logo
Volume 15, Issue 2 (10-2025)                   PCNM 2025, 15(2): 13-22 | Back to browse issues page

Ethics code: IR.ZUMS.REC. 1400.226

XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Aligholipour M, Ramezani-Badr F, Hanifi N, Hormati Oghol Beig Z, Khezerlou Z. Examining the relationship between moral sensitivity and compassion satisfaction and fatigue among icu nurses: a correlational study. PCNM 2025; 15 (2) :13-22
URL: http://nmcjournal.zums.ac.ir/article-1-989-en.html
Associate Professor, Department of Critical Care and Emergency Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran. , Ramezanibadr@gmail.com
Abstract:   (168 Views)

Background: Caring for critically ill patients in intensive care units (ICUs) requires high moral sensitivity among nurses. Moral sensitivity may be associated with dimensions of nurses’ professional quality of life, including compassion satisfaction and fatigue, yet sufficient evidence in ICU settings is lacking.
Objective: This study aimed to examine the relationship between moral sensitivity and professional quality of life among ICU nurses in Zanjan.
Methods: A descriptive-correlational study was conducted with 146 ICU nurses. Convenience sampling was used from October 2021 to June 2022 in two teaching hospitals affiliated with Zanjan University of Medical Sciences. Data were collected using demographic and occupational questionnaires, Lützén’s Moral Sensitivity Questionnaire, and Stamm and Figley’s Professional Quality of Life Questionnaire, and analyzed with SPSS-22. A significance level of 0.05 was considered.
Results: The mean moral sensitivity score was 87.18 (SD= 5.51), and professional quality of life was 106.19 (SD= 11.51). The mean compassion satisfaction score was 73.36 (SD= 6.12), and compassion fatigue was 65.02 (SD= 14.55). A significant positive correlation was observed between moral sensitivity and compassion satisfaction (r=0.345, P<0.01) and a significant negative correlation between moral sensitivity and compassion fatigue (r=-0.321, P<0.01).
Conclusion: Given the moderate compassion satisfaction and high compassion fatigue among more than half of the nurses, enhancing moral sensitivity skills should be prioritized. Strengthening moral sensitivity through professional knowledge, respect for patient autonomy, experience with ethical conflicts, supportive environments, and nurse retraining can reduce compassion fatigue, increase compassion satisfaction, and improve nurses’ professional quality of life.

 

Full-Text [PDF 744 kb]   (35 Downloads)    
Type of Study: Orginal research | Subject: Nursing
Received: 2025/09/30 | Accepted: 2025/10/2 | Published: 2025/10/2

References
1. Arries-Kleyenstuber E, Dierckx de Casterle B, Kynoch K, Ramis MA, Suhonen R, Ventura C, et al. Ethical Challenges Nurses Faced During the COVID-19 Pandemic: Scoping Review. Nursing Ethics. 2025;9697330251339417. [https://doi.org/10.1177/09697330251339417]
2. Atashzadeh-Shoorideh F, Tayyar-Iravanlou F, Chashmi ZA, Abdi F, Cisic RS. Factors Affecting Moral Distress in Nurses Working in Intensive Care Units: A Systematic Review. Clinical Ethics. 2020;16(1):25-36. [https://doi.org/10.1177/1477750920927174]
3. Marshall JC, Bosco L, Adhikari NK, Connolly B, Diaz JV, Dorman T, et al. What Is an Intensive Care Unit? A Report of the Task Force of the World Federation of Societies of Intensive and Critical Care Medicine. Journal of Critical Care. 2017;37:270-6. [https://doi.org/10.1016/j.jcrc.2016.07.015]
4. Karaca A, Durna Z. Patient Satisfaction With the Quality of Nursing Care. Nursing Open. 2019;6(2):535-45. [https://doi.org/10.1002/nop2.237]
5. Shalaby SA, Janbi NF, Mohammed KK, Al-harthi KM. Assessing the Caring Behaviors of Critical Care Nurses. Journal of Nursing Education and Practice. 2018;8(10):77-85. [https://doi.org/10.5430/jnep.v8n10p77]
6. Wang K, Mi Y, Wu Y, Sun H. Career Calling, Ethical Sensitivity, and Decision-Making Ability in Intensive Care Nurses: A Mediating Effect Model. Frontiers in Psychology. 2025;16:1512533. [https://doi.org/10.3389/fpsyg.2025.1512533]
7. Sharifnia AM, Green H, Fernandez R, Alananzeh I. Empathy and Ethical Sensitivity Among Intensive and Critical Care Nurses: A Path Analysis. Nursing Ethics. 2024;31(2-3):227-42. [https://doi.org/10.1177/09697330231167543]
8. İlter SM, Ovayolu Ö, Serçe S, Ovayolu N. An Investigation of the Relationship Between Compassion Fatigue and Moral Sensitivity of Intensive Care Nurses. Omega-Journal of Death and Dying. 2024;90(2):521-35. [https://doi.org/10.1177/00302228221107976]
9. Matsuishi Y, Mathis BJ, Hoshino H, Enomoto Y, Shimojo N, Kawano S, et al. PERSonality, Ehical, and PROfessional Quality of Life in Pediatric/Adult Intensive Nurses Study: PERSEPRO PAIN Study. PLoS One. 2022;17(3):e0259721. [https://doi.org/10.1371/journal.pone.0259721]
10. Babaei SM, Araghian Mojarrad F, Kamali M, Arab Larimi M, Jafari H. Moral Sensitivity and Related Factors in Iranian Critical Care Nurses: A Narrative Review. Journal of Nursing Reports in Clinical Practice. 2023;1(2):78-83. [https://doi.org/10.32598/JNRCP.23.42]
11. Nazari AM. Relationship Between Ethical Sensitivity and the Nurses’ Quality of Care: A Systematic Review. Iranian Biomedical Journal. 2024;28:439. [https://doi.org/10.61186/ibj.25th-11th-IACRTIMSS]
12. Rigi ZE, Fard SB, Saadatifar B, Miri M, Akbari O. The Relationship Between Moral Sensitivity, Moral Distress, Perceived Organizational Support, and Self‐Esteem in Iranian Nurses: A Cross‐Sectional Analytical Study. International Nursing Review. 2025;72(3):e70058. [https://doi.org/10.1111/inr.70058]
13. Stamm B. The Concise Manual for the Professional Quality of Life Scale. 2010.
14. Panagou E, Missouridou ED, Zartaloudi A, Koutelekos J, Dousis E, Dafogianni C, et al. Compassion Fatigue and Compassion Satisfaction in Pediatric Intensive Care Professionals. Materia Socio-Medica. 2023;35(1):28. [https://doi.org/10.5455/msm.2023.35.28-32]
15. Azadehjo N, Nasrabadi T, Nasrollah S. The Relationship of Compassion Fatigues and Moral Sensitivity in Critical Care Nurses. Iranian Journal of Cardiovascular Nursing. 2018;6(4):50-9. [http://journal.icns.org.ir/article-1-506-en.html]
16. Mazaheri Z, Sajjadian I. Structural Model of the Relationship of Empathic Concerns With Compassion Satisfaction and Compassion Fatigue in Intensive Care Units Nurses. 2019. [https://www.sid.ir/paper/363198/en]
17. Durgannavar MS, Sajjan MS, Natekar DS. A Correlational Study to Assess the Percieved Stress and Professional Quality of Life Among NICU Staff Nurses at Selected Hospitals of Bagalkot, With View to Develop an Interventional Package. Scholars Journal of Applied Medical Sciences. 2025;13(1):235-41. [https://doi.org/10.36347/sjams.2025.v13i01.037]
18. Hinderer KA, VonRueden KT, Friedmann E, McQuillan KA, Gilmore R, Kramer B, et al. Burnout, Compassion Fatigue, Compassion Satisfaction, and Secondary Traumatic Stress in Trauma Nurses. Journal of Trauma Nursing. 2014;21(4):160-9. [https://doi.org/10.1097/JTN.0000000000000055]
19. Karakoc Kumsar A, Polat S, Taskin Yilmaz F. The Effect on Ethical Sensitivity of Compassion Level in Nurses. Electronic Journal of General Medicine. 2021;18(5):em302. [https://doi.org/10.29333/ejgm/11011]
20. Bilgiç Ş. Does the Compassion Level of Nursing Students Affect Their Ethical Sensitivity? Nurse Education Today. 2022;109:105228. [https://doi.org/10.1016/j.nedt.2021.105228]
21. Lützén K, Nordin C, Brolin G. Conceptualization and Instrumentation of Nurses' Moral Sensitivity in Psychiatric Practice. International Journal of Methods in Psychiatric Research. 1994.
22. Mostafavian Z, Gholampour J, Faraj Pour A, Akbari Farmad S, Rahchamani MA. Comparison of Moral Sensitivity Among Last Year Nursing Students and Nurses Working at Teaching Hospitals of Islamic Azad University of Mashhad. Education and Ethics In Nursing. 2019;8(3-4):30-6. [https://doi.org/10.52547/ethicnurs.8.3.4.30]
23. Ghorji M, Keshavarz Z, Ebadi A, Nasiri M. Persian Translation and Psychometric Properties of Professional Quality of Life Scale (ProQOL) for Health Care Providers. Journal of Mazandaran University of Medical Sciences. 2018;28(163):93-106. [https://jmums.mazums.ac.ir/article-1-10095-en.html]
24. Baghaei R, Moradi Y, Aminolshareh S, Zareh H. The Ethical Sensitivity of Nurses in Decision Making in Ayatollah Taleghani Hospital, 1391. Nursing And Midwifery Journal. 2014;11(11). [https://unmf.umsu.ac.ir/article-1-1700-en.html]
25. Frastkish R. Investigating the Sensitivity of ICU Nurses in Shahid Rajaie Cardiovascular Center. Cardiovascular Nursing Journal. 2015;4(3):36-45.
26. Momennasab M, Homayoon Z, Torabizadeh C. Critical Care Nurses’ Adherence to Ethical Codes and Its Association With Spiritual Well‐Being and Moral Sensitivity. Critical Care Research and Practice. 2023;2023(1):8248948. [https://doi.org/10.1155/2023/8248948]
27. Ghanei Gheshlagh R, Dehvan F, Sedighi L. Moral Sensitivity in Iranian Nurses: Insights From a Nationwide Meta-Analysis. BMC Nursing. 2025;24(1):294. [https://doi.org/10.1186/s12912-025-02940-1]
28. He Q, Huang C, Feng Z, Shen H. The Relationships Between Ethical Sensitivity, Ethical Decision‐Making Ability, and Ethical Conflict Among ICU Nurses: A Structural Equation Model. Journal of Nursing Management. 2025;2025(1):7756343. [https://doi.org/10.1155/jonm/7756343]
29. Imani J, Rezae HH, Mirzai M. Evaluation the Effect of Work Conscientiousness and Moral Sensitivity With Ethical Stress in Nurses Working in Intensive Care Units in Educational and Therapeutic Centers Affiliated to Zahedan University of Medical Sciences. Quarterly Journal of Iranian Society Anaesthesiology and Intensive Care Quarterly. 2018;2(4):20-7.
30. Lützen K, Dahlqvist V, Eriksson S, Norberg A. Developing the Concept of Moral Sensitivity in Health Care Practice. Nursing Ethics. 2006;13(2):187-96. [https://doi.org/10.1191/0969733006ne837oa]
31. Khorani H, Momeni M, Ahmadi A, Motalebi SA. Predictive Value of Moral Sensitivity for Quality of Care Among Iranian Nurses. Jundishapur Journal of Chronic Disease Care. 2024;13(1). [https://doi.org/10.5812/jjcdc-138899]
32. Hojjati H, Koupaei SE, Madvar TR, Pour NH, Delavari A, Niya HM, et al. The Relationship Between Futile Care and Moral Sensitivity in Nurses Working in the Neonatal Intensive Care Unit of Medical Training Centers in Gorgan 2024. Archives of Anesthesiology and Critical Care. 2025. [https://doi.org/10.18502/aacc.v11i4.9373]
33. Borhani F, Abbaszadeh A, Mohamadi E, Ghasemi E, Hoseinabad-Farahani MJ. Moral Sensitivity and Moral Distress in Iranian Critical Care Nurses. Nursing Ethics. 2017;24(4):474-82. [https://doi.org/10.1177/0969733015604700]
34. Sadrollahi A, KZ. A Survey of Professional Moral Sensitivity and Associated Factors Among the Nurses in West Golestan Province of Iran. Iranian Journal of Medical Ethics and History of Medicine. 2015;8(3):50-61.
35. Abbaszadeh A, Borhani F, Moazen N. The Comparison of the Level of Moral Sensitivity in Nursing Students and Nursing Staffs in Kerman in 1389. Medical Ethics. 2010;4(12):39-54. [https://www.sid.ir/paper/195578/en]
36. Mazaheri Z, Sajjadian I. Structural Model of the Relationship of Empathic Concerns With Compassion Satisfaction and Compassion Fatigue in Intensive Care Units Nurses. Nursing And Midwifery Journal. 2019;17(1):62-70. [https://www.sid.ir/paper/363198/en]
37. Mohammady S. Self-Compassion in Critical Care Nurses. Faslname-i mudiriyyat-e parastari. 2016;5(2):44-50. [https://doi.org/10.29252/ijnv.5.2.44]
38. Ye L, Tang X, Li Y, Zhu Y, Shen J, Zhu Y, et al. The Prevalence and Related Factors of Compassion Fatigue Among Nursing Interns: A Cross-Sectional Study. BMC Nursing. 2024;23(1):762. [https://doi.org/10.1186/s12912-024-02384-z]
39. Maytum JC, Heiman MB, Garwick AW. Compassion Fatigue and Burnout in Nurses Who Work With Children With Chronic Conditions and Their Families. Journal of Pediatric Health Care. 2004;18(4):171-9. [https://doi.org/10.1016/j.pedhc.2003.12.005]
40. Xie W, Chen L, Feng F, Okoli CT, Tang P, Zeng L, et al. The Prevalence of Compassion Satisfaction and Compassion Fatigue Among Nurses: A Systematic Review and Meta-Analysis. International Journal of Nursing Studies. 2021;120:103973. [https://doi.org/10.1016/j.ijnurstu.2021.103973]
41. Liu D, Xie S, Jing J, Niyomsilp E, Xie L, Nie X, et al. The Effect of Perceived Organizational Support and Ego-Resilience on the Relationship Between Occupational Stressors and Compassion Fatigue in COVID-19 Frontline Nurses: A Cross-Sectional Study in Sichuan, China. BMC Nursing. 2024;23(1):817. [https://doi.org/10.1186/s12912-024-02473-z]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.