Effects of education based on ethical leadership on moral distress, perceived organisational justice and clinical competence among nurses.

Abstract

Background and aim: Nurses encounter various ethical issues in their daily practice, and the inability to manage these challenges can adversely impact their care delivery. This study aimed to evaluate the effects of education based on ethical leadership (EL) on moral distress (MD), perceived organisational justice (OJ) and clinical competence (CC) among nurses.

Methods: This study was conducted from 2020 to 2021 using a two-group pretest-post-test design. Eighty nurses were purposively selected from Hajar and Kashani teaching hospitals in Shahrekord, Iran and were randomly assigned to either a control group or an intervention group. Data were collected through a demographic questionnaire, the CC Assessment Questionnaire, the MD Scale and the OJ Scale. EL-based education focusing on trust, integrity, reciprocity, self-regulation and public service was delivered over 5-2-hour sessions. Statistical analyses were performed using SPSS software (V.24.0), employing tests such as mean, SD, median, IQR, χ², Fisher's exact test, independent sample t-test, Mann-Whitney U test and Friedman test.

Results: No significant differences were observed between the groups regarding the scores of MD, perceived OJ and CC at pretest and immediately after the intervention (p>0.05). However, significant between-group differences were noted in the scores of MD, perceived OJ and CC 3 months postintervention (p<0.01).

Conclusion: Education based on EL significantly reduces MD and enhances perceived OJ and CC among nurses. As a simple and safe intervention, EL-based education can effectively improve nurses' abilities to manage ethical issues and challenges.