The predictive role of moral courage in guilt feelings and occupational hardiness among NICU nurses

Moral courage plays an important role in nurses’ ethical practice, particularly in high-stress settings such as neonatal intensive care units (NICUs). This study examined whether moral courage predicts guilt feelings and occupational hardiness among NICU nurses. In this descriptive–analytical study, 174 NICU nurses from three tertiary hospitals were recruited using quota sampling. Data were collected using validated questionnaires and analyzed using Spearman correlation and multiple linear regression. Moral courage was positively and significantly associated with occupational hardiness (r = 0.40, p < 0.001). Multiple linear regression showed that the model explained 17% of the variance in moral courage (F(2,171) = 17.56, p < 0.001). Occupational hardiness was a significant positive predictor of moral courage (β = 0.43, p < 0.001), whereas guilt feelings were not a significant predictor (β = −0.04, p = 0.56). Occupational hardiness is a key factor associated with moral courage among NICU nurses. Educational and managerial interventions aimed at strengthening occupational hardiness may help enhance moral courage and support professional performance in NICU settings.