ArticleBMC nursing2024
Moral courage level of nurses: a systematic review and meta-analysis.
Article in BMC nursing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Severity and Associated Factors of Alarm Fatigue Among Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis.Nursing in critical care · 2026Pooled it
- Moral courage in health sciences students: a systematic review of challenges, influencing factors, and consequences.BMC medical education · 2026Pooled it
- Moral Courage Mediates the Relationship Between Ethical Climate and Sustainable Environmental Health Literacy Among Nurses.International journal of environmental research and public health · 2026Article
- Nursing Leadership Styles and Moral Courage: The Mediating Role of Ethical Dilemma Identification and the Moderating Effects of Ethical Climate and Compassion Fatigue.Journal of nursing management · 2026Article
- The relationship between social intelligence, moral courage, and resilience in nurses: a cross-sectional correlational study.Journal of medical ethics and history of medicine · 2026Article
- Professional Identity as a Mechanism Linking Moral Sensitivity to Moral Courage Among Clinical Nurses: A Cross-Sectional Study.Journal of nursing management · 2026Article
- Retaining Those Who Care: Ethical Climate, Leadership, and Workforce Sustainability in Healthcare.Healthcare (Basel, Switzerland) · 2025Article
- Moral sensitivity and professional quality of life in EMS personnel: a cross-sectional multicenter study.BMC emergency medicine · 2025Article
- Moral courage as a predictor of patient safety: reflections from the COVID-19 era.BMC health services research · 2025Article
- Moral courage of palliative care nurses and affecting factors.BMC palliative care · 2025Article
- Article
- Analysis of the current status and influencing factors of moral courage among operating room nurses in Southwest China: a multi-center study.BMC nursing · 2025Article
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Authors and funding
10 authors.
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Abstract
backgroundMoral distress occurs in daily nursing work and plagues nurses. Improving the level of moral courage is one of the main strategies to reduce moral distress, and low levels of moral courage may lead to nurse burnout, increased turnover, and reduced quality of care.
methodsNine electronic databases in Chinese and English were searched for the level of moral courage among nurses, including PubMed, Web of Science, EMBASE, CINAHL, CNKI, Wan fang, Wei pu, CBM and Cochrane Library, for the period from the date of database creation to April 5, 2023. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies, followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analysis and Systematic Reviews of Observational Studies guidelines, and data from the included studies were meta-analyzed in STATA version 15 using a fixed-effects model.
resultsSeventeen cross-sectional studies of moderate or high quality met the eligibility criteria and involved 7718 nurses, and the Nurses' Moral Courage Scale (NMCS) was used to measure the self-assessed moral courage level of nurses. Eleven of these studies reported total scores for nurses' moral courage, and the meta-analysis results showed a pooled mean score of 78.94 (95% CI: 72.17, 85.72); Fourteen studies reported mean entry scores for nurses' moral courage, and the meta-analysis results showed a pooled mean score of 3.93 (95% CI: 3.64, 4.23).
conclusionThe results of the meta-analysis showed that nurses' moral courage levels were in the medium to high range, among the nurses who seemed to be male, non-nursing managers, high school education, had not experienced ethical issues, and considering resignation had lower levels of moral courage. The results of the meta-analysis may provide some reference for nursing managers and even hospital administrators to develop strategies to optimize nursing quality.
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