Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students

Chua, Rowena L. Escolar

doi:10.1177/0969733016654317

Cited by 105 publications

(163 citation statements)

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“…Thus, nursing students experience morally distressing situations and they witness circumstances of care and behavior that are morally inappropriate in the academic environment, disrespect to the subjects and their rights, incompatible with their values, principles and personal standards learned during their academic training, possibly experiencing moral distress (MD). Studies on MD in nursing students have been prominent in the international (1,(3)(4)(5)(6)(7) and national (8)(9)(10) fields. In this context, students may face difficulties to resist disciplinary mechanisms of power, which aim to form docile bodies with maxims of obedience and submission to norms and hierarchy (11) .…”

Section: Introductionmentioning

confidence: 99%

Nursing students facing moral distress: strategies of resistance

et al. 2018

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Objective: To understand the resistance strategies adopted by undergraduate students in nursing, faced with situations of moral distress (MD). Method: Qualitative research, developed in three universities in the south of Brazil, two federal and one private, with 21 undergraduate students in nursing from December 2015 to February 2016; the data was submitted to the discursive textual analysis and Foucauldian theoretical reference. Results: Students resisting demonstrate a sense of self-preservation and moral empowerment. Moreover, non-resistance initiatives are related to the fear of possible sanctions. Thus, by resisting or not, students may experience both positive and negative repercussions. Final considerations: By resisting, students aim to defend what they believe to be right, demonstrating their moral empowerment in the face of their moral distress. However, the exercise of disciplinary power seems to contribute to their moral fragilization, making it diffi cult to implement resistance strategies. Descriptors: Nursing Students; Nursing Education; Power; Moral; Ethics. RESUMO Objetivo: Compreender as estratégias de resistência adotadas pelos estudantes de graduação em enfermagem, diante de situações de sofrimento moral (SM). Método: Pesquisa qualitativa, desenvolvida em três universidades do sul do Brasil, duas federais e uma privada, com 21 estudantes de graduação em enfermagem, entre dezembro de 2015 e fevereiro de 2016; os dados foram submetidos à análise textual discursiva e referencial teórico foucaultiano. Resultados: Os estudantes ao resistirem demonstram um senso de autopreservação e fortalecimento moral. Ainda, ações de não resistência relacionam-se ao medo de possíveis sanções. Assim, ao resistir ou não, os estudantes podem vivenciar repercussões tanto positivas como negativas. Considerações fi nais: Ao resistir, os estudantes visam defender o que acreditam ser o correto, demonstrando seu fortalecimento moral diante do sofrimento moral. No entanto, o exercício do poder disciplinar parece contribuir para sua fragilização moral, difi cultando a implementação de estratégias de resistência. Descritores: Estudantes de Enfermagem; Educação em Enfermagem; Poder; Moral; Ética. RESUMEN Objetivo: Comprender las estrategias de resistencia adoptadas por los estudiantes de graduación en enfermería, ante situaciones de sufrimiento moral (SM). Método: La investigación cualitativa, desarrollada en tres universidades del sur de Brasil, dos públicas y una privada, con 21 estudiantes de graduación en enfermería, entre diciembre de 2015 y febrero de 2016; los datos fueron sometidos al análisis textual discursivo y referencial teórico foucaultiano. Resultados: Los estudiantes al resistir demuestran un sentido de autopreservación y fortalecimiento moral. Aún, acciones de no resistencia se relacionan con el temor de posibles sanciones. Así, al resistir, o no, los estudiantes pueden experimentar repercusiones tanto positivas como negativas. Consideraciones fi nales: Al resistir, los estudiantes pretenden defende...

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Section: Introductionmentioning

confidence: 99%

Nursing students facing moral distress: strategies of resistance

et al. 2018

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“…Studies have shown that personal and professional factors(Suhonen et al, 2011), organizational culture, and leadership style(Escolar, 2018), can affect moral courage in nurses. It appears that ethical climate of organization also affects moral courage (Höge et al, 2019; Suhonen et al, 2011).…”

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confidence: 99%

The Relationship Between Moral Courage and the Perception of Ethical Climate in Nurses

Hakimi

Mousazadeh²,

Nia

et al. 2020

Preprint

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Background: Moral courage, as a strategy to reinforce ethics and doing courageous deeds, is essential in providing nursing cares. Proper management of ethical challenges, professional commitment to patients, and ethical performance require moral courage. In addition, this concept is affected by personal and professional traits and organizational cultural. Ethical climate is a part of organization character, represents ethics in the organization. Ethical climate helps individuals to assess the problems and also acts as a guide for making decision about acceptable and unacceptable behaviors. The present study is an attempt to examine some of the predicting variables of moral courage in nurses. Methods: The study was carried out as predictive study in 2019. The subjects were 267 nurses working in hospitals who were selected through simple random sampling. Data gathering tool included a demographics form, Sekerka’s job satisfaction standardized questionnaire, and Elson’s ethical climate standardized questionnaire. Results: The mean scores of moral courage and ethical climate in nurses were 87.07±15.52 and 96.12±17.17 respectively. The findings showed that 16% of moral courage score in nurses was attributed to ethical climate and overtime work hours per month. Conclusions: Although, ethical climate and overtime work hours were the main factors in moral courage, not a notable percentage of the variance of moral courage was attributed to them. Therefore, there is a need to determine other factors in moral courage.

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“…2,17 Moral courage has been studied from the perspective of nursing students also earlier, mainly in the 2000s. 5,9,12,14,17 It has been shown that students feel an obligation to act as patients' advocates, 12,17 and for this, they need moral courage. 9,14,17 However, students sometimes seem to lack courage.…”

Section: Introductionmentioning

confidence: 99%

Analysis of graduating nursing students’ moral courage in six European countries

Koskinen¹,

Pajakoski

Linares

et al. 2020

Nurs Ethics

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Background: Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career. Aim: To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries. Research design: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0–100), the questionnaire also covered several background variables. Participants and research context: The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires. Ethical considerations: Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent. Results: The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves. Discussion and conclusions: In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research.

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Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students

Abstract: Results of the study imply that moral distress is a reality among all healthcare professionals including nursing students and requires more consideration by nurse educators.

Cited by 105 publications

References 45 publications

Nursing students facing moral distress: strategies of resistance

Nursing students facing moral distress: strategies of resistance

The Relationship Between Moral Courage and the Perception of Ethical Climate in Nurses

Analysis of graduating nursing students’ moral courage in six European countries

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