Explaining the Concept of Moral Resilience in Intensive Care Unit Nurses: A Directed Content Analysis.

Moral resilience is an emerging concept that has not been fully acknowledged. The aim of this study is to explain lived experiences of moral resilience in intensive care units nurses. This is a qualitative study with a content analysis approach guided by the method of Elo and Kyngäs and based on the theoretical framework of Defilippis et al. Data were collected through 17 in-depth, individual, and semi-structured interviews with 17 nurses, who were selected by purposeful sampling. The results of the present study support the theory of Defilippis et al. while adding another category to it. Three categories of self-awareness, harmonized connection, and moral well-being, which are consistent with the result of Defilippis et al. were extracted deductively, while the category of moral agency was also extracted inductively from the data. The explanatory theory resulting from Defilippis et al.'s study can be used as a guide to cultivate and improve the moral resilience of nurses working in intensive care units. Moral resilience is fostered in nurses by nurturing and improving their capacities, such as self-awareness, self-efficacy, self-confidence, and self-reflection. These traits can help maintain and promote moral agency while establishing harmonized connections. Acquiring moral resilience skills can lead to positive outcomes and reduced moral distress.