Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 12 05 1071 1071 EN Mahnaz Khatiban Professor, Mother and Child Care Research Center, Department of Ethics Education in Medical Sciences, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran. Seyedeh Nayereh Falahan Instructor, Chronic Diseases (Home Care) Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran. Ali Reza Soltanian Professor, Modelling of Noncommunicable Diseases Research Centre, Department of Biostatistics, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran. 2021 07 15 2021 12 28 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. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1071 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1071/382