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"Moral"

Original Articles
Influence of Nurses' Moral Distress and Ethical Nursing Competence on Retention Intention
Ji-Hyun Choi, Mi-Jin Byun, Thi Ninh Do
J Korean Acad Nurs Adm 2025;31(1):36-44.   Published online January 31, 2025
DOI: https://doi.org/10.11111/jkana.2025.31.1.36
Purpose
This study aimed to ascertain the influence of moral distress and ethical nursing competence on retention intention among nurses.
Methods
Participants included 191 nurses working in general hospitals. Data were collected from July 11 to 18, 2023 and analyzed using SPSS/WIN 23.0.
Results
Factors Influencing retention intention were clinical experience in the present department (β=.22, t=3.20, p=.002), moral distress (β=-.22, t=-3.15, p=.002) and ethical nursing competence (β=.26, t=3.82, p<.001). These variables accounted for 19.7% of nurses' retention intentions.
Conclusion
Based on our findings, it is necessary to identify interventions aimed at alleviating moral distress, and establish and implement systematic programs to improve ethical nursing competence in order to increase the retention intention of nurses.
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Effects of Clinical Nurses' Ethical Climate and Ethical Nursing Competence on Moral Distress
Sun Mi Ha, Yeong Ju Yoon
J Korean Acad Nurs Adm 2025;31(1):25-35.   Published online January 31, 2025
DOI: https://doi.org/10.11111/jkana.2025.31.1.25
Purpose
This study aimed to identify the effects of clinical nurses' ethical climate and ethical nursing competence on moral distress.
Methods
The participants were clinical nurses who provided direct nursing care; nurses with more than one year of work experience in general hospitals were targeted. The data were collected between January 3 and 19, 2024, and analyzed using t-test, analysis of variance, Games-Howell test, Pearson correlation coefficient, and multiple regression.
Results
Moral distress was significantly and negatively correlated with ethical climate and ethical nursing competence. Factors affecting the moral distress of clinical nurses included having a position of charge nurse or higher, total clinical experience of more than 20 years, turnover intention from current job due to ethical issues, hospital sub factors of the ethical climate, and ethical behavior sub factors of ethical nursing competence, showing 27.0% explanatory power.
Conclusion
Establishing a positive ethical climate and improving ethical nursing competence providing opportunities for nurses to raise and solve ethical issues will contribute to resolving nurses' ethical conflicts and reducing moral distress.

Citations

Citations to this article as recorded by  
  • Influential factors of moral distress and job satisfaction on turnover intention of long-term care hospital nurses: A cross-sectional descriptive study
    Ningjie Liu, Sun Mi Ha
    Journal of Korean Gerontological Nursing.2025; 27(2): 216.     CrossRef
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  • 1 Crossref
Purpose
This study was done to identify the mediating effect of biomedical ethics awareness in the relationship between moral sensitivity and perceived ethical confidence among nursing students. Methods Participants were 211 nursing students from 7 universities in G city. A self-report questionnaire was used to measure moral sensitivity, biomedical ethics awareness, and perceived ethical confidence. The data were analyzed with descriptive statistics, Pearson correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method. Results Moral sensitivity was significantly positively correlated with biomedical ethics awareness (r=.52, p<.001) and perceived ethical confidence (r=.60, p<.001). Biomedical ethics awareness was also significantly correlated with perceived ethical confidence (r=.50, p<.001). Also, biomedical ethics awareness (β=.25, p<.001) showed a partial mediating effect on the relationship between moral sensitivity and perceived ethical confidence. Conclusion The impact of moral sensitivity on perceived ethical confidence in nursing students was mediated by biomedical ethics awareness. Therefore, it is suggest that strategies for improving biomedical ethics awareness in nursing students should be considered when developing an educational program for enhancing their perceived ethical confidence.

Citations

Citations to this article as recorded by  
  • Assessing the relationship between ethical reasoning confidence and self-esteem among female nursing students for enhancing the quality of work life: A cross-sectional study
    Shaherah Yousef Andargeery, Sally Mohammed Farghaly Abdelaliem
    Medicine.2024; 103(14): e37614.     CrossRef
  • Mediating effect of moral sensitivity on the relationship between nursing professionalism and ethical decision-making confidence in nursing students
    Bae-Hwa Kang, Hye-Young Cho
    The Journal of Korean Academic Society of Nursing Education.2023; 29(2): 180.     CrossRef
  • The impact of nursing students’ biomedical and artificial intelligence ethical awareness, ethical values, and professional self-concept on their ethical decision-making confidence
    Seungmi Park, Insun Jang
    The Journal of Korean Academic Society of Nursing Education.2023; 29(4): 371.     CrossRef
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  • 3 Crossref
Relationship of ICU Nurses' Difficulties in End-of-Life Care to Moral Distress, Burnout and Job Satisfaction
Kkot Bi Jeon, Mihyun Park
J Korean Acad Nurs Adm 2019;25(1):42-51.   Published online January 31, 2019
DOI: https://doi.org/10.11111/jkana.2019.25.1.42
PURPOSE
The aim of this study was to identify the relationships between the difficulty of end-of-life care and moral distress, burnout and job satisfaction of nurses working in intensive care units (ICUs).
METHODS
This descriptive study was conducted using self-report questionnaires. Participants were nurses who had more than one year of ICU experience and were recruited from three university hospitals (N=168).
RESULTS
The mean scores for ICU nurses' difficulty in end-of-life care, moral distress, burnout and job satisfaction were 3.42, 113.88, 3.16 and 2.58 points, respectively. Difficulty in end-of-life care was positively correlated with moral distress (r=.48, p < .001) and burnout (r=.26, p=.001) and was negatively correlated with job satisfaction (r=−.17, p=.024). Difficulties in end-of-life was identified as a predictor of moral distress (β=.44, p < .001), burnout (β=.26, p=.001) and job satisfaction (β=−.18, p=.024).
CONCLUSION
The results of this study suggest the following: it is important to have a deep understanding of ICU nurses who experience various difficulties in end-of-life care and to provide realist support for these nurses. And practical efforts by nursing organizations are needed, including support systems and education programs to alleviate ICU nurses' difficulties in end-of-life care.

Citations

Citations to this article as recorded by  
  • A Conceptual Analysis of Psychological Burnout Among Nurses Providing Terminal Care
    Sunjung Kim, Sunghee H. Tak
    Journal of Advanced Nursing.2025;[Epub]     CrossRef
  • Relationship between moral resilience and secondary traumatic stress among ICU nurses: A cross‐sectional study
    Mengyi Hu, Hongli Zhang, Chao Wu, Lu Li, Xinhui Liang, Yu Zhang, Hongjuan Lang
    Nursing in Critical Care.2024; 29(6): 1363.     CrossRef
  • The Relationship Between Perceived Comfort Level with Moral Sensitivity and Moral Distress Among Oncology Nurses: A Descriptive Correlational Study
    Samira Beiranvand, Kourosh Zarea, Shahram Molavynejad, Simin Madhooshi, Parisa Sheini Jaberi
    Seminars in Oncology Nursing.2024; 40(6): 151742.     CrossRef
  • Factors related to burnout of nurses working at intensive care units: A descriptive survey study
    Yeon Ju Lee, Heeok Park, Ji Hun Joung
    Journal of Korean Gerontological Nursing.2024; 26(2): 221.     CrossRef
  • The Relationship Between Nurses’ Moral Distress, Their Spiritual Well-Being, and Moral Intelligence
    Masoume Moqaddam, Nasrin Hanifi, Parvin Shiri Ghaidari
    Journal of Archives in Military Medicine.2024;[Epub]     CrossRef
  • Talking about dying and death: Essentials of communicating about approaching death from the perspective of major stakeholders
    Sibylle J. Felber, Tommaso Guffi, Beate G. Brem, Felix M. Schmitz, Kai P. Schnabel, Sissel Guttormsen Schär, Steffen Eychmüller, Sofia C. Zambrano
    Palliative and Supportive Care.2024; 22(5): 1199.     CrossRef
  • National and International Trends in Research on Moral Distress in Nursing: Text-network Analysis and Topic Modeling
    Chan-Sook PARK
    Korean Journal of Medical Ethics.2023; 26(2): 133.     CrossRef
  • Perceived Stress, Moral Distress, and Spiritual Intelligence of Clinical Nurses in the Coronavirus Disease 2019 Pandemic
    Milad Bazghaleh, Mohammad Abbasi, Elahe Bahonar, Zohreh Ghomian, Mahdi Sadeghi, Reza Norouzadeh
    Annals of Military and Health Sciences Research.2023;[Epub]     CrossRef
  • The Relationship between Clinical Competence and Ethical Reasoning and Factors Affecting it in Nurses Working in Therapeutic Educational Centers of Ilam
    Masoumeh Otaghi, Mosayeb Mozafari, Yosof Veysani, Azam Taheri
    Romanian Journal of Military Medicine.2023; 126(1): 106.     CrossRef
  • The relationship between secondary traumatic stress and burnout in critical care nurses: The mediating effect of resilience
    Yun Jeong Jeong, Sujin Shin
    Intensive and Critical Care Nursing.2023; 74: 103327.     CrossRef
  • How Do Nursing Students Perceive Moral Distress? An Interpretative Phenomenological Study
    Chiara Gandossi, Elvira Luana De Brasi, Debora Rosa, Sara Maffioli, Sara Zappa, Giulia Villa, Duilio Fiorenzo Manara
    Nursing Reports.2023; 13(1): 539.     CrossRef
  • The severity of moral distress in nurses: a systematic review and meta-analysis
    Nader Salari, Shamarina Shohaimi, Behnam Khaledi-Paveh, Mohsen Kazeminia, Mohammad-Rafi Bazrafshan, Masoud Mohammadi
    Philosophy, Ethics, and Humanities in Medicine.2022;[Epub]     CrossRef
  • The Effect of Nursing Competence on Patient-Centered Care among Nurses Caring for Patients with Chronic Disease: The Mediating Effect of Burnout and the Moderating Effect of Nursing Work Environment
    Jin-Yeong Ahn, Young Eun
    Korean Journal of Adult Nursing.2021; 33(2): 134.     CrossRef
  • Levels of Moral Distress among Health Care Professionals Working in Hospital and Community Settings: A Cross Sectional Study
    Noemi Giannetta, Rebecca Sergi, Giulia Villa, Federico Pennestrì, Roberta Sala, Roberto Mordacci, Duilio Fiorenzo Manara
    Healthcare.2021; 9(12): 1673.     CrossRef
  • End-of-Life Care Mobile App for Intensive-Care Unit Nurses: A Quasi-Experimental Study
    Jin Hee Yang, Gisoo Shin
    International Journal of Environmental Research and Public Health.2021; 18(3): 1253.     CrossRef
  • Mixed Method Research Investigating Turnover Intension with ICU Nurses
    Jung-Hoon Lee, Yeoungsuk Song
    Journal of Korean Academy of Fundamentals of Nursing.2020; 27(2): 153.     CrossRef
  • Emergency nurses’ experience of coping with moral distress
    Na Kyoung Lee, Jee-In Hwang
    The Journal of Korean Academic Society of Nursing Education.2020; 26(2): 176.     CrossRef
  • Current Status of End-of-Life Care Education in Undergraduate Nursing Curriculum
    So-Hi Kwon, Yeon-Su Cho
    The Korean Journal of Hospice and Palliative Care.2019; 22(4): 174.     CrossRef
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  • 18 Crossref
Informed Consent: A Complex Process in Iran's Nursing Practice
Alireza Nikbakht Nasrabadi, Mahboobeh Shali
J Korean Acad Nurs Adm 2017;23(3):223-228.   Published online June 30, 2017
DOI: https://doi.org/10.11111/jkana.2017.23.3.223
Informed consent should not be regarded as a rigid process. Instead, it should be regarded as a flexible process that provides patient with the right amount of information required to facilitate meaningful decision-making. Informed consent is an important ethical and practical part of patient care. Understanding the moral foundation of informed consent can help to guide therapists in their communication with all patients. Nurses, as members of the multidisciplinary team, are currently key contributors in providing information to patients regarding the treatment process. But in this process, there are some challenges that make it difficult. This paper describes the underlying ethical and regulatory requirements as well as related challenges regarding informed consent in the context of a nursing practice in Iran.

Citations

Citations to this article as recorded by  
  • Assessment of biobank awareness among medical students in Iran
    Jan Domaradzki, Reza Jahanshahi, Marcin Piotr Walkowiak, Dariusz Walkowiak
    Journal of Community Genetics.2025; 16(2): 183.     CrossRef
  • Informed consent practice and associated factors among healthcare professionals in public hospitals of Southern Ethiopia, 2023: a mixed-method study
    Getachew Nigussie Bolado, Bizuayehu Atnafu Ataro, Mulualem Gete Feleke, Christian Kebede Gadabo, Tamirat Ersino Kebamo, Worku Mimani Minuta
    BMC Nursing.2024;[Epub]     CrossRef
  • Hemşirelik Uygulamalarında Aydınlatılmış Onam
    Gülşen ALTUNTAŞ ÇALIM, Semra ELMAS
    Akdeniz Hemşirelik Dergisi.2023; 2(2): 65.     CrossRef
  • Content Validity of the AHRQ Health Care Professional Survey on Informed Consent: A Methodological Study
    Eyad Abu Alhaijaa, Fathieh Abu Moghli
    The Open Nursing Journal.2022;[Epub]     CrossRef
  • The Role of the Nurse in Informed Consent to Treatments: An Observational-Descriptive Study in the Padua Hospital
    Veronica Strini, Roberta Schiavolin, Angela Prendin
    Clinics and Practice.2021; 11(3): 472.     CrossRef
  • Promoting informed consent in a children's hospital in Tabriz, Iran: a best practice implementation project
    Neda Kabiri, Sakineh Hajebrahimi, Gisoo Alizadeh, Solmaz Azimzadeh, Nayyereh Farajzadeh, Amin Talebpour
    JBI Database of Systematic Reviews and Implementation Reports.2019; 17(12): 2570.     CrossRef
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Changes in Nursing Students' Moral Judgment and Ways to Evaluate the Effect of Ethics Education
MI Aie Lee
J Korean Acad Nurs Adm 2013;19(3):351-360.   Published online June 30, 2013
DOI: https://doi.org/10.11111/jkana.2013.19.3.351
PURPOSE
This study was done to investigate changes in nursing students' moral judgment throughout their professional education, and to identify more suitable ways to evaluate ethics education by using P (%) scores only and P (%) scores with 4th scores.
METHODS
The study consisted of cross-sectional and longitudinal surveys as well as a study using a nonequivalent control group pre-post experimental design. The participants were nursing students attending a university in Gyeongju, Korea. The data were collected from September 1, 2006 to October 31, 2009 using the Korean version of the Defining Issues Test.
RESULTS
In the cross-sectional survey, there was no significant difference in the nursing students' moral judgment scores according to their school grades. In the longitudinal survey, nursing students' moral judgment scores did not change significantly over the duration of their education. In the nonequivalent control group study, the effectiveness of nursing ethics education was identified by P (%) scores only.
CONCLUSION
The evidence indicates that nursing professional education does not influence the development of nursing students' moral judgment, and using P (%) scores only seems to be a better way compared to other ways to evaluate the effects of nursing ethics education.

Citations

Citations to this article as recorded by  
  • When You Think of and Identify Yourself as a Nurse, You Will Become More Deontological and Less Utilitarian
    Mufan Zheng, Junhua Zhao, Xielan Zhang
    International Journal of Environmental Research and Public Health.2024; 21(6): 712.     CrossRef
  • EEG Correlates of Moral Decision-Making: Effect of Choices and Offers Types
    Giulia Fronda, Laura Angioletti, Michela Balconi
    AJOB Neuroscience.2024; 15(3): 191.     CrossRef
  • Ethical Sensitivity in Nursing Students: Developing a Context–based Education
    Marzieh Shayestehfard, Camellia Torabizadeh, Sakineh Gholamzadeh, Abbas Ebadi
    Electronic Journal of General Medicine.2020; 17(2): em195.     CrossRef
  • The Experience of Nursing Students' Moral Distress in Clinical Practice
    Chanhee Kim, Heeseung Choi
    The Journal of Korean Academic Society of Nursing Education.2016; 22(3): 355.     CrossRef
  • Cross-sectional comparison on human rights sensitivity changes in nursing students and non-nursing students
    Seong-Eun Kim
    Journal of Digital Convergence.2016; 14(4): 355.     CrossRef
  • Effectiveness of a Case-Based Computer Program on Students’ Ethical Decision Making
    Eun-Jun Park, Mihyun Park
    Journal of Nursing Education.2015; 54(11): 633.     CrossRef
  • Comparing the Ethical Knowledge, Ethical Values and Class Satisfaction by Students' Cognitive Style to Develope the Convergent Nursing Ethic Class
    Sun-Young Jeong, Chang-Hee Kim
    Journal of Digital Convergence.2015; 13(11): 205.     CrossRef
  • Effects of a Blended Learning Program on Ethical Values in Undergraduate Nursing Students
    Sang Dol Kim
    Journal of Korean Academy of Nursing Administration.2014; 20(5): 567.     CrossRef
  • 17 View
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  • 8 Crossref
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