Abstract
Introduction
In clinical settings, nurses’ job satisfaction plays an important role in the quality of patient care and their engagement in their work. However, despite job satisfaction's importance, little is known about how to contribute to its enhancement. Assessing the relationships between job satisfaction and other constructs is crucial to suggesting appropriate approaches.
Objective
This study aimed to examine the relationship between moral and spiritual intelligence with job satisfaction of clinical nurses.
Methods
A descriptive correlational study was conducted from July to December 2024. A random stratified sampling of 200 nurses working at selected hospitals of Shahid Beheshti University of Medical Sciences participated in this study. Data collection tools were Lennik and Keil's Moral Intelligence Questionnaire, Spiritual intelligence scale, and Minnesota Satisfaction Questionnaire.
Results
The mean and standard deviation of moral intelligence were 67.50 ± 11.03; spiritual intelligence 140.81 ± 15.31, and job satisfaction 61.24 ± 12.92. There was a positive significant correlation between moral intelligence and job satisfaction (r = 0.312, p < .001) and between spiritual intelligence and job satisfaction (r = 0.396, p < .001).
Conclusion
This study found that nurses’ job satisfaction can be improved by strengthening their moral and spiritual intelligence.
Background
In the nursing profession, job satisfaction is a crucial concept, as a workforce invested in its work is undeniably the most vital component of any organization, making job satisfaction especially significant in service-oriented settings like hospitals, particularly for nurses (Ataallahi et al., 2015; Mortazavi & Meybodi, 2013; Purgaz et al., 2010).
Low job satisfaction presents a considerable obstacle to the effective functioning of the healthcare system, with nurses experiencing this challenge particularly acutely; this satisfaction is a vital component when evaluating occupational health and is fundamentally important in enhancing the quality of patient care provided by nursing staff (Tallman & Bruning, 2005; Zangaro & Soeken, 2007). Therefore, identifying factors affecting this variable can play a significant role in improving healthcare services.
Moral intelligence, a significant aspect of overall intelligence, offers a structural guide for ethical human conduct and serves as a theoretical indicator of how people will behave in various situations (Amini & Rahimi, 2015). Moral intelligence, as defined in the literature, encompasses the cognitive capacity to discern right from wrong, the possession of firm and deeply held moral convictions, and the consistent demonstration of ethically sound behavior. The critical nature of moral intelligence is underscored by the observation that a substantial number of human behaviors and performance outcomes originate from and are demonstrably affected by the individual's moral principles and values (Abdellatif, 2022; Azar & Samari, 2017).
Moral intelligence is directly reflected in the conduct of individuals, forming a coherent set of principles and norms that provide a moral compass, guiding human behavior toward what is considered right and proper (Segon & Booth, 2015; Yousefi & Heshmati, 2015). The cultivation of moral intelligence contributes to stronger teamwork and heightened productivity, deters criminal activity, promotes ethical decision-making, and enables the development of a structured program for assessing ethical needs (Liu et al., 2004).
Spiritual intelligence, a multifaceted construct encompassing a blend of spiritual aptitudes and passions, inherent personality traits, unique cognitive skills, and distinctive psychological mechanisms, proves invaluable in addressing profound existential and supernatural questions (Zarrinabadi et al., 2018). The cultivation of both spiritual and moral intelligence is critically important for enhancing interpersonal relationships, especially within demanding professions such as medicine and nursing, where practitioners are constantly engaged with challenging situations (Eskandari et al., 2019).
Review of Literature
Studies have demonstrated a correlation between the levels of spiritual and moral intelligence and the performance of nurses, suggesting that nurses possessing higher levels of these intelligence exhibit a greater commitment to their organizations, achieve more professional success, and demonstrate enhanced clinical capabilities (Mehralian et al., 2024).
The research conducted by Motlagh et al. (2020) explored the relationship between nurses’ moral intelligence and their job satisfaction within the emergency department, revealing that their empirical data did not support a statistically significant association between these two variables (Motlagh et al., 2020).
In addition, Heydari et al. (2022) examined how spiritual intelligence training impacts psychiatric nurses’ job satisfaction and found that the intervention group had significantly higher levels of job satisfaction as compared to the control group (Abbas et al., 2017). A fundamental element of improving the quality of healthcare services is job satisfaction, so identifying the factors influencing it is vital for nurses. This study aimed to investigate the relationship between moral intelligence, spiritual intelligence, and job satisfaction of clinical nurses. It may be possible to improve job satisfaction in clinical nurses by promoting moral intelligence and spiritual intelligence if a correlation between these factors can be established.
Methods
Study Design
This descriptive-analytical, cross-sectional study was conducted from July to December 2024 based on the STROBE Statement (Strengthening the Reporting of Observational Studies in Epidemiology) (Von Elm et al., 2007) (Supplementary file 1).
Research Question
Is there a relationship between moral intelligence and spiritual intelligence with clinical nurses’ job satisfaction?
Sample and Setting
This study was conducted at four selected teaching hospitals (Ayatollah Taleghani Hospital, Loghman Hakim Hospital, Imam Hossein Hospital, Shohadaye Tajrish Hospital) affiliated to Shahid Beheshti University of Medical Sciences. The minimum sample size was calculated based on a similar study (Nobahar et al., 2022) and the correlation sample size formula. Accordingly, with a minimum correlation = 0.2, power = 0.80, and 95% confidence interval, the sample size was determined to be 194 people, which was increased to 200 people, taking into account a 10% dropout.
Inclusion and Exclusion Criteria
The inclusion criteria were as follows: (1) Having at least 1 year of clinical work experience in a hospital; (2) Having at least a nursing degree or higher; (3) Having consent to participate in the study. The exclusion criterion was the submission of incomplete questionnaires and questionnaires exhibiting invalid response patterns (e.g., identical responses to all items).
Measurements
For this study, data was collected using a self-reporting method, which involved the administration of four different questionnaires.
Demographic Information Questionnaire
This questionnaire collected information about the participants’ age, gender, marital status, education levels, and work experiences.
Lennik and Keil's Moral Intelligence Questionnaire
This questionnaire, developed by Lennik and Keil with 40 items on a 5-point Likert scale (1 = almost never, 5 = almost always), measures four dimensions of moral intelligence: integrity (items 1–10), responsibility (items 11–20), compassion (items 21–30), and forgiveness (items 31–40). Final scores are divided by two, the result is placed between 20 and 100, and finally, the score categorization would be 90–100 (excellent), 80–89 (very good), 70–79 (good), and 69 or lower (weak) (Lennick & Kiel, 2005). The validity of this questionnaire was established in Iran by Arasteh and colleagues, who reported a Cronbach's alpha coefficient of 0.897 (Arasteh et al., 2010). The reliability of the questionnaire was determined to be 86.5 using the Cronbach's alpha test.
Spiritual Intelligence Scale
The 42-item spiritual intelligence questionnaire was developed and validated in Iran by Badie et al. (2010). This scale contains four dimensions: assessing general thinking context and belief dimension (12 items); ability to deal with problems (15 items); self-awareness, love, and interest (8 items); and addressing moral virtues (7 items). Each item is scored on a 5-point Likert scale ranging from “strongly disagree = 1” to “strongly agree = 5”. Reverse scoring is applied to 14 items (items 1, 2, 3, 7, 8, 9, 10, 13, 14, 15, 19, 20, 26, and 35). The questionnaire's total range score is 42–210. Content validity and Cronbach alpha coefficient (0.85) were used to verify the validity and reliability of the questionnaire (Badie et al., 2010). Cronbach's alpha, calculated by this study, yielded a value of 82.8 for the reliability of the questionnaire.
Minnesota Satisfaction Questionnaire
Minnesota Satisfaction Questionnaire (MSQ) is a 19-item questionnaire designed to evaluate job satisfaction levels. This questionnaire is divided into six subscales, which include compensation systems (3 items), job types (4 items), advancement opportunities (3 items), organizational climate (2 items), leadership style (4 items), and physical conditions (3 items). Based on the Likert scale, each item is rated from “strongly disagree = 1” to “strongly agree = 5”. For each respondent, there is a total score ranging from 19 to 95. Total scores represent levels of job satisfaction, classified as high job satisfaction (above 57), moderate job satisfaction (39–57), and low job satisfaction (19–38) (Wiess et al., 1967). In a study, the reliability of MSQ was validated, showing a Cronbach's alpha of 0.89 (Walkowiak & Staszewski, 2019). MSQ reliability in an African context has been confirmed, with Cronbach's alpha values of 0.79 for intrinsic, 0.82 for extrinsic, and 0.86 for the overall scale, indicating strong internal consistency (Buitendach & Rothmann, 2009). Based on the results of Heydari et al.'s research, this questionnaire was valid and reliable in Iranian populations, obtaining a reliability of 0.86 (Heydari et al., 2022). Also, in their study, Otaghi et al. found an internal consistency reliability of 0.87 based on Cronbach's alpha (Otaghi et al., 2023). In the current study, the reliability of the questionnaire was calculated through Cronbach's alpha, which yielded a score of 90.4.
Data Collection
After receiving approval from the university's ethics committee and obtaining permits from the appropriate directors of selected hospitals, the researcher presented himself to the hospital directors. Following this, the researcher explained the study objectives to nurses at the appropriate time and place, and obtained their written consent.
In accordance with the inclusion criteria, eligible nurses were recruited, and the nurses were then selected proportionately stratified randomly according to the hospital's nurse population (200 nurses). The participants were chosen based on a table of random numbers within each stratum; this sampling approach ensured that participants were drawn from a variety of hospital wards and job categories (e.g., intensive care units, emergency rooms, and medical-surgical units), improving the representativeness of the sample and reducing the risk of selection bias.
Then, the questionnaires were distributed equally between nurses in three shifts (morning, evening, and night). The samples were given 3 days to collect the questionnaires, so that they could complete them when they felt relaxed and free.
Ethical Considerations
The study adhered to the Helsinki declaration's principles, and participants were told about the study's purpose, and they were assured that their personal information would be kept confidential. During the enrollment process, participants were informed that the study would be voluntary, and that they could leave at any time. A written consent form was signed by each participant before participating in the study, and the study was approved by the Shahid Beheshti University of Medical Sciences Review Board with code number of IR.SBMU.RETECH.REC.1403.113.
Statistical Analysis
In this study, the data analysis was conducted using descriptive and inferential statistics through SPSS software version 20. The Kolmogorov–Smirnov test was utilized to determine the normal distribution of variables. Various descriptive statistics were described, such as frequency, percentage, mean, and standard deviation. The correlation between moral intelligence, spiritual intelligence, and job satisfaction was examined using Pearson's correlation test. A linear regression analysis was also conducted to determine the factors affecting job satisfaction. The significance level was set as p-value < 0.05.
Results
The results of the study showed that the average age of the participants was 35.65 ± 6.43 and the average work experience of the nurses was 11.66 ± 5.57. Also, the findings demonstrated that most of the participants were female (52.5%), married (56%), and had a bachelor's degree (87.5%), Table 1.
The Demographic Characteristics of the Participants (n = 200).
Note. SD=standard deviation.
The mean and standard deviation of moral intelligence were 67.50 ± 11.03, spiritual intelligence 140.81 ± 15.31, and job satisfaction 61.24 ± 12.92. The participants showed a weak level of moral intelligence, an acceptable level of spiritual intelligence, and a high level of job satisfaction (Table 2).
Mean and Standard Deviation of Moral Intelligence, Spiritual Intelligence, and Job Satisfaction of the Participants (n = 200).
Dimensions of moral intelligence.
Dimensions of Spiritual intelligence.
Dimensions of job satisfaction.
The findings of the study indicated that there was a positive significant correlation between moral intelligence and job satisfaction (r = 0.312, p < .001), between spiritual intelligence and job satisfaction (r = 0.396, p < .001), and between moral intelligence and spiritual intelligence (r = 0.285, p < 0.001) (Table 3).
Pearson's Correlation Coefficient Between Moral Intelligence, Spiritual Intelligence, and Job Satisfaction of the Participants (n = 200).
**Correlation is significant at the 0.01 level (two-tailed).
*Correlation is significant at the 0.05 level (two-tailed).
The results of linear regression analysis showed that the variables of work experience (β = 0.689, p < .001), addressing moral virtues (β = 0.904, p < .001), ability to deal with problems (β = 0.313, p = .011), and integrity (β = 0.400, p = .018) were the positive predictors of job satisfaction. These variables could explain 30.3% of the variation in job satisfaction of clinical nurses (Table 4).
The Predictor Variables of Job Satisfaction Among Nurses (n = 200).
R2= 0.303; Adjusted R2 = 0.289.
Discussion
This study aimed to investigate the relationship between moral and spiritual intelligence with job satisfaction of clinical nurses. According to the present study findings, the clinical nurses in the targeted community reported a high level of job satisfaction. Research across diverse geographical locations has revealed a range of job satisfaction levels.
The research by Javanmardnejad et al., carried out in Iran in 2021, indicated that nurses experienced a moderate degree of job satisfaction (Javanmardnejad et al., 2021). A separate study conducted during the COVID-19 pandemic produced findings comparable to the current study, revealing high job satisfaction among nurses despite the ongoing pandemic crisis (Giménez-Espert et al., 2020).
Previous research has identified various factors that contribute to job satisfaction. According to a study by Yasin et al., peer support, work conditions, quality of supervision, and a sense of achievement, job interest, and responsibility were identified as substantial predictors of job satisfaction (Yasin et al., 2020). A study conducted during the COVID-19 pandemic indicated that Spiritual intelligence, psychosocial stressors (including interpersonal conflict, perceived lack of organizational justice, role conflict, and workload), social support, and emotional labor may influence job satisfaction (Soto-Rubio et al., 2020).
A recent systematic review in this field categorizes factors influencing job satisfaction into two distinct domains: individual and organizational. Individual factors such as age, health status, self-determination/autonomy, psychological empowerment, job involvement, work exhaustion, and work stress significantly affected the job satisfaction. Organizational factors were considered to be of minimal significance (Aloisio et al., 2021).
Furthermore, another study has demonstrated that enhancing job satisfaction can substantially diminish the likelihood of nurses intending to leave their positions (Zahednezhad et al., 2021). In the present study, a significant association had been observed between higher levels of moral and spiritual intelligence and greater job satisfaction. Also, the findings showed that in addition to the moral and spiritual intelligence, work experience was significantly contributed to job satisfaction. Therefore, based on the identified risk factors, implementing strategies aimed at enhancing job satisfaction among healthcare professionals by policymakers can contribute to improved outcomes within the health system.
Numerous interventions have been implemented to enhance nurses’ job satisfaction. A recent systematic review revealed that the majority of interventions evaluated were educational in nature, comprising workshops and training sessions. Among the evaluated interventions, the spiritual intelligence training protocol and the professional identity development program demonstrated the greatest efficacy in enhancing job satisfaction (Niskala et al., 2020).
Additionally, another study in 2021 showed a strong direct effect of communication skills and the transformational leadership style on nurses’ job satisfaction (Jankelová & Joniaková, 2021). Also, complementary medicine interventions may offer significant benefits. A study investigating the impact of mindfulness-based training on nurses demonstrated its effectiveness in mitigating anxiety and enhancing job satisfaction among participants (Ghawadra et al., 2020).
The current study found that clinical nurses exhibited a weak level of moral intelligence, although spiritual intelligence was remained within acceptable parameters. Furthermore, considering the correlation between these variables and job satisfaction, it appears that enhancing moral and spiritual intelligence may contribute to increased job satisfaction. Consequently, any intervention designed to enhance moral and spiritual intelligence will positively affect job satisfaction.
Moreover, a systematic review and meta-analysis, involving seven studies, indicated that educational interventions designed to foster spiritual intelligence positively affected both the spiritual intelligence and professional outcomes of nurses (Sharifnia et al., 2022). Additionally, a study focused on evaluating the influence of spiritual intelligence training on nurses’ communication with patients concluded that these training exercises were successful in improving nurses’ communication abilities (Arad et al., 2022). In general, this study, along with related research, was designed to draw the attention of researchers to the critical concerns of nurses, enabling the future development and implementation of intervention studies to improve nursing conditions.
Strengths and Limitations
Although previous studies have evaluated moral intelligence, spiritual intelligence, and job satisfaction separately, and this study is one of the first to evaluate the relationship between moral and spiritual intelligence and job satisfaction among clinical nurses, it is crucial to acknowledge several limitations inherent to the present study: the cross-sectional design restricts causal inferences between variables. Furthermore, given the nature of the study, which involved self-report measures, there is a possibility of bias affecting the objectivity and authenticity of the results; the results of the study also only considered some specific dimensions of the variables of moral intelligence and spiritual intelligence and some socio-demographic factors as potential predictors of the job satisfaction. It is recommended that future studies have a multi-centered approach and use a longitudinal or interventional research approaches to more profound understanding the relationship between these variables.
Implications for Practice
Given the positive and significant correlation between moral intelligence and spiritual intelligence with clinical nurses’ job satisfaction, nursing administrators and hospital administrators can use strategies to improve moral intelligence and spiritual intelligence to improve clinical nurses’ job satisfaction. Future interventions should prioritize strengthening these aspects—especially spiritual intelligence and moral intelligence. Furthermore, future research efforts should examine a broader range of factors influencing nurses’ job satisfaction to provide a more comprehensive understanding for policymakers to inform the development and implementation of effective and targeted strategies aimed at increasing job satisfaction in the nursing profession.
Conclusions
The results of this study showed that there is a significant positive correlation between moral and spiritual intelligence with job satisfaction of clinical nurses, so that enhancing moral and spiritual intelligence may lead to improved job satisfaction in clinical nurses.
Supplemental Material
sj-docx-1-son-10.1177_23779608261444464 - Supplemental material for The Relationship Between Moral Intelligence and Spiritual Intelligence with job Satisfaction of Clinical Nurses: A Descriptive Correlational Study
Supplemental material, sj-docx-1-son-10.1177_23779608261444464 for The Relationship Between Moral Intelligence and Spiritual Intelligence with job Satisfaction of Clinical Nurses: A Descriptive Correlational Study by Amir Mohamad Nazari, Esmaeil Bashiri Bonab, Arman Ryahin and Fariba Borhani in SAGE Open Nursing
Footnotes
Acknowledgment
Researchers would like to express their sincere gratitude and appreciation to the Dean of the Medical Ethics and Law Research Center, as well as the Honorable Research Vice President of Shahid Beheshti University of Medical Sciences for making this research possible.
Ethical Statement
The study adhered to the Helsinki declaration's principles, and participants were told about the study's purpose, and they were assured that their personal information would be kept confidential. During the enrollment process, participants were informed that the study would be voluntary, and that they could leave at any time. A written consent form was signed by each participant before participating in the study, and the study was approved by the Shahid Beheshti University of Medical Sciences Review Board with code number of IR.SBMU.RETECH.REC.1403.113.
Author Contributions
Design of the study was done by AMN and FB; data collection was done by AMN, EBB, and AR; analysis and interpretation of data was done by AMN and FB; manuscript preparation was done by AMN, EBB, AR, and FB; manuscript revision was done by AMN, EBB, AR, and FB; the final manuscript was checked and confirmed by all authors before submission, and they were all read and approved.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this research was provided by Shahid Beheshti University of Medical Sciences for study design, data collection, interpretation, and analysis, as well as preparation of the article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Availability of Data and Materials
On request, the corresponding authors will provide the datasets used and analyzed during this study.
Supplemental Material
Supplemental material for this article is available online.
References
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