Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN (Chair), Ann M. Mayo, DNSc, RN, FAAN, Dan Jordan, PhD


moral development, public health nursing, social justice


Public health nurses (PHNs) have the opportunity and professional obligation to be at the forefront of the fight to eliminate health disparities based on the practice principle of social justice. The overall purpose of this descriptive study was to explore the stage of the moral development in a convenience sample of practicing public health nurses (PHNs) and the differences in moral development stage across selected demographic variables (age, gender, race/ethnicity, level of entry into professional nursing, highest level of education, years practicing as an RN, years practicing in a public health department, self-identified political views, primary language, and region of California.) The sample consisted of 196 PHNs from four regions in the state of California. A demographic data survey and the Defining Issues Test 2 (DIT-2) developed by Rest et al. (1999) to identify the stage of moral development based on Kohlberg’s 6 stages were administered to participants. Descriptive statistics, t-test, one-way and two-way ANOVA were used to achieve the specific aims. Results demonstrated that participants scored at either stage 4 or 5 out of 6 possible stages. The following significant relationships were found between DIT scores and demographic variables. A significant relationship was noted between higher scores on the DIT-2 and being less than 50 years of age, having more liberal political views, and having English a primary language. Future studies are needed to accommodate a larger, more diverse sample size to compare gender and educational differences. Additional longitudinal studies examining the moral development and characteristics of registered nurses who self-select as career PHNs are indicated to examine the complex relationships between these factors.

Document Type

Dissertation: Open Access