ArticleBMC nursing2026
The relationship between spiritual well-being and moral resilience in nursing students: a mixed-methods study.
Article in BMC nursing, 2026. 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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Abstract
backgroundThis study was conducted to investigate the relationship between spiritual well-being and moral resilience among nursing students via a convergent parallel mixed-methods design.
methodsThe quantitative phase included 236 nursing students purposively selected from a university in the Central Anatolia Region of Türkiye (response rate: 62.9%). The quantitative data were collected via the three-factor spiritual well-being scale and the Rushton Moral Resilience Scale. The qualitative phase consisted of semistructured in-depth interviews with 17 nursing students selected through purposive sampling.
resultsA weak positive correlation was found between the Harmony with Nature dimension and the overall Rushton Moral Resilience Scale score (r = 0.190, p = 0.003). A weak positive correlation was also identified between the overall Spiritual Well-Being Scale score and the overall Rushton Moral Resilience Scale score (r = 0.312, p < 0.001). In addition, the transcendence dimension was negatively correlated with moral adversity (r=-0.229, p < 0.001) and positively correlated with moral efficacy (r = 0.351, p < 0.001). The qualitative findings indicated that spiritual well-being was associated with moral resilience through empathy and compassion, a tendency toward right and good behaviors, motivation and satisfaction, coping with challenging situations, and professional responsibility. However, qualitative findings also revealed that spirituality-related values and beliefs may sometimes contribute to internal tensions in ethical decision-making processes. CONCLUSION AND RECOMMENDATIONS: Spiritual well-being was positively associated with moral resilience among nursing students. However, some aspects of spirituality may also create ethical tensions in clinical decision-making. Therefore, nursing education should strengthen content related to spirituality, ethics, cultural competence, and ethical decision-making while supporting students in managing potential value conflicts encountered in clinical practice.
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