Volume 33, Issue 127 (December 2020)                   IJN 2020, 33(127): 35-44 | Back to browse issues page


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Hassanzadeh Naeini M, Nasiriani K, Fazljoo S. Moral Courage of the Nursing Students of Yazd University of Medical Sciences, Iran. IJN 2020; 33 (127) :35-44
URL: http://ijn.iums.ac.ir/article-1-3359-en.html
1- Student Research Committee, Meybod School of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Department of Nursing, Research Center for Nursing and Midwifery Care, Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Department of Nursing, Meybod School of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran (Corresponding author) Tel: +989337655574 Email: efazljoo@gmail.com
Abstract:   (1597 Views)
Background & Aims: Nursing performance within the framework of professional ethics makes nurses respect their clients' needs, security, and privacy and enhance the welfare criteria. In contrast, lack of commitment to professional ethics in nurses may influence patient satisfaction and improvement, quality of care, standards of nursing services, and promotion of the nursing profession. Today, nurses are faced with spiritual and ethical issues and conflicts in an unprecedented manner due to their professional status and key role in health care. Some of these ethical issues include the use of invasive treatment protocols for dying patients, unnecessary tests, the manipulation and forging of the test reports, lack of complete and sufficient treatment by other employees, and the unjust distribution of power among healthcare employees. In addition, personal and organizational obstacles may often prompt nurses to avoid fulfilling their ethical obligations toward patients, which in turn prevents value-based nursing performance. Therefore, nurses need ethical courage to properly manage the ethical issues arising in the clinical setting. Biological ethics experts believe that professional ethics must be instructed and strengthened through university courses to enable nurses to battle ethical challenges in clinical settings. Clinical settings are considered a basic component of the nursing curriculum, as well as a permanent source of anxiety for nursing students, especially in the cases where they may be confronted with poor performance. Such examples of poor performance in clinical settings are the physical or emotional abuse of patients, violation of patient's privacy, non-standard/outdated care, clinical errors, and the performance of healthcare experts beyond their authority. If nursing students are faced with poor performance in clinical settings, they may internalize their negative feelings and associate them with the nursing profession, questioning whether they must continue their education. Some nursing students question their capability in finding a solution to ethical challenges, which is a major source of diffidence and anxiety in the future. Given the importance of ethical courage in nursing students and its impact on the quality of care in their future profession, the present study aimed to evaluate the ethical courage of the nursing students of Shahid Sadoughi University of Medical Sciences in Yazd, Iran in 2020.
Materials & Methods: This descriptive, cross-sectional study was conducted in 2019 at the nursing schools of Shahid Sadoughi University of Medical Sciences. A sample of BA and MA nursing students (n=242) were selected via stratified random sampling. In sampling, the level of the students in the class was considered, and the sample size was determined in proportion to the number of the students in each class. The participants were selected randomly from each class. Data were collected using Sekerka's ethical courage questionnaire, which was developed by Sekerka et al. in 2009 and consists of 15 items. The questionnaire items measure the adherence of nurses to ethical principles despite their intrinsic needs and external pressures. The five dimensions of the questionnaire include ethical aspects, multiple values, tolerance of threat, sensitivity, and ethical objectives. Each dimension has three items, which are scored based on a five-point Likert scale (Never=1, Rarely=2, Sometimes=3. Often=4, Always=5). The minimum and maximum scores of the questionnaire are 15 (low ethical courage) and seven (high ethical courage), respectively. Data analysis was performed in SPSS version 16 using descriptive statistics (mean, standard deviation, percentile) and inferential statistics (Pearson's correlation-coefficient, independent t-test, one-way ANOVA).
Results: In total, 242 nursing students aged 18-44 years (mean age: 21.90 ± 3.45 years) were enrolled in the study. The mean score of ethical courage was 55.72 ± 7.84. In Meybod and Yazd, the mean score of ethical courage was 56.98 ± 7.06 and 54.46 ± 8.62, respectively, and no significant difference was observed in this regard (P=0.38). The highest score of ethical courage was denoted in the ethical dimension (11.88 ± 2.21), while the lowest score belonged to the dimension of threat tolerance (10.25 ± 1.90). Moreover, data analysis indicated a significant correlation between ethical courage and gender, and the female nursing students reported a higher ethical courage score compared to the males (P=0.04). However, no significant correlations were observed between ethical courage and other demographic variables, such as marital status and place of residence (P>0.05).
Conclusion: According to the results, the mean ethical courage score of the nursing students was average. It seems that nursing students feel responsible when faced with ethical issues. However, optimizing their sense of responsibility requires proper interventions since ethical courage in today's nursing students could result in a favorable ethical atmosphere in the healthcare system, thereby improving the quality of healthcare services and increasing patient satisfaction. Therefore, it is essential for nursing schools to promote ethical responses in the students. Furthermore, instructors should live up to their role and encourage ethical courage in nursing students.   
Keywords: Moral, Courage, Nursing, Student
Full-Text [PDF 892 kb]   (760 Downloads)    
Type of Study: Research | Subject: nursing
Received: 2020/09/9 | Accepted: 2020/12/9 | Published: 2021/04/7

References
1. Abadi NE, Rahimzadeh M, Omidi A, Farahani F, Malekyan L, Jalayer F. The relationship between moral courage and quality of work life among nursing staff in Bam hospitals. J Adv Pharm Educ Res Jan-Mar. 2020;10(S1):127-32.
2. Gholamhosseini L, Hanafiye Moghadas M, Vandaee O. Value and Status of Professional Morality in the Providing Nursing Services. Paramedical Sciences and Military Health. 2015;10(1):55-62.
3. Fazljoo E, Borhani F, Hoseini SH, Abbaszadeh A. Nurses' perception of moral distress among nurses working in educational hospitals affiliated to Yazd university of medical sciences. Medical Ethics Journal. 2017;11(40):7-15.
4. Numminen O, Repo H, Leino-Kilpi H. Moral courage in nursing: A concept analysis. Nurs Ethic. 2017;24(8):878-91. [DOI:10.1177/0969733016634155] [PMID]
5. Kleemola E, Leino-Kilpi H, Numminen O. Care situations demanding moral courage: content analysis of nurses' experiences. Nurs Ethic. 2020;27(3):714-25. [DOI:10.1177/0969733019897780] [PMID]
6. Moosavi SS, Borhani F, Abbaszadeh A. The moral courage of nurses employed in hospitals affiliated to Shahid Beheshti University of Medical Sciences. Journal of hayat. 2017;22(4):339-49.
7. Sadooghiasl A, Parvizy S, Ebadi A. Concept analysis of moral courage in nursing: A hybrid model. Nurs Ethic. 2018;25(1):6-19. [DOI:10.1177/0969733016638146] [PMID]
8. Mollaei F, Abbaszadeh A, Loghmani L, Khabazkhob M, Borhani F. Moral courage of nursing students: A descriptive study in Iran 2017. Astra Salvensis. 2018;6:39-44.
9. Ahanchian M, Sharafi S, Vafaee M, Hajiabadi F. Evaluate the Effectiveness of internship program in nursing student using Kirkpatrick's model. Research in Medical Education. 2017;9(1):17-9. [DOI:10.18869/acadpub.rme.9.1.17]
10. Monrouxe LV, Rees CE, Endacott R, Ternan E. 'Even now it makes me angry': health care students' professionalism dilemma narratives. Medical Education. 2014;48(5):502-17. [DOI:10.1111/medu.12377] [PMID]
11. Rees CE, Monrouxe LV, McDonald LA. 'My mentor kicked a dying woman's bed…'Analysing UK nursing students''most memorable'professionalism dilemmas. J Adv Nurs. 2015;71(1):169-80. [DOI:10.1111/jan.12457] [PMID]
12. Bickhoff L, Sinclair PM, Levett-Jones T. Moral courage in undergraduate nursing students: A literature review. Collegian. 2017;24(1):71-83. [DOI:10.1016/j.colegn.2015.08.002] [PMID]
13. Borhani F, Alhani F, Mohammadi E, Abbaszadeh A. Nursing students perception of barriers of acquiring professional ethics: a qualitative research. Strides in Development of Medical Education. 2011;8(1):67-80.
14. Hanifi N, Moqaddam M, Ghahremani Z. Factors Related to Moral Courage of Nursing Students in Zanjan. Preventive Care in Nursing & Midwifery Journal. 2019;9(1):22-8. [DOI:10.29252/pcnm.9.1.22]
15. Sekerka LE, Bagozzi RP, Charnigo R. Facing ethical challenges in the workplace: Conceptualizing and measuring professional moral courage. J Busin Ethic. 2009;89(4):565-79. [DOI:10.1007/s10551-008-0017-5]
16. Hannah ST, Avolio BJ, Walumbwa FO. Relationships between authentic leadership, moral courage, and ethical and pro-social behaviors. Busin Ethic Quart. 2011;21(4):555-78. [DOI:10.5840/beq201121436]
17. Namadi F, Shahbazi A, Khalkhali H. Moral Courage of Nurses in Educational and Therapeutic Centers of Urmia University of Medical Sciences. Nurs Midwifery J. 2019;17(7):574-81.
18. Escolar-Chua RL. Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students. Nurs Ethic. 2018;25(4):458-69. [DOI:10.1177/0969733016654317] [PMID]
19. Aminizadeh M, Arab M, Mehdipour R. Relationship moral courage to moral distress in nurses the intensive care unit. Iranian Journal of Medical Ethics and History of Medicine. 2017;10(1):131-40.
20. Hoseini M, Ebadi M, Farsi Z. The effect of ethical motivational program on nurses' moral courage in Mashhad's military hospitals. Journal of Military Medicine. 2019;21(4):410-7.
21. Moosavi S, Izadi A. Comparison of moral courage of the nurses and nursing managers working in hospitals affiliated to Shahid Beheshti University of Medical Sciences. Medical Ethics Journal. 2017;11(41):17-24.
22. Mahdaviseresht R, Atashzadeh-Shoorideh F, Borhani F. Correlation between moral sensitivity and moral courage in nurses of selected hospitals affiliated to Tabriz University of Medical Sciences in 2014. Iranian Journal of Medical Ethics and History of Medicine. 2015;8(3):27-39.

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