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Background <p>Moral courage plays an important role in nurses’ ethical practice, particularly in high-stress settings such as neonatal intensive care units (NICUs).</p> Aim <p>This study examined whether moral courage predicts guilt feelings and occupational hardiness among NICU nurses.</p> Methods <p>In this descriptive–analytical study, 174 NICU nurses from three tertiary hospitals were recruited using quota sampling. Data were collected using validated questionnaires and analyzed using Spearman correlation and multiple linear regression.</p> Results <p>Moral courage was positively and significantly associated with occupational hardiness (r = 0.40, p &lt; 0.001). Multiple linear regression showed that the model explained 17% of the variance in moral courage (F(2,171) = 17.56, p &lt; 0.001). Occupational hardiness was a significant positive predictor of moral courage (β = 0.43, p &lt; 0.001), whereas guilt feelings were not a significant predictor (β = −0.04, p = 0.56).</p> Conclusion <p>Occupational hardiness is a key factor associated with moral courage among NICU nurses. Educational and managerial interventions aimed at strengthening occupational hardiness may help enhance moral courage and support professional performance in NICU settings.</p>

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The predictive role of moral courage in guilt feelings and occupational hardiness among NICU nurses

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月31日

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  • Mitra Soltanian,
  • Zeinab Rahaei,
  • Neda Jamalimoghadam,
  • Parvin Ghaemmaghami

摘要

Background

Moral courage plays an important role in nurses’ ethical practice, particularly in high-stress settings such as neonatal intensive care units (NICUs).

Aim

This study examined whether moral courage predicts guilt feelings and occupational hardiness among NICU nurses.

Methods

In this descriptive–analytical study, 174 NICU nurses from three tertiary hospitals were recruited using quota sampling. Data were collected using validated questionnaires and analyzed using Spearman correlation and multiple linear regression.

Results

Moral courage was positively and significantly associated with occupational hardiness (r = 0.40, p < 0.001). Multiple linear regression showed that the model explained 17% of the variance in moral courage (F(2,171) = 17.56, p < 0.001). Occupational hardiness was a significant positive predictor of moral courage (β = 0.43, p < 0.001), whereas guilt feelings were not a significant predictor (β = −0.04, p = 0.56).

Conclusion

Occupational hardiness is a key factor associated with moral courage among NICU nurses. Educational and managerial interventions aimed at strengthening occupational hardiness may help enhance moral courage and support professional performance in NICU settings.