Emotional Exhaustion, Moral Sensitivity, and Happiness Among Nurses in Cardiac Wards: A Multicenter Cross-Sectional Study.

AIM(S): To examine associations of emotional exhaustion and moral sensitivity with happiness among nurses in cardiac wards.

BACKGROUND

Cardiac nursing involves sustained emotional demands and ethical challenges, yet their relative associations with happiness are unclear.

METHOD(S): This multicenter cross-sectional study randomly sampled 220 nurses from four Iranian teaching hospitals. Validated questionnaires assessed happiness, moral sensitivity, and emotional exhaustion. Pearson correlations were primary, with Spearman sensitivity analyses. HC3-robust multivariable linear regression estimated adjusted associations.

RESULTS

Happiness was inversely correlated with emotional exhaustion (r = -0.409, 95% CI -0.515 to -0.291) and moral sensitivity (r = -0.245, 95% CI -0.374 to -0.106). In the complete-case model (n = 181), emotional exhaustion remained clearly associated with lower happiness (B = -0.184, 95% CI -0.262 to -0.107), whereas the adjusted moral sensitivity association was smaller and less precise (B = -0.069, 95% CI -0.140 to 0.002). Sensitivity analyses supported the stability of the emotional exhaustion estimate.

CONCLUSION(S): Emotional exhaustion showed the stronger and more consistent association with happiness; however, findings should be interpreted considering the modest reliability of the happiness measure and the cross-sectional design, which limits causal inference.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should address modifiable work conditions and recovery opportunities while preserving organizational support for ethical practice.