Moral sensitivity in Iranian nurses: insights from a nationwide meta-analysis

Moral sensitivity is essential for nurses to recognize and appropriately respond to ethical issues, understanding the impact of their actions on patient well-being. It improves care quality, ethical decision-making, and equips nurses with skills to handle moral dilemmas in clinical settings. Various studies in Iran have reported different results. Accordingly, this study was conducted to estimate the pooled standardized moral sensitivity score among Iranian nurses.

A systematic search of national and international databases was conducted up until June 2023, yielding 563 articles. After screening by two independent researchers, 52 articles with a total sample size of 11,621 participants were included in the analysis. Any discrepancies were resolved through discussion. Heterogeneity was assessed using the I² index. Subgroup analyses were performed based on the language of the articles, sample size, and country region. Meta-regression analysis was conducted to explore the relationship between the moral sensitivity score and variables such as age, year of publication, and sample size. All analyses were performed using Stata software, version 17.

The pooled moral sensitivity score was 69% (95% CI: 66-72, I² = 94.03%). The highest overall ethical sensitivity score was observed in region 5 of the country (73.6%, 95% CI: 67-80.1), in articles published in Farsi (70.2%, 95% CI: 65.8-74.7), and in articles with a sample size of less than 200 participants (70%, 95% CI: 66.3-73.6). No significant relationship was found between the overall ethical sensitivity score and variables such as age, year of publication, or sample size. Publication bias was significant (p = 0.001).

This meta-analysis indicates a moderate level of moral sensitivity among Iranian nurses. While regional and study-related differences were observed, no significant relationship was found between the moral sensitivity score and variables like age, year of publication, or sample size. Publication bias suggests the need for more representative studies to fully understand the factors influencing moral sensitivity in nursing.

This study is a systematic review and meta-analysis, and not a clinical trial.