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Adjei MD, Diji AKA, Oduro E, Bam VB, Dzomeku VM, Budu IH, Lomotey AY, Sakyi R, Kyerew AA. Experiences of patient advocacy among nurses working in a resource constrained emergency department in Ghana. Int Emerg Nurs 2023; 67:101252. [PMID: 36801654 DOI: 10.1016/j.ienj.2022.101252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 11/28/2022] [Accepted: 12/23/2022] [Indexed: 02/19/2023]
Abstract
BACKGROUND Patient advocacy at the emergency department is stressful and cumbersome as a result of the increasing patient-to-nurse ratio and high patient turnovers. It is also unclear what patient advocacy entails and the experiences of patient advocacy in a resource-constrained emergency department. This is significant because advocacy underpins the care provided in the emergency department. AIM The primary aim of this study is to explore the experiences and underpinning factors that influence patient advocacy among nurses working in a resource constrained emergency department. METHODS A descriptive qualitative study was conducted among 15 purposively sampled ED nurses working at a resource-constrained secondary-level hospital facility. Study participants were individually interviewed via a recorded telephone conversation, after which the interviews were transcribed verbatim and inductively analyzed using the content analysis approach. The study participants described patient advocacy, situations in which they advocated for patients, the factors that motivated them and the challenges they encountered practicing patient advocacy. RESULTS Three major themes generated from the study included: "stories of advocacy", "motivating" factors and "challenging" factors. ED nurses understood patient advocacy and also advocated for patients in various instances. There were factors such as personal upbringing, professional training and religious training that motivated them and they were challenged by negative inter-professional experiences, patient and relatives' attitudes and healthcare system factors. CONCLUSION Participants understood patient advocacy and incorporated it into daily nursing care. Unsuccessful advocacy causes disappointment and frustrations. There were no documented guidelines on patient advocacy.
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Affiliation(s)
- Mabel Dorothy Adjei
- Nursing And Midwifery Training College, P.M.B 4, Sunyani Bono Region, Ghana; Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana.
| | | | - Evans Oduro
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
| | - Victoria Bubunyo Bam
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana.
| | | | - Isaac Hayford Budu
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Richard Sakyi
- Nursing And Midwifery Training College, P.M.B 4, Sunyani Bono Region, Ghana; Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
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Abstract
As health care professionals practice as a team, they take on responsibilities that are specific to their roles-responsibilities that are recognized and understood by the team and management as pertaining to their professional domain and expertise. Is advocacy part of the role of the nurse? Members of the nursing profession commonly maintain that it is, but is there a consensus on this issue, both within the profession and among other stakeholders? Is there a clear understanding of the term advocacy, and is this reflected in Codes of Practice and research into practice? An examination of significant documents and reports of empirical research reveals conflicting conceptions and opinions. There is potential for a common definition, but agreements need to be reached on whether advocacy is an essential function of nursing within the management of health care, and if so, what is advocacy's importance, focus, and limits.
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Khoshghadm M, Khanjari S, Haghani H, Asayesh H. The effect of combined external cold and vibration during immunization on pain and anxiety levels in children. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2021. [DOI: 10.4103/jnms.jnms_128_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Determining if nurses are involved in political action or politics: A scoping literature review. Appl Nurs Res 2020; 54:151279. [DOI: 10.1016/j.apnr.2020.151279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/19/2020] [Accepted: 04/29/2020] [Indexed: 11/22/2022]
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Salim N, Joshua R, AbuBaker N, Chehab F, Jose A. Effect of a Nursing In-Service Education Program on Nurses’ Knowledge and Attitudes towards Pain Management in a Governmental Hospital in the United Arab Emirates: Experimental Random Assignment Study. DUBAI MEDICAL JOURNAL 2019. [DOI: 10.1159/000503560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
Background: The concept of patient advocacy is still poorly understood and not clearly conceptualized. Therefore, there is a gap between the ideal of patient advocacy and the reality of practice. In order to increase nursing actions as a patient advocate, a comprehensive and clear definition of this concept is necessary. Research objective: This study aimed to offer a comprehensive and clear definition of patient advocacy. Research design: A total of 46 articles and 2 books published between 1850 and 2016 and related to the concept of patient advocacy were selected from six databases and considered for concept analysis based on Rodgers’ evolutionary approach. Ethical considerations: This study was approved by the Research Ethics Committee of Tarbiat Modares University. Findings: The attributes of patient advocacy are safeguarding (track medical errors, and protecting patients from incompetency or misconduct of co-workers and other members of healthcare team), apprising (providing information about the patient’s diagnosis, treatment, and prognosis, suggesting alternatives of healthcare, and providing information about discharge program), valuing (maintaining self-control, enabling patients to make decisions freely, maintaining individualization and humanity, maintaining patient privacy, and acting in the patients’ values, culture, beliefs, and preferences), mediating (liaison between patients, families, and healthcare professionals, being patients’ voice, and communicate patient preferences and cultural values to members of the healthcare team), and championing social justice in the provision of healthcare (confronting inappropriate policies or rules in the healthcare system, identifying and correcting inequalities in delivery of health services, and facilitating access to community health services and health resources). Discussion and conclusion: The analysis of this concept can help to develop educational or managerial theories, design instruments for evaluating the performance of nurses in patient advocacy, develop strategies for enhancing patient advocacy, and improve the safety and quality of nursing care in the community and healthcare system.
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Tomaschewski-Barlem JG, Lunardi VL, Barlem ELD, Silveira RSD, Ramos AM, Santos JMD. AÇÕES DOS ENFERMEIROS NO EXERCÍCIO DA ADVOCACIA DO PACIENTE: REVISÃO INTEGRATIVA. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-070720180000730014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: identificar as ações dos enfermeiros no exercício da advocacia do paciente, na literatura científica internacional publicada nos últimos dez anos. Método: revisão integrativa da literatura, cujos dados foram coletados na base de dados Cumulative Index to Nursing and Allied Health Literature e SAGE Journals Online, utilizando-se os descritores "patient advocacy" e "nursing", sendo encontrados 27 artigos. Resultados: como resultados, emergiram duas categorias: ações de advocacia exercidas por enfermeiros em diferentes nações e culturas; e ações de advocacia nos diferentes ambientes de atuação dos enfermeiros. Conclusão: acredita-se que os achados deste estudo poderão contribuir para a produção de pesquisas e conhecimentos em enfermagem, ampliando a compreensão da advocacia do paciente como um componente ético da prática dos enfermeiros.
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An Analysis of Italian Nurses' Approach to Patients' Pain: A Nationwide Online Survey. Pain Res Manag 2018; 2018:5165262. [PMID: 29849844 PMCID: PMC5937389 DOI: 10.1155/2018/5165262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/07/2018] [Accepted: 03/18/2018] [Indexed: 01/28/2023]
Abstract
Healthcare providers play a fundamental role in evaluating pain. Several issues about how nurses are educated remain unsolved. The aim of our study was to address how Italian nurses manage patients suffering from pain in daily practice. A cross-sectional survey was administered among Italian registered nurses. Data were collected using a 34-item questionnaire that had been previously validated during a pilot study. The lowest level of participation/education/information events was observed in the South (p=0.0001). A significant difference among the four areas was found in the department affiliation of responders (p=0.0001). Pain assessment at patients' admission was most frequent in the Northeast (32.9%), whereas the lowest frequency was found in the South (15.1%) (p=0.0001). The prevalence of nurses' knowledge of pain scales and their distribution in usual applications was similar in the Northwest and -east, and Central Italy, but lower in the South (p=0.0001). This study underlines the need for change in the clinical approach to pain treatment in healthcare. Pain assessment is a fundamental step for preparing individualized therapeutic plans, and nurses play a crucial role in improving the quality of life of suffering patients.
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Dadzie G, Aziato L, Aikins ADG. "We are the best to stand in for patients": a qualitative study on nurses' advocacy characteristics in Ghana. BMC Nurs 2017; 16:61. [PMID: 29162984 PMCID: PMC5686914 DOI: 10.1186/s12912-017-0259-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 11/07/2017] [Indexed: 01/08/2023] Open
Abstract
Background Patient advocacy has been identified as a core duty of the nurse, and certain nurse characteristics influence the performance of the role. However, these characteristics have not been adequately explored in Ghana. This study aimed to explore the perspectives of nurses about the characteristics of nurses that influence their role as patient advocates. Methods An exploratory descriptive qualitative study was conducted among 15 nurses from a regional hospital in Ghana. Purposive sampling was used to select participants and individual in-depth interviews were conducted in English using a semi-structured interview guide. The interviews were audio-taped and transcribed. Data analysis was done concurrently employing the principles of thematic analysis. Ethical approval was obtained for the study from the Noguchi Memorial Institute of Medical Research and the Ghana Health Service Ethical Review Committee. Results Themes generated revealed nurse traits which enhanced the advocacy role of nurses such as being empathetic, nurturing, ethical, assertive and persistent and nurse states which hindered the performance of the role such as fatigue and frustration. However, “compassionate” emerged as an additional nurse trait from this study. Out of empathy, participants availed themselves for patients to share their problems with them. In their nurturing roles, spending more time with patients and providing personal care fostered closeness which helped in identifying patients’ problems. Helping patients navigate the health system was also found. They perceived patient advocacy as a moral responsibility and identified good communication skills and determination to help patients get their problems solved as important in patient advocacy. Some participants also described compassion-based activities such as pleading on patients’ behalf, providing material and financial assistance, facilitating care and providing emotional support in their advocacy. However, heavy workload and lack of appreciation from patients were found to hinder the performance of the advocacy role. Conclusions We concluded that nurse characteristics that influence patient advocacy are comparable to those identified internationally such as being empathetic, assertiveness and fatigue. Enhancing these characteristics could help nurses overcome the negative states that undermine the patient advocacy role of nurses.
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Affiliation(s)
- Grace Dadzie
- Department of Adult Health, School of Nursing, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Accra, Ghana
| | - Lydia Aziato
- Department of Adult Health, School of Nursing, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Accra, Ghana
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Accra, Ghana
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Quinlan-Woodward J, Gode A, Dusek JA, Reinstein AS, Johnson JR, Sendelbach S. Assessing the Impact of Acupuncture on Pain, Nausea, Anxiety, and Coping in Women Undergoing a Mastectomy. Oncol Nurs Forum 2017; 43:725-732. [PMID: 27768139 DOI: 10.1188/16.onf.725-732] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To compare the effect of acupuncture to a standard-of-care (control) group on pain, nausea, anxiety, and ability to cope.
. DESIGN Pilot randomized, controlled trial.
. SETTING Abbott Northwestern Hospital, a large, urban, tertiary care hospital in Minneapolis, Minnesota.
. SAMPLE 30 adult women undergoing surgery for breast cancer.
. METHODS Women were randomly assigned to two hospital-based acupuncture treatments versus usual care after breast cancer surgery. Pain, nausea, anxiety, and the patient's ability to cope pre- and post-treatment were compared within and between groups at two different time points postoperatively.
. MAIN RESEARCH VARIABLES Mean change in pain, nausea, anxiety, and ability to cope by treatment group.
. FINDINGS Compared to women assigned to the control group, women who received acupuncture reported a statistically significant greater reduction in pain, nausea, anxiety, and increase in ability to cope on the first postoperative day and in pain on the second postoperative day following mastectomy surgery.
. CONCLUSIONS Acupuncture delivered postoperatively in the hospital after mastectomy can reduce the severity of symptoms experienced, as well as increase the patient's ability to cope with her symptoms. However, before implementation as a standard of care, further research needs to be conducted.
. IMPLICATIONS FOR NURSING Acupuncture adds a nonpharmacologic intervention for symptom management in women undergoing mastectomies for breast cancer.
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Affiliation(s)
| | - Autumn Gode
- Penny George Institute for Health and Healing
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Dequeker S, Van Lancker A, Van Hecke A. Hospitalized patients’ vs. nurses’ assessments of pain intensity and barriers to pain management. J Adv Nurs 2017; 74:160-171. [DOI: 10.1111/jan.13395] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Sara Dequeker
- Department of Public Health; Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Ghent Belgium
| | - Aurélie Van Lancker
- Department of Public Health; Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Ghent Belgium
| | - Ann Van Hecke
- Department of Public Health; Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Ghent Belgium
- Ghent University Hospital; Ghent Belgium
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Pain Intensity in Hospitalized Adults: A Multilevel Analysis of Barriers and Facilitators of Pain Management. Nurs Res 2017; 65:290-300. [PMID: 27362515 DOI: 10.1097/nnr.0000000000000160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite an enhanced interest and evolution in pain management, prevalence remains high. Interventions to optimize pain-related care can only be effective if barriers are identified and accounted for. AIM To assess pain intensity and examine its association with patient- (including health literacy defined in this study as "requiring help to read health information"), nurse-, and system-related (including social capital defined as "the importance of network and norms at work") barriers/facilitators to pain management. METHODS A two-center, cross-sectional study was performed between October 2012 and April 2013. The study included patients and nurses of 39 noncritical wards of two hospitals in Belgium. Patients who were 18 years of age or older and without impaired cognition or consciousness were eligible to take part. All nurses working in the included ward were invited to participate. Pain intensity and patient-related barriers were collected by a structured and standardized questionnaire, completed in dialogue with the patient. Nurses completed the questionnaire on the nurse- and system-related barriers and the social capital scale. Multilevel analysis was used to analyze the data because of the hierarchical structure of the data. RESULTS The average pain of all patients across all wards on a 0-10 scale was 2.2 (SD = 3.6). The multilevel analysis indicates that pain intensity can be explained by variables at patient and ward levels. A significant independent association was found between higher pain intensity and younger age, receiving pain medication, the conviction of patients that pain medication does not improve pain, inadequate health literacy in patients, nurses without advanced education, and nurse's concerns about side effects. Social capital did not emerge as predictor of pain intensity. DISCUSSION Patient and nurse level factors should be taken into account in hospitals when setting up strategies to improve pain management.
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Abstract
As health care professionals practice as a team, they take on responsibilities that are specific to their roles-responsibilities that are recognized and understood by the team and management as pertaining to their professional domain and expertise. Is advocacy part of the role of the nurse? Members of the nursing profession commonly maintain that it is, but is there a consensus on this issue, both within the profession and among other stakeholders? Is there a clear understanding of the term advocacy, and is this reflected in Codes of Practice and research into practice? An examination of significant documents and reports of empirical research reveals conflicting conceptions and opinions. There is potential for a common definition, but agreements need to be reached on whether advocacy is an essential function of nursing within the management of health care, and if so, what is advocacy's importance, focus, and limits.
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Tomaschewski-Barlem JG, Lunardi VL, Barlem ELD, Silveira RSD, Ramos AM, Piexak DR. ADVOCACIA DO PACIENTE NA ENFERMAGEM: BARREIRAS, FACILITADORES E POSSÍVEIS IMPLICAÇÕES. TEXTO & CONTEXTO ENFERMAGEM 2017. [DOI: 10.1590/0104-0707201700010001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: realizar uma reflexão acerca das barreiras, facilitadores e possíveis implicações do exercício da advocacia do paciente pelos enfermeiros. Resultados: essa reflexão resulta de uma leitura minuciosa da literatura internacional acerca da advocacia do paciente, acrescida de estudos nacionais e internacionais acerca do sofrimento moral e suas relações com o exercício da advocacia. Conclusão: as barreiras diante do exercício da advocacia do paciente são notórias, pautando-se na própria estrutura organizacional das instituições de saúde e nas relações de poder entre equipes médica e de enfermagem, desafiando e desencorajando os enfermeiros a agirem de acordo com seus conhecimentos e consciências, implicando, muitas vezes, em situações reconhecidas como de sofrimento moral.
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Water T, Ford K, Spence D, Rasmussen S. Patient advocacy by nurses – past, present and future. Contemp Nurse 2016; 52:696-709. [DOI: 10.1080/10376178.2016.1235981] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tineke Water
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Katrina Ford
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Deb Spence
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Shayne Rasmussen
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
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Abstract
A correlation study design was used to examine the interrelatedness of power, attitudes regarding intermittent fetal monitoring, and perceived barriers to research utilization with a labor and delivery nurse’s attitude toward patient advocacy using the conceptual framework of the science of unitary human beings. The linear combination of the three independent variables was significantly correlated to attitude toward patient advocacy and power as knowing participation in change had the greatest impact on patient advocacy.
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Mędrzycka-Dąbrowska WA, Dąbrowski S, Basiński A, Pilch D. Perception of barriers to postoperative pain management in elderly patients in Polish hospitals with and without a "Hospital Without Pain" Certificate - a multi-center study. Arch Med Sci 2016; 12:808-18. [PMID: 27478463 PMCID: PMC4947611 DOI: 10.5114/aoms.2015.54768] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/15/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In 2005-2050, the global population of elderly people will increase by 12%. This will lead to increased demand for such healthcare services as hospital care or surgical interventions. Pain in elderly patients is a substantial problem. Insufficiently controlled postoperative pain continues to be a widespread phenomenon. Pain management in Poland is usually based on nursing care supervised by an anesthesiologist or surgeon. The aim of the study was to identify barriers to effective nurse-controlled analgesia in postoperative pain management in elderly patients in hospitals with and without a Hospital Without Pain certificate. MATERIAL AND METHODS The study was conducted after the approval of the study protocol by the Independent Bioethics Committee for Scientific Research of the Medical University of Gdansk. The study project was multicenter and was conducted from July 2012 to December 2013. The research was questionnaire-based and used the Polish version of the Nurses' Perceived Obstacles to Pain Assessment and Management Practices questionnaire. The project included 676 nurses from hospitals awarded the Hospital Without Pain Certificate and 926 respondents from hospitals without the certificate. RESULTS After calculating the overall average result in particular groups, healthcare system-related problems were first among the barriers hindering pain management in elderly patients M = (C = 3.81, N/C = 3.87). Patient-related barriers were second (M = 3.77). Physician- and nurse-related barriers took the subsequent positions, with very similar scores M = (C = 3.47, N/C = 3.44) and M = (C = 3.46, N/C = 3.44), respectively. CONCLUSIONS The greatest barriers to pain management in elderly patients are related to the healthcare system. Nurses from Hospital Without Pain certified hospitals devoted significantly more time to relieving pain through non-pharmacological methods.
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Affiliation(s)
| | - Sebastian Dąbrowski
- Anesthesiology and Intensive Care Unit, District Health Center, Malbork, Poland
| | - Andrzej Basiński
- Clinical Emergency Department, Medical University of Gdansk, Gdansk, Poland
| | - Dorota Pilch
- Nursing Department, Pomeranian University, Szczecin, Poland
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Johnson JR, Rivard RL, Griffin KH, Kolste AK, Joswiak D, Kinney ME, Dusek JA. The effectiveness of nurse-delivered aromatherapy in an acute care setting. Complement Ther Med 2016; 25:164-9. [DOI: 10.1016/j.ctim.2016.03.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 03/01/2016] [Accepted: 03/05/2016] [Indexed: 10/22/2022] Open
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Tomaschewski-Barlem JG, Lunardi VL, Barlem ELD, Ramos AM, Silveira RS, Vargas MADO. COMO ENFERMEIROS VÊM EXERCENDO A ADVOCACIA DO PACIENTE NO CONTEXTO HOSPITALAR? - UMA PERSPECTIVA FOUCAULTIANA. TEXTO & CONTEXTO ENFERMAGEM 2016. [DOI: 10.1590/0104-0707201600002560014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objetivou-se conhecer como os enfermeiros vêm exercendo a advocacia do paciente no contexto hospitalar. Realizou-se uma pesquisa qualitativa, do tipo exploratório-descritiva, em um hospital universitário do Sul do Brasil. Foram respondentes da pesquisa 16 enfermeiros, selecionados por meio de amostragem não probabilística, do tipo bola de neve. Para a coleta de dados, foram realizadas entrevistas semiestruturadas, gravadas e transcritas, analisadas mediante análise textual discursiva e referencial teórico foucaultiano. Como resultados, emergiram duas categorias: a coragem de verdade: o exercício da advocacia mediado pelo diálogo franco; estratégias de resistência para o exercício da advocacia do paciente. Conclui-se que a estabilidade profissional e o apoio da instituição contribuem para que os enfermeiros se sintam encorajados a exercer a advocacia, mesmo diante de situações de difícil enfrentamento, utilizando-se da parrésia e de estratégias de resistência para garantir a defesa efetiva dos interesses dos pacientes.
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Barlem JGT, Lunardi VL, Barlem ELD, Ramos AM, Figueira AB, Fornari NC. Nursing beliefs and actions in exercising patient advocacy in a hospital context. Rev Esc Enferm USP 2015; 49:811-8. [DOI: 10.1590/s0080-623420150000500015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 05/05/2015] [Indexed: 11/22/2022] Open
Abstract
AbstractOBJECTIVEAnalyzing beliefs and actions of nurses in exercising patient advocacy in a hospital context.METHODA quantitative cross-sectional exploratory and descriptive study, conducted with 153 nurses from two hospitals in southern Brazil, one public and one philanthropic, by applying Protective Nursing Advocacy Scale - Brazilian version. Data were analyzed using descriptive statistics and analysis of variance.RESULTSNurses believe they are advocating for patients in their workplaces, and agree that they should advocate, especially when vulnerable patients need their protection. Personal values and professional skills have been identified as major sources of support for the practice of advocacy.CONCLUSIONNurses do not disagree nor agree that advocating for patients in their working environments can bring them negative consequences. It is necessary to recognize how the characteristics of public and private institutions have helped or not helped in exercising patient advocacy by nurses.
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Nogario ACD, Barlem ELD, Tomaschewski-Barlem JG, Lunardi VL, Ramos AM, Oliveira ACCD. Nursing Actions in practicing inpatient advocacy in a Burn Unit. Rev Esc Enferm USP 2015; 49:580-8. [DOI: 10.1590/s0080-623420150000400007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVEUnderstanding nursing actions in the practice of inpatient advocacy in a burn unit.METHODA single and descriptive case study, carried out with nurses working in a referral burn center in southern Brazil. Data were collected through focus group technique, between February and March 2014, in three meetings. Data was analysed through discursive textual analysis.RESULTSThree emerging categories were identified, namely: (1) instructing the patient; (2) protecting the patient; and (3) ensuring the quality of care.CONCLUSIONSThis study identified that the nurses investigated exercised patient advocacy and that the recognition of their actions is an advance for the profession, contributing to the autonomy of nurses and the effectiveness of patients' rights and social justice.
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Tomaschewski-Barlem JG, Lunardi VL, Barlem ELD, da Silveira RS, Dalmolin GDL, Ramos AM. Cross-cultural adaptation and validation of the Protective Nursing Advocacy Scale for Brazilian nurses. Rev Lat Am Enfermagem 2015; 23:669-76. [PMID: 26444169 PMCID: PMC4623730 DOI: 10.1590/0104-1169.0214.2602] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 02/21/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to adapt culturally and validate the Protective Nursing Advocacy Scale for Brazilian nurses. METHOD methodological study carried out with 153 nurses from two hospitals in the South region of Brazil, one public and the other philanthropic. The cross-cultural adaptation of the Protective Nursing Advocacy Scale was performed according to international standards, and its validation was carried out for use in the Brazilian context, by means of factor analysis and Cronbach's alpha as measure of internal consistency. RESULTS by means of evaluation by a committee of experts and application of pre-test, face validity and content validity of the instrument were considered satisfactory. From the factor analysis, five constructs were identified: negative implications of the advocacy practice, advocacy actions, facilitators of the advocacy practice, perceptions that favor practice advocacy and barriers to advocacy practice. The instrument showed satisfactory internal consistency, with Cronbach's alpha values ranging from 0.70 to 0.87. CONCLUSION it was concluded that the Protective Nursing Advocacy Scale - Brazilian version, is a valid and reliable instrument for use in the evaluation of beliefs and actions of health advocacy, performed by Brazilian nurses in their professional practice environment.
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Jansson BS, Nyamathi A, Heidemann G, Duan L, Kaplan C. Predicting Patient Advocacy Engagement: A Multiple Regression Analysis Using Data From Health Professionals in Acute-Care Hospitals. SOCIAL WORK IN HEALTH CARE 2015; 54:559-581. [PMID: 26317762 DOI: 10.1080/00981389.2015.1054059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Although literature documents the need for hospital social workers, nurses, and medical residents to engage in patient advocacy, little information exists about what predicts the extent they do so. This study aims to identify predictors of health professionals' patient advocacy engagement with respect to a broad range of patients' problems. A cross-sectional research design was employed with a sample of 94 social workers, 97 nurses, and 104 medical residents recruited from eight hospitals in Los Angeles. Bivariate correlations explored whether seven scales (Patient Advocacy Eagerness, Ethical Commitment, Skills, Tangible Support, Organizational Receptivity, Belief Other Professionals Engage, and Belief the Hospital Empowers Patients) were associated with patient advocacy engagement, measured by the validated Patient Advocacy Engagement Scale. Regression analysis examined whether these scales, when controlling for sociodemographic and setting variables, predicted patient advocacy engagement. While all seven predictor scales were significantly associated with patient advocacy engagement in correlational analyses, only Eagerness, Skills, and Belief the Hospital Empowers Patients predicted patient advocacy engagement in regression analyses. Additionally, younger professionals engaged in higher levels of patient advocacy than older professionals, and social workers engaged in greater patient advocacy than nurses. Limitations and the utility of these findings for acute-care hospitals are discussed.
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Affiliation(s)
- Bruce S Jansson
- a School of Social Work , University of Southern California , Los Angeles , California , USA
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Asadi-Noghabi F, Tavassoli-Farahi M, Yousefi H, Sadeghi T. Neonate pain management: what do nurses really know? Glob J Health Sci 2014; 6:284-93. [PMID: 25168978 PMCID: PMC4825505 DOI: 10.5539/gjhs.v6n5p284] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 06/05/2014] [Accepted: 07/14/2014] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this study was to determine knowledge, attitude, and performance vis-à-vis pain management in neonates by nurses working in neonatal units in Bandar Abbas University hospitals. METHOD This descriptive and analytical study was executed from March-August 2011 in the neonatal units and NICU in Bandar Abbas educational hospitals. A total of 50 nurses and nurse assistants working in the neonatal units participated in the study. The data collection tool was a structured questionnaire investigating knowledge (28 items), attitude (20 items) and practices (5 items). Data was analyzed using descriptive statistical tests (Frequency, Mean and Standard deviation tables) and inferential statistic (T-test, Variance analysis). RESULTS The knowledge scores of participants had a mean value of 13.51 (48.2%) out of 28. The mean score of attitude was 54.22 out of 60 and the mean score for the nurses' level of practices was found to be 4.22 out of 10. There was a significant relationship between nurses' knowledge scores and the level of education, i.e. nurses with more education had more knowledge. CONCLUSION Results showed that the nurses had poor performance regarding the assessment, measurement, and relief of pain. However, they showed positive attitudes towards pain control in neonates.
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Bice AA, Gunther M, Wyatt T. Increasing Nursing Treatment for Pediatric Procedural Pain. Pain Manag Nurs 2014; 15:365-79. [DOI: 10.1016/j.pmn.2012.06.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 06/07/2012] [Accepted: 06/07/2012] [Indexed: 11/28/2022]
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Cho KC. Review on the Theory of Nursing Client Advocacy and Its Applications in Child Healthcare. CHILD HEALTH NURSING RESEARCH 2013. [DOI: 10.4094/chnr.2013.19.3.149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kap-Chul Cho
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
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Josse-Eklund A, Petzäll K, Sandin-Bojö AK, Wilde-Larsson B. Swedish registered nurses' and nurse managers' attitudes towards patient advocacy in community care of older patients. J Nurs Manag 2012; 21:753-61. [DOI: 10.1111/j.1365-2834.2012.01453.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2012] [Indexed: 11/29/2022]
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