Association of professional ethics adherence and moral comfort among intensive care unit nurses

Abstract

Moral comfort is essential for intensive care nurses facing ethical situations and complex clinical decisions. Adhering to professional ethical standards in nursing care may contribute to the development of moral comfort. This study was conducted to investigate the relationship between professional ethics adherence and moral comfort among nurses working in intensive care units (ICUs). This descriptive cross-sectional study was conducted in 2025 among nurses working in ICUs of two hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd, Iran. A total of 165 nurses were selected using simple random sampling. Data were collected using a demographic information form, the Professional Ethics Adherence Questionnaire, and the Moral Comfort Questionnaire. Data analysis was performed using SPSS version 16 through descriptive statistics, Pearson correlation coefficient, independent t-test, one-way ANOVA, and stepwise multiple linear regression. The mean total score for moral comfort was 103.79 ± 14.72, and the mean score for professional ethics adherence was 143.86 ± 20.39. Professional ethics adherence showed a significant positive correlation with moral comfort (r = .685, p < .001). Age, clinical work experience, and ICU work experience were also significantly and positively correlated with moral comfort. In the hierarchical multiple linear regression analysis, professional ethics adherence remained independently and positively associated with moral comfort (β = .670, p < .001) after adjusting for these variables. The addition of professional ethics adherence significantly increased the explained variance (ΔR² = 0.366, ΔF (1,160) = 113.660, p < .001), with the model explaining 48.5% of the variance in moral comfort. This study found that higher professional ethics adherence is associated with greater moral comfort among intensive care unit nurses. Ethics education, organizational support, and nurses' participation in ethical decision-making may contribute to strengthening adherence to professional ethical standards, which, in turn, may be associated with greater moral comfort.