LAUSR

BACKGROUND There are many studies that indicate moral distress is a widespread problem in health care systems. However, some nurses are able to moderate moral distress and show competence and resilience in morally tense situations. AIM The aim of this study is to explain the concept of moral resilience using the experiences of nurses working in intensive care units. STUDY DESIGN This is a qualitative study with a content analysis approach guided by the method of Elo and Kyngäs in 2008 and based on the theoretical framework of Defilippis et al. in 2020. PARTICIPANTS AND RESEARCH CONTEXT The study sample included all nurses working in intensive care units, who were selected by purposeful sampling. Data were collected through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Elo and Kyngäs method was used to analyze the data. Data management was also performed by MAXQDA software version 20. ETHICAL CONSIDERATIONS This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed. RESULTS The results of present study support the theory of Defilippis et al., while adding another category to it. Four categories of awareness and self-awareness, harmonious connection, improvement of moral agency, and moral well-being were extracted from the data. DISCUSSION Explanatory theory resulted from the study of Defilippis et al. can be used as a guide to cultivate and improve moral resilience skills in nurses working in intensive care units. Nurturing and improving individual capacities such as self-awareness, self-efficacy, and self-confidence in nurses to maintain and promote morality and also establishing a harmonious connection between the treatment team members help to foster moral resilience in the intensive care unit nurses. Acquiring the moral resilience skills can lead to positive consequences, while preventing the negative consequences of moral distress.