The Relationship Between Ethical Ideology and Moral Resilience in Critical Care Nurses Publisher Pubmed



Karimi N ; Asgari P ; Esmaeili M
Source: Critical Care Nursing Quarterly Published:2026

Abstract

Moral resilience plays a key role in providing quality care to patients. The way nurses view ethical issues directly affects their decision-making. This study aimed to investigate the relationship between the ethical ideology and moral resilience of nurses working in critical care units. The present study is a cross-sectional, correlational study. The study sample included 196 nurses working in critical care units. In addition to the demographic questionnaire, Forsyth’s Ethics Position Questionnaire was used to examine ethical ideology, and Rushton Moral Resilience Scale (RMRS-16) questionnaire was employed to assess moral resilience. The relationship between ethical ideology and the moral resilience of nurses was examined via Spearman’s correlation coefficient. The total RMRS-16 score was 2.67 (median: 2.69). Per quartile analysis, 75% of nurses achieved scores beyond 2.44, with 50% reaching beyond 2.69 and 25% above 2.88. The results revealed that most nurses tended toward idealism. The overall level of moral resilience of nurses was also assessed as moderate to high. There was a significant positive correlation between the mean score of relativism and the total score of the RMRS-16. The results of this study indicate that ethical ideology can affect nurses’ ability to maintain moral values and cope with job pressures. Additionally, relativistic nurses showed significantly higher moral resilience, suggesting their context-dependent approach may better navigate complex ethical decisions. Our findings show that critical care nurses’ ethical beliefs directly influence their moral resilience and clinical decisions. To support idealist nurses facing systemic barriers, units should implement ethics consultations and structured debriefings. Simultaneously, units can leverage relativist nurses’ resilience by adopting flexible decision frameworks that balance contextual needs with core principles. These targeted improvements will help nurses navigate ethical challenges more effectively. © 2026 Wolters Kluwer Health, Inc. All rights reserved.