Original Article

Professional moral courage and moral reasoning among nurses in clinical environments: a multivariate model


Improving ethical practice needs recognizing the relationship between moral reasoning and moral courage among nurses. We examined factors (moral reasoning, practical consideration, moral dilemmas familiarity, and demographic and work characteristics) associated with moral courage among nurses. A cross-sectional design was run at all five hospitals affiliated to Hamadan University of Medical Sciences in west of Iran. A proportionate random sampling due to the total size of the nurse population in each hospital, 224 eligible nurses were completed the study questionnaires: demographic-work characteristics, Professional Moral Courage (PMC), and Nursing Dilemma Test. The relationships were examined by multiple regression analysis. Participants reported a more than moderate level of moral reasoning and PMC (43.21±5.98 and 56.16±10.18 respectively). The multivariate model showed the nurses’ PMC is positively predisposed with moral reasoning (β=0.21, p<0.01), but negatively with practical consideration (β=-0.16, p<0.01). More moral courage was found in the nurses who were never married (p<0.001), graduated from a public university (p<0.01), working in the critical care and emergency environments, as well as night shifts (all p<0.001). Moral reasoning is a predictor of moral courage, and both should be considered in designing nursing education to improve ethical nursing practice.

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IssueVol 14 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jmehm.v14i20.8180
Decision-making Ethics courage Ethical analytic Nursing thinking

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How to Cite
Khatiban M, Falahan SN, Soltanian AR. Professional moral courage and moral reasoning among nurses in clinical environments: a multivariate model. J Med Ethics Hist Med. 2021;14.