The pervasiveness of moral distress in nursing can no longer be ignored. Moral distress can have devastating effects on a nurse and lead to burnout and/or cause the nurse to leave the profession. To mitigate these effects, strategies to decrease moral distress should be implemented as early as nursing school. Related concepts such as moral courage and moral resilience show favorable effects as strategies to combat moral distress. However, little evidence is known as to how these three moral concepts are related with one another.

Chapter 2, “Student Courage: An Essential for Today’s Health Education” provides a concept analysis of student courage within nursing education. In order to enhance nursing knowledge, this concept is defined using language to help operationalize the term.

Chapter 3 provides an integrative review that summarizes empirical literature from 2012 to 2018 with a comprehensive understanding of moral distress in baccalaureate nursing students. This synthesis of the literature was conducted in consideration of Corley’s (2002) Moral Distress Theory.

A descriptive correlational design was used to explore the interrelationships between moral distress, moral courage, and moral resilience in nursing students. Quantitative data was collected using the Moral Distress Thermometer, the Connor-Davidson Moral Resilience Scale (CD-RISC), and the Moral Courage Scale for Physicians (MSCP). The data was analyzed using Pearson r correlations and multiple regression analyses to determine the relationship between these moral concepts. A multiple regression analysis was used to determine if one of the two moral concepts better predicted moral distress in students than the other.

Date of publication

Spring 5-4-2019

Document Type




Persistent identifier


Committee members

Gloria Duke, Danita Alfred, Paul Clark


Doctor of Philosophy in Nursing

Available for download on Saturday, May 22, 2021

Included in

Nursing Commons