Clinical nurses’ moral courage and related factors: an empowerment perspective

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.

The influence of psychological resilience and nursing practice environment on nurses' moral courage: A cross‐sectional study

“…00), which was in the middle and upper level compared with the average score of the scale (52. 5); consistent with the findings of this study, other studies have shown that nurses, especially in central China and Finland, have reported high moral courage (Hu et al, 2022;Kleemola et al, 2020).…”

“…The organization can establish a virtuous loop and boost moral courage when these actions are permitted and affirmed by the organization (Pajakoski et al, 2021). (Hu et al, 2022).…”

“…However, all subscales scored below 3.0 except for nursing foundations for quality of care and nurse manager ability. Based on the general background of China, workforce shortage and poor organizational communication are two challenges affecting the nursing practice environment, and taking appropriate measures to improve the nursing practice environment from the root is essential to creating a positive ethical climate (Hu et al., 2022).…”

Moral courage and its influencing factor among oncology specialist nurses: A multi‐centre cross‐sectional study

“…Considerable empirical research has been conducted to better understand nurses' moral courage and how to support them under complex ethical challenges. Previous cross‐sectional studies have explored the relationship among nurses (Gibson et al., 2020 ; Hauhio et al., 2021 ; Hu et al., 2022 ; Peng et al., 2023 ; Wenwen et al., 2018 ). One study demonstrated that the mean score for moral courage among nurses working in ICUs in COVID‐19 pandemic hospitals was 82.08 (Goktas et al., 2023 ).…”

“…A moral perspective is implicit in all nursing activities since ethical problems are a component of daily nursing practice (Thompson et al., 2006 ). There has been a growing focus on nurses' moral courage as a component of their moral competence (Hu et al., 2022 ). In the field of nursing, moral courage is defined as a nurse's adherence to their professional code of ethics and strict adherence to these guidelines, even if such adherence has a foreseeable or real negative impact on them (Numminen et al., 2017 ).…”