Exploring the Relationships Among Moral Distress, Moral Courage, and Moral Resilience in Undergraduate Nursing Students

Gibson, Erin; Duke, Gloria; Alfred, Danita

doi:10.3928/01484834-20200617-07

Cited by 38 publications

(45 citation statements)

References 28 publications

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“… 38 Authors analyzed the data from 529 nurses to demonstrate the convergent validity and concurrent validity of MDT, and then indicated that MDT has great potential as a screening tool for use in research, evaluating the effectiveness of interventions designed to decrease a nurse’s level of MD. To date, some empirical studies have employed this instrument to examine the level of MD in school nurses 62 , 63 and intensive care unit nurses. 64 , 65 However, the application in other clinical nurses or cultural settings has not yet been reported.…”

Section: Resultsmentioning

confidence: 99%

Instruments for Detecting Moral Distress in Clinical Nurses: A Systematic Review

Tian

Jin

Chen

et al. 2021

INQUIRY

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Moral distress (MD) has become a seriously negative problem experienced by healthcare professionals, especially clinical nurses. Early and accurate detection of MD by the validated and reliable instrument is critically important to further develop an effective intervention strategy. We performed the current systematic review to comprehensively summarize the evidence of instruments for the detection of MD in clinical nurses. The research design was a systematic literature review. We assigned 2 investigators to independently search potential studies in PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) from their inception to June 2020. We used data extraction table extracting essential information, and the modified critical appraisal tool evaluating the reliability and validity of eligible instruments. Finally, we qualitatively summarized results of all included instruments. No ethical approval was required because this systematic review was performed based on published studies. We included 16 eligible studies covering 10 original and 6 revised or modified instruments for the final analysis. The overall quality of all instruments was moderate because test-retest reliability was inadequately examined in most instruments. Of 16 instruments, MDS-revised (MDS-R) was broadly validated and employed in different working or cultural settings. Meanwhile, it also extensively expands to specifically detect MD. Moreover, other instruments including moral distress risk scale (MDSR) and moral distress thermometer (MDT) should be further validated and utilized because it covered the gap missed by most instruments. Although several instruments have been made available for clinical nurses, some of them have inadequate psychometric properties test, especially test-retest reliability evaluation. Meanwhile, most of them have not be validated and employed in other working or cultural settings. We therefore suggested further studies to validate the psychometric properties of existing instruments and then employed instruments with high reliability and validity to detect MD in clinical nurses.

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Section: Resultsmentioning

confidence: 99%

Instruments for Detecting Moral Distress in Clinical Nurses: A Systematic Review

Tian

Jin

Chen

et al. 2021

INQUIRY

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“…They also found a significant correlation between the nurses’ moral courage and resilience, which is consistent with the present study's findings. On a similar note, Gibson et al (2020) found a direct correlation between nursing students’ resilience and moral courage [ 35 ]. Cerit et al (2021) reported a significant negative correlation between nurses’ death anxiety and ethical sensitivity: elevated ethical sensitivity correlated with reduced death anxiety in the nurses [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Death anxiety, moral courage, and resilience in nursing students who care for COVID-19 patients: a cross-sectional study

et al. 2022

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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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“…Good interpersonal relationships, high academic grades, having a role model, and student satisfaction with their major are characteristics of students with high academic resilience levels (Hwang & Shin, 2018). Emerging studies on moral resilience in nursing students demonstrated significant associations with moral courage, age, and previous degrees (Gibson et al., 2020).…”

Section: Review Of Literaturementioning

confidence: 99%

Moral Resilience in Nursing Education: Exploring Undergraduate Nursing Students Perceptions of Resilience in Relation to Ethical Ideology

Arries-Kleyenstüber

2021

SAGE Open Nursing

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Introduction Moral resilience has recently been proposed as one strategy to address moral distress in nurses and nursing students. Central to nursing students’ capacity for moral resilience is how they understood and enact resilience with an element of realism, suggesting an ethical, ideological influence. Resilience is shown to differ significantly across students, and possibly because of a disconnect between a students’ perceived resilience and their ethical ideology. Yet, resilience seldom has been explored in relation to ethical ideology. Objective This study aims to explore self-reported resilience in relation to ethical ideology in undergraduate nursing students, compare differences in scores, and explore relationships between study variables and selected demographic characteristics. Methods A descriptive cross-sectional research design was followed. An online encrypted survey was conducted among a convenient sample of nursing undergraduates who met the eligibility criteria and provided implied informed consent. This study complied with ethical principles outlined in the Canadian Tri-Council Policy Statement for research with human subjects. Ethical approval was secured from the University’s Research Ethics Board. Data were analyzed using mean scores, standard deviations, independent sample t-test, variance analysis with post hoc–testing, and Pearson correlation to explore differences in perceptions and associations between study and selected demographic variables. Results Undergraduate students have a high level of self-reported resilience. Statistically significant differences in self-reported resilience across selected demographic variables were observed. The association between resilience and ethical ideology was not significant. Ethical relativism was significantly correlated with age and year of study. Conclusion Findings suggest that faculty cultivating resilience in nursing students pays attention to gender’s influence discourses in students’ perceptions of resilience and ethical ideology and provides students with opportunities for ethical self-reflection and dialogue to critically examine their ethical ideological perspectives and the influence these may have on moral resilience development. Implications for future research are discussed.

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Exploring the Relationships Among Moral Distress, Moral Courage, and Moral Resilience in Undergraduate Nursing Students

Cited by 38 publications

References 28 publications

Instruments for Detecting Moral Distress in Clinical Nurses: A Systematic Review

Instruments for Detecting Moral Distress in Clinical Nurses: A Systematic Review

Death anxiety, moral courage, and resilience in nursing students who care for COVID-19 patients: a cross-sectional study

Moral Resilience in Nursing Education: Exploring Undergraduate Nursing Students Perceptions of Resilience in Relation to Ethical Ideology

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