The Relationship Between Nurses' Moral Courage and Caring Behaviours: A Cross-Sectional Study in Türkiye

Moral courage is a fundamental professional trait that enables nurses to uphold ethical principles, protect patient rights and provide safe and compassionate care. Care behaviours constitute the essence of nursing practice and reflect the ethical, humanistic and professional dimensions of care. Although it is assumed that moral courage influences the quality of care, empirical evidence directly examining this relationship is limited.

This study aimed to determine nurses' levels of moral courage and caring behaviours and to examine the relationship between these two concepts.

This cross-sectional, correlational study was conducted among nurses working at three public hospitals in Turkey between March and July 2025. The sample consisted of 328 nurses selected from a population of 1800 nurses using a stratified proportional sampling method. Data were collected online using the Nurses' Ethical Courage Scale and the Nursing Care Behaviours Inventory-30. The data were analysed using descriptive statistics, Pearson correlation analysis, the independent samples t-test, one-way ANOVA and linear regression.

It was determined that nurses' levels of moral courage (83.51 ± 12.53) and care behaviours (144.39 ± 19.62) were high. A moderate, positive and statistically significant relationship was found between moral courage and total care behaviours (r = 0.407, p < 0.01). Regression analysis results indicated that moral courage is a predictor of care behaviours and explains 16.3% of the variance (R² = 0.163, p < 0.001). Additionally, it was found that nurses with a lower patient load, aged ≥ 41, with ≥ 16 years of professional experience and who believe the nursing profession is care-focused had significantly higher care behaviour scores (p < 0.05).

The findings indicate a significant positive relationship between moral courage and nursing caring behaviours and demonstrate that moral courage is a predictor of caring behaviours. These results suggest that moral courage may contribute to the delivery of ethical, holistic and high-quality nursing care. In this context, enhancing ethics education and fostering supportive organisational environments are recommended to strengthen nurses' moral courage. Future research should examine contextual and organisational factors influencing moral courage and caring behaviours using larger and more diverse samples.