Moral Sensitivity Questionnaire Research Articles

Comparison of the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses: A cross-sectional-correlation study

IntroductionNurses’ sensitivity to moral issues, especially in emergency and intensive care units is essential for providing complex nursing care. Therefore, the present study aimed to determine the correlation between moral sensitivity and clinical competence in emergency and intensive care nurses. MethodsThe present multi-center cross-sectional correlational study was conducted in 2022 on 180 nurses in five emergency departments and four intensive care units of general hospitals affiliated to Semnan University of Medical sciences. The study tools include a demographic questionnaire, 25 item Lutzen Moral Sensitivity Questionnaire (MSQ), and a standardized Competency Inventory for Registered Nurses (CIRN). Data were analyzed by mean, standard deviation and MANOVA, Pearson’s correlation coefficient test. ResultsThe two groups did not have significant differences in demographic characteristics (p < 0.05). Majority of two emergency department nurses (83.9%) and Intensive care nurses (81.8%) had a moderate level of moral sensitivity. Also, clinical competence of majority of emergency department nurses (73.3%) and Intensive care nurses (75.8%) were in moderate level. There was significant positive relationship between moral sensitivity with Clinical competence in emergency department nurses (p ≤ 0.01, r = 0.61). No significant relationship was observed between moral sensitivity and the clinical competence of intensive care nurses (p > 0.05, r = 0.15). ConclusionsThere is need for improving the level of knowledge of nurses about moral principles and increasing moral sensitivity which can expand the components of clinical competence, especially in intensive care units.

Father-Love Absence and Moral Sensitivity: The Mediating Effect of Awe and Perspective-Taking

ABSTRACT Paternal love plays a crucial role in a child’s moral sensitivity. Previous studies in psychology focused on exploring the relationship between mother figures and their children’s moral development, while there needed to be more research on paternal love. Moreover, the potential path by which father-love absence affects an individual’s moral sensitivity is still unclear. Thus, based on social learning theory, we explored the mediating roles of awe and perspective-taking in the relationship between the lack of fatherly love and individuals’ moral sensitivity. 1,795 adolescents living in mainland China were recruited to participate in the study. They were asked to complete four different assessment scales, including the Father-Love Absence Scale (FLAS), the Interpersonal Reactivity Index-C Scale (IRI-C), the Dispositional Positive Emotion Scale (DPES), and the Moral Sensitivity Questionnaire (MSQ). The results showed that, firstly, father-love absence directly negatively affected children’s moral sensitivity. Secondly, awe emotion mediated the effect of father-love absence on children’s moral sensitivity. Thirdly, perspective-taking ability mediated the effect of father-love absence on children’s moral sensitivity. This study provided theoretical support to explore factors in enhancing individuals’ moral sensitivity, such as inhibiting father-love absence by experiencing awe emotion and promoting the ability of perspective-taking.

Predicting Missed Nursing Care Based on Moral Sensitivity and Care-Related Factors

Predicting Missed Nursing Care Based on Moral Sensitivity and Care-Related Factors

Missed nursing care and its relationship with nurses’ moral sensitivity: a descriptive-analytical study

BackgroundMissed care rates are an indicator of healthcare quality. Missed nursing care can reduce patient safety and lead to adverse events. Moral sensitivity enables nurses to interpret and respond to clients’ needs according to ethical principles. Despite the importance of moral sensitivity and its role in the quality of care, the relationship between nurses' moral sensitivity and missed nursing care has not been extensively studied. This raises the question of whether there is an association between nurses' moral sensitivity and missed care. This study was conducted to investigate the relationship between nurses’ moral sensitivity and missed nursing care in the medical and surgical departments of Imam Khomeini Hospital in Urmia, Iran.MethodsA cross-sectional study was conducted in 2022, on 202 nurses working in the medical and surgical departments of Imam Khomeini Medical Education Center, Urmia, Iran. Stratified random sampling was used to select the participants. A questionnaire on demographic characteristics, Kalisch's missed care questionnaire, and Lutzen's moral sensitivity questionnaire were used to collect data. Data were analyzed using the Pearson correlation test and linear regression analysis.ResultsMost participants (52.97%) showed moderate moral sensitivity. Nurses’ mean moral sensitivity and total missed care scores were 149.07 ± 21.60 and 59.45 ± 4.87, respectively. Pearson correlation test showed no significant correlation between moral sensitivity scores and the total missed care scores (r = 0.041, p = 0.152). However, in the regression analysis, moral sensitivity (β = 0.213, p < 0.001), age (β = 0.131, p < 0.001), working in rotating shifts (β = 0.183, p < 0.001), monthly income (β = 0.079, p = 0.004), work experience (β = 0.030, p = 0.010), and monthly work hours (β = 0.247, p = 0.010) influenced missed care. Approximately, 0.98% of the variance in the missed care was explained by these variables.ConclusionOur nurses reported moderate levels of moral sensitivity and a concerning level of missed care. Missed care can have detrimental effects on patient safety. Therefore, nursing managers must address this issue promptly.

Sociodemographic characteristics, moral sensitivity, and moral distress as predictors of nurses’ ageism toward older adults

ABSTRACT The present study aimed to reflect on the predictive role of socio-demographic characteristics (SDCs), moral sensitivity (MS) and moral distress (MD) in nurses’ ageism toward older adults. A total of 145 nurses were recruited to complete the main research instruments, i.e. a Sociodemographic Information Form, the Tool for Evaluating Ageism in Nursing Care of Older People, the Moral Sensitivity Questionnaire and the Moral Distress Scale. The results of the study confirmed that gender and MS could predict nurses’ ageism toward older adults. However, MD was not correlated with ageism. The results of the study could therefore contribute to the development of some strategies to improve nurses’ gerontological nursing knowledge and skills through continuing education.

MORAL SENSITIVITY OF PHYSICAL THERAPY CLINICIANS IN VARIED CLINICAL SETTINGS IN THE PHILIPPINES

Introduction: Moral sensitivity (MS) is the personal attribute needed to handle ethical conflicts in a specific scenario that the medical practitioner face in vulnerable situations due to the patient’s presence of an illness. Physical Therapists (PTs) are licensed practitioners who assess, diagnose and provide treatment that restore patients to optimal function, which requires moral competence. Thus, this study aimed to determine the level of moral sensitivity of PTs clinicians in the Philippines in varied clinical settings. Methods: This is a descriptive, cross-sectional study where the MS of 40 licensed PTs with at least 3 years of experience practice in the Philippines were assessed. The Lutzen's Moral Sensitivity (MSQ) questionnaire (1997) was modified to a 21-item checklist to meet the internal consistency reliability measured by Cronbach’s alpha of 0.70 and above. The MSQ utilized a 7-point Likert scale along 6 elements of MS: interpersonal orientation, structural moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict and confidence in medical knowledge. Results: Data shows that Structural Moral Meaning obtained the highest mean of 1.83+0.70. Overall MS of PTs in the Philippines was high (2.75+0.75). The levels of MS do not vary in all demographic profiles, except gender in Confidence in Medical Knowledge (X2=7.417, p=0.025) and years of experience in Modifying Autonomy (X2=17.625, p=0.0072). Male PTs have significantly higher MS compared to their counterpart; and &gt;10 years of experience have significantly higher MS among the PTs. Discussion: The years of experience towards modifying autonomy indicates the treatment choices and applications of PTs with more years of experience tend to be more flexible owing to their practice and knowledge of efficiency and effectivity. Moreover, the level of MS varies in gender towards confidence in medical knowledge as it demonstrate moral choices are governed by rules and regulations among the male PTs rather than subjective feelings on particular situation.

Development and validation of nursing students' moral sensitivity questionnaire in Taiwan.

Ethical literacy is a critical aspect of professional nursing development. It is considered an essential quality that nursing professionals should possess throughout their careers. Moral sensitivity serves as the foundation for developing ethical literacy. The objective of this study was to develop a reliable tool for assessing moral sensitivity among nursing students. The questionnaire was developed following a rigorous approach, consisting of three stages process, combining the Schwartz-Barcott and Kim hybrid model of concept development with the methodology suggested by Devellis and Waltz. A total of 297 nursing students (287 females, 10 males; mean age: 18.7 years) participated in the study, with five invalid questionnaires excluded from the analysis. The questionnaire's reliability was established through internal consistency and test-retest reliability analyses. Furthermore, the moral sensitivity questionnaire for nursing students demonstrated satisfactory validity through the results of construct, convergent and discriminant validation procedures. The study findings revealed a significant correlation between the internship performance of students and their overall moral sensitivity score. The questionnaire would be appropriated to be included as a supplemental measure for ethical literacy evaluation.

The relationship between subjective compliance with isolation precautions and moral sensitivity in novice nurses: cross-sectional study

BackgroundIncreasing compliance with isolation precautions is important in reducing hospital-acquired infections and their consequences. It is not possible to achieve and maintain nurse compliance through supervision, control, pressure, or training. Therefore, nurses must personally demand compliance with isolation precautions. This study aimed to determine the relationship between compliance with isolation precautions and the moral sensitivity levels of nurses who have just started working.MethodsThis study employed a descriptive and cross-sectional research design. The study population consisted of 456 new nurses recruited during the pandemic. All of the new nurses who volunteered to participate in the study and completed the questionnaires completely were included in the study and 398 nurses constituted the sample of the study. Data were collected from 398 out of 456 novice nurses who agreed to participate in the study. The population coverage rate was 87.28%. Participants were selected using convenience sampling method. The data collection tools included an Introductory Information Form, The Isolation Compliance Precautions Scale (TIPCS), and the Moral Sensitivity Questionnaire (MSQ). Descriptive statistics, correlation analyses, and regression models were used to analyze data.FindingsThe mean score of the MSQ was high (mean ± SD = 90.49 ± 25.94; median (P25-P75) = 84 (range, 74–97), and the score for TIPCS was high (mean ± SD = 79.29 ± 7.68; median (P25-P75) = 82 (range, 76–85)). No correlation was found between MSQ and TIPCS (p > 0.05). According to the regression analysis, although the MSQ did not correlate with TIPCS, compliance with isolation measures was found to increase as the conflict subscale of moral sensitivity increased (β= -0.36, CI= -0.55 to -0.16; p < 0.001). Choosing the profession willingly had a positive correlation with compliance with isolation measures (β = 5.3, CI = 2.4 to 8.3; p < 0.001). In addition, starting the profession at an early age had a positive correlation with compliance with isolation measures (β= -0.49, CI= -0.8 to -0.17; p = 0.002).ConclusionThe conflict sub-dimension of moral sensitivity is an important factor in nurses’ compliance with isolation measures, and conducting necessary training and other studies to improve nurses’ moral sensitivity may increase their compliance with isolation measures.

COVID-19 Sürecinde Hemşirelerin Merhamet ile Ahlaki Duyarlılıkları Arasındaki İlişki

Background: Nurses have encountered with care load, different physical, psychological and emotional ef-fects during Covid-19 pandemic. &#x0D; &#x0D; Objectives: This study conducted to investigate the correlation between nurses compassion and moral sen¬sitivities during Covid-19 pandemic. &#x0D; &#x0D; Method: The study was designed in descriptive and correlational type. The study was completed with 713 nurses between January 20 and February 20, 2021 at the Training and Research Hospital, which has been serving as a pandemic hospital for a year. In the study, a questionnaire including data about the socio-demo¬graphic and professional characteristics of the nurses and Compassion Scale and Moral Sensitivity Ques¬tionnaire were used. The data were collected online. In the analysis of comparative data, Pearson correlation analysis, t-test, one way ANOVA analysis and tests were used. &#x0D; &#x0D; Results: In the study, it was found that the total mean scores of the nurses were 94.45±11.75 for the com-passion scale and 76.76±26.91 for the moral sensitivity questionnaire. There was negative correlation be-tween the compassion total score and holistic approach, orientation while positive correlation between the total score and conflict, practice subscales. There was positive correlation moral sensitivity total scale and subscales kindness, common humanity, mindfulness while negative correlation between total score and disengagement. Younger, female, single, childless, getting opinion from patient/relative nurses have high compassion. High school graduate, employed 11 years and above, nurses have high moral sensitivity. &#x0D; &#x0D; Conclusion: It can be said that compassion affects moral sensitivity in positive and negative dimensions during the pandemic process. In this stressful process, it can be suggested to organize trainings to support nurses morally and psychologically and to increase moral sensitivity.

Components related to ethical decision making in medical science students: A structural equation model.

Evaluating moral principles in the Society of Medical Sciences and health care workers (HCWs) is imperative due to their direct contact with the community and the significant impact of their attitudes and decisions on people's lives. This study aimed to determine the components related to ethical decisions in medical sciences students. One thousand two hundred thirty-five eligible students in the Alborz University of Medical Sciences participated in this descriptive study. We gathered their socio-demographic information, assessed their moral reasoning, and used the ethical decisions questionnaire, Lutsen moral sensitivity questionnaire, and general health questionnaire (GHQ) for data gathering. The data were analyzed with SPSS software version 25 and LISREL version 8.8. According to the path analysis test findings, ethical reasoning significantly correlated with ethical decision-making (B = 0.40). The number of clinical courses passed, moral sensation (moral sensitivity), and the total number of passed academic semesters had the greatest positive and negative association with ethical decision-making, respectively. (B = 0.54), (B = 0.524) and (B = -0.11). Based on the findings of the moral reasoning test, the moral sensation was associated with ethical decision-making, which indicates the necessity of attending to ethical aspects, promoting moral reasoning, sensitivity, and students' accuracy.

Predictive Value of Moral Sensitivity for Quality of Care Among Iranian Nurses

Background: Morality is an important factor affecting the quality of care. To provide high-quality patient care, nurses are facing a number of ethical problems that need moral skills to be solved. Moral sensitivity is the first logical step toward ethical decision-making and judgment. Objectives: This study was conducted to determine the predictive value of moral sensitivity for the quality of care delivered by Iranian nurses. Methods: This cross-sectional study was undertaken on 250 nurses who were selected by census sampling based on inclusion and exclusion criteria from selected hospitals in Qazvin, Iran, in 2022. The required data were gathered by the Moral Sensitivity Questionnaire (MSQ) and the Quality Patient Care Scale (QUALPAC). Data were analyzed using a multivariate regression model. Results: The mean age of the nurses was 32.62 ± 6.95 years old, ranging from 22 to 54 years. The quality of care from the viewpoint of most nurses (n = 198, 78.0%) was desirable. The highest quality of care was related to the physical dimension (69.56 ± 8.48), and the least was related to the psychosocial dimension (89.74 ± 9.47). The highest moral sensitivity was related to the dimensions of relational orientation (15.03 ± 2.93) and respect for the patient's autonomy (7.88 ± 1.73). The results also revealed that moral sensitivity (β = 0.43, P &lt; 0.001), gender (β = 0.30, P &lt; 0.001), and economic status (β = -0.17, P = 0.003) were the most significant predictors of the quality of nursing care. Conclusions: Our results highlighted that boosting moral sensitivity among nurses could be effective in improving the quality of nursing care. So, it is recommended to hold periodic training programs to teach ethical principles to nurses to promote their moral sensitivity and, therefore, the quality of patient care.

Effect of moral sensitivity on professional values of undergraduate nursing students: Mediating effect of empathic tendency

BackgroundThe development of professional values in nursing students is an important issue for the nursing profession. However, the research on nursing students' professional values and its related factors is very limited. PurposeThis cross-sectional and correlational study aimed to examine the mediating effect of empathy between moral sensitivity and professional values. MethodsThis study was conducted with 328 second, third and fourth-year students. The participants completed an online survey consisting of the student information form, Modified Moral Sensitivity Questionnaire for Student Nurses, Empathic Tendency Scale and Nursing Professional Values Scale. ResultsThe results showed that moral sensitivity affected undergraduate nursing students' professional values not only directly but also indirectly through empathic tendency. ConclusionsThe results of the study show that moral sensitivity and empathic tendency support the acquisition of professional values in undergraduate nursing students. Nurse educators needs to realize that can be improved professional values by integrating moral sensitivity and empathic tendency in their curriculum.

Correlations between moral courage, moral sensitivity, and ethical decision-making by nurse interns: a cross-sectional study

BackgroundClinical decision-making involves ethical issues that become more and more complex. Nurse interns must be more skilled in making rational and timely decisions when facing ethical dilemmas. The contributing factors and their relationships that challenge ethical decision-making among nurse interns must be fully understood, as this level of knowledge can support the development of strategies and interventions that improve the ethical decision-making ability of nurse interns.ObjectiveThis study examined the relationships between moral courage, moral sensitivity, and ethical decision-making by nurse interns. In addition, we investigated whether moral sensitivity mediates the relationship between moral courage and ethical decision-making.DesignA descriptive cross-sectional study using an online questionnaire.SettingThe study sampled nurse interns from Class iii Grade A general hospitals in Sichuan Province, China.ParticipantsA convenience sampling method was used to select 1334 nurse interns from March 2022 to May 2022.MethodsA general information questionnaire, the Nurses’ Moral Courage Scale (NMCS), the Chinese Moral Sensitivity Questionnaire (MSQ), and the Judgement About Nursing Decision (JAND) were used for data collection. Data was processed and analysed using SPSS 26.0 and Amos 28.0. Data analysis included descriptive statistics, Pearson correlation analysis, and structural equation modelling.ResultsMoral courage was found to be positively correlated with ethical decision-making (P < 0.01). Moral sensitivity was also positively correlated with ethical decision-making (P < 0.01) and had a mediating effect on the relationship between moral courage and ethical decision-making (P < 0.01).ConclusionsThe moral courage and moral sensitivity of nurse interns are positively correlated with ethical decision-making ability. Moral sensitivity significantly mediates the relationship between moral courage and ethical decision-making ability. The knowledge gained from this study can inform educational strategies and interventions in supporting the development of nurse interns’ ethical decision-making ability.

The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: a clinical randomized controlled trial

BackgroundEthical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses’ moral reasoning, moral distress and moral sensitivity.MethodsIn this randomized clinical trial study with a pre- and post-test design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals.ResultsAdjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238–15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171–2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15–5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043–12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454–16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015–0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015–0.547, P = 0.009).ConclusionsThe results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students.RegistrationThis randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016.

The relationship between teamwork, moral sensitivity, and missed nursing care in intensive care unit nurses

BackgroundTeamwork, moral sensitivity, and missed nursing care are important healthcare challenges for Intensive Care Unit (ICU) nurses and the existence of a relationship between these variables can be useful for developing better care improvement strategies. This study aimed to determine the relationship between teamwork, moral sensitivity, and missed nursing care in ICU nurses.MethodsThis is a descriptive cross-sectional study conducted on a total of 200 ICU nurses working at teaching hospitals affiliated to Semnan and Shahroud Universities of Medical Sciences, Semnan, Iran in 2022. Sampling was conducted using the census method. Data collection was conducted using a demographic checklist, the TeamSTEPPS Team Perception Questionnaire (T-TPQ), Lützén Moral Sensitivity Questionnaire (L-MSQ), and Kalisch and Williams Missed Nursing Care (MISSCARE) Survey. The examination of the relationship between the three variables was conducted using Pearson’s correlation coefficient and multiple regression analysis.ResultsThe mean and standard deviation of teamwork, moral sensitivity, and missed nursing care was 3.47 ± 0.69, 64.19 ± 13.43, and 55.04 ± 34.10, respectively. The variable of teamwork had a significant positive relationship with moral sensitivity (p < .001) and a significant negative relationship with missed nursing care (p < .001). Teamwork was also a positive predictor of moral sensitivity (p < .001) and a negative predictor of missed nursing care (p < .001). The clinical experience of ICU nurses was a positive predictor of teamwork (p = .01) and a negative predictor of missed nursing care (p = .001). The age of ICU nurses was a positive predictor of moral sensitivity (p = .001) and a negative predictor of missed nursing care (p = .008).ConclusionThe findings showed that a higher level of teamwork was associated with increased moral sensitivity and reduced missed nursing care among ICU nurses. Therefore, focusing on planning interventions on teamwork improvement can lead ICU nurses to improve moral sensitivity, lower missed nursing care, and promote the quality of patient care.

Cognitive biases and moral characteristics of healthcare workers and their treatment approach for persons with advanced dementia in acute care settings.

Palliative care (PC) delivery for persons with advanced dementia (AD) remains low, particularly in acute-care settings. Studies have shown that cognitive biases and moral characteristics can influence patient care through their effect on the thinking patterns of healthcare workers (HCWs). This study aimed to determine whether cognitive biases, including representativeness, availability, and anchoring, are associated with treatment approaches, ranging from palliative to aggressive care in acute medical situations, for persons with AD. Three hundred fifteen HCWs participated in this study: 159 physicians and 156 nurses from medical and surgical wards in two hospitals. The following questionnaires were administered: a socio-demographic questionnaire; the Moral Sensitivity Questionnaire; the Professional Moral Courage Scale; a case scenario of a person with AD presenting with pneumonia, with six possible interventions ranging from PC to aggressive care (referring to life-prolonging interventions), each given a score from (-1) (palliative) to 3 (aggressive), the sum of which is the "Treatment Approach Score;" and 12 items assessing perceptions regarding PC for dementia. Those items, the moral scores, and professional orientation (medical/surgical) were classified into the three cognitive biases. The following aspects of cognitive biases were associated with the Treatment Approach Score: representativeness-agreement with the definition of dementia as a terminal disease and appropriateness of PC for dementia; availability-perceived organizational support for PC decisions, apprehension regarding response to PC decisions by seniors or family, and apprehension regarding a lawsuit following PC; and anchoring-perceived PC appropriateness by colleagues, comfort with end-of-life conversations, guilt feelings following the death of a patient, stress, and avoidance accompanying care. No association was found between moral characteristics and the treatment approach. In a multivariate analysis, the predictors of the care approach were: guilt feelings about the death of a patient, apprehension regarding senior-level response, and PC appropriateness for dementia. Cognitive biases were associated with the care decisions for persons with AD in acute medical conditions. These findings provide insight into the potential effects of cognitive biases on clinical decisions, which may explain the disparity between treatment guidelines and the deficiency in the implementation of palliation for this population.

Problem-based learning versus reflective practice on nursing students’ moral sensitivity

BackgroundMoral sensitivity is one of the prerequisites for nurses’ professional competency and patient care. It is critical to teach professional ethics in a student-centered manner in order to increase students’ moral sensibility. This study evaluated the effects of professional ethics education via problem-based learning and reflective practice on nursing students’ moral sensitivity.MethodsThis experimental study was performed on 74 nursing students who were randomly divided into three groups of problem-based learning, reflective practice and control. Principles of professional ethics were presented for the two intervention groups in four 2-hour sessions using ethical dilemmas scenarios. Participants completed the Moral Sensitivity Questionnaire before, immediately, and three months after the intervention. Data were analyzed using SPSS16.ResultsDemographic characteristics of the three groups were similar (p > 0.05). The total moral sensitivity score significantly differed between the groups immediately and three months after the intervention (p < 0.001). The total mean score for moral sensitivity was significantly different between the two groups of problem-based learning and reflective practice, with the mean scores in the problem-based learning group being higher (p = 0.02). The mean score of moral sensitivity decreased statistically significantly in both experimental groups three months after the intervention as compared to immediately after the intervention (p < 0.001).ConclusionNursing students’ moral sensitivity can be increased through reflective practice and problem-based learning. While the results indicated that problem-based learning was more successful than reflective practice, additional research is recommended to confirm the influence of these two strategies on moral sensitivity.

The relationship between professional values, ethical sensitivities and caring behaviors among nursing students: A structural equation modeling approach

AimTo examine the relationship between professional values, ethical sensitivity and caring behaviors among nursing students and determine whether professional values play a moderator role in the relationship between ethical sensitivity and caring behaviors among nursing students. BackgroundDeveloping professional nursing values, ethical sensitivity and caring behaviors is critical in nursing programs from the first year to graduation to prepare students for increasingly complex and diverse work environments. DesignA cross‐sectional study using structural equation modeling. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. MethodsThis study was conducted with 189 undergraduate nursing students. The study was conducted in a four-year nursing faculty in the Mediterranean region of Turkey from February to June 2022. Data were collected using a personal information form, the Nurses’ Professional Values Scale, the Moral Sensitivity Questionnaire and the Caring Behaviors Assessment Tool Nursing Version-Short Form. ResultsWe found that nursing students' perceptions of professional values and caring behaviors were high and their ethical sensitivity was moderate. Nursing students who are successful in high school have higher professional values. In addition, it was determined that nursing students who chose the nursing profession because of altruism had higher perceptions of caring behaviors. A positive relationship exists between professional values, ethical sensitivity (r = −0.258, p < 0.001) and caring behaviors (r = 0.431, p < 0.001) (p < 0.05). Professional values have a positive effect on ethical sensitivity and caring behaviors. ConclusionProfessional values, ethical sensitivity and caring behaviors are relationships and professional values positively predict nursing students' ethical sensitivities and caring behaviors. As the professional value perceptions of nursing students increase, their ethical sensitivity and caring behaviors increase. Improving the curricula in a way that will improve professional values may enable nursing students to increase their ethical sensitivity and caring behaviors. The research contributes to a broader understanding of nursing education curriculum content.

Hemşirelerin Bakım Davranışları İle Ahlaki Duyarlılık Düzeyleri Arasındaki İlişkinin Belirlemesi

Aim: This research aims to determine the relationship between nurses’ care behaviors and moral sensitivity levels. Methods: The sample of the study consists of nurses (N=445) who are working in the university and public hospital in Sivas and who agreed to participate in the study between June 1 and September 30, 2018. Personal Information Form, Caring Behaviors Inventory-24 (CBI-24) and Moral Sensitivity Questionnaire (MSQ) were used to collect research data. Data were evaluated by using frequency, mean, minimum and maximum values, standard deviation, Mann Whitney U test, and Kruskal-Wallis. Results: The mean total score of CBI-24 has been found to be 5.12±0.63. The overall total score of MSQ is 93.14±21.79. It has been found out that there is a reverse and weak level (r=-259; p=0.001) relationship between the total score averages of MSQ and CBI scale, and this relationship is statistically significant. As the MSQ score average decreases, the CBI score average increases. Accordingly, as moral sensitivity increases, care behaviors also increase. Conclusion: While the results of the research show that the nurses’ moral sensitivity is at moderate level and their care behaviors are at good level, the care behaviors of nurses with high moral sensitivity are also higher.

Critical Care Nurses' Adherence to Ethical Codes and Its Association with Spiritual Well-Being and Moral Sensitivity.

Adherence to ethical codes is a major pillar of nursing care that is affected by various factors. Identifying these factors can lead to better ethical performance. The present study was conducted to determine critical care nurses' adherence to ethical codes and its association with spiritual well-being (SWB) and moral sensitivity (MS). In this descriptive-correlational study, data were collected using the moral sensitivity questionnaire (MSQ) by Lützén et al., Paloutzian and Ellison's spiritual well-being scale (SWBS), and the adherence to ethical codes questionnaire. The study was conducted on 298 nurses working in critical care units of hospitals affiliated with Shiraz University of Medical Sciences in southern Iran in 2019. This study was examined and approved by the Ethics Committee of Shiraz University of Medical Sciences. The majority of the participants were female (76.2%) and single (60.1%), with a mean age of 30.69 ± 5.74 years. The mean scores of adherence to ethical codes, SWB, and MS were 64.06 (good), 91.94 (moderate), and 134.08 (moderate), respectively. Adherence to ethical codes had a positive correlation with the total score of SWB (P < 0.001, r = 0.25) and MS (P < 0.001, r = 0.27). A positive correlation was also observed between MS and SWB (P < 0.001, r = 0.41). Meanwhile, MS (β = 0.21) had a greater effect than SWB (β = 0.157) on adherence to ethical codes. Critical care nurses showed a good adherence to ethical codes. MS and SWB also positively affected their adherence to ethical codes. Nursing managers can use these findings to devise plans for the promotion of MS and SWB in nurses and thus help improve their ethical performance.