Effectiveness of CURA: Healthcare professionals' moral resilience and moral competences

Nurs Ethics. 2024 Sep;31(6):1140-1155. doi: 10.1177/09697330231218344. Epub 2023 Nov 30.

Abstract

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences.Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences.Design: Single group pre-/post-test design with two questionnaires.Methods: Questionnaires used were the Rushton Moral Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist.Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents.Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales.Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice.

Keywords: Palliative care < topic areas; care homes < areas of practice; clinical ethics < topic areas; home care < areas of practice; moral competences; moral distress < topic areas; moral resilience; quantitative research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Health Personnel* / psychology
  • Health Personnel* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Morals*
  • Netherlands
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Resilience, Psychological*
  • Surveys and Questionnaires