Jurnal Ners This is an Open Access article distributed

Vol. 15, No. 2, October 2020 under the terms of the Creative Commons
Attribution 4.0 International License
http://dx.doi.org/10.20473/jn.v15i2.19634

Original Research

Relationship between Demographic Characteristics and Moral Sensitivity among

Professional Nursing Students in Bali

Ni Putu Emy Darma Yanti and Komang Menik Sri Krisnawati

Program Studi Sarjana Keperawatan dan Keperawatan, Fakultas Kedokteran, Universitas Udayana

ABSTRACT ARTICLE HISTORY

Introduction: Moral sensitivity is indispensably required in nurses for them to Received: June 5, 2020
be aware of and be able to understand clients’ needs. This study aimed to Accepted: July 4, 2020
determine the relationship between demographic characteristics and moral
KEYWORDS
sensitivity among professional nursing students in Bali.
demographic characteristics;
Methods: The research used a descriptive-correlation method and a cross- moral sensitivity; nurse;
sectional approach. The study population was all professional nursing students nursing students
in Bali with 162 students as research respondents, sampled using the purposive
sampling technique. The dependent variable is the moral sensitivity among CONTACT
professional nursing students and the independent variable is the demographi c Ni Putu Emy Darma Yanti
characteristics consisting of gender, age, religion, and number of siblings. Data 
were collected by means of a moral sensitivity questionnaire for nursing students emydarmayanti@unud.ac.id
developed by Lutzen in 1993 consisting of 27 statements.  Program Studi Sarjana
Keperawatan dan
Results: The results of this study show that there is a significant relationshi p Keperawatan, Fakultas
between religion and moral sensitivity (p=0.027; α=0.05), and that there is no Kedokteran, Universitas
relationship between sex, age, and number of siblings and moral sensi tivity Udayana
(p>0.05; α=0.05).
Conclusion: The nursing students’ level of faith and understanding of their
respective religious teachings can increase their moral sensitivity in providing
nursing care.

Cite this as: Yanti, N, P, E, D., & Krisnawati, K, M, S. (2020). Relationship between Demographic Characteristics and
Moral Sensitivity among Professional Nursing Students in Bali. Jurnal Ners, 15(2). 113-117.
doi:http://dx.doi.org/10.20473/jn.v15i2.19634

relationship with the patient, in order to improve the

INTRODUCTION
patient’s wellbeing (Kim, Kang, & Ahn, 2013). Moral
In providing nursing care to the clients, nurses must sensitivity and consideration could improve the
consider the ethical and moral aspects. They have the quality of relationship between the patient and the
responsibility to apply the ethics of caring for every nurse (Heggestad, Nortvedt, & Slettebø, 2013).
patient they are treating as part of their professional Improvement of moral sensitivity in nursing practice
role. Law No. 38 of 2014 on Nursing mandates that is needed to prepare nurses that are ethically
the delivery of nursing services must be carried out competent in implementing nursing care and
responsibly, based on ethics and professionalism. decision-making (Ohnishi et al., 2019).
Nevertheless, nurses are not always completely Several studies found that the mean score of
prepared to deliver optimum nursing services or they nurses’ moral sensitivity was in the moderate
are not able to properly care for their patients category, which contributed to a decrease in the
(Woods, Rodgers, Towers, & La Grow, 2015). quality of services (Nora, Zoboli, & Vieira, 2017;
In this case, sensitivity to address these problems, Range & Rotherham, 2010). A study in Iran, Thailand,
which is known as moral sensitivity, is required to and South Korea also showed that nurses’ moral
respond to various ethical issues (Trobec & Starcic, sensitivity was in the moderate category
2015). Moral sensitivity is a fundamental personal (Boonyamanee, Suttharangsee, Chaowalit, & Parker,
attribute required in a nurse to be competent in 2014; Borhani, Abbaszadeh, Mohamadi, Ghasemi, &
identifying, interpreting, and appropriatel y Hoseinabad-Farahani, 2017; Han, Kim, Kim, & Ahn,
responding to ethical issues in the nurse’s 2010). Ethical and moral education for nursing

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N. P. E. D. YANTI ET AL.

students in Indonesia is given since the first year of and understanding of the research assistant's about
college students, so it is expected to increase moral procedures and how to fill out the questionnaire.
sensitivity of students from the start of nursing Determination of respondents was done by looking at
education. the names of students who are registered as study
Moral sensitivity in nursing practice is expected to populations. They were given an explanation of the
be applied starting from nursing school. A previous objectives, benefits and procedures of the research
study regarding ethics in nursing practice revealed conducted. The researcher or research assistant
the importance of preparing nursing students to asked the respondent to fill in the consent form to
adjust themselves to the ethical challenges in their become a respondent after agreeing to be a
future role as a nurse (Muramatsu, Nakamura, Okada, participant in the research conducted.
Katayama, & Ojima, 2019). This requirement has to be Univariate analysis was performed to examine the
met because newly-registered nurses will face distribution frequency and mean value of the nursing
different moral dilemmas occurring in every nursing students’ demographic characteristics and moral
care administration, which may cause nurses to sensitivity. Meanwhile, the relationship between
experience stress and burnout (Fairchild, 2010). The gender and moral sensitivity among the nursing
level of moral sensitivity was influenced by a number students was analyzed using an independent t test. In
of factors, such as socio-demographic factors and addition, the relationship between religion and moral
professional characteristics, including income, sensitivity among the nursing students was analyzed
quality of work life, professional satisfaction, nurse’s using one-way ANOVA. Finally, a Spearman’s Rank
length of service, number of patients per day, and test was performed to analyze the relationshi p
total number of nurses in the workplace (Öztürk, between the nursing students’ age and number of
Şener, Koç, & Duran, 2019). Study on the description siblings and their moral sensitivity with Confidence
of the moral sensitivity and the determinant factor Interval at 95% (α = .05).
that influence the moral sensitivity among This study was granted the approval of the
professional nursing students in Indonesia especially Institutional Review Board of the Faculty of Medicine,
has never been done before. Udayana University and Sanglah Hospital by virtue of
Based on the problems described above, this study Approval No. 1673/UN14.2.2/PD /KEP/2018. All of
aimed to identify the relationship between the participants voluntarily signed the informed
demographic characteristics and moral sensitivity consent as a participant in the present study.
among professional nursing students in Bali by means
of a quantitative approach. RESULTS
The participants’ demographic characteristics are
MATERIALS AND METHODS
presented in Table 1 and Table 2. Meanwhile, Table 3
The present study is a correlative analytic study with presents the distribution frequency of the
a cross-sectional design. The dependent variable of participants’ moral sensitivity. The results showed
the study is the moral sensitivity among professional that the majority of respondents were women
nursing students and the independent variable is the (75.3%) and Hindu (92.6%). In addition, the average
demographic characteristics consisting of gender, age of respondents in this study was 23 years. The age
age, religion, and number of siblings. A total of 162 of the youngest respondent was 21 years and the
professional nursing students in Bali were recruited oldest was 24 years. The average number of
as participants by using the purposive sampling respondent siblings was two people with at least one
technique from September to November 2018 with person and at most eight people. The results of the
inclusion criteria: (1) professional nursing students normality test using the Kolmogorov Smirnov test
in the regular program, (2) Students not on leave showed that the moral sensitivity scores of students
when the entire research process is carried out, (3) were normally distributed. Table 4 shows the data
Students are willing to become respondents by categories of moral sensitivity of students with mean
signing the informed consent form as a participant. scores as cut of points. Mean score > 142.27 is good
The 27-item moral sensitivity questionnai re moral sensitivity and mean score <142.27 is student
developed by Lutzen (1993) and the participants ’ with low moral sensitivity.
demographic data form were used to collect the data The results show that there is a significant
(gender, age, religion, and number of siblings). The relationship between religion and moral sensitivity
questionnaire had been proven to have good validity among the nursing students in Bali Province (p =
and reliability (Park, 2012). .027). This means that there are differences in the
The procedure in this study began with organizing mean score of moral sensitivity among the nursing
a research permit. Permission to conduct research students between Hindus, Muslims and Christians.
was obtained from relevant institutions. The However, there was no significant relationshi p
researcher then chose one lecturer in each nursing between gender, age, and number of siblings and
institution as an assistant in this study. Research moral sensitivity among the nursing students (p >
assistants have the same role as researchers. This role .05).
is carried out when researchers cannot meet directly
with students. The researcher provided guidance

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Table 1. Participants’ Demographic Characteristics based on Gender and Religion (n = 162)

Variables n %
Gender
Male 40 24.7
Female 122 75.3
Religion
Hindu 150 92.6
Islam 10 6.2
Christianity 2 1.2

Table 2. Distribution Frequency of Age and Number of Siblings (n = 162)

Variables Median (Min–Max) 95% CI
Age (years) 23 (21–24) 22.79; 23.85
Number of siblings (person) 2 (1–8) 2.04; 2.45

Table 3. Distribution Frequency of Participants’ Moral Sensitivity (n =162)

Variable Mean (SD) 95% CI
Moral sensitivity 142.27 (20.31) 139.12; 145.42

Table 4. Distribution Frequency of Participants’ Moral Sensitivity Category (n =162)

Variable Mean (SD) 95% CI
Moral sensitivity 142.27 (20.31) 139.12; 145.42
Moral sensitivity n %
Low 73 45.1
Good 89 54.9

Table 5. The Relationship between Demographic Characteristics and Moral Sensitivity among Professional Nursing
Students in Bali (n = 162)
Median (Min–
Variable n Mean (SD) MD r P value
Max)
Age (years) 162 - 23 (21–24) - -0.026 0.745 ┼
Number of sibling (person) 162 - 2 (1–8) - -0.18 0.818 ┼
Gender -2.651 - 0.224 ╪
Male 40 140.28 (22.69) -
Female 122 142.93 (19.52) -
Religion - - 0.027 *
Hindu 150 143.39 (20.30) -
Islam 10 131.00 (14.30) -
Christianity 2 115.00 (14.14) -
┼
Spearman’s Rank test; ╪ T Independent t- test; *One Way ANOVA test (α = .05)

search for moral meaning of human acts (Kim Lützén

DISCUSSION & Ewalds-Kvist, 2013; Tuvesson & Lützén, 2017).
Moral sensitivity comprises the experiences and
The majority of the participants in the present study
personal development of an individual and the
have good moral sensitivity. The results of this study
experiences of others. It is in a constant process of
support previous studies which reported that moral
change and development throughout a professional’s
sensitivity among nursing students or nurses was
life (Baykara, Demir, & Yaman, 2015). The process of
relatively high (Borhani, Abbaszadeh, & Hoseinabadi -
moral sensitivity takes place before an individual
Farahani, 2016; Kim, Park, You, Seo, & Han, 2005).
considers a moral decision. The components of moral
Students who have good moral sensitivity have a
sensitivity include showing kindness, developing a
better ability in identifying moral or ethical issues and
moral understanding, modifying autonomy,
determining an action, in doing which they tend to
interpersonal orientation, moral conflict experiences ,
refer to moral principles (Reza, 2013).
and using knowledge as health professionals (Lützén,
Moral sensitivity is an ability to identify moral
1993). Students’ moral sensitivity is also influenced
issues. Moral sensitivity is defined as an individual’s
by their demographic characteristics, including age,
ability to understand that a certain situation has a
gender, religion, and number of siblings (Park, 2012).
moral meaning when that situation is experienced by
However, this study shows different results. This can
an individual (Kim, Kang, & Ahn, 2013). Moral
be caused by other factors that might influence the
sensitivity can be considered as a personal, intuitive
moral sensitivity of students, such as student practice
concept, or even a competence and an essential
dimension in daily decision-making that arises from a

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N. P. E. D. YANTI ET AL.

experience and culture or family environment, which patients as other people. It is possible for students to
need to be further investigated. feel a sense of belonging to their siblings due to their
The present study reported that there was a blood ties and growing up together since they were
significant relationship between religion and the young in one family environment. Whereas, with
nursing students’ moral sensitivity. Religion is one patients, it is felt necessary to have a relationship over
factor that contributes to an individual’s moral a longer time so that a sense of belonging or
development. What makes people understand and sensitivity arises like a brother.
implement moral principles in life can be linked with This study has several limitations, although efforts
religion (Park, 2012). It is related to an individual’s have been made to overcome them. This research
level of moral sensitivity (Han, Kim, Park, Ahn, Meng, cannot involve all nursing institutions in Bali because
& Kim, 2007). Thus, religion can shape people’s the periods of practice between institutions are
mindset toward moral principles. different. Students in some institutions were not in
In addition, this result is also in congruence with a the practice period when the research is conducted.
study that reported a strong significant positive The researcher also cannot fully control and see
correlation between religiosity and morality in directly when the respondent answers the
adolescents (Reza, 2013). In other words, the higher questionnaire.
the religiosity, the higher the adolescents’ morality.
Problem solving through religion had significant CONCLUSION
contributions in overcoming work stress (Safaria,
This study concludes that there is a significant
2012).
relationship between religion and moral sensitivity
An individual who is mature in practicing her/his
among professional nursing students in Bali.
religion and routinely carries out religious rituals will
However, gender, age, and number of siblings were
always try to obey the teachings of her/his religion.
found to be unrelated to the moral sensitivity. The
Consequently, it has a positive effect on the person’s
majority of professional nursing students have good
behavior (Nashori, 1997). In addition, people will be
moral sensitivity.
more open to all facts and values and present moral
Students are expected to increase their faith and
and practical purposes in life while still adhering to
understanding of the teachings of their respectiv e
the teachings of the religion that they believe in
religions. This will affect the moral sensitivity of
(Indrawati, 2006).
students, especially in providing care to patients .
The present study also found that there was no
Researchers also recommend that future researchers
significant correlation between age and gender and
can identify more deeply about other factors that can
moral sensitivity in this study. These results are
influence the application of moral sensitivity, such as
contrary to a previous study that reported that there
morality knowledge, practical experience, family
was a significant difference between demographi c
culture, spirituality, and emotional intelligence. The
characteristics, age, and gender and moral sensitivity
results of the study are expected to provide
(Tuvesson & Lützén, 2017). Students who were older
appropriate interventions to improve the moral
and female had a higher level of moral burden and
sensitivity of nursing students.
strength. In addition to this, a study also reported that
there was a significant difference between age and
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