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Background Moral courage means courage to act according to individual’s own ethical values and principles despite the risk of negative consequences for them. Research about the moral courage of whistle-blowers in health care is scarce, although whistleblowing involves a significant risk for the whistle-blower. Objective To analyse the moral courage of potential whistle-blowers and its association with their background variables in health care. Research design Was a descriptive-correlational study using a questionnaire, containing Nurses Moral Courage Scale©, a video vignette of (...) the wrongdoing situation with an open question about the vignette, and several background variables. Data were analysed statistically and inductive content analysis was used for the narratives. Participants and research context Nurses as healthcare professionals (including registered nurses, public health nurses, midwives, and nurse paramedics) were recruited from the membership register of the Nurses’ Association via email in 2019. A total of 454 nurses responded. The research context was simulated using a vignette. Ethical considerations Good scientific inquiry guidelines were followed. Permission to use the Nurses’ Moral Courage Scale© was obtained from the copyright holder. The ethical approval and permission to conduct the study were obtained from the participating university and the Nurses’ Association. Findings The mean value of potential whistle-blowers’ moral courage on a Visual Analogue Scale (0–10) was 8.55 and the mean score was 4.34 on a 5-point Likert scale. Potential whistle-blowers’ moral courage was associated with their socio-demographics, education, work, personality and social responsibility related background variables. Discussion and conclusion In health care, potential whistle-blowers seem to be quite morally courageous actors. The results offer opportunities for developing interventions, practices and education to support and encourage healthcare professionals in their whistleblowing. Research is needed for developing a theoretical construction to eventually increase whistleblowing and decrease and prevent wrongdoing. (shrink)

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Ethics is a foundational competency in healthcare inherent in everyday nursing practice. Therefore, the promotion of qualified nurses’ and nursing students’ moral competence is essential to ensure ethically high-quality and sustainable healthcare. The aim of this integrative literature review is to identify the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence. The review has been registered in PROSPERO (CRD42023386947) and reported according to the PRISMA guideline. Focusing on qualified nurses’ and nursing students’ moral competence, a (...) literature search was undertaken in January 2023 in six scientific databases: CINAHL, Cochrane Library, PsycINFO, PubMed Medline, Scopus and Web of Science. Empirical studies written in English without time limitation were eligible for inclusion. A total of 29 full texts were retrieved and included out of 5233 citations. Quality appraisal was employed using Joanna Briggs Institute checklists and the Mixed Method Appraisal Tool. Data were analysed using inductive content analysis. Research about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence is limited and mainly explored using descriptive research designs. The contributing factors were identified as comprising two main categories: (1) human factors, consisting of four categories: individual, social, managerial and professional factors, and ten sub-categories; and (2) structural factors, consisting of four categories: educational, environmental, organisational and societal factors, and eight sub-categories. This review provides knowledge about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence for the use of researchers, nurse educators, managers, organisations and policymakers. More research about the contributing factors is needed using complex intervention, implementation and multiple methods designs to ensure ethically sustainable healthcare. (shrink)

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Background Ethics is a fundamental component of nursing education to increase students’ moral competence and moral reasoning abilities. However, the core ethics content that should be included in undergraduate education has not been established to date at the international level. Aim To identify the core contents required in formal undergraduate education to ensure morally competent nurses. Research Design An international workshop-research study design in 2023 reported here according to the COnsolidated criteria for REporting Qualitative research. Participants and Research Context Five (...) countries in the context of Promoting a Morally Competent Nurse project participated. In each country, two workshops took place, one with nurse professionals and one with patients’ representatives for a total of 58 individuals (32 and 26, respectively). After being translated into English language, data were categorized deductively. The Dublin Learning Outcomes Descriptors and the blueprint methodology were applied. Ethical Considerations The research protocol was ethically approved in every country where the study was performed. Results A total of 59 core content elements emerged, with ‘ethics of individualized/tailored/patient-centred care’ ( n = 8) and ‘empathy’ ( n = 6) as the most suggested. Nearly half ( n = 26) of the core content items suggested were reported only once (e.g. ‘priority setting’) while overall several referred to ‘communication skills’ ( n = 17). A diverse richness across countries emerged, with some suggesting a few items, and others providing several. Similarly, professionals and patients in most countries agreed that some contents of individualized care, empathy and responsibility should be taught in nursing education, but several core contents were mentioned by only one group of participants and in one country. Conclusion The lack of convergence on core content to be taught suggests that different views are still present. Merging these perspectives may stimulate a reciprocal understanding between professionals and patients, as well as across countries, and support the identification of commonalities and differences to further harmonize undergraduate education in the field. (shrink)

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