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Relationship Between Moral Intelligence and Psychological Safety Among Emergency and Intensive Care Unit Nurses

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Relationship Between Moral Intelligence and Psychological Safety Among Emergency and Intensive Care Unit Nurses Original Article Health, Spirituality and Medical Ethics. 2020;7(1):2-8 Relationship between Moral Intelligence and Psychological Safety among Emergency and Intensive Care Unit Nurses Received 06 Nov 2019; Accepted 28 Dec 2019 http://dx.doi.org/10.29252/jhsme.7.1.2 Gholamhossein Mahmoudirad1 , Hoda Khoshbakht2* , Gholamreza Sharifzadeh3 , Alimohammad Izadpanah1 1 School of Nursing and Midwifery, Birjand University of Medical Sciences, Iran. 2 Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran. 3 School of Health, Birjand University of Medical Sciences, Iran. Abstract Background and Objectives: High moral intelligence in nurses is considered a supportive factor against different pressures and is assumed to promote psychological safety. The present study aimed to investigate the relationship between moral intelligence and psychological safety of nurses in emergency and intensive care units. Methods: This descriptive-correlational study was conducted on 255 nurses working in the intensive care unit and emergency department of tertiary hospitals affiliated to Birjand University of Medical Sciences, Birjand, Iran. Data collection tools included Lennick and Kiel’s moral intelligence scale and Edmonson’s psychological safety scale. Data were analyzed in SPSS software (version 16) using descriptive statistics and regression. Results: The mean scores of moral intelligence and psychological safety were measured at 73.10±8.13 and 26.91±3.35, respectively. The results of regression analysis indicated that among the dimensions of moral intelligence, compassion (β=0.21) and responsibility (β=0.19) had the power to predict nurses’ psychological safety. In doing so,the predictor variables (i.e., compassion and responsibility) could explain 12% of the variance in the response variable (psychological safety). Conclusion: As evidenced by the obtained results, it can be concluded that moral intelligence as an intrinsic supportive factor can improve nurses’ psychological safety and reduce work-related injury by reinforcing positive psychological factors. Keywords: Moral intelligence, Psychological safety, Nurses. Correspondence: Should be addressed to Ms. Hoda This is an open-access article distributed under the * terms of the Creative Commons Attribution-Non Khoshbakht. Email: [email protected] Commercial 4.0 International License Please Cite This Article As: Mahmoudirad Gh, Khoshbakht H, Sharifzadeh Gh, Izadpanah A. Relationship between Moral Intelligence and Psychological Safety among Emergency and Intensive Care Unit Nurses. Health Spiritual Med Ethics. 2020;7(1):2-8. Introduction he needs of today's employees have special conditions of the patients (3). undergone dramatic changes as The provision of psychological safety to nurses T compared to the past. In this regard, the improves patient safety and enhances the personnel demand special privileges, such as a quality of care (4). Therefore, hospital sense of security, participation, the inclusion of managers always seek to develop effective their opinions in work, apart from salary and methods to improve nurses’ psychological benefits (1). On the other hand, healthcare safety. Psychological safety is one of the key professions are exposed to many sources of factors of a healthy lifestyle and indicates the psychological stress (2). Among healthcare extent to which people in an organization professionals the emergency department nurses believe they can perform activities without are under constant mental pressures which can experiencing stress (5). In other words, affect their psychological safety. It is due to psychological safety reflects the mental state the stressful nature of their workplace and the of individuals in which they feel secure and Health, Spirituality and Medical Ethics - Vol.7, No.1, Mar 2020 2 Relationship between Moral Intelligence can easily express their thoughts, perceptions, and their practice, and proper and respectful and opinions without the fear of interrogation behavior. It encompasses four dimensions, or threat (6,7). As illustrated by the results of a namely honesty (righteousness), responsibility study conducted by Ross and Jones, the (acknowledgment of actions and psychological safety of team members fosters consequences), compassion (empathetic creativity and active participation in teamwork attention to others), and forgiveness (8). The results of several studies suggested (awareness of imperfections and mistakes and that the feeling of psychological stress and the forgiveness of oneself and others) (16). Moral lack of positive and effective communication intelligence is one of the dimensions of in the organization are regarded as serious intelligence which can provide a framework threats to the formation of psychological safety for the proper functioning of human beings (9). and is considered a predictor of one’s behavior Lack of psychological safety leads to increased (17). Moral intelligence is known as the vital mental stress, absenteeism, and decreased job intelligence for all human beings since it satisfaction in physicians and nurses (10). directs other forms of intelligence (18). This Psychological and workplace empowerment intelligence encompasses the way we think, programs are among the strategies feel, and act (17). The role of moral recommended for the improvement of nurses’ intelligence and its importance is highly psychological safety (2). These programs rely noticeable in the enhancement of interpersonal on hospital ethical leadership (10), safety- and social relationships, especially in the oriented leadership (9), and improved nursing profession that deals directly with interpersonal communication (11). Feelings of people and their lives (19). psychological safety can enhance one’s The results of the studies conducted on ethical motivations in the workplace and prevent intelligence have highlighted the significant disinterest, hostility, and unhealthy impact of employing ethical intelligence in the competition (12). Moreover, the results of a workplace on organizations output. This effect study performed by Coombe suggested that is the result of the regulation of interactions, safety-oriented leadership affects reduced conflicts, an enhanced atmosphere of psychological safety and leader-follower understanding and cooperation, and reduced interaction (13). Research results demonstrated costs of managing employee performance (20). that nurses’ enhanced psychological Donkor reported that nurses’ moral empowerment can improve their psychological intelligence both improves the services safety (14). Rahmati examined the predictors provided to patients and increases their of nurses’ psychological safety considering empathy towards patients (21). Psychological different dimensions of forgiveness. The safety and moral intelligence play a significant results of the mentioned study revealed that role in the enhancement of nurses’ productivity psychological safety has a significant in the workplace and exert positive effects on association with self-forgiveness and other care provision and hospital efficiency. aspects of forgiveness. Therefore, self- Therefore, the identification of the forgiveness as an aspect of moral intelligence relationships between these two variables is of can improve nurses’ psychological safety by paramount importance. In addition, to the best reinforcing positive psychological factors and of our knowledge, no study has so far been reducing work pressure-related injuries (15). conducted on the relationship between these Therefore, moral intelligence is seemingly one two variables. With this background in mind, of the variables that can act as a barrier to the present study was conducted to investigate psychological stress in the workplace and a the relationship between psychological safety contributor to increased psychological safety and moral intelligence in nurses of emergency of nurses. Moral intelligence is defined as the departments and intensive care units in the capacity and ability to differentiate right from tertiary hospitals affiliated to Birjand. wrong, the possession of strong ethical beliefs 3 Health, Spirituality and Medical Ethics - Vol.7, No.1, Mar 2020 Mahmoudirad Gh, et al Methods Therefore, the total score is within the range of This was a cross-sectional descriptive- 7-35. The total score of each scale was correlational study. The study population reported from the highest to lowest based on consisted of nurses working in Birjand public the 5-point Likert scale and the logic of 20%. hospitals (Imam Reza, Valiasr, and Razi In so doing, the difference between the score hospitals). A total number of 255 nurses were range of each questionnaire is multiplied by selected using the census method from nurses 20%.Thereafter, the result is added to the working in the emergency departments and lowest score of the questionnaire and continues intensive care units. The researchers obtained to 5 categories. Finally, in the psychological the approval of Ethics Committee and a safety questionnaire, the scores within the written introduction letter from the nursing and range of 35-29.5, 29.4-23.9, 23.8-18.3, 8.2- midwifery school as well as the needed 12.7, and 12.6-7 were rated as excellent, good, permissions from the health care centers' moderate, poor, and very poor. On the other authorities. Before the commencement of the hand, in the moral intelligence scale, the scores study, the researchers obtained the approval of within the range of 85-100, 69-84, 53-68, 37- the Vice-chancellor
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