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Exploring the foundations and influences of nurses'moral courage: a scoping review

Mina Mollaei¹, Fateme Metanat¹, Amirreza Rafiei Javazm¹

¹Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

BMC Medical Ethics

|April 4, 2025

Abstract

Introduction:

In the realm of healthcare, nurses frequently encounter complex ethical issues that demand moral courage. Nurses'moral courage is defined as the ability to act in alignment with their moral beliefs, even when faced with difficulties and dangers during ethical challenges. This study aims to explore the role of moral courage in nursing practice, highlighting its importance in maintaining patient care standards and fostering ethical decision-making.

Methods:

This scoping review on nurses' moral courage was conducted following Arksey and O'Malley's five-step approach. Relevant literature was sourced from databases such as Embase, PubMed, ScienceDirect, Web of Science, PsycINFO, Scopus, and CINAHL, spanning the years 2000-2024. A total of 40 studies were selected, focusing specifically on the foundations and influences of nurses' moral courage, with data extraction and synthesis for reporting.

Results:

The study highlights moral courage as crucial in nursing for ethical decision-making and patient care. Global variations in moral courage are influenced by cultural, contextual, and organizational factors. Tools for measurement show score discrepancies. Nursing education shapes moral courage, necessitating tailored programs. Research explores personal and organizational influences on ethical behavior, with factors like age, work experience, and ethics training impacting moral courage. Morning shift nurses and those with official employment exhibit higher moral courage. Gender's impact remains inconclusive, requiring further study. Training in nursing ethics enhances moral courage, emphasizing its role in care quality.

Conclusion:

In conclusion, understanding the diverse factors shaping moral courage in nursing is vital for navigating ethical challenges and improving patient care quality. Tailored educational strategies are essential to foster moral courage among nursing professionals globally, emphasizing the need for ongoing research and interventions to enhance ethical practice and patient outcomes.

Keywords:

Moral courage Nurses Nursing Scoping Review

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