajakoski E, Rannikko S, Leino-Kilpi H, Numminen O. Moral courage in nursing – An integrative literature review. Nursing Health Sciences. 2020;23:570–585. doi:10.1111/nhs.12805
- 11. Khoshmehr Z, Barkhordari-Sharifabad M, Nasiriani K, Fallahzadeh H. Moral courage and psychological empowerment among nurses. BMC nursing. 2020. doi:10.1186/s12912-020-00435-9
- 12. 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. Frontiers in Psychiatry. 2022. doi:10.3389/fpsyt.2022.844901
- 13. Amos VK, Epstein E. Moral distress interventions: An integrative literature review. Nursing Ethics. 2022;29(3):582–607. doi:10.1177/09697330211035489
- 14. Taraz Z, Loghmani L, Abbaszadeh A, Ahmadi F, Safavibiat Z, Borhani F. The relationship between ethical climate of hospital and moral courage of nursing staff. Electronic Journal of General Medicine. 2019;16(2):1-6. doi:10.29333/ejgm/93472
- 15. Lachman VD. Moral courage: A virtue in need of development? MedSurg Nursing Journal. 2007;16:131–133.
16. Kleemola E, Leino-Kilpi H, Numminen O. Care situations demanding moral courage: content analysis of nurses' experiences. Nursing Ethics. 2020; 27:714–725. doi:10.1177/0969733019897780
- 17. Pohjanoksa J, Stolt M, Suhonen R, Leino‐Kilpi H. Wrongdoing and whistleblowing in health care. Journal of Advanced Nursing. 2019;75(7):1504–1517. doi: 10.1111/jan.13979
- 18. Khodaveisi M, Oshvandi K, Bashirian S, et al. Moral courage, moral sensitivity and safe nursing care in nurses caring of patients with COVID-19. Nursing Open. 2021;8(6):3538-3546. doi: 10.1002/nop2.903.
- 19. Gallagher A. Moral distress and moral courage in everyday nursing practice. Online Journal of Issues Nursing. 2011;16(2):1-12.
- 20. Elmaoğlu E, Eriş H. Hemşirelerde ahlaki cesaretin otonomiye etkisi. Journal on Mathematic, Engineering and Natural Sciences. 2022. doi:10.5281/zenodo.7221103
- 21. Ayaz E, Akkuş Y. Nurses' Moral Courage Scale:Adaptation, validity and reliability study. Sağlık Bilimlerinde Değer. 2023;13(2):238-44. doi:10.33631/sabd.1142622
- 22. Numminen O, Katajisto J, Leino-Kilpi H. Development and validation of Nurses’ Moral Courage Scale. Nursing Ethics. 2019;26(8):2438-2455. doi:10.1177/0969733018791325
- 23. Goktas S, Aktug C, Gezginci E. Evaluation of moral sensitivity and moral courage in intensive care nurses in Turkey during the COVID-19 pandemic. Nursing in Critical Care. 2023;28(2):261–271. doi: 10.1111/nicc.12820
- 24. Kovancı MS, Hiçdurmaz D. Ahlaki cesaret: Tanımı, ahlaki sıkıntı ve ahlaki duyarlılık ile ilişkisi ve geliştirilmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2021;11(1):96-102. doi:10.33631/duzcesbed.683548
- 25. Konings KJP, Gastmans C, Numminen OH, et al. Measuring nurses’ moral courage: An explorative study. Nursing Ethics. 2022;29(1):114-130. doi: 10.1177/09697330211003211.
- 26. Gibson E, Duke G, Alfred D. Exploring the relationships among moral distress, moral courage, and moral resilience in undergraduate nursing students. Journal of Nursing Education. 2020;59(7):392-395. doi: 10.3928/01484834-20200617-07.
- 27. Huang M, Dong W, Zhao Q, Mo N. Factors associated with the moral courage of nurses in China: A cross‐sectional study. Nursing Open. 2023;10(7):4305-4312. doi:10.1002/nop2.1672
- 28. Hauhio N, Leino-Kilpi H, Katajisto J, Numminen O. Nurses’ self-assessed moral courage and related socio-demographic factors. Nursing Ethics. 2021;28(7–8):1402–1415. doi:10.1177/0969733021999763.
- 29. Moosavi SS, Borhani F, Abbaszadeh A. The moral courage of nurses employed in hospitals affiliated to Shahid Beheshti University of Medical Sciences. Journal of Hayat. 2017;22(4):339‐349.