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Moral Reasoning and Moral Behavior Among Selected Groups of Practicing Nurses
Abstract
This study examined the relationship between moral reasoning and moral behavior in 79 practicing nurses. Moral reasoning was measured by Rest's Defining Issues Test. Judgments about Nursing Decisions (JAND), developed by the investigator, was used to measure moral behavior. JAND is compromised of seven stories, each depicting a nurse in an ethical dilemma, with a total of 48 items. It measures two components of moral behavior: knowledge and valuation of ideal moral behavior and perception of realistic moral behavior. The hypothesis that moral reasoning would be positively related to knowledge and valuation of ideal moral behavior was tested by Pearson product moment correlation; the obtained coefficient of .28 was significant at the .01 level. The hypothesis that moral reasoning would be positively related to nurses' perception of realistic moral behavior was also tested by Pearson product moment correlation; the obtained coefficient of .19 was significant at the .05 level. Additional analyses showed significant differences in the knowledge and valuation component of JAND between educational groups, ethnic groups, age groups, and years of practice in nursing; but, there were no differences between these groups with respect to the perception of realist moral behavior component of JAND. Implications of the findings for nursing practice, education, and research are discussed.
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“In line with previous research [53–55], the findings of this study showed that moral reasoning decreases with increasing nurses’ work experience.”
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Åkerlund, B. M. (1990) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 5
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Hartranft, S. R. (2009) · Digital Commons - University of South Florida (University of South Florida) · Cited by 4
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Ellis, R. (1984) · Springer eBooks · doi:10.1007/978-3-662-40453-9_9 · Cited by 3
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Han, H. (2022) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-99550-8_12 · Cited by 3
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Johnson, I. G. (2013) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 2
Tang, Y., Yang, Y., Zhang, L., Yang, Y., & Li, G. (2026) · BMC Medical Ethics · doi:10.1186/s12910-026-01441-3 · Cited by 1
Liu, K. M., Wang, X., Li, Q., Wang, J., Qin, L., Jiang, L., Yang, M., & Li, Y. (2026) · Nurse Education Today · doi:10.1016/j.nedt.2026.107281 · Cited by 1
Wu, W., Huang, X., Ntim, S. Y., Shen, Y., Li, X., & Wang, G. (2024) · KSII Transactions on Internet and Information Systems · doi:10.3837/tiis.2024.06.009 · Cited by 1
Philpott, D. W. (2000) · Language arts journal of Michigan · Cited by 1
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O'Neil, J. A. (1991) · The Journal of Continuing Education in Nursing · doi:10.3928/0022-0124-19910901-04 · Cited by 1
Dr. Rogers was Invited to Reply
Rogers, B. (1989) · AAOHN Journal · doi:10.1177/216507998903700210 · Cited by 1
Ethical Decision-Making among Critical Care Unit Nurses
Bowen, M. E. (1996) · doi:10.22371/07.1996.002 · Cited by 1
Gerstle, D. S. (2001) · University Microfilms International eBooks
Nurses' Resolutions of Six Ethical Dilemmas.
Lawrence, J. A., & Crisham, P. (1983)
Keehne, J. A. (1993) · ScholarWorks - GVSU (Grand Valley State University)
Ethical issues encountered by nurses
Hollands, D. (2009) · cIRcle (University of British Columbia) · doi:10.14288/1.0087382
Metadata
- Authors
- KETEFIAN, S.
- Venue
- Nursing Research
- Published
- 1981-05
- Volume
- 30
- Issue
- 3
- Pages
- 171???176
- ISSN
- 0029-6562 (ISSN-L)
- OpenAlex
- W197499387
- Cited by
- 112
- References
- 0
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 1 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 6.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nursing Research (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Ethics in Business and Education
- Life Sciences › Neuroscience › Cognitive Neuroscience › Psychology of Moral and Emotional Judgment
- Keywords
- moral reasoning, moral behavior, nurses, ethical dilemmas, nursing ethics, nursing education, ethnic differences, age differences, years of practice
- MeSH terms
- Decision Making, Ethics, Nursing, Humans, Judgment, Morals, Surveys and Questionnaires, Moral Development
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