Moral distress in pediatric nurses: The influence of spiritual care competence and professional values.

PURPOSE: Pediatric nurses frequently encounter ethically challenging situations involving seriously ill children, family-centered decision-making, and end-of-life care, increasing their risk of moral distress. This study examined the relationships among professional values, spiritual care competence, and moral distress in pediatric nurses and whether professional values and spiritual care competence predict moral distress. DESIGN AND METHODS: A cross-sectional correlational study included 135 pediatric nurses from pediatric units of three hospitals in Türkiye. Data were collected using the Nurses' Professional Values Scale, Spiritual Care Competence Scale, and Moral Distress Scale-Revised for Pediatric Nurses. RESULTS: Spiritual care competence was positively associated with professional values (r = 0.267, p = .002) and negatively associated with moral distress (r = -0.312, p < .001). No significant association was found between professional values and moral distress (p = .883). Multiple regression analysis showed that spiritual care competence was a significant negative predictor of moral distress (β = -0.339, p < .001), whereas professional values were not (β = 0.103, p = .228). CONCLUSIONS: Higher spiritual care competence was associated with lower moral distress and remained significantly associated with moral distress in the regression model. Spiritual care competence may therefore be relevant to ethically challenging pediatric care, although causal relationships cannot be inferred. PRACTICE IMPLICATIONS: Educational and institutional initiatives supporting spiritual care competence may enhance holistic, family-centered pediatric nursing practice. Intervention studies are needed to determine whether strengthening this competence can reduce moral distress.