Influencing factors of moral resilience among psychiatric nurses: a cross-sectional survey

Objective This study investigates the level of moral resilience among psychiatric nurses and the factors influencing it. The aim is to provide foundational insights for developing targeted interventions to enhance moral resilience within this nursing specialty. Background Psychiatric nurses face unique ethical challenges due to their exposure to complex moral dilemmas, workplace violence, and coercive practices in mental health settings. These challenges can lead to moral distress, impacting both their well-being and the quality of patient care. Understanding the factors influencing moral resilience—such as psychological traits, organizational support, and coping strategies is crucial for developing targeted interventions to enhance their ethical decision-making and professional sustainability. Design A cross-sectional survey. Methods Five hundred and ninety-two psychiatric nurses from the psychiatric departments of five tertiary-level general hospitals, one tertiary-level psychiatric hospital, and three municipal psychiatric hospitals in Sichuan Province from June to September 2024, and they were assessed using a general information questionnaire, the Rushton moral resilience scale, and the hospital ethical climate survey. Results The total moral resilience score of psychiatric nurses was (41.84 ± 6.22) and the hospital ethical climate score was (105.42 ± 13.04). The results of univariate analysis showed that the effects of education, position, years of experience in psychiatry, whether or not a national counselor, whether or not a psychiatric nurse, and whether or not a psychiatric nurse had received medical ethics education and training on the moral resilience score of psychiatric nurses were statistically significant (all P  < 0.05); Pearson correlation analysis showed that the correlation coefficient of the moral resilience score of psychiatric nurses with the score of the ethical climate of hospitals was 0.55 ( P  < 0.05); multiple regression analysis showed that education, years of experience in psychiatry, qualification of psychiatric nurses, receiving medical ethics education and hospital ethical climate score were the main influences on psychiatric nurses’ moral resilience, explaining 34.9% of the total variance. Conclusion The level of moral resilience of psychiatric nurses is in urgent need of improvement, and it is significantly influenced by professional qualification, training experience and organizational ethical environment. It is recommended to improve the moral resilience of nurses by constructing an ethical support system, improving the function of ethics committees, incorporating medical ethics into the mandatory curriculum of continuing education, implementing a tiered training program for psychiatric nurses, and at the same time establishing an ethical decision-making case base and a multidisciplinary collaboration platform. Impact This study proposes that educators and administrators provide psychiatric nurses with targeted interventions to enhance moral resilience, thereby improving clinical practice and long-term career sustainability. Clinical trial number Not applicable.