The Relationship Between Compassion Fatigue and Moral Intelligence Among Nurses in Tehran: A Cross-Sectional Study Publisher



Tabatabaei MS ; Esmaeili M ; Karimi Z ; Dehghan AH ; Kaviani M
Source: BMC Nursing Published:2025

Abstract

Background: Nurses often face emotionally demanding and ethically complicated situations that leads to compassion fatigue, that negatively affects both their well-being and patient care. Moral intelligence, the ability to differentiate right from wrong and act based on ethical values, may act as a protective factor against such emotional exhaustion. This study aimed to examine the relationship between moral intelligence and compassion fatigue among nurses working in hospitals affiliated with Tehran University of Medical Sciences. Methods: This cross-sectional descriptive-analytical study was conducted from 2024 to 2025 among 333 nurses selected through stratified random sampling from Imam Khomeini, Shariati, and Sina Hospitals in Tehran, Iran. Data were collected using the Professional Quality of Life Scale (ProQOL) to assess compassion fatigue and the Moral Intelligence Questionnaire by Lennick and Kiel. Descriptive statistics, Spearman’s correlation, and multiple regression analyses were performed using SPSS version 21. Results: The mean compassion fatigue score was 3.24 ± 0.78 and the mean moral intelligence score was 3.06 ± 0.70, both indicating moderate levels. A significant moderate inverse correlation was found between total moral intelligence and compassion fatigue (r = − 0.339, p < 0.01). Linear regression analysis revealed that moral intelligence explained approximately 11% of the variance in compassion fatigue (R² = 0.113). Among the moral intelligence subdimensions, “ability to forgive others’ mistakes” (r = − 0.330, p < 0.01) and “taking responsibility for personal decisions” (r = − 0.267, p < 0.01) showed the strongest negative correlations with compassion fatigue. Age was positively associated with both compassion fatigue (B = 0.025, p < 0.001) and moral intelligence (B = 0.35, p = 0.004), while work experience was positively associated only with moral intelligence (B = 0.41, p = 0.009). Gender, education, and income adequacy were not significant predictors of either variable. Conclusions: These findings suggest that higher moral intelligence is associated with lower levels of compassion fatigue. Educational interventions aimed at enhancing moral competencies, particularly those related to forgiveness and responsibility, may have the potential to support nurses’ emotional well-being, although longitudinal and interventional studies are required to confirm causality and effectiveness. Clinical trial number: Not applicable. © The Author(s) 2025.