{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:00Z","timestamp":1790060460295,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Professional values and moral resilience are recognized as essential attributes of nursing practice. In critical care settings, where nurses routinely face ethical complexity and high\u2010stakes decisions, it is important to understand how these attributes shape professional competence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the relationship between professional values and professional competence among critical care nurses, and to determine whether moral resilience mediates this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This descriptive and correlational study was conducted among nurses working in the critical care units of six hospitals between August and October 2025. The reporting was conducted in accordance with the STROBE guidelines. Three validated instruments were used: a professional values scale (range 1\u20135, with higher scores indicating stronger professional values), a moral resilience scale (range 1\u20134, with higher scores indicating greater moral resilience) and a professional competence scale (range 1\u20135, with higher scores indicating greater professional competence).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 201 nurses participated in the study. Mean scores were high for professional values (4.45\u2009\u00b1\u20090.61 out of 5), moral resilience (3.27\u2009\u00b1\u20090.43 out of 4) and professional competence (4.26\u2009\u00b1\u20090.36 out of 5). Professional values were significantly and positively correlated with professional competence (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.329,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas moral resilience showed no significant association with either variable. The direct effect of professional values on professional competence was significant (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.193,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas the indirect effect through moral resilience was non\u2010significant (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.003, 95% CI [\u22120.005, 0.014]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Professional values appear to play an important role in promoting professional competence among critical care nurses, whereas moral resilience did not mediate this relationship. Strengthening ethics\u2010based education and professional value development may enhance competence in critical care practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Nurse educators and managers should prioritize the integration of professional values into nursing curricula, continuing professional development and clinical practice to strengthen professional competence among critical care nurses. Because moral resilience was not associated with competence, resilience\u2010supporting initiatives may be directed primarily at nurses' well\u2010being and retention rather than competence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70608","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:43:53Z","timestamp":1785404633000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Professional Values, Moral Resilience and Professional Competence in Critical Care Nursing: A Mediation Analysis"],"prefix":"10.1111","volume":"31","author":[{"given":"Shaimaa Mohamed","family":"Amin","sequence":"first","affiliation":[{"name":"Department of Community, Psychiatric, and Mental Health Nursing College of Nursing, Qassim University  Buraydah Saudi Arabia"},{"name":"Community Health Nursing Department Faculty of Nursing, Damanhour University  Damanhour Egypt"},{"name":"Nursing Services Department Qassim University Medical City  Buraydah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0185-859X","authenticated-orcid":false,"given":"Heba Emad","family":"El Gazar","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration and Education College of Nursing, Imam Mohammad Ibn Saud Islamic University (IMSIU)  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4298-1121","authenticated-orcid":false,"given":"Mohamed Ali","family":"Zoromba","sequence":"additional","affiliation":[{"name":"College of Nursing Prince Sattam Bin Abdulaziz University  Al\u2010Kharj Saudi Arabia"},{"name":"Psychiatric and Mental Health Nursing Department Faculty of Nursing, Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman Yasser","family":"Hammouda","sequence":"additional","affiliation":[{"name":"Department of Critical Care and Emergency Nursing Faculty of Nursing, Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5044-3668","authenticated-orcid":false,"given":"Haitham Mokhtar Mohamed","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Critical Care and Emergency Nursing Faculty of Nursing, Alexandria University  Alexandria Egypt"},{"name":"Medical Surgical Department College of Nursing, Jouf University  Sakaka Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2168-5195","authenticated-orcid":false,"given":"Suebsarn","family":"Ruksakulpiwat","sequence":"additional","affiliation":[{"name":"Department of Medical Nursing Faculty of Nursing, Mahidol University  Bangkok 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