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Background: The urgency of ensuring adequate moral courage in clinical nursing practice is evident. However, currently, there are few formal intervention plans targeted at enhancing the moral courage of nurses. Aim: To develop a training program for improving the moral courage of nurses using the modified Delphi method. Research design: A modified Delphi study. Participants and research context: From November to December 2022, a literature review and expert group discussion were conducted to develop a preliminary training plan framework. From January to March 2023, a two-round Delphi survey was performed, and a consensus was reached regarding the plan through online questionnaires. Descriptive statistics were used to analyze the data. Ethical considerations: This study was approved by the institutional ethics committee (No. 138, 30 August 2021). All participants provided written informed consent. Results: Consensus was reached on eight themes and 33 items to strengthen the moral courage training program for nurses. Conclusions: Guided by a unified goal of moral education, a multi-level and acceptable intervention plan was designed to enhance the moral courage of nurses. [ABSTRACT FROM AUTHOR]

The purpose of this paper is twofold: first, it clarifies the different connotations of moral and civil courage and reviews education literature demonstrating the understanding and value of this construct; and, second, it argues that the best schools can do in liberal democracies is to stimulate critical reflection and discussion about acts of moral and civil courage, rather than ‘teach’ moral and civil courage as such. Unlike nursing and medical education that advocates the teaching of moral courage, the paper shows the limits of (neo)liberal visions of ‘cultivating’ students’ individual competences of moral and civil courage as a response to the serious challenges experienced by liberal democracies in recent years. It is argued that greater emphasis should be placed on moral and civil courage in education, not in moralizing ways, but in ways that empower teachers, students and school leaders to reinforce civic values. [ABSTRACT FROM AUTHOR]

Background: Critical thinking, moral courage, and moral sensitivity are among the topics that are widely considered today in response to turbulent and complex environments in organizations. The purpose of this study was to investigate the state of critical thinking and its effect on moral courage and moral sensitivity in nurses working in hospitals under Jiroft University of Medical Sciences in southern Iran in 2024. Methods: This descriptive-analytical cross-sectional study was conducted on 385 nurses. The data collection tools were standard questionnaires of critical thinking, moral courage and moral sensitivity. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and multiple linear regression using SPSS23 software. Results: The average scores of critical thinking, moral courage, and moral sensitivity of the studied nurses were 188.16 ± 8.22 out of 450, 62.32 ± 7.45 out of 105, and 71.55 ± 6.39 out of 100, respectively, indicating the weak level of critical thinking and the average level of moral courage and moral sensitivity of nurses. Between moral courage (p < 0.001, r = 0.574) and moral sensitivity (p < 0.001, r = 0.611) with critical thinking, a statistically significant correlation was observed in the direct direction. Based on the results of multiple linear regression, the components of critical thinking, which include truth-seeking, inquisitiveness, analyticity, systematicity, self-confidence, cognitive maturity, and open-mindedness, respectively, were identified as predictors of moral sensitivity and moral courage (P < 0.001). Conclusion: The critical thinking of the examined nurses was estimated at a weak level, and moral courage and moral sensitivity were estimated at a moderate level. Based on the results, there is a possibility that by improving critical thinking, the state of moral courage and moral sensitivity of nurses will improve. Therefore, it is suggested that the hospital managers provide an opportunity to improve the critical thinking status of nurses by holding related courses and workshops, so that by this means, we can witness the growth and improvement of their courage and moral sensitivity. [ABSTRACT FROM AUTHOR]

Background: Whistleblowing is an action that particularly requires moral courage. Understanding the relationship between nurses' levels of moral courage and their whistleblowing approaches is important for reducing adverse situations in healthcare services. Objectives: This study aims to understand and analyze the relationship between nurses' levels of moral courage and their whistleblowing approaches. Research design: This is a descriptive and correlational study. Methods: The study sample consists of 582 nurses actively working in a province in northwest Türkiye. Research data were collected using an Information Form, the Nurses' Moral Courage Scale, and the Whistleblowing Scale. Ethical considerations: Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Findings: Nurses were found to perceive their moral courage as high, and their whistleblowing levels were at a moderate level. There was a significant and moderate relationship between participants' levels of moral courage and whistleblowing levels (p <.05). Conclusions: The findings emphasize the importance of promoting moral courage and creating an appropriate environment for exposing ethical violations. This study can contribute to the development of strategies to enhance nurses' moral courage and foster a more ethical working environment in healthcare services. [ABSTRACT FROM AUTHOR]

Aim: To empirically investigate the impact of ethical leadership on nurses' moral courage in China and examine the mediating role of psychological empowerment in this relationship. Background: Moral courage is essential for alleviating nurses' moral distress, safeguarding patients' safety and rights, and providing high‐quality care. Previous studies have emphasized the strong relationship between ethical leadership and moral courage; however, little is known about the actual impact of ethical leadership on nurses' moral courage. This study introduces psychological empowerment, sets out to test empirically its role in the relationship between ethical leadership and moral courage, and provides countermeasures and a theoretical basis for cultivating nurses' moral courage. Methods: Between February and May 2023, a questionnaire survey was conducted among 837 nurses from five hospitals in Sichuan Province, southwest China. The three validated self‐report scales, the ethical leadership scale, psychological empowerment scale, and nurses' moral courage scale, were used to collect data. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, Cronbach's α, and correlations of each variable, modeling a hypothesized model of ethical leadership on moral courage in nurses and testing the internal mechanisms by AMOS 26.0. Results: Ethical leadership significantly positively correlated with psychological empowerment (r = 0.374, p < 0.01), as well as moral courage (r = 0.341, p < 0.01). In addition, psychological empowerment significantly positively correlated with moral courage (r = 0.518, p < 0.01). The structural equation modeling (SEM) shows a satisfactory model fit: χ2 = 2156.36, df = 849, χ2/df = 2.540, root mean square of approximation = 0.043, standard root mean square residual = 0.047, normed fit index = 0.911, Tucker–Lewis index = 0.941, and comparative fit index = 0.944. Ethical leadership directly influenced moral courage (β = 0.135, p = 0.006) and indirectly affected moral courage via psychological empowerment (β = 0.247, p = 0.001). Conclusion: Promoting ethical leadership and psychological empowerment is essential for nurses to promote moral courage. The results of this study illustrate the pivotal role of psychological empowerment in establishing the impact of ethical leadership on nurses' moral courage and the partially mediating part of psychological empowerment in this relationship. Implications for Nursing Management: Nursing managers should understand the importance of moral courage in protecting patients' rights and interests, as well as in maintaining a stable nursing workforce. They should reinforce the positive influence of ethical leadership and embrace an ethical leadership style. In addition, providing relevant training to enhance nurses' psychological empowerment will help cultivate moral courage among them. [ABSTRACT FROM AUTHOR]

Aim: To examine the correlation between moral courage and caregiving behaviour among nurses who are employed in the COVID‐19 ward in Iran. Design: This study is a descriptive‐correlational and cross‐sectional research conducted in 2021 in the city of Tehran, Iran. Methods: A total of 270 nurses employed in COVID‐19 wards, who had been working in these wards for at least 1 month, were recruited from XXX hospitals and XXX Hospital. Data collection was conducted from September to November 2021. The data collection tools included a demographic information form, the Caring Dimension Inventory (CDI‐25), and the Professional Moral Courage Scale (PMC). The designed questionnaire links were provided to the participants virtually through the Persian platform 'Pars Line' and via WhatsApp. Descriptive statistics and inferential statistics were used to examine the relationship between moral courage and care behaviour. Results: There was a significant difference in the mean of caring behaviour between the age groups (<30 and >40 years old), and the work experience groups (<5 years and >15 years) (p < 0.05). Ethical values also varied significantly between certain age and experience groups (p < 0.05), but no significant differences were found in ethical behaviour across most ages (30–40 years) and work experience categories (>10 years) (p > 0.05). The level of moral courage among the nurses was higher than the median score of the instrument (87.31 ± 10.37). Among the dimensions of moral courage, the highest score was related to the dimension of ethical factors (17.64 ± 2.64), and the lowest score was related to the dimension of multiple values (17.26 ± 2.78). The level of caring behaviours among the nurses was lower than the median score of the instrument (46.11 ± 10.84). Among the dimensions of caring behaviours, the highest score was related to physical‐technical behaviours (19.22 ± 5.27), and the lowest score was related to professional behaviours (1.35 ± 0.67). Based on the analysis, moral courage had a weak and inverse correlation with caring behaviours among nurses. The higher moral courage does not necessarily result in improved caregiving behaviours, emphasizing the need for further research to explore and address this relationship. Patient: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Abstract Background Critical thinking, moral courage, and moral sensitivity are among the topics that are widely considered today in response to turbulent and complex environments in organizations. The purpose of this study was to investigate the state of critical thinking and its effect on moral courage and moral sensitivity in nurses working in hospitals under Jiroft University of Medical Sciences in southern Iran in 2024. Methods This descriptive-analytical cross-sectional study was conducted on 385 nurses. The data collection tools were standard questionnaires of critical thinking, moral courage and moral sensitivity. Data were analyzed using t-test, ANOVA, Pearson’s correlation coefficient and multiple linear regression using SPSS23 software. Results The average scores of critical thinking, moral courage, and moral sensitivity of the studied nurses were 188.16 ± 8.22 out of 450, 62.32 ± 7.45 out of 105, and 71.55 ± 6.39 out of 100, respectively, indicating the weak level of critical thinking and the average level of moral courage and moral sensitivity of nurses. Between moral courage (p

Introduction: The study aimed to assess the impact of Case-based Learning on nursing students' sensitivity and moral courage. Method: The present study is semi-experimental with non-equivalent control group. The research population is nursing students in Medical Sciences who entered the study by census (61 people). The educational program was designed, and the principal learning method was based on case-based learning (CBL). Latzen's ethical sensitivity questionnaire was used to check the level of moral sensitivity, and Sekerka's questionnaire was used to determine the level of moral courage. The students completed the questionnaires before and twice after the educational interventions. The data were analyzed with descriptive and analytical tests (Pearson RM-ANOVA). Results: The number of 61 students participated in the present study. The 29 people were in the intervention group and 32 in the control group. The average age of the participants was 18.41 ± 0.49. The study results showed that the moral sensitivity scores of the students in the intervention and control groups changed significantly over time (one week and three months after the intervention) compared to before the intervention (P = 0.02). Regarding moral courage scores, no significant change was reported between the intervention and control groups before, one week, and three months after the intervention (P = 0.82). Conclusion: The present results showed that the educational intervention using the case-based learning method improved the student's moral sensitivity and maintained it over time. However, improvement in moral courage over time has not been reported significantly.

Abstract Background The growing number of older people worldwide poses challenges for health policy, particularly in the Global North, where policymakers increasingly expect seniors to live and receive care at home. However, healthcare professionals, particularly in home-based care, face dilemmas between adhering to care ideals and meeting external demands. Although they strive to uphold ethical care standards, they must deal with patients’ needs, cooperation with colleagues and management guidelines. Home-based care is an essential part of healthcare services in Norway, but staff struggle with high patient numbers and time management. This article focuses on how staff deal with ethical challenges related to contextual and organisational constraints. Methods An ethnographic fieldwork in three municipalities in South-East Norway. The first author conducted three to four months of participant observation in each municipality. In addition, she conducted in-depth interviews with key informants in two municipalities and a focus group interview with seven home-based care workers in one municipality. The data was analysed by using a reflexive thematic analysis. Results Staff in home-based care are frequently more loyal to the patient than to the system and to their own needs. To provide good care, all informants disregarded the patient’s formal decision, i.e. they provided more care than the formalised decision stipulated. To prioritise beneficence to patients, informants also disregarded some of the rules applicable in home-based care. In addition, staff accepted risks to their own safety and health to provide care in the patient’s home. Conclusion The loyalty of home-based care staff to their patients can go beyond their loyalty to the rules of the system and even their own safety. This commitment might be attributed to a sense of doing meaningful work, to providing relationship-based and individualised care, and to strong moral courage. However, the staff’s emphasis on flexibility and individualised care also brings challenges related to unclear boundaries related to patient care.

Abstract Background Compassion fatigue in nursing interns contributes to career indecision and worsens the nursing shortage. While work environment and psychological factors are well-studied, the ethical dimension remains unexplored. Understanding these mechanisms, particularly the role of moral courage, is essential for designing interventions to combat compassion fatigue and address the workforce crisis. This study investigates the influence of moral courage on compassion fatigue among Chinese nursing interns, focusing on the mediating roles of moral sensitivity and professional identity. Methods A quantitative, cross-sectional study was conducted in accordance with the STROBE guidelines. We used the convenience sampling method to recruit 467 nursing interns from four public junior colleges in Hunan Province, China in February, 2024. Data were collected using Compassion Fatigue Short Scale, Moral Courage Scale, Revised Moral Sensitivity Questionnaire, and Professional Identity Scale. Data analyses were conducted using SPSS 22.0 and Amos 21.0. Results The modified model exhibited a good fit (χ2/df = 3.437, AGFI = 0.928, IFI = 0.984, TLI = 0.976, CFI = 0.984, NFI = 0.977, RMSEA = 0.072). Moral sensitivity positively influenced both moral courage and professional identity, while professional identity negatively impacted compassion fatigue. Importantly, the effect of moral courage on compassion fatigue was entirely mediated by moral sensitivity and professional identity (β = -0.114, P = 0.001). Conclusion This study suggests that moral courage in nursing interns mitigates compassion fatigue through the combined mediating effects of moral sensitivity and professional identity. Ethics education programs fostering moral courage, moral sensitivity, and professional values in nursing students could be crucial in alleviating compassion fatigue.

Abstract The COVID-19 pandemic deeply affected healthcare workers, although the impact may have differed according to different workplace contexts. The aim of this current research was to compare the psychopathology presented by hospital versus nursing home healthcare workers during the COVID-19 pandemic and to analyse the predictive role of purpose in life and moral courage in the appearance of psychopathology. This was an observational, cross-sectional study carried out on a sample of 108 healthcare workers, 54 each from a hospital or nursing homes, who were recruited during the 5 and 6th waves of the COVID-19 pandemic in Spain. Various self-reported scales were used to assess anxiety, depression, acute/post-traumatic stress disorder, drug and alcohol abuse, burnout, purpose in life, and moral courage. Compared to the hospital healthcare workers, nursing home healthcare workers had higher scores and a higher prevalence of anxiety (74.1% vs. 42%), depression (40.7% vs. 14.8%), and post-traumatic stress disorder (55.6% vs. 25.9). In the overall sample, purpose in life was a protective factor against psychopathology (OR = 0.54) and burnout (OR = 0.48); moral courage was a protective factor against depression (OR = 0.47) and acute stress (OR = 0.45); and exposure of family/friends to SARS-CoV-2 was a risk factor for acute stress (OR = 2.24), post-traumatic stress disorder (OR = 1.33), and higher burnout depersonalisation subscale scores (OR = 1.84). In conclusion, the increased presence of psychopathology in nursing home healthcare workers may be influenced by workplace and occupational contexts, personal factors such as exposure of family/friends to SARS-CoV-2, or internal dimensions such as purpose in life and moral courage. This knowledge could be useful for understanding how a future epidemic or pandemic might affect the mental health of healthcare workers in different labour contexts.

Abstract Background Moral distress occurs in daily nursing work and plagues nurses. Improving the level of moral courage is one of the main strategies to reduce moral distress, and low levels of moral courage may lead to nurse burnout, increased turnover, and reduced quality of care. Methods Nine electronic databases in Chinese and English were searched for the level of moral courage among nurses, including PubMed, Web of Science, EMBASE, CINAHL, CNKI, Wan fang, Wei pu, CBM and Cochrane Library, for the period from the date of database creation to April 5, 2023. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies, followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analysis and Systematic Reviews of Observational Studies guidelines, and data from the included studies were meta-analyzed in STATA version 15 using a fixed-effects model. Results Seventeen cross-sectional studies of moderate or high quality met the eligibility criteria and involved 7718 nurses, and the Nurses’ Moral Courage Scale (NMCS) was used to measure the self-assessed moral courage level of nurses. Eleven of these studies reported total scores for nurses’ moral courage, and the meta-analysis results showed a pooled mean score of 78.94 (95% CI: 72.17, 85.72); Fourteen studies reported mean entry scores for nurses’ moral courage, and the meta-analysis results showed a pooled mean score of 3.93 (95% CI: 3.64, 4.23). Conclusion The results of the meta-analysis showed that nurses’ moral courage levels were in the medium to high range, among the nurses who seemed to be male, non-nursing managers, high school education, had not experienced ethical issues, and considering resignation had lower levels of moral courage. The results of the meta-analysis may provide some reference for nursing managers and even hospital administrators to develop strategies to optimize nursing quality.

Background and purpose: Moral courage is a crucial aspect of the nursing profession that significantly influences the quality of healthcare services. Moral courage refers to the courage or inner strength that an individual exhibits in ethical situations, acting based on their ethical principles, values, and beliefs despite potential negative consequences for themselves. Enhancing moral courage in nurses can lead to better decision-making and improved healthcare quality, thus, the understanding of the various factors related to this characteristic is of great importance. This article aims to investigate the relationship between moral courage and the personal and occupational characteristics of nurses. Materials and methods: This is a cross-sectional descriptive study. The research population in this study consisted of all nurses employed in hospitals affiliated with Mazandaran University of Medical Sciences in the eastern province of Mazandaran. The sample size was determined to be 300 individuals. Sampling was conducted using the convenience sampling method. Data was collected through a questionnaire related to demographic characteristics (age, gender, marital status, education level, type of employment, years of service, service department, shift work, hospital of service, and history of attending ethics courses or seminars), and the Sekerka Ethical Courage questionnaire was utilized. Data analysis was performed using measures of central tendency, standard deviation, independent t-tests, analysis of variance, and multiple linear regression. SPSS 22 software was employed for data analysis, with a significance level of less than 0.05. Results: The average age of the participants was 32.85±7.54 years. The average score of nurses' moral courage was 60.24±4.37 out of (105), indicating a moderate level. The highest score of moral courage was commonly associated with the moral agent dimension (13.87±1.42) and multiple values (13.43±1.54), while the lowest score of ethical courage was related to the threat tolerance dimension (8.82±1.74). Participation in ethics courses had a significant effect on the moral courage score (P=0.004), where nurses with a history of attending ethics courses obtained higher scores in moral courage. Other variables did not have a significant impact on the ethical courage score. Regression analysis results also showed that only participation in ethics courses had a significant effect on the moral courage score, as nurses without a history of attending these courses scored lower (1.26 units). Conclusion: Based on the findings of this study, it was revealed that participation in ethics-related training courses has a significant impact on nurses' ethical courage. These results indicate that ethics-related education (familiarity with professional ethics principles in nursing, values, and ethics in nursing decision-making, ethics in patient confidentiality and privacy, ethical collaboration and interaction with colleagues and other members of the healthcare team, patient involvement in ethical decision-making, ethical relationships with patient's families, and respect for their rights) can help strengthen and enhance nurses' ethical courage. Since ethical courage plays a crucial role in nurses' decision-making in challenging situations, designing effective and appropriate educational programs in this area can contribute to improving the quality of care and fostering a more ethical environment in the nursing setting.

Background: The growing number of older people worldwide poses challenges for health policy, particularly in the Global North, where policymakers increasingly expect seniors to live and receive care at home. However, healthcare professionals, particularly in home-based care, face dilemmas between adhering to care ideals and meeting external demands. Although they strive to uphold ethical care standards, they must deal with patients' needs, cooperation with colleagues and management guidelines. Home-based care is an essential part of healthcare services in Norway, but staff struggle with high patient numbers and time management. This article focuses on how staff deal with ethical challenges related to contextual and organisational constraints. Methods: An ethnographic fieldwork in three municipalities in South-East Norway. The first author conducted three to four months of participant observation in each municipality. In addition, she conducted in-depth interviews with key informants in two municipalities and a focus group interview with seven home-based care workers in one municipality. The data was analysed by using a reflexive thematic analysis. Results: Staff in home-based care are frequently more loyal to the patient than to the system and to their own needs. To provide good care, all informants disregarded the patient's formal decision, i.e. they provided more care than the formalised decision stipulated. To prioritise beneficence to patients, informants also disregarded some of the rules applicable in home-based care. In addition, staff accepted risks to their own safety and health to provide care in the patient's home. Conclusion: The loyalty of home-based care staff to their patients can go beyond their loyalty to the rules of the system and even their own safety. This commitment might be attributed to a sense of doing meaningful work, to providing relationship-based and individualised care, and to strong moral courage. However, the staff's emphasis on flexibility and individualised care also brings challenges related to unclear boundaries related to patient care. [ABSTRACT FROM AUTHOR]

This text explores Aristotle's theory of the good, which suggests that moral virtue is always beneficial for human beings, even if it may seem counterintuitive. The debate centers around how moral virtues, such as courage, contribute to the contemplative life. The text also discusses the importance of courage in Aristotle's philosophy and its connection to the survival and well-being of communities. It suggests that a further account of the value of courage is needed to fully understand its importance. Additionally, the text explores Aristotle's views on reproduction and how it relates to the desire for immortality and the preservation of one's existence. Overall, the text highlights the complexity of Aristotle's views on courage and the need for a comprehensive understanding of its value in the good life. [Extracted from the article]

Background: Compassion fatigue in nursing interns contributes to career indecision and worsens the nursing shortage. While work environment and psychological factors are well-studied, the ethical dimension remains unexplored. Understanding these mechanisms, particularly the role of moral courage, is essential for designing interventions to combat compassion fatigue and address the workforce crisis. This study investigates the influence of moral courage on compassion fatigue among Chinese nursing interns, focusing on the mediating roles of moral sensitivity and professional identity. Methods: A quantitative, cross-sectional study was conducted in accordance with the STROBE guidelines. We used the convenience sampling method to recruit 467 nursing interns from four public junior colleges in Hunan Province, China in February, 2024. Data were collected using Compassion Fatigue Short Scale, Moral Courage Scale, Revised Moral Sensitivity Questionnaire, and Professional Identity Scale. Data analyses were conducted using SPSS 22.0 and Amos 21.0. Results: The modified model exhibited a good fit (χ2/df = 3.437, AGFI = 0.928, IFI = 0.984, TLI = 0.976, CFI = 0.984, NFI = 0.977, RMSEA = 0.072). Moral sensitivity positively influenced both moral courage and professional identity, while professional identity negatively impacted compassion fatigue. Importantly, the effect of moral courage on compassion fatigue was entirely mediated by moral sensitivity and professional identity (β = -0.114, P = 0.001). Conclusion: This study suggests that moral courage in nursing interns mitigates compassion fatigue through the combined mediating effects of moral sensitivity and professional identity. Ethics education programs fostering moral courage, moral sensitivity, and professional values in nursing students could be crucial in alleviating compassion fatigue. [ABSTRACT FROM AUTHOR]

Witnesses of moral violations stand up for their moral principles, despite facing substantial costs for intervening. Notwithstanding its importance, little is known whether responsibility attributions and the relation between the victim and a witness (i.e., kinship) have different effects on the intention to intervene in situations of different severity (e.g., moral courage situations). We predict an interaction between the situation's severity and the victims' responsibility for their plight. In less-severe situations, witnesses would be less willing to help when they perceive the victim to be responsible for their plight. However, those who are not seen as responsible would receive more help. For more-severe situations, responsibility is predicted to have no effect. Opposite effects are predicted for the relationship between the helper and the victim. We further predict that perceived costs for helping mediates witnesses' willingness to intervene. Two studies showed that people are more willing to help individuals who are perceived as being innocent, but only in less-severe situations. In more-severe situations, people's willingness to intervene increases, regardless of responsibility attributions. We did not observe effects for kinship. Moreover, we provide partial evidence that witnesses of more-severe situations indeed accept higher costs for intervention. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic deeply affected healthcare workers, although the impact may have differed according to different workplace contexts. The aim of this current research was to compare the psychopathology presented by hospital versus nursing home healthcare workers during the COVID-19 pandemic and to analyse the predictive role of purpose in life and moral courage in the appearance of psychopathology. This was an observational, cross-sectional study carried out on a sample of 108 healthcare workers, 54 each from a hospital or nursing homes, who were recruited during the 5 and 6th waves of the COVID-19 pandemic in Spain. Various self-reported scales were used to assess anxiety, depression, acute/post-traumatic stress disorder, drug and alcohol abuse, burnout, purpose in life, and moral courage. Compared to the hospital healthcare workers, nursing home healthcare workers had higher scores and a higher prevalence of anxiety (74.1% vs. 42%), depression (40.7% vs. 14.8%), and post-traumatic stress disorder (55.6% vs. 25.9). In the overall sample, purpose in life was a protective factor against psychopathology (OR = 0.54) and burnout (OR = 0.48); moral courage was a protective factor against depression (OR = 0.47) and acute stress (OR = 0.45); and exposure of family/friends to SARS-CoV-2 was a risk factor for acute stress (OR = 2.24), post-traumatic stress disorder (OR = 1.33), and higher burnout depersonalisation subscale scores (OR = 1.84). In conclusion, the increased presence of psychopathology in nursing home healthcare workers may be influenced by workplace and occupational contexts, personal factors such as exposure of family/friends to SARS-CoV-2, or internal dimensions such as purpose in life and moral courage. This knowledge could be useful for understanding how a future epidemic or pandemic might affect the mental health of healthcare workers in different labour contexts. [ABSTRACT FROM AUTHOR]

Aim Background Data Sources Methods Results Conclusion Patient or Public Contribution To understand how pre‐registration student nurses experience moral distress and refine the concept in this population.The experience of moral distress has positive and negative effects for health professionals and negatively impacts on patient care. Moral distress is a fluid concept which permits the experience to be varied among different populations. Despite empirical research, a concept analysis has not been performed in the student nurse population.Electronic databases were searched via Ebsco Host Complete and included Cinahl, Medline, APA Psych in March 2024. Search terms included ‘Moral Distress’ AND ‘Student’, ‘Moral Distress’ and ‘Baccalaureate.’ Search limits included articles between 2014 and 2024, English Language. Twenty‐five papers were included in the review and consisted of eight quantitative studies, 11 qualitative studies, three mixed methods studies and three literature/systematic reviews.An integrated mixed research synthesis (Sandelowski, Voils, Barroso 2006) was conducted and organized into Walker, Avant's (2005) framework of antecedents, attributes and consequences. Braun and Clarkes (2006) thematic analysis was then used to generate themes from the literature.Antecedents emerged as students having moral sensitivity, they recognize unethical circumstances. Attributes identified roots of moral distress. These roots include poor patient care, harm to the patient and unsafe care. Students experience of morally reprehensible events is exacerbated by the disempowerment they experience as being ‘just a student’. Student nurses who do not exhibit moral courage and do not oppose immoral practices do so due to internal constraints which transpire as fear of conflict, withdrawal of learning opportunities, and fear of disruption to learning. This is influenced by their registered nurse supervisor relationship. Consequences of moral distress identify negative feelings, coping mechanisms and positive effects.The attributes of moral distress in the student nurse population have distinctive features which should be considered by nurse educators and in empirical research.None, as this is a concept analysis that contributes to theory development and is not empirical research. [ABSTRACT FROM AUTHOR]

"When Conscience Calls: Moral Courage in Times of Confusion and Despair" by Kristen Monroe is a thought-provoking and inspiring book that explores the concept of moral courage in liberal democracy. Monroe presents a new conceptualization of moral courage that focuses on agency and intentionality, supported by interviews with nearly 100 individuals who have demonstrated moral courage. The book raises questions about risk perception, the role of support networks, and the social consequences of moral courage. While further empirical studies are needed, the book offers valuable insights into the conditions under which moral courage is displayed. [Extracted from the article]

Background and purpose: Moral courage is a crucial aspect of the nursing profession that significantly influences the quality of healthcare services. Moral courage refers to the courage or inner strength that an individual exhibits in ethical situations, acting based on their ethical principles, values, and beliefs despite potential negative consequences for themselves. Enhancing moral courage in nurses can lead to better decision making and improved healthcare quality, thus, the understanding of the various factors related to this characteristic is of great importance. This article aims to investigate the relationship between moral courage and the personal and occupational characteristics of nurses. Materials and methods: This is a cross-sectional descriptive study. The research population in this study consisted of all nurses employed in hospitals affiliated with Mazandaran University of Medical Sciences in the eastern province of Mazandaran. The sample size was determined to be 300 individuals. Sampling was conducted using the convenience sampling method. Data was collected through a questionnaire related to demographic characteristics (age, gender, marital status, education level, type of employment, years of service, service department, shift work, hospital of service, and history of attending ethics courses or seminars), and the Sekerka Ethical Courage questionnaire was utilized. Data analysis was performed using measures of central tendency, standard deviation, independent t-tests, analysis of variance, and multiple linear regression. SPSS 22 software was employed for data analysis, with a significance level of less than 0.05. Results: The average age of the participants was 32.85±7.54 years. The average score of nurses' moral courage was 60.24±4.37 out of (105), indicating a moderate level. The highest score of moral courage was commonly associated with the moral agent dimension (13.87±1.42) and multiple values (13.43±1.54), while the lowest score of ethical courage was related to the threat tolerance dimension (8.82±1.74). Participation in ethics courses had a significant effect on the moral courage score (P=0.004), where nurses with a history of attending ethics courses obtained higher scores in moral courage. Other variables did not have a significant impact on the ethical courage score. Regression analysis results also showed that only participation in ethics courses had a significant effect on the moral courage score, as nurses without a history of attending these courses scored lower (1.26 units). Conclusion: Based on the findings of this study, it was revealed that participation in ethics-related training courses has a significant impact on nurses' ethical courage. These results indicate that ethics-related education (familiarity with professional ethics principles in nursing, values, and ethics in nursing decision making, ethics in patient confidentiality and privacy, ethical collaboration and interaction with colleagues and other members of the healthcare team, patient involvement in ethical decision-making, ethical relationships with patient's families, and respect for their rights) can help strengthen and enhance nurses' ethical courage. Since ethical courage plays a crucial role in nurses' decision-making in challenging situations, designing effective and appropriate educational programs in this area can contribute to improving the quality of care and fostering a more ethical environment in the nursing setting. [ABSTRACT FROM AUTHOR]

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The extant research on deviant workplace behavior has mainly examined the consequences of such behavior from a "victim-centric" perspective, while ignoring the psychological and behavioral responses of the employees who engaged in it. Drawing upon moral cleansing theory, we adopt a "victimizer-centric" perspective and contend that employees experience moral deficits after engaging in deviant workplace behavior, which consequently lead to subsequent proactive behavior. We also propose that the indirect relationship between deviant workplace behavior and proactive behavior is contingent upon individuals' moral courage. Specifically, employees with high moral courage are more inclined to perform subsequent proactive behavior upon perceiving a moral deficit than those with low moral courage. Our hypotheses are supported by empirical data from an experimental study involving 128 participants in the United Kingdom (Study 1) and a multi-wave survey-based field study with a sample of 180 employees conducted in the United States (Study 2). Our research provides contributions to the literature on deviant workplace behavior by demonstrating how and when deviant workplace behavior can lead to subsequent compensatory behavior, as well as practical insights for both employees and organizations. [ABSTRACT FROM AUTHOR]

In 2008, Ruben Salazar was memorialized on a US postage stamp, one of several media icons of moral courage that included John Hersey, George Polk, and Martha Gellhorn, so honored at the same time. Unlike most postage stamp journalists, Salazar—whose career is a study in civil rights reportage—has largely faded from public memory and journalism history. Salazar lived and died civil rights reporting, killed by authorities while covering a Mexican American Vietnam War protest. This essay traces Salazar's impact as a narrator of the Mexican American freedom struggle, putting his work at the Los Angeles Times, and at Spanish-language station KMEX, in context with the broader civil rights movement. [ABSTRACT FROM AUTHOR]

Fostering students’ knowledge and courage to face illegal or immoral problems is a critical aim in educational settings. However, it is challenging for students who lack knowledge and social experience to comprehend the sins behind the immoral cases and have the moral courage to deal with those problems. Therefore, in the present study, an approach combining AR with game-based learning (ARGBL) was proposed. Furthermore, a quasi-experimental design was adopted to examine the effectiveness of the approach in terms of developing students’ moral courage regarding anti-corruption and their learning satisfaction. The participants were recruited from two classes in a university. One class with 30 students was assigned to be the experimental group who played the developed game for 4 weeks; the other class with 30 students was the control group who learned with the conventional technology-based learning (C-TL) mode (i.e. the teacher gave lectures using slides and multimedia). The results revealed that the experimental group’s moral courage and learning satisfaction was significantly higher than those of the control group. The findings of this study provide a reference for those intending to foster students’ moral courage when facing other immoral cases.

Abstract Aim To examine the correlation between moral courage and caregiving behaviour among nurses who are employed in the COVID‐19 ward in Iran. Design This study is a descriptive‐correlational and cross‐sectional research conducted in 2021 in the city of Tehran, Iran. Methods A total of 270 nurses employed in COVID‐19 wards, who had been working in these wards for at least 1 month, were recruited from XXX hospitals and XXX Hospital. Data collection was conducted from September to November 2021. The data collection tools included a demographic information form, the Caring Dimension Inventory (CDI‐25), and the Professional Moral Courage Scale (PMC). The designed questionnaire links were provided to the participants virtually through the Persian platform ‘Pars Line’ and via WhatsApp. Descriptive statistics and inferential statistics were used to examine the relationship between moral courage and care behaviour. Results There was a significant difference in the mean of caring behaviour between the age groups (40 years old), and the work experience groups (15 years) (p 10 years) (p > 0.05). The level of moral courage among the nurses was higher than the median score of the instrument (87.31 ± 10.37). Among the dimensions of moral courage, the highest score was related to the dimension of ethical factors (17.64 ± 2.64), and the lowest score was related to the dimension of multiple values (17.26 ± 2.78). The level of caring behaviours among the nurses was lower than the median score of the instrument (46.11 ± 10.84). Among the dimensions of caring behaviours, the highest score was related to physical‐technical behaviours (19.22 ± 5.27), and the lowest score was related to professional behaviours (1.35 ± 0.67). Based on the analysis, moral courage had a weak and inverse correlation with caring behaviours among nurses. The higher moral courage does not necessarily result in improved caregiving behaviours, emphasizing the need for further research to explore and address this relationship. Patient No Patient or Public Contribution.

Background Despite advocacy from the Association of American Medical Colleges (AAMC) and The Lancet Commission on medicine, Nazism, and the Holocaust, Holocaust education is lacking in medical education. To address this gap, students at Geisinger Commonwealth School of Medicine (GCSOM) viewed an Association of American Medical College (AAMC) webinar about medicine during the Holocaust as part of the required curriculum for first year medical students introduced in 2022. Methods As part of their doctoring course, Physician and Patient Centered Care (PPCC), students viewed the AAMC webinar “The legacy of the role of medicine during the Holocaust and its contemporary relevance” and participated in two structured reflections: a written reflection on how webinar topics inform students' professional development and a verbal reflection on learning from the Holocaust to develop a sense of moral courage, advocacy, and activism in medicine. Researchers conducted qualitative analysis of written reflections and analyzed session surveys to determine key themes and impact of the session. Results Of the 108 enrolled in PPCC, 59 (54.6%) completed a post session Likert scale survey assessing the impact of the webinar on their personal and professional development. As an average, respondents moderately agreed that the webinar impacted their personal and professional development, with 91% slightly, moderately, or strongly agreeing. Additionally, thematic analysis of required written reflections indicated a majority of students (62.5%) identified the need for additional medical humanities education about the Holocaust and its relevance to medicine. Conclusion Holocaust education encourages medical students to bear witness to past medical atrocities and critically assess the profession and their personal–professional growth. Continued structured integration of the Holocaust in medical education supports critical self-reflection and the development of morally courageous physicians who endorse and practice social accountability in medicine.

Abstract Background Moral courage and team work are the most important aspects of professional competence in clinical nurses; nurses with moral courage and team work are thought to be able to deliver safe nursing care to patients. The present study aimed to investigate whether moral courage and teamwork correlate with safe nursing care among clinical nurses. Methods This descriptive cross-sectional multicenter study was carried out from December 2023 to February 2024. A total of 375 nurses who were practicing in four hospitals in the south of Iran were enrolled in this study using convenience sampling. The data collection tools used consisted of a demographics survey, Moral Courage Questionnaire (MCQ), Team STEPPS Team Perception Questionnaire (T-TPQ), and the Assessment of Safe Nursing Care Questionnaire (ASNCQ). The data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson’s correlation coefficient. SPSS version 22 was used to analyze the data. Results The participants’ mean age was 32.66 ± 6.63 years, and their work experience was 8.56 ± 6.22 years. The total mean scores for moral courage, teamwork, and safe care were 422.37 ± 52.92, 144.09 ± 18.43, 315.84 ± 41.95, respectively. A statistically significant positive correlation was found between teamwork and safe care (r = 0.57, p

Abstract Background Medical students, especially during the clinical years, are often exposed to breaches of safety and professionalism. These contradict personal and professional values exposing them to moral distress and to the dilemma of whether and how to act. Acting requires moral courage, i.e., overcoming fear to maintain one’s core values and professional obligations. It includes speaking up and “doing the right thing” despite stressors and risks (e.g., humiliation). Acting morally courageously is difficult, and ways to enhance it are needed. Though moral courage efficacy, i.e., individuals’ belief in their capability to act morally, might play a significant role, there is little empirical research on the factors contributing to students’ moral courage efficacy. Therefore, this study examined the associations between perceived stress, academic burnout, and moral courage efficacy. Methods A cross-sectional study among 239 medical students who completed self-reported questionnaires measuring perceived stress, academic burnout (‘exhaustion,’ ‘cynicism,’ ‘reduced professional efficacy’), and moral courage efficacy (toward others’ actions and toward self-actions). Data analysis via Pearson’s correlations, regression-based PROCESS macro, and independent t-tests for group differences. Results The burnout dimension of ‘reduced professional efficacy’ mediated the association between perceived stress and moral courage efficacy toward others’ actions. The burnout dimensions ‘exhaustion’ and ‘reduced professional efficacy’ mediated the association between perceived stress and moral courage efficacy toward self-actions. Conclusions The results emphasize the importance of promoting medical students’ well-being—in terms of stress and burnout—to enhance their moral courage efficacy. Medical education interventions should focus on improving medical students’ professional efficacy since it affects both their moral courage efficacy toward others and their self-actions. This can help create a safer and more appropriate medical culture.

BackgroundNurses' moral courage is a special type of altruistic behavior， which is considered to be a key factor to improve patient safety. Empathy level can positively predict altruistic behavior， and moral sensitivity exerts an obvious mediation role in the positive prediction. At present， there is no relevant research to explore the path role of moral sensitivity in the relationship between empathy and moral courage.ObjectiveTo verify the mediation role of moral sensitivity in the relationship between empathy and moral courage among nursing students， so as to provide references for increasing the moral courage among nursing students.MethodsFrom June 1 to June 30， 2022， a total of 602 nursing students were recruited via convenience sampling from a tertiary grade A hospital in Mianyang， and participants were assessed using Interpersonal Reactivity Index-Chinese （IRI-C）， Moral Sensitivity Questionnaire-Revised Chinese Version （MSQ-R-CV） and Nurses' Moral Courage Scale （NMCS）. Pearson correlation analysis was used to assess the correlation among above scales. The Process macro plug-in for SPSS was used to test the mediation effect of moral sensitivity on the relationship between empathy and moral courage.ResultsA total of 602 valid questionnaires were collected， with an effective recovery rate of 96.78%. IRI-C score of nursing students was positively correlated with MSQ-R-CV score and NMCS score （r=0.269， 0.146， P

Background: Moral courage and team work are the most important aspects of professional competence in clinical nurses; nurses with moral courage and team work are thought to be able to deliver safe nursing care to patients. The present study aimed to investigate whether moral courage and teamwork correlate with safe nursing care among clinical nurses. Methods: This descriptive cross-sectional multicenter study was carried out from December 2023 to February 2024. A total of 375 nurses who were practicing in four hospitals in the south of Iran were enrolled in this study using convenience sampling. The data collection tools used consisted of a demographics survey, Moral Courage Questionnaire (MCQ), Team STEPPS Team Perception Questionnaire (T-TPQ), and the Assessment of Safe Nursing Care Questionnaire (ASNCQ). The data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson's correlation coefficient. SPSS version 22 was used to analyze the data. Results: The participants' mean age was 32.66 ± 6.63 years, and their work experience was 8.56 ± 6.22 years. The total mean scores for moral courage, teamwork, and safe care were 422.37 ± 52.92, 144.09 ± 18.43, 315.84 ± 41.95, respectively. A statistically significant positive correlation was found between teamwork and safe care (r = 0.57, p < 0.001), teamwork and moral courage (r = 0.49, p = 0.002), and moral courage and safe nursing care (r = 0.59 p < 0.001). According to the results, work experience, moral courage, and teamwork explained 44.4% of the variance in safe nursing care (R2 = 0.44, p < 0.001). Conclusion: The results indicated that the moral courage and teamwork of nurses were positively and significantly correlated with the participants' safe nursing care. Accordingly, since moral courage and teamwork are the qualities that can contribute to improving the quality of care and ensuring safe nursing care, it is recommended that nursing managers pay special attention to these factors. [ABSTRACT FROM AUTHOR]

AbstractClinical medicine’s complexities and demands often surpass the scope of formal ethics and leadership training that medical schools and residency programs provide. The discrepancy between medical education and the realities of clinical work may contribute to ethical erosion among learners, namely, medical students and residents. Unlike traditional approaches to teaching professional ethics and leadership in medicine, rights-based (aspirational) pedagogies approach trainees as autonomous moral agents, whose work has moral value to themselves and others, who live with the ethical consequences of their professional choices, and whose work shapes their individual moral character. By incorporating teaching strategies that intentionally build learners’ rights-based leadership through the development of moral courage, medical educators may counter important aspects of ethical erosion while promoting learner preparedness, outcomes, and well-being. Military teaching approaches offer a valuable example to medical educators seeking to create structured curricula that foster moral courage to promote rights-based leadership, given the high level of moral and managerial complexity present in both medicine and the military. Through a comparative analysis of professional ethics in the medical and military disciplines, this Observation article explores the validity of applying precedents from military ethics and leadership education to medical training. Through arguments rooted in moral philosophy, military history, and military organizational research, we explore the expansion of rights-based teaching methods within the predominantly traditional and rules-based norms of medical education. In relating these findings to real-life clinical scenarios, we offer six specific, rights-based modifications to medical ethics curricula that have potential to promote morally courageous leadership and counteract the ethical erosion medical students and residents face. [ABSTRACT FROM AUTHOR]

This research aimed to contribute to the literature on internet addiction (IA) and moral development among university students. Moral potency (MP) encompasses the interconnected dimensions of moral courage, moral ownership, and moral efficacy. Studies on the relationships between students' problematic behaviors (e.g., IA) and cognitive processes like MP, mindfulness (MI), and psychological capital (PsyCap) are scarce in educational research. Therefore, this study investigated the relationships among IA, MP, MI, and PsyCap in university students. This study included 868 undergraduate students from a state university in Ethiopia, with 526 male students (60.6%) and 342 female students (39.4%). Participants' ages ranged from 21 to 29 years, with a mean age of 22.31 and a standard deviation of 4.03. The findings indicated that IA was negatively correlated with MI, PsyCap, and MP. Both MI and PsyCap showed positive correlations with MP. Importantly, this study revealed that IA had a direct and negative impact on MI, PsyCap, and MP. Further, MI and PsyCap partially mediated and fully mediated the relationship between IA and MP. These findings suggest that cultivating MI and positive PsyCap among university students could be an important strategy to reduce the risks of IA and enhance their moral development. This study contributes to the limited research on the complex relationships between technology use, psychological resources, and moral functioning in emerging adulthood. [ABSTRACT FROM AUTHOR]

The article "'Eccentricity', by DH Tuke (1892)" explores the concept of eccentricity and its connection to mental health. It defines eccentricity as a departure from societal norms, characterized by peculiar habits. The article emphasizes that eccentricity is not a fundamental change in character, but rather a persistent oddity that is under the control of the individual. It acknowledges the challenge of distinguishing eccentricity from insanity, considering factors such as education, environment, and social status. The article provides examples of eccentric individuals and suggests that studying eccentricity in relation to an individual's circumstances is crucial in understanding its nature. It also mentions the recent Lunacy Act, which addresses legal concerns related to eccentric behavior and financial matters. [Extracted from the article]

Introduction: Moral courage manifests in acts intended to intervene to stop or redress witnessed moral norm violations, despite the risk of negative consequences for the intervener. We investigate moral courage in everyday life and ask what personality processes are involved. Based on an extended process model of moral courage, we derived hypotheses on cognitive and emotional processes that should facilitate or hinder intervention. Further, we identified candidate personality dispositions that should shape these processes and thereby predict who tends to intervene against others' norm violations and who does not. Methods: Using a quota‐based sample of the German population (N = 1108), we conducted a personality assessment, followed by a 7‐day experience sampling during which participants reported norm violations witnessed in their daily life as well as their cognitive, emotional, and behavioral reactions. Results: In total, 678 participants reported 1965 norm violations and intervened against 32% of them. Dispositional self‐efficacy facilitated intervention by increasing a sense of efficacy when confronted with others' norm violations. Conversely, dispositional moral disengagement hindered intervention by reducing perceived own responsibility. Discussion: Our findings provide novel insights into the situations affording moral courage in everyday life, and the personality processes that uniquely guide this behavior. [ABSTRACT FROM AUTHOR]

Background & Purpose: Courageous behaviors are very important for organizations because they can solve their problems and instill long-term trust in the organization. The purpose of this research is to understand the process of choosing courageous behavior in public organizations. Methodology: This research is applied research with a qualitative approach and grounded theory method was used. The participants in this research were experts in the behavioral-human resources field of public organizations of East Azerbaijan province (Tabriz & Marand Cities) were selected as a statistical sample through a purposeful sampling method. The tool of data collection was semi-structured interview. The obtained interview data was analyzed and codified using Maxquda Version 2020. Findings: Based on the result, the central category was explained in four subcategories of "persistence and resilience", "brave and boldness", "activity and not being indifferent to observed deviations", and "the ability to preserve identity and honesty in telling the truth". Causal conditions were classified in the form of two categories of individual and structural factors, background conditions in the form of managers' personality and performance, social pressure, informal organization and educational and social contexts, and intervening conditions in the form of economic, political and cultural factors. Actions-reactions were also identified in the form of the categories of developing a risk-taking culture, modeling brave people and publishing their narratives, raising awareness and training human resources, expanding effective bilateral and multilateral interactions, and designing encouraging and supportive mechanisms promoting courage behaviors. Finally, the results were categorized into the categories of individual, organizational, and extra-organizational achievements. Conclusion: Human resources managers can learn about courageous behavior, its choosing process, and the consequences of this behavior in organizations with the help of the paradigm model presented in this research and finally, make a series of structural, cultural, and political reforms to develop courage behavior. [ABSTRACT FROM AUTHOR]

Background: Medical students, especially during the clinical years, are often exposed to breaches of safety and professionalism. These contradict personal and professional values exposing them to moral distress and to the dilemma of whether and how to act. Acting requires moral courage, i.e., overcoming fear to maintain one's core values and professional obligations. It includes speaking up and "doing the right thing" despite stressors and risks (e.g., humiliation). Acting morally courageously is difficult, and ways to enhance it are needed. Though moral courage efficacy, i.e., individuals' belief in their capability to act morally, might play a significant role, there is little empirical research on the factors contributing to students' moral courage efficacy. Therefore, this study examined the associations between perceived stress, academic burnout, and moral courage efficacy. Methods: A cross-sectional study among 239 medical students who completed self-reported questionnaires measuring perceived stress, academic burnout ('exhaustion,' 'cynicism,' 'reduced professional efficacy'), and moral courage efficacy (toward others' actions and toward self-actions). Data analysis via Pearson's correlations, regression-based PROCESS macro, and independent t-tests for group differences. Results: The burnout dimension of 'reduced professional efficacy' mediated the association between perceived stress and moral courage efficacy toward others' actions. The burnout dimensions 'exhaustion' and 'reduced professional efficacy' mediated the association between perceived stress and moral courage efficacy toward self-actions. Conclusions: The results emphasize the importance of promoting medical students' well-being—in terms of stress and burnout—to enhance their moral courage efficacy. Medical education interventions should focus on improving medical students' professional efficacy since it affects both their moral courage efficacy toward others and their self-actions. This can help create a safer and more appropriate medical culture. [ABSTRACT FROM AUTHOR]

Moral courage is defined as standing up for others and intervening when a norm is violated. This research aimed to examine the effect of relationship type between the bystander and the victim (close or distant) and the moral context in which the norm violation occurs (care/harm or fairness/reciprocity) on moral courage. Two studies (n = 164 and n = 200) utilized a scenario method in which participants were presented with short vignettes of another person (close or distant) being victimized (in either a care or a fairness context) and were asked to indicate their willingness to intervene, representing degree of moral courage. As expected, participants reported greater levels of moral courage when the victim was their family member or friend (vs. stranger) and this effect was stronger in the care (vs. fairness) context. Moreover, anger — a moral emotion — mediated the relationship effect on moral courage in both contexts. Consequently, relationship type and context should be considered when addressing interventions against norm violations. [ABSTRACT FROM AUTHOR]

Aim: To determine the relationship between psychological resilience, nursing practice environment, and moral courage of clinical nurses and also the factors influencing moral courage. Design: Cross‐sectional study. Methods: 586 nurses from a general hospital were selected by convenience sampling method in January 2023. The general information questionnaire, Nurses' Moral Courage Scale (NMCS), Resilience Scale, and Practice Environment Scale (PES) were measured. Hierarchical linear regression analysis was used to explore the influencing factors of clinical nurses' moral courage. Results: Nurses' average moral courage score was 79.00 (69.00, 91.00). The nurses' moral courage was positively correlated with psychological resilience and nursing practice environment. Multivariate linear regression analysis showed that psychological resilience and nursing practice environment entered the regression equation, accounting for 23.4% of the total variation. Psychological resilience and nursing practice environment are the main factors affecting the moral courage of clinical nurses. Nursing managers should conduct moral courage training, develop a decent nursing practice environment, pay attention to the psychological emotions of nurses, and actively build a safe, open, and supportive atmosphere for moral behaviour. [ABSTRACT FROM AUTHOR]