Department of the Nursing Science, University of Turku, Turku, Finland.
Turku University Hospital, Turku, Finland.
Nurs Health Sci. 2021 Sep;23(3):570-585. doi: 10.1111/nhs.12805. Epub 2021 Feb 15.
Moral courage and understanding of its meaning are essential when nurses face ethical conflicts in their practice. This integrative review aimed to explore moral courage in nursing and possible associated individual and organizational factors. A database search in January 2020 identified 1308 scientific articles of which 25 were selected for the review. Inductive analysis with clear steps for defining and synthesizing themes in research reviews revealed three categories concerning moral courage in nursing: definition and descriptions of moral courage, characteristics of the morally courageous nurse, and skills and acts of the morally courageous nurse. Individual and organizational factors, such as positive personal experiences, commitment to ethical principles, supportive work environment and teamwork, were associated with moral courage in nursing, contributing to a more comprehensive description of nurses' moral courage. Findings indicate that in nursing practice, there is a need for promoting multi-professional collaboration and discussion of ethical dilemmas to provide opportunities to enhance moral courage. Developing care environments in which hierarchy does not inhibit nurses' moral courage seems justified. Further research on moral courage with varying methodologies and multi-disciplinary and international approaches is needed.
当护士在实践中面临伦理冲突时，道德勇气和对其含义的理解是必不可少的。本综述旨在探讨护理中的道德勇气以及可能与之相关的个体和组织因素。2020 年 1 月的数据库搜索共确定了 1308 篇科学文章，其中有 25 篇被选入综述。通过明确定义和综合研究综述主题的归纳分析步骤，揭示了护理中道德勇气的三个范畴：道德勇气的定义和描述、有道德勇气的护士的特征、以及有道德勇气的护士的技能和行为。个体和组织因素，如积极的个人经历、对道德原则的承诺、支持性的工作环境和团队合作，与护理中的道德勇气相关，有助于更全面地描述护士的道德勇气。研究结果表明，在护理实践中，需要促进多专业合作和对伦理困境的讨论，为增强道德勇气提供机会。营造一种环境，在这种环境中，层级制度不会抑制护士的道德勇气，这似乎是合理的。需要采用不同方法和多学科、国际方法对道德勇气进行进一步研究。
