Happiness and Moral Courage Among Iranian Nurses During the COVID-19 Pandemic: The Role of Workplace Social Capital

The Relationship among Crisis and Emergency Risk Communication, Managerial Support, and Nurses' Social Capital During COVID-19 Pandemic

Background

The COVID-19 pandemic has significantly impacted the nursing team, emphasizing the need for effective emergency risk communication in public health situations. The current study aims to explore the relationship among CERC, managerial support, and nurses' social capital during recovery the from COVID-19 pandemic.

Method

The researchers utilized a descriptive correlational research design. The study was carried out at four large hospitals that provide mainly tertiary health care services. A systemic random sampling technique was adopted to select 839 nurses working at the selected settings. Three instruments were used; Crisis and Emergency Risk Communication, Top management Support, and Nurses' Social Capital questionnaires. The researchers used Spearman correlation, Mann-Whitney U test, Student t test, analysis of variance, and Kruskal-Wallis tests to analyze collected data.

Results

Significant positive correlations were noted between Crisis and Emergency Risk Communication as independent variables, and each of top management support and social capital as dependent variables.

Conclusion

COVID-19 pandemic had put significant pressure on nurses' social capital and their ability to communicate effectively. Thus, focusing on risk communication and managerial support are crucial for keeping staff social capital, especially during health crisis.

Implications for Nursing Management

Continuous training centered on risk communication during emergencies and health crises coupled with high managerial support would keep staff nurses' social capital.

Enhancing the moral courage of nurses: A modified Delphi study

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.

Nurses' Workplace Social Capital and Sustainable Development: An Integrative Review of Empirical Studies

Aim

The purpose of our review was to assess the role of nurses' workplace social capital in meeting the Sustainable Development Goals (SDGs) of the United Nations (UN).

Background

In 2015, the 2030 Agenda for Sustainable Development with 17 universal goals was adopted by members of the UN. Although nurses have been acknowledged as important contributors to sustainable development, they still have difficulties in connecting their work to the SDGs. Nurses' workplace social capital is an important concept in nursing management due to its constructive consequences. However, the potential association between nurses' workplace social capital and the SDGs has not been evaluated. Evaluation. We conducted an integrative review, following the methodology of Whittemore and Knafl. Seven databases, Medline, CINAHL, Web of Science, Cochrane Library, Embase, PsycINFO, and Scopus with no restriction on publication year, were searched in May 2023 to identify statistically significant empirical evidence. Only peer-reviewed research papers published in English language journals were considered. We applied the Mixed Methods Appraisal Tool to evaluate the quality of the selected articles. We categorized outcomes of nurses' workplace social capital into themes and connected them to the SDGs through repeated comparisons and discussions. Key Issues. Twenty-nine of 2,188 retrieved articles were included in the final data analysis. Twenty-three outcomes of nurses' workplace social capital were identified, and three themes were abstracted. Nurses' workplace social capital is positively associated with SDG 3 (good health and well-being), SDG 8 (decent work and economic growth), and SDG 17 (partnerships for the goals).

Conclusion

Findings of our integrative review shed light on the importance of nurses' workplace social capital and the role of nurses in achieving the global movement for sustainable development. Implication for Nursing Management. Investment in nursing workforce and nurses' workplace social capital can further strengthen the position of nurses to support and deliver the SDGs.

Nurses' perspectives on professional self-concept and its influencing factors: A qualitative study

BACKGROUND

Nurses with a strong professional self-concept tend to exhibit a positive mindset and strong work engagement, delivering high-quality patient care. Although numerous quantitative studies have examined the factors impacting professional self-concept, there remains a limited exploration of these factors from the perspective of nurses themselves.

METHODS

This qualitative descriptive study uses the PERMA theory and Social Cognitive Theory as the theoretical framework. Semi-structured interviews were conducted with 15 nurses from six public hospitals in China. The data were analyzed thematically using a combination of inductive and deductive approaches.

RESULTS

Nurses' understanding of professional self-concept could be divided into four categories: professional identity, competence, care, and knowledge. Factors influencing nurses' professional self-concept were categorized into eight subthemes in three domains: (1) personal factors, including psychological qualities and attitude towards the nursing profession; (2) occupational-related behavioral factors, including role-oriented behavior and knowledge-oriented behavior; and (3) work environment and external factors, including external evaluation and perceptions of nurses, time allocation, nursing work tasks, work atmosphere, school education, and perceived supports.

CONCLUSIONS

This study found that, although nurses had different personal experiences, their perceptions of professional self-concept were similar. Nurses' professional self-concept is a multidimensional concept and involves various factors, such as personality, work-related characteristics, environment, and family. To thrive in a nursing career, nurses must discern the factors that can enhance or hinder their professional self-concept. By identifying and adjusting these factors, personalized support and positive interventions can be tailored to meet nurses' specific needs, which ultimately nurtures their professional development.

TRIAL REGISTRATION

This study was registered on December 14, 2022, in the Chinese Clinical Trial Registry (ChiCTR2200066699) as part of our ongoing study.

The influence of psychological resilience and nursing practice environment on nurses' moral courage: A cross-sectional study

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.

Nurses' moral courage and related factors: A systematic review

BACKGROUND

Nurses face various ethical conflicts when taking care of patients, and such conflicts require moral courage. This systematic review was conducted with the aim of investigating moral courage and its related factors among nurses.

METHODS

To find related studies, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The PubMed, Web of Science, Google Scholar, Scopus, Embase and Science Direct databases were searched using keywords such as Courage, Moral Courage, and Nurses, and no lower time limit was imposed when conducting the searches. The identified studies were published between January 2000 and March 2023. Quality of articles was assessed using the STROBE checklist.

RESULTS

The pooled sample size for the 19 included studies was 7863. All studies were observational and cross-sectional. The results showed that three categories of factors most related to moral courage are individual, moral, and factors related to the organization. Underlying factors of each category are also provided within this paper.

CONCLUSION

Moral courage is an integral part of nursing, which as a profession, is becoming even more challenging with the advancement of science and technology. Therefore, there is a need for nurses and especially nursing managers to be considerate of factors affecting moral courage of nurses, with a view to strengthening the positive factors and reducing the negative impacts.

Moral courage and its influencing factor among oncology specialist nurses: A multi-centre cross-sectional study

AIM

Moral courage among healthcare workers has been extensively studied. However, few studies have been conducted on oncology specialist nurses, who frequently encounter complex moral situations. This study aimed to describe the current situation regarding moral courage and explored its influence on oncology specialist nurses in China.

DESIGN

This was an exploratory, descriptive study.

METHODS

A convenience sample of 390 nurses was conducted from 15 hospitals in Sichuan Province, China, between March and May 2023. Participants were assessed using the Moral Distress Scale-Revised, Nurses' Moral Courage Scale and the Moral Sensitivity Questionnaire.

RESULTS

The results demonstrated that moral courage was negatively associated with moral distress, and positively associated with moral sensitivity. Having a master's degree or above, an intermediate title or senior title, medical ethics training, moral distress or moral sensitivity contributed to explaining 54.1% of the variance in moral courage.

CONCLUSIONS

Moral courage was associated with several factors. Developing clinical intervention strategies and effective teaching methods will be critical for improving moral courage. No Patient or Public Contribution.

Reflections of nurses in the fight against COVID-19 in Hubei: a qualitative study

OBJECTIVES

To explore the reflections and experiences of nurses who were deployed to the frontline to combat COVID-19 in Wuhan, China. In order to gain insights that can be useful in developing cultivating positive professional values and attitudes towards future public health emergencies.

DESIGN

Qualitative study using semistructured interviews. Data were transcribed and analysed using the Colaizzi's 7-step method. The study is reported in accordance with the consolidated Standards for Reporting Qualitative Research.

SETTING

Telephonic interviews with nine participants who were deployed from Nanjing to Hubei Province for the fight against COVID-19.

PARTICIPANTS

Of 11 volunteer nurses deployed to Hubei Province for the fight against COVID-19, two nurses did not finish the interview because of their working hours. The remaining nine were recruited through purposive sampling using the following criteria: nurses who were deployed at the first stage and those who verbally agreed and signed an informed consent form to participate in the study.

RESULTS

Three thematic categories and subthemes that were identified from the analysis were as follows: (1) 'Assertive attitude to fight against the pandemic', included three subthemes: 'Inner calling towards professional accountability for saving lives', 'Extrinsic support that facilitates the commitment to the nursing profession' and 'Holistic value ascribed to the nursing profession'. (2) 'Challenges associated with the anti-pandemic mission', included 'overcoming challenges around the strict requirements for personal protection' and 'Fear and uncertainty over the rapid progression of the disease'. (3) 'Unbearable heaviness and lightness of being a nurse', with two subthemes: 'the heavy crown of the anti-pandemic hero' and 'eternal reverence without regrets'.

CONCLUSIONS

As reflected by the nurses on frontline combating COVID-19, it was necessary to inculcate professional nursing values in them, as only their dedication and selflessness could improve humanity's chances against the disease.

Moral courage of master's students of nursing during COVID-19

BACKGROUND

Moral courage is a recognized virtue. In the context of the COVID-19 pandemic, the master's students of nursing (MSNs) in China have shown tenacious moral courage.

OBJECTIVE

This study elaborates on the moral courage of Chinese MSNs through their experiences of volunteering during the pandemic.

RESEARCH DESIGN

Descriptive qualitative, interview-based.

PARTICIPANTS AND RESEARCH CONTEXT

Participants were nursing postgraduate students who participated in the prevention and control of the COVID-19 pandemic selected by purposeful sampling. The sample size was determined by data saturation, which was reached with 10 participants. Data were analyzed using a deductive method of content analysis. Because of the isolation policy, telephone interviews were adopted.

ETHICAL CONSIDERATIONS

After obtaining the approval of the ethical institution of the author's school (No. 138, 30 August 2021), verbal consent was obtained before the interview with the participants. All data were processed anonymously and confidentially. In addition, we recruited participants through MSNs' counselors, and obtained their phone numbers with their permission.

RESULTS

Data analysis resulted in 15 subcategories that were subsequently grouped into 3 major categories including proceed without hesitation, the outcome of practicing moral courage, and develop and maintain moral courage.

CONCLUSION

This qualitative study is based on the special background of the COVID-19 pandemic, and the MSNs in China have shown tenacious moral courage in the work of epidemic prevention and control. Five factors led them to take action without hesitation, and six possible outcomes followed. Lastly, this study provides some suggestions for nurses and nursing students to enhance their moral courage. To better develop and support moral courage in the future, it is necessary to use different methods and multidisciplinary approaches to study moral courage.