ArticleBMC nursing2025
The mediation effects of moral resilience on the relationship between hospital ethical climate and work engagement among nurses: a cross-sectional study.
Article in BMC nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Self-Leadership and Caring as Foundations of Relational Accountability in Nursing Clinical Judgement: A Conceptual Analysis.Nursing open · 2026Review
- Associations of Emotional Intelligence and Ethical Climate With Job Involvement Among Operating Room Personnel: A Cross-Sectional Study.Journal of nursing management · 2026Article
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5 authors.
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Abstract
purposeNurses work in complex healthcare environments characterized by high-stakes decisions, moral dilemmas, and ethical challenges. While prior studies link hospital ethical climate to work engagement, the mechanisms underlying this relationship remain under explored. The purpose of this study To explore the mediation effects of moral resilience on the relationship between hospital ethical climate and work engagement among nurses.
methodsA total of 281 Chinese nurses completed an online survey in October 2024, including Hospital Ethical Climate Survey, Rushton Moral Resilience Scale, and Utrecht Work Engagement Scale. Pearson's correlation was performed to examine the associations among the three variables. The mediation model was analyzed using SPSS 25.0 and the PROCESS macro 4.3.
resultsHospital ethical climate was positive associated with moral resilience(r = 0.491, p < 0.01) and work engagement(r = 0.625, p < 0.01). Moral resilience was positive associated with work engagement (r = 0.426, p < 0.01). In the mediation model, the direct effect of hospital ethical climate on work engagement was significant (β = 0.377, 95%CI = 0.306-0.449), and moral resilience significantly mediated this relationship (β = 0.053, 95%CI = 0.013-0.097). The mediation effect accounted for 12.33% of the total effect.
conclusionThe results revealed moral resilience played a mediating role in the relationship between hospital ethical climate and work engagement in clinical nurses. Nursing administrators should prioritize cultivating hospital ethical climate and enhancing moral resilience to improve clinical nurses' work engagement.
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