Professional values, cultural competence, and moral sensitivity of surgical nurses: Mediation analysis and structural equation modeling

BackgroundDeveloping a framework that illustrates causal relationships and an in-depth comprehension of contextual elements is essential for steering the development of ethical interventions to enhance nurses' ethical decision-making.Research aimTo examine the relationship between cultural competence, professional nursing values, and moral sensitivities of surgical nurses with a mediation analysis and structural equation model.Research designThis study is descriptive and correlational.Participantsand research context: This study was conducted with a total of 201 surgical nurses from two university hospitals in Konya, Türkiye. Data were gathered face-to-face between June and October 2023 with the Moral Sensitivity Questionnaire (MSQ), Nurses Professional Values Scale-Revised (NPVS-R), and Nurse Cultural Competence Scale (NCCS).Ethical considerationsEthical approval from Necmettin Erbakan University Ethics Committee was obtained (Number: 2023/419).ResultsIn this study, the mean scores for the surgical nurses were as follows: 89.3 ± 19.33 on the MSQ, 113.1 ± 20.74 on the NPVS-R, and 72.06 ± 18.61 on the NCCS. Nurses' cultural competence level significantly affected their professional nursing values (β = 0.192; <i>p</i> = .007; R² = 0.04), and their professional nursing values, in turn, had a significant effect on their moral sensitivities (β = -0.363; <i>p</i> < .001; R² = 0.16). However, it was determined that the direct effect of nurses' cultural competence level on their moral sensitivity was not statistically significant. In contrast, the indirect effect of nurses' cultural competence level on their moral sensitivity, mediated by their professional nursing values was seen to be statistically significant (B = -0.070; <i>p</i> = .008).ConclusionsThis study showed that there is a significant positive relationship between the professional nursing values and cultural competence levels of surgical nurses and that as professional nursing values increase, their moral sensitivity also rises. Sensitivity with higher professional nursing values. Additionally, it was found that nurses' professional values served as a mediating factor between their levels of cultural competence and moral sensitivity. Therefore, it is crucial to enhance the cultural competence, professional nursing values, and moral sensitivity of nursing students and registered surgical nurses and to improve their reasoning and decision-making skills in ethical dilemmas.