Ghanei Gheshlagh Reza, Dehvan Fazel, Sedighi Ladan
Lahore School of Nursing, The University of Lahore, Lahore, Pakistan.
Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
BMC Nurs. 2025 Mar 19;24(1):294. doi: 10.1186/s12912-025-02940-1.
Moral sensitivity is essential for nurses to recognize and appropriately respond to ethical issues, understanding the impact of their actions on patient well-being. It improves care quality, ethical decision-making, and equips nurses with skills to handle moral dilemmas in clinical settings. Various studies in Iran have reported different results. Accordingly, this study was conducted to estimate the pooled standardized moral sensitivity score among Iranian nurses.
A systematic search of national and international databases was conducted up until June 2023, yielding 563 articles. After screening by two independent researchers, 52 articles with a total sample size of 11,621 participants were included in the analysis. Any discrepancies were resolved through discussion. Heterogeneity was assessed using the I² index. Subgroup analyses were performed based on the language of the articles, sample size, and country region. Meta-regression analysis was conducted to explore the relationship between the moral sensitivity score and variables such as age, year of publication, and sample size. All analyses were performed using Stata software, version 17.
The pooled moral sensitivity score was 69% (95% CI: 66-72, I = 94.03%). The highest overall ethical sensitivity score was observed in region 5 of the country (73.6%, 95% CI: 67-80.1), in articles published in Farsi (70.2%, 95% CI: 65.8-74.7), and in articles with a sample size of less than 200 participants (70%, 95% CI: 66.3-73.6). No significant relationship was found between the overall ethical sensitivity score and variables such as age, year of publication, or sample size. Publication bias was significant (p = 0.001).
This meta-analysis indicates a moderate level of moral sensitivity among Iranian nurses. While regional and study-related differences were observed, no significant relationship was found between the moral sensitivity score and variables like age, year of publication, or sample size. Publication bias suggests the need for more representative studies to fully understand the factors influencing moral sensitivity in nursing.
This study is a systematic review and meta-analysis, and not a clinical trial.
道德敏感性对于护士识别并恰当应对伦理问题、理解自身行为对患者福祉的影响至关重要。它能提高护理质量、促进伦理决策，并使护士具备在临床环境中处理道德困境的技能。伊朗的多项研究报告了不同的结果。因此，本研究旨在估计伊朗护士的合并标准化道德敏感性得分。
截至2023年6月，对国内和国际数据库进行了系统检索，共获得563篇文章。经过两名独立研究人员的筛选，分析纳入了52篇文章，总样本量为11,621名参与者。任何分歧都通过讨论解决。使用I²指数评估异质性。根据文章语言、样本量和国家地区进行亚组分析。进行元回归分析以探讨道德敏感性得分与年龄、发表年份和样本量等变量之间的关系。所有分析均使用Stata软件17版进行。
合并道德敏感性得分为69%（95%置信区间：66 - 72，I = 94.03%）。在该国第5地区观察到最高总体伦理敏感性得分（73.6%，95%置信区间：67 - 80.1），发表于波斯语的文章中（70.2%，95%置信区间：65.8 - 74.7），以及样本量小于200名参与者的文章中（70%，95%置信区间：66.3 - 73.6）。未发现总体伦理敏感性得分与年龄、发表年份或样本量等变量之间存在显著关系。发表偏倚显著（p = 0.001）。
这项荟萃分析表明伊朗护士道德敏感性处于中等水平。虽然观察到了地区和研究相关差异，但道德敏感性得分与年龄、发表年份或样本量等变量之间未发现显著关系。发表偏倚表明需要更多具有代表性的研究来全面了解影响护理中道德敏感性的因素。
本研究是一项系统评价和荟萃分析，而非临床试验。
