Nurses’ self-assessed moral courage and related socio-demographic factors

Abstract

Background: Nurses need moral courage to ensure ethically good care. Moral courage is an individual characteristic and therefore it is relevant to examine its association with nurses’ socio-demographic factors. Objective: To describe nurses’ self-assessed level of moral courage and its association with their socio-demographic factors. Research design: Quantitative descriptive cross-sectional study. The data were collected with Nurses’ Moral Courage Scale and analyzed statistically. Participants and research context: A total of 482 registered nurses from a major university hospital in Southern Finland completed the Finnish language version of Nurses’ Moral Courage Scale in autumn 2017. Ethical considerations: Ethical approval was obtained from the university ethics committee and permission for the data collection from the participating hospital. Ethical principles and scientific guidelines were followed throughout the research process. Findings: Nurses’ self-assessed level of moral courage was rather high. On Visual Analogy Scale (0–10), the mean value was 8.20 and the mean score of the four dimensional, 21-item Nurses’ Moral Courage Scale was 4.09 on a 5-point Likert-type scale. Respondents’ gender, present work role, ethical knowledge base, additional ethics education, self-study as a means to acquire ethical knowledge, and frequency of work situations needing moral courage were statistically significantly associated with nurses’ moral courage. Discussion: Strongest association was found between nurses’ higher moral courage level and formal and informal ethics education. Honesty and patient’s humane and dignified encounter received the highest scores indicating respondents’ internalization of the core values of nursing. Conclusion: Although nurses were fairly morally courageous, moral courage should be a part of nurses’ basic and continuing education thus covering its theoretical and practical learning. Since moral courage is a virtue that can be taught, learnt, and practiced, education is a relevant way to maintain and further strengthen nurses’ moral courage.

The relationship between ethical leadership, conscientiousness, and moral courage from nurses’ perspective

“…The results showed that demographic characteristics did not contribute to explaining variance in conscientiousness and moral courage significantly. In line with the results of the present study, the results of Hauhio et al 's study showed that there was no relationship between age, work experience, and highest degree with moral courage [30]. No significant correlation was found between the level of conscientiousness and job factors in the study by Kwiatosz-Muc et al [84].…”

“…Moral courage and conscientiousness are characteristics that are related to individual and organizational factors [10,30]. Individual factors include socio-demographic factors such as work experience [31,32], level of education [33,34], age [33,35], frequency of challenging situations [31], marital status [32] and so on.…”

Whistle-blowers – morally courageous actors in health care?

“…Moral courage is "the golden mean" between cowardice and rashness, with the former indicating irrational fear and the latter thoughtlessness. 16,31,33,34 In the health care context, research about moral courage has been scarce, although it has increased during the past decade, particularly among nurses 33,[35][36][37] and nurse students. [38][39][40][41] The characteristics of a morally courageous nurse 14,30,32,33,37,38,42 and the background variables associated with moral courage have been described in previous literature.…”

“…[38][39][40][41] The characteristics of a morally courageous nurse 14,30,32,33,37,38,42 and the background variables associated with moral courage have been described in previous literature. 36,41 Morally courageous nurses are ethically sensitive, willing to risk themselves for the benefit of others and to act according to their own conscience. 37,[43][44][45] They feel responsibility for others 14,32,45 and possess confidence in situations requiring moral courage 14,43 and are confident in their own ethical principles 41 and value base.…”

“…37 Studies describe associations between moral courage and socio-demographics: age 41 and gender. 36 However, some studies indicate that in terms of moral courage, gender is not a significant variable. 32,45 In addition, education related variablesadditional ethics education, continuing education, 32,37,46 higher level of education and previous degree in health care 41 are associated with moral courage and beneficial for strengthening it.…”