Correlation between moral sensitivity and self-esteem in nursing personnel

  • Farideh Rahnama MSc Education Development Center, Saveh University of Medical Sciences, Saveh, Iran.
  • Marjan Mardani - Hamooleh Assistant Professor Department of Psychiatric Nursing, Iran University of Medical Sciences, Tehran, Iran.
  • Marjan Kouhnavard Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Moral sensitivity, Nurse, Nursing ethics, Self-esteem


Nurses are continuously involved with ethical problems in their area of practice and need to possess a satisfactory level of moral sensitivity in order to be able to offer moral care. Additionally, they act as agents for proper management of ethical dilemmas and are therefore required to have high self-esteem. This study aimed to determine the correlation between moral sensitivity and self-esteem in nurses. In this descriptive-correlational research, sample study included 204 nursing personnel working in hospitals affiliated with Iran University of Medical Sciences. Participants were selected by convenience sampling. The data were collected using a demographic form, Lützén’s Moral Sensitivity Questionnaire, and Rosenberg’s Self-Esteem Questionnaire. Then, the data were analyzed using descriptive and analytical statistics. Written informed consent was obtained from each subject who participated in the research. The mean score for moral sensitivity of the samples was 69.15 ± 5.70, and 20.01 ± 4.76 for their self-esteem. Pearson’s correlation coefficient test indicated a meaningful and positive relationship between the two variables under study (r = 0.472 and P = 0.001). There was no correlation between the participants’ demographic data and moral sensitivity (P > 0.05), but a significant relationship was found between the participants' level of education and the variable self-esteem (P < 0.05). Since there was a positive and significant relationship between moral sensitivity and self-esteem among the nursing staff, nursing managers should focus on improving the quality of patient care by promoting nurses’ moral sensitivity inspired by high self-esteem.


1. Kulju K, Suhonen R, Leino-Kilpi H. Ethical problems and moral sensitivity in physiotherapy: a descriptive study. Nurs Ethics. 2013; 20(5):568-77.
2. Shoorideh FA, Ashktorab T, Yaghmaei F, Alavi MH. Relationship between ICU nurses' moral distress with burnout and anticipated turnover. Nurs Ethics. 2015; 22(1): 64-76.
3. Thorup CB, Rundqvist E, Roberts C, Delmar C. Care as a matter of courage: vulnerability, suffering and ethical formation in nursing care. Scand J Caring Sci. 2012; 26(3): 427-35.
4. Lützén K, Blom T, Ewalds-Kvist B, Winch S. Moral stress, moral climate and moral sensitivity among psychiatric professionals. Nurs Ethics. 2010; 17(2): 213-24.
5. Borhani F, Keshtgar M, Abbaszadeh A. Moral self-concept and moral sensitivity in Iranian nurses. J Med Ethics Hist Med. 2015; 8: 4.
6. Kim YS, Kang SW, Ahn JA. Moral sensitivity relating to the application of the code of ethics. Nurs Ethics. 2013; 20(4):470-8.
7. Borhani F, Abbaszadeh A, Mohamadi E, Ghasemi E, Hoseinabad-Farahani MJ. Moral sensitivity and moral distress in Iranian critical care nurses. Nurs Ethics. 2017; 24(4): 474-82.
8. Esmaelzadeh F, Abbaszadeh A, Borhani F, Peyrovi H. Ethical sensitivity in nursing ethical leadership: a content analysis of Iranian nurses experiences. Open Nurs J. 2017; 11:1-13.
9. Cha NH, Sok SR. Depression, self-esteem and anger expression patterns of Korean nursing students. Int Nurs Rev. 2014; 61(1):109-15.
10. Chen MF, Ho CH, Lin CF, et al. Organisation-based self-esteem mediates the effects of social support and job satisfaction on intention to stay in nurses. J Nurs Manag. 2016; 24(1):88-96.
11. Losa Iglesias ME, Becerro de Bengoa Vallejo R. Prevalence of bullying at work and its association with self-esteem scores in a Spanish nurse sample. Contemp Nurse. 2012; 42(1):2-10.
12. Ling IL, Marshall R, Xu Y, Lin WY. Jaypatient-induced service sabotage behavior: the issue of self-esteem of hospital nurses. Health Mark Q. 2014; 31(3):213-30.
13. Sturm BA, Dellert JC. Exploring nurses' personal dignity, global self-esteem and work satisfaction. Nurs Ethics. 2016; 23(4):384-400.
14. Peterson-Graziose V, Bryer J, Nikolaidou M. Self-esteem and self-efficacy as predictors of attrition in associate degree nursing students. J Nurs Educ. 2013; 52(6):351-4.
15. Papazisis G, Nicolaou P, Tsiga E, Christoforou T, Sapountzi-Krepia D. Religious and spiritual beliefs, self-esteem, anxiety, and depression among nursing students. Nurs Health Sci. 2014; 16(2): 232-8.
16. Mahmoodishan G, Alhani F, Ahmadi F, Kazemnejad A. Iranian nurses' perception of spirituality and spiritual care: a qualitative content analysis study. J Med Ethics Hist Med. 2010; 3:6.
17. Lee HL, Huang SH, Huang CM. Evaluating the effect of three teaching strategies on student nurses' moral sensitivity. Nurs Ethics. 2017; 24(6):732-43.
18. Lützén K, Nordin C, Brolin G. Conceptualization and instrumentation of nurses' moral sensitivity in psychiatric practice. International Journal of Methods in Psychiatric Research. 1994; 4(4): 241-8.
19. Rosenberg, M. Society and the Adolescent Self-Image. USA; Princeton University Press.1965.
20. Acharya Pandey R, Chalise HN. Self-Esteem and academic stress among nursing students. Kathmandu Univ Med J (KUMJ). 2015; 13(52):298-302.
21. Van Eckert S, Gaidys U, Martin CR. Self-esteem among German nurses: does academic education make a difference? J Psychiatr Ment Health Nurs. 2012; 19(10): 903-10.
22. Ebrahimi H, Navidian A, Keykha R. Effect of supportive nursing care on self-esteem of patients receiving electroconvulsive therapy: a randomized controlled clinical trial. J Caring Sci. 2014; 3(2):149-56.
23. Khajehdaluee M, Zavar A, Alidoust M, Pourandi R. The relation of self-esteem and illegal drug usage in high school students. Iran Red Crescent Med J. 2013; 15(11):e7682.
24. Iacobucci TA, Daly BJ, Lindell D, Griffin MQ. Professional values, self-esteem, and ethical confidence of baccalaureate nursing students. Nurs Ethics. 2013; 20(4): 479-90.
25. Sodeify R, Vanaki Z, Mohammadi E. Nurses'experiences of perceived support and their contributing factors: A qualitative content analysis. Iran J Nurs Midwifery Res. 2013; 18(3):191-7.
26. Jaafarpour M, Khani A. Evaluation of the nurses' job satisfaction, and its association with their moral sensitivities and well-being. J Clin Diagn Res. 2012; 6(10):1761-4.
27. Borhani F, Abbaszadeh A, Hoseinabadi-Farahani MJ. Moral sensitivity and its dimensions in Iranian nursing students. J Med Ethics Hist Med. 2016; 9:1.
28. Baykara ZG, Demir SG, Yaman S. The effect of ethics training on students recognizing ethical violations and developing moral sensitivity. Nurs Ethics. 2015; 22(6): 661-75.
29. Borhani F, Abbaszadeh A, Mohsenpour M. Nursing students' understanding of factors influencing ethical sensitivity: A qualitative study. Iran J Nurs Midwifery Res. 2013; 18(4): 310-5.
30. Huang FF, Yang Q, Zhang J, Khoshnood K, Zhang JP. Chinese nurses' perceived barriers and facilitators of ethical sensitivity. Nurs Ethics. 2016; 23(5): 507-22.
31. Nejadsarvari N, Abbasi M, et al. Relationship of moral sensitivity and distress among physicians. Trauma Mon. 2015; 20(2): e26075.
32. Sadoughi F, Ebrahimi K. Self-esteem and organizational commitment among health information management staff in tertiary care hospitals in Tehran. Glob J Health Sci. 2014; 7(2): 328-34.
33. Ahn YH, Choi J. Factors affecting Korean nursing student empowerment in clinical practice. Nurse Educ Today. 2015; 35(12):1301-6.
34. Shrestha T. Self-esteem and stress coping among proficiency certificate level nursing students in nursing campus Maharajgunj and Lalitpur Nursing Campus. J Nepal Health Res Counc. 2013; 11(25): 283-8.
35. Liu J, Liu YH. Perceived organizational support and intention to remain: The mediating roles of career success and self-esteem. Int J Nurs Pract. 2016; 22(2): 205-14.
36. Valizadeh L, Zamanzadeh V, Gargari RB, Ghahramanian A, Tabrizi FJ, Keogh B. Pressure and protective factors influencing nursing students' self-esteem: A content analysis study. Nurse Educ Today. 2016; 36: 468-72.
How to Cite
Rahnama F, Mardani - Hamooleh M, Kouhnavard M. Correlation between moral sensitivity and self-esteem in nursing personnel. jmehm. 10.
Original Article(s)