Moral Courage Among Nurses Working at Zahedan University of Medical Sciences
akhlāq-i pizishkī i.e., Medical Ethics,
Vol. 20 (1405),
13 Tir 2026
,
Page 1-14
https://doi.org/10.22037/mej.v20i.52691
Abstract
Background and Aim: Moral courage is a very critical aspect in the nursing profession that can significantly affect the quality of nursing care. Given the limited number of studies on the moral courage of nurses working in border regions of Iran, as well as its vital role in managing context-specific ethical challenges, this study aimed to determine the level of moral courage among nurses working at Zahedan University of Medical Sciences.
Methods: The present research is a descriptive cross-sectional study conducted among 300 nurses working in educational hospitals affiliated with Zahedan University of Medical Sciences. Participants were selected using proportionate stratified random sampling. Data were collected using the Sekerka Moral Courage Questionnaire from April 2026 to May 2026, which had been culturally adapted and validated for the Iranian context by Mohammadi et al. Data were analyzed using SPSS version 22 through independent-samples t-test, one-way analysis of variance (ANOVA), Tukey's test, and multiple linear regression. A p-value of <0.05 was considered statistically significant.
Ethical Considerations: This study was conducted following the approval of the Research Ethics Committee of Zahedan University of Medical Sciences. Written informed consent was obtained from all participants, and the confidentiality of their information was maintained.
Results: The results of the present study showed that the majority of participants were female (75%) and married (62%). The mean age of participants was (38.8±8.63) years, and the mean work experience was (15.1±3.60) years. The mean moral courage score among the nurses was (73.9±9.24). The results of the independent-samples t-test and one-way analysis of variance (ANOVA) showed significant associations between moral courage and age (P=0.02), work experience (P=0.05), educational level (P=0.04), employment status (P=0.03), and workplace unit (P=0.04). However, in the multiple linear regression analysis, participation in ethics-related training courses remained the only significant predictor of moral courage (P=0.003). The highest scores were observed in the dimensions of moral agency and multiple values, whereas the lowest score was observed in the and the lowest in tolerance for threat dimension. No statistically significant associations were found between the moral courage score and sex, marital status, and work shift variables (P≥0/05).
Conclusion: Given that the nurses’ mean moral courage score was at a moderate level, with the lowest score observed in the tolerance for threat dimension, and that nurses with non-permanent employment had lower moral courage scores, the need for multi-level interventions, including targeted training programs, strengthening organizational support, enhancing job security for non-permanent nurses, and promoting ethical leadership in hospital management, is suggested as essential solutions. Conducting interventional studies to determine the effectiveness of these solutions is recommended
- Moral Courage
- Nurse
- Ethics
How to Cite
References
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