Dehghan Nayeri Nahid, Shahmari Mehraban, Shifteh Shahin, Rasouli Kian, Ranjbar Arash, Zare Leily
Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical-Surgical, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
BMC Health Serv Res. 2025 Aug 13;25(1):1077. doi: 10.1186/s12913-025-13310-7.
The moral courage of nurses is crucial for complex decision-making, patient safety, and communication. However, the direct relationship between nurses' moral courage and patient safety, particularly during the COVID-19 pandemic, remains unconfirmed. This study aims to investigate this relationship in both COVID-19 and non-COVID-19 departments.
A cross-sectional analytical design was employed, with a sample of 300 nurses from five public hospitals in northwestern (…) affiliated with the University of Medical Sciences. Data were collected between 2021 and 2022 using the validated (…) version of the Hospital Survey on Patient Safety Culture and the Sekerka Moral Courage Scale. Descriptive and inferential statistical analyses were conducted.
The safety climate scores were 23.7% in the COVID-19 ward and 25.8% in the non-COVID-19 ward, with no significant difference between the two sectors. Moral courage scores were 50.4% in the COVID-19 wards and 44.9% in the non-COVID-19 wards, showing no significant difference. A strong relationship between moral courage and safety climate was observed in both wards. Regression analysis indicated a Cohen's f² effect size of 1.77 for moral courage, suggesting a significant impact on patient safety culture.
This study found no significant differences in moral courage or patient safety culture between COVID-19 and non-COVID-19 departments. However, moral courage can predict improvements in patient safety, even in complex situations like the COVID-19 crisis. To enhance patient safety, it may be necessary to strengthen nurses' moral courage through experiential training, supportive environments, and leadership workshops emphasizing empathy and ethical decision-making. Additionally, integrating these educational components into nursing education is important. By enhancing these skills in nursing education, we may improve patient safety and better prepare them to tackle future challenges and crises effectively.
护士的道德勇气对于复杂决策、患者安全及沟通至关重要。然而，护士的道德勇气与患者安全之间的直接关系，尤其是在新冠疫情期间，仍未得到证实。本研究旨在调查新冠科室和非新冠科室中的这种关系。
采用横断面分析设计，样本来自西北（…）医科大学附属的五家公立医院的300名护士。2021年至2022年期间，使用经过验证的（…）版《患者安全文化医院调查》和塞克卡道德勇气量表收集数据。进行了描述性和推断性统计分析。
新冠病房的安全氛围得分为23.7%，非新冠病房为25.8%，两个科室之间无显著差异。新冠病房的道德勇气得分为50.4%，非新冠病房为44.9%，无显著差异。两个病房中均观察到道德勇气与安全氛围之间存在密切关系。回归分析表明，道德勇气的科恩f²效应量为1.77，表明对患者安全文化有显著影响。
本研究发现新冠科室和非新冠科室在道德勇气或患者安全文化方面无显著差异。然而，即使在新冠危机这样的复杂情况下，道德勇气也能预测患者安全的改善。为提高患者安全，可能有必要通过体验式培训、支持性环境以及强调同理心和道德决策的领导力研讨会来增强护士的道德勇气。此外，将这些教育内容纳入护理教育很重要。通过在护理教育中提高这些技能，我们可以改善患者安全，并更好地使他们做好准备，有效应对未来的挑战和危机。
