In Iranian undergraduate nursing students, the level of moral intelligence, self-compassion, and cultural competence was respectively good, moderate, and weak. The findings showed that the variables of marital status, academic year, and self-compassion could predict moral intelligence, and the most significant impact was on self-compassion. No significant relationship was seen between self-compassion and cultural competence.
The present study demonstrated that undergraduate students had a good level of moral intelligence. Mohammadi et al.’s study in Tehran, Iran, also showed a good level of moral intelligence for medical students . In the study conducted by Poourtimore et al. in Urmia, Iran, nursing students had a good level of moral intelligence . Moral intelligence is not intrinsic and is obtained by training and modeling. Universities are important social environments that can develop social, moral, and cultural values; moreover, they transfer advanced knowledge and capacities to students and motivate identity, emotional, behavioral, mental, and moral growth. In order to promote moral intelligence to a high level, it is necessary to include this concept in the nursing curriculum. Because nursing students, as future nurses, can improve the quality of care provided to patients and, as a result, enhance the health of society .
Based on this study’s results, participants’ self-compassion had a moderate level. In line with our findings, Kotera et al., in their research, reported moderate self-compassion in undergraduate nursing students in the U.K. . Self-compassion is the ability to observe one’s and other’s suffering and the commitment to eliminate it , which is strongly related to positive mental health experiences in many student populations . Self-compassion in nursing students can prepare them for compassionate care. Focusing more on this concept in nursing education allows for the growth and development of compassionate care practice . The results of Chen et al.’s study in the U.S. demonstrated that self-compassion effectively reduces depression symptoms in nursing students by increasing flexibility and optimism and reducing perceived stress . Therefore, educational planners must pay more attention to this concept and conduct studies to improve self-compassion in nursing students.
In our study, there was a statistically significant relationship between self-compassion and moral intelligence, which was a predictive factor for moral intelligence among undergraduate nursing students. There are some aspects of moral intelligence, like integrity (doing what we know is right and telling the truth at all times), responsibility (embracing liability for behaviors and outcomes of some behaviors and defeats), compassion (sympathetic pity and concern for the suffering or misfortune of others), and forgiveness (perception of one’s defects and wrongs) . These dimensions have a close relationship with self-compassion, and achieved results in this study acknowledge all presumptions about that. Therefore, by improving self-compassion, we can expect to improve moral intelligence. Considering this result, educators could integrate self-compassion into their teaching curriculum and link it with moral intelligence.
We revealed that the cultural competence of our participants was at a weak level. The consequences of the same studies on nursing students demonstrate that cultural competence in South Korea was medium to high , and in Saudi Arabia was low . Cultural competence is the most basic need and necessity of nursing to develop the care of patients with various backgrounds due to the increased cultural diversity and migration of nurses worldwide [20, 29]. So nurses who care for patients from various cultures should comprehend and respect several cultures and opinions. They should be competent in preparing meaningful care for patients from different cultures through effective interactions. Cultural encounters and cultural knowledge are two strong predictors of cultural competence in nursing students . Since cultural knowledge can be achieved through the training of cultural competence in the curriculum of undergraduate nursing students , it seems necessary to provide continuous opportunities to improve the cultural competence of nursing students so that they interact more with different cultures.
Although, we did not observe a significant relationship between cultural competence and moral intelligence in undergraduate nursing students. However, the perception and intuition of nurses about the vulnerability of patients from various cultures illustrate their moral sensitivities in conducting ethical decisions . Due to the lack of a similar study in this field, it seems necessary to conduct more studies.
Moreover, according to the study’s results, a significant relationship was not seen between self-compassion and cultural competence in undergraduate nursing students. Gottlieb’s study in the U.S. demonstrated a significant relationship between self-compassion and cultural competence in social work students, and self-compassion was considered a strong predictor of cultural competence in these students . Acquiring cultural competence leads to acceptance of oneself and others and the promotion of compassionate care, so it is necessary to conduct more research on cultural competence in the community of nursing students .
This study showed that married students had higher moral intelligence than single students. Also, Gholami et al.’s study indicated that married nurses had higher moral intelligence. Since different genetic, psychological, and social factors affect moral intelligence , it seems that high moral intelligence in married students is more due to having social life skills in married people.
This study showed that students in higher academic years have lower moral intelligence. Among the possible reasons, we can mention the choice of wrong models during education, the student’s attention to improving practical skills, and neglecting morals. Teaching the basic nursing courses and ethics in the undergraduate nursing curriculum in the first years of study influences the fading of moral intelligence during the study course. We could find no accurate studies that addressed this issue.
Finally, the results of this research can be used to develop knowledge related to the concept of moral intelligence, which has recently entered the nursing profession and identify ways to improve it. The results of this study can help policy makers, nursing managers, and educational designers to design and implement more effective educational programs in order to have nursing students and nurses with high moral intelligence.
One of the strengths of the present study is examining and measuring the correlation of several concepts with moral intelligence. The second strength of this study is the multi-center study design that was carried out on students in medical sciences universities in three provinces that can develop the generalizability of the outcomes. There were also limitations in this study. First, there were many questionnaires, and participants completed them slowly, so it was challenging to convince them. We overcame this problem more patiently and continued communication with the research participants. Since the data gathering tools were completed self-reporting, the respondents’ bias and social desirability can be increased. On the other hand, convenience sampling limited the results’ generalizability. Moreover, understanding the causality of the relationships between variables requires further studies. Therefore, some observational studies are needed to clarify the relationships between variables.