Investigating the Factors Influencing Moral Courage in Nurses: A Systematic Review

Javanmardi , Morteza; Karimipour , Seyede Elahe; Bakhshizadeh , Zahra; Taklif, Mohammad Hossein; Farid, Negin

Volume 17 - Supplement of 11th Annual Iranian Congress of Medical Ethics IJMEHM 2024, 17 - Supplement of 11th Annual Iranian Congress of Medical Ethics : 1-2 | Back to browse issues page

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Javanmardi M, Karimipour S E, Bakhshizadeh Z, Taklif M H, Farid N. Investigating the Factors Influencing Moral Courage in Nurses: A Systematic Review. IJMEHM 2024; 17 (S1) :1-2
URL: http://ijme.tums.ac.ir/article-1-6989-en.html

Investigating the Factors Influencing Moral Courage in Nurses: A Systematic Review

Morteza Javanmardi¹, Seyede Elahe Karimipour², Zahra Bakhshizadeh³, Mohammad Hossein Taklif⁴, Negin Farid ^*⁵

1- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
2- Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3- Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
4- Marine Medicine Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
5- Student Research Committee, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract: (953 Views)

Moral courage, encompassing the ability to act ethically in the face of adversity and uphold ethical principles, is crucial for nurses. This systematic review aimed to investigate the factors influencing moral courage among nurses. A comprehensive literature search was conducted using keywords such as "moral courage," "ethics," "nurses," and "courage" in major databases, including PubMed/Medline, Web of Science Core Collection, Scopus, Google Scholar, Irandoc, SID, and Magiran. The search included publications in both English and Persian with no time limitations. After excluding duplicates and screening the initial 2577 studies, 21 studies met the inclusion criteria. The review adhered to the PRISMA guidelines for reporting systematic reviews, ensuring ethical considerations were maintained throughout the selection, extraction, and analysis processes. The review revealed that moral courage in nurses is influenced by a multifaceted array of factors. Individual factors such as age, gender, work experience, and type of employment (e.g., permanent vs. temporary) were found to influence moral courage. Higher education, particularly possessing a master's degree or higher, and participation in medical ethics training were significantly associated with increased moral courage. Ethical sensitivity, defined as the ability to recognize and appreciate ethical dilemmas, was a significant facilitator of moral courage. A supportive work environment, characterized by factors such as strong ethical leadership, open communication, and adequate resources, was found to positively influence moral courage. Conversely, ethical distress experienced in challenging clinical situations can negatively impact moral courage. This review demonstrates that moral courage among nurses is influenced by a complex interplay of individual, professional, and environmental factors. Enhancing moral courage requires a multi-pronged approach, including strengthening nursing education with a robust emphasis on ethics training, fostering a supportive and ethically sound work environment, and implementing strategies to mitigate ethical distress. These interventions can significantly contribute to improved clinical practice and enhanced patient care.

Keywords: Moral courage, Ethics, Nurses, Courage, Systematic review

Full-Text [PDF 377 kb] (242 Downloads)

Type of Study: Poster | Subject: Health Ethics Congress (11th) - Poster Presentation
Received: 2025/07/16 | Revised: 2026/01/12 | Accepted: 2024/12/23 | Published: 2024/12/23