Evidence map›Paper›PMID 42051370›Full record

ArticleJournal of medical ethics and history of medicine2025

Explicating the process of moral courage in clinical nurses: a grounded theory study.

Shirmohammad Davoodvand, Somayeh Mohammadi, Shahriyar Salehi, Mostafa Roshanzadeh

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Article in Journal of medical ethics and history of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Shirmohammad DavoodvandAssistant Professor, Department of Adults and Geriatric Nursing, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Somayeh MohammadiStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Shahriyar SalehiAssociate Professor, Department of Adults and Geriatric Nursing, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Mostafa RoshanzadehAssistant professor, Nursing Department, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Moral courage in nurses is the product of a complex process and can be enhanced by identifying the steps through which nurses make morally courageous decisions. This qualitative study aimed to explicate the process of moral courage in clinical nurses and present a descriptive model. The study was conducted in Shahrekord University of Medical Sciences in 2022 using the grounded theory approach. Twenty-one clinical nurses were selected through purposive and theoretical sampling. Data were analyzed using Strauss and Corbin's 2015 approach and data management was supported by MAXQDA software (version 11). The core variable identified was moral excellence. When faced with a misalignment between authority and responsibility, nurses experience ambiguity in ethical decision-making. The nurses in this study employed spirituality, legality, and self-sacrifice strategies, which helped them to manage system expectations. In this model, moral courage ultimately gravitates toward managing system expectations-a deviant mechanism failing to yield positive outcomes due to organizational infrastructures and conditions. Therefore, it is recommended that healthcare organizations address factors contributing to ambiguity in nurses' decision-making, such as lack of operational protocols for ethical decisions, mismatched expectations and responsibilities, and deficiencies in professional autonomy.

Indexed as

Clinical nurses.Decision-makingMedical ethicsMoral courage

Identifiers

PMID42051370
PMCPMC13120816

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