Objective


This review put together evidence on MS levels, factors linked to it, predictors and interventions in nursing groups, mostly from Asia.


Methods


A narrative review of studies on nursing staff was done with thematic synthesis of evidence.


Results


The review looked at studies from 2010 to 2023, mainly from Asian countries and one study that compared Japan and Finland, which showed moderate levels of moral sensitivity in many nursing groups. These groups included students, ICU nurses, critical care nurses, midwives, mental health nurses and nurses who care for older people. Data from quantitative studies indicated that moral sensitivity had positive links with ethical decision-making which indicated professional values played a mediating role, emotional intelligence, moral awareness, moral self-concept, person-centered care and positive attitudes toward care of older people. The same data showed an inverse link with perceived quality of nursing care that included psychosocial and physical parts. Moral sensitivity appeared as a strong predictor of person-centered care and of compassion fatigue, especially during the COVID-19 period. Results were mixed for links with moral distress because some studies indicated no connection while others showed it existed.


Conclusions


Moral sensitivity is a clear predictor of ethical nursing practice and care quality which indicates it can also make nurses more open to distress and fatigue when conditions are hard. Targeted interventions and supportive ethical climates are needed that show how to keep moral sensitivity strong and reduce bad outcomes.