Table 1 Extracted studies
From: Exploring the foundations and influences of nurses’moral courage: a scoping review
Authors | Year | Type of Study | Results | |
|---|---|---|---|---|
1 | Numminen et al. [4] | 2017 | Rodgers’ evolutionary method | The research has identified the antecedents, attributes (seven core), and consequences of moral courage |
2 | Sadooghiasl et al. [20] | 2018 | Hybrid model | 26 texts were analyzed and features, antecedents, and consequences of moral courage were identified in 3 study phases |
3 | Kleemola et al. [21] | 2020 | Qualitative research | Findings indicated that nurses generally acted morally courageously, but sometimes did not. Additionally, situations requiring moral courage were divided into seven main domains |
4 | Ebadi et al. [12] | 2020 | Descriptive analytical | The study found that 76% of the nurses demonstrated a high level of moral courage, which was significantly related to their job position, participating in professional ethics courses, age, years of experience, employment status, and working shift |
5 | Karampourian et al. [22] | 2023 | Cross-sectional | The moral courage was significantly negatively related to the moral distress experienced by the nurses |
6 | Shahbaz et al. [23] | 2021 | Correlational | The leadership style of head nurses was significantly related to the moral courage of the nurses |
7 | Hauhio et al. [24] | 2021 | Cross-sectional | Nurses rated their level of moral courage as high, which was associated with gender, work role, ethical knowledge, supplementary ethics education, ethics self-study, and frequency of work situations requiring moral courage |
8 | Pajakoski et al. [25] | 2020 | Integrative literature review | Based on research, moral courage is defined by its characteristics, skills, and acts, as well as individual and organizational factors |
9 | Khoshmehr et al. [26] | 2020 | Cross-sectional | The study results revealed a positive correlation between"psychological empowerment"and"moral courage and its dimensions." |
10 | Aminizadeh et al. [17] | 2017 | Descriptive-analytic | The results showed a negative significant relationship between moral courage and moral distress. Additionally, moral courage varied based on position, department type, and marital status |
11 | Nasiriani et al. [27] | 2021 | Descriptive-analytic | The analysis revealed that there was no significant statistically relationship between the ethical climate within the organization and the level of nurses'moral courage |
12 | HU et al. [28] | 2022 | Cross-sectional | Nurses have an above-average level of moral courage. The main factors that promote moral courage are structural and psychological empowerment |
13 | Hthelee et al. [29] | 2023 | Cross-sectional and Correlational | The majority of nurses experienced a moderate degree of moral distress and a high level of moral courage. Also, moral courage revealed a significant indirect relationship with moral distress |
14 | Montazeri et al. [30] | 2022 | Cross-sectional | Nurses'moral courage has a significant direct relationship with their clinical competence |
15 | Hoseini et al. [31] | 2019 | Semi-experimental | The moral courage score and all its dimensions in the three stages of study in the intervention group were significantly different |
16 | Taghadosi et al. [32] | 2019 | Cross-sectional | The research findings revealed a significant relationship between the attitudes of nurses, their commitment to prayer in practice, and their moral courage in professional roles |
17 | Konings et al. [33] | 2022 | Forward–backward translation and cross-sectional | The research revealed that Flemish nurses perceived themselves as displaying moral courage and it was associated with age, professional experience, function, education level and personal interest |
18 | Khajevandi et al. [34] | 2019 | Cross-sectional | In the study, it was found that 69.5% of nurses demonstrated high moral courage. Additionally, a significant relationship was discovered between the employment status of nurses and their moral courage |
19 | Mardanian et al. [35] | 2024 | Hermeneutic phenomenological | The results indicated two main themes: moral conscience and ethical strategy development |
20 | Taraz et al. [36] | 2019 | Correlational | According to the study, the nurses'perception of the ethical climate within the hospital was rated as average, and their level of courage was found to be moderate. The research also revealed a significant positive correlation between the ethical climates experienced by the nurses and their moral courage |
21 | Khodaveisi et al. [37] | 2020 | Cross-sectional | Nurses'moral courage was associated with their moral sensitivity, providing safe and high-quality nursing care, work experience, age, and current employment status |
22 | Abdeen et al. [38] | 2020 | Correlational | Ethical work climate had a significant positive correlation with moral courage and organizational citizenship behavior and a negative correlation with moral distress |
23 | Kashani et al. [39] | 2023 | Cross‑sectional | The findings indicated a significant correlation between the scores of safe nursing care and the demonstration of moral courage. Gender, moral courage, and work experience explained 54% of safe nursing care scores variability |
24 | Dinndorf-Hogenson [40] | 2015 | Correlational | The findings indicate that perioperative nurses'moral courage is significantly influenced by several factors, including their certification status, level of education, support from peers, institutional culture, magnet designation, apprehension of reprisal and retaliation, as well as prior experience in the operating room |
25 | Namadi et al. [16] | 2019 | Cross-sectional | The nurses demonstrated the desired level of moral courage. Age, work history, and marital status were positively and significantly related to moral courage |
26 | Numminen et al. [10] | 2019 | Methodological | The Psychometric evaluation of the Nurses’ Moral Courage Scale found that it is reliable and valid in its current state of development. It also demonstrates a good internal consistency for a new scale |
27 | Naeini et al. [41] | 2020 | Cross-sectional | According to the findings, nursing students had an average score in mean moral courage. Furthermore, a significant correlation was discovered between moral courage and gender, with female students reporting higher moral courage than male students |
28 | Koskinen et al. [42] | 2021 | Cross‑sectional | The mean self-assessed moral courage score of graduating nursing students differed significantly between countries |
29 | Khatiban et al. [43] | 2021 | Cross‑sectional | The study showed that nurses have above-average moral reasoning and professional moral courage. Nurses who were unmarried had graduated from a public university, worked in critical care and emergency environments, and worked night shifts showing more moral courage |
30 | Tehranineshat et al. [44] | 2022 | Methodological | The results supported the validity of the Professional Moral Courage (PMC) questionnaire structures. The reliability (Cronbach's alpha) of the questionnaire for this tool was 0.956 |
31 | Mohammadi et al. [45] | 2014 | Correlational | The findings showed a significant relationship between the intensity of moral distress and moral courage |
32 | Bickhoff et al. [46] | 2016 | Qualitative | Four main themes were identified: (1) patient advocate identity; (2) consequences to the patient and the participant; (3) the impact of key individuals; and (4) picking your battles |
33 | Bickhoff et al. [15] | 2017 | literature review | Most nursing students feel a moral obligation to act, but they often lack the courage to intervene or speak up when they encounter poor practices |
34 | Sadooghiasl [47] | 2016 | Mixed | The questionnaire appears to have acceptable validity (S-CVI = 0.87) and reliability with values ranging from 0.82 to 0.88 |
35 | Moosavi et al. [48] | 2017 | Cross-sectional | The nurses showed a desirable level of moral courage. The more experience they had, the more moral courage they demonstrated |
36 | Abadi et al. [49] | 2020 | Correlational | The study results revealed that moral courage had no statistically significant relationship with the level of education, job titles, employment status, and the quality of work life |
37 | Hakimi et al. [50] | 2020 | Predictive | The research found that the moral courage of nurses is mainly influenced by the ethical work environment and the overtime hours worked |
38 | Wawersik et al. [51] | 2023 | Qualitative | Organizational factors, necessary characteristics of an individual for enacting moral courage and priority methods for guiding moral courage were identified |
39 | Bruun et al. [14] | 2022 | Thematic analysis | Research results suggest that instances of unethical behavior that could compromise patient safety or create issues in the work environment can be prevented when operating room staff demonstrate moral courage by speaking out in support of their patients or colleagues |
40 | Numminen et al. [52] | 2021 | Methodological | The Nurses'Moral Courage Scale in the Dutch language is a reliable and valid tool for measuring moral courage within the field of specialty care nursing |