Hu Xiao, Long Yu, Wang Chenfang, Yi Jianping, Peng Feng, Chen Yidi
Medical Simulator Center, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Qingxiu District, Nanning, 530021, China.
Department of Anesthesiology, The First Affiliated Hospital of Chengdu Medical College, No. 278 Baoguang Avenue, Xindu District, Chengdu, 610500, China.
BMC Nurs. 2025 Mar 31;24(1):342. doi: 10.1186/s12912-025-02991-4.
Moral courage is crucial for nurses to act ethically despite professional risks. Operating room (OR) nurses frequently encounter ethical dilemmas, requiring a balance between personal convictions and institutional policies. This study investigates the current status of moral courage among OR nurses in Southwest China and explores key influencing factors.
The cross-sectional, multi-center study was conducted from April to May 2024. A total of 482 operating room nurses from 16 hospitals in Southwest China were surveyed. The nurses were assessed using a self-designed demographic questionnaire, the Nurses' Moral Courage Scale (NMCS), the Psychological Empowerment Scale (PES), and the Hospital Ethical Climate Survey (HECS). Statistical analyses, including Spearman's rho and multiple linear regression, were used to explore the relationships between nurses' moral courage and various influencing factors, such as age, educational level, income, professional title, psychological empowerment, and hospital ethical climate.
The total score for operating room nurses' moral courage in this study was 80.26 ± 19.30, with subscale scores as follows: moral integrity (26.89 ± 6.73), moral responsibility (15.33 ± 3.92), commitment to providing quality care to patients (18.81 ± 4.77), and compassion and genuine presence with patients (19.23 ± 4.86). The moral courage was positively correlated with age, hospital level, years of experience, professional title, income, psychological empowerment and hospital ethical climate score. The multiple linear regression analysis revealed that work meaning, autonomy, work impact, and relationships with nurses, patients, and the hospital being significant factors influencing moral courage. The correlation analysis showed no significant correlation between educational level and moral courage. Furthermore, although nurses with lower income had lower moral courage scores, there was no significant correlation between income satisfaction and moral courage.
Psychological empowerment and a positive hospital ethical climate are key determinants of moral courage among OR nurses. Hospitals should implement targeted interventions to enhance nurses' ethical decision-making capacities, foster professional autonomy, and strengthen interpersonal support networks to mitigate ethical distress.
Not applicable.
道德勇气对于护士在面对职业风险时坚守道德行为至关重要。手术室护士经常遇到伦理困境，需要在个人信念和机构政策之间取得平衡。本研究调查了中国西南地区手术室护士的道德勇气现状，并探讨了关键影响因素。
本横断面、多中心研究于2024年4月至5月进行。对中国西南地区16家医院的482名手术室护士进行了调查。使用自行设计的人口统计学调查问卷、护士道德勇气量表（NMCS）、心理授权量表（PES）和医院伦理氛围调查问卷（HECS）对护士进行评估。采用Spearman秩相关和多元线性回归等统计分析方法，探讨护士道德勇气与年龄、教育水平、收入、职称、心理授权和医院伦理氛围等各种影响因素之间的关系。
本研究中手术室护士道德勇气总分80.26±19.30，各分量表得分如下：道德正直（26.89±6.73）、道德责任（15.33±3.92）、致力于为患者提供优质护理（18.81±4.77）、对患者的同情和真诚陪伴（19.23±4.86）。道德勇气与年龄、医院级别、工作年限、职称、收入、心理授权和医院伦理氛围得分呈正相关。多元线性回归分析显示，工作意义、自主性、工作影响以及与护士、患者和医院的关系是影响道德勇气的重要因素。相关性分析显示，教育水平与道德勇气之间无显著相关性。此外，虽然收入较低的护士道德勇气得分较低，但收入满意度与道德勇气之间无显著相关性。
心理授权和积极的医院伦理氛围是手术室护士道德勇气的关键决定因素。医院应实施有针对性的干预措施，以提高护士的伦理决策能力，促进职业自主性，并加强人际支持网络，以减轻伦理困扰。
不适用。
