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Laari L, Duma SE. Barriers to nurses health advocacy role. Nurs Ethics 2023; 30:844-856. [PMID: 36999769 DOI: 10.1177/09697330221146241] [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] [Indexed: 04/01/2023]
Abstract
BACKGROUND Speaking up to safeguard patients is a crucial ethical and moral obligation for nurses, but it is also a difficult and potentially dangerous component of nursing work. Health advocacy is gaining impetus in the medical literature, despite being hampered by barriers resulting in many nurses in Ghana remaining mute when faced with advocacy-required situations. We explored situations that thwart nurses from performing their health advocacy role. RESEARCH QUESTION What would cause nurses to take no action when they witness situations that require them to act as health advocates for their clients or communities? RESEARCH DESIGN An inductive, descriptive qualitative design was used to collect and analyse data on barriers that prevent nurses from practising their health advocacy role in Ghana. Individual one-on-one in-depth interviews were conducted using a semi-structured interview guide. The data were analysed using qualitative content analysis. PARTICIPANTS AND RESEARCH CONTEXT Twenty-four professional nurses and midwives registered with the Nursing and Midwifery Council were recruited from three regional hospitals in Ghana. These public hospitals were chosen from the upper, middle and coastal regions. ETHICAL CONSIDERATIONS The UKZN Ethics Review Committee in South Africa and the GHS Ethics Review Committee in Ghana both gave their approval for this study. FINDINGS Intrapersonal barriers, interpersonal barriers, and structural barriers emerged as major obstacles that nurses experience when performing their health advocacy role. CONCLUSIONS Barriers to health advocacy have undermined nurses' ability to function as health advocates and are preventing them from utilising their health advocacy position in nursing practise. Giving nursing students positive role models in the classroom and in the clinic can help them become more effective health advocates.
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Affiliation(s)
- Luke Laari
- School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sinegugu E Duma
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Heck LO, Carrara BS, Mendes IAC, Arena Ventura CA. Nursing and advocacy in health: An integrative review. Nurs Ethics 2022; 29:1014-1034. [PMID: 35172646 DOI: 10.1177/09697330211062981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The practice of health advocacy in nursing has been defined as a process aimed at promoting the independence and autonomy of users of health services, in addition to providing information on healthcare decision-making and offering support for decisions taken. ETHICAL CONSIDERATIONS Ethics approval was not required to conduct this review. AIM This integrative review aims to synthesize evidence in the literature on health advocacy in professional nursing practice. METHODS An integrative review methodology guided by Whittemore and Knalf was used. Studies were identified by conducting searches on PubMed, Scopus, Web of Science, CINAHL, and LILACS databases. Of 2179 records, 34 studies matched the inclusion criteria. RESULTS The main aspects involved in the practice of health advocacy by professional nurses are related to the ethical principles of the nursing profession, such as protecting patients seeking autonomy and care. Furthermore, the practice of health advocacy by nurses requires an empathetic attitude, responsibility, and assertive communication. CONCLUSION The diverse possibilities for the practice of advocacy synthesized in this study allow nurses to approach and become familiarized with the topic, being able to acquire and complement knowledge that will reflect on their professional practice in different work environments such as the educational field, in hospital practice, or basic health care.
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Jones D, Randall S, White D, Darley LM, Schaefer G, Wellington J, Thomas A, Lyle D. Embedding public health advocacy into the role of school-based nurses: addressing the health inequities confronted by vulnerable Australian children and adolescent populations. Aust J Prim Health 2020; 27:67-70. [PMID: 33264584 DOI: 10.1071/py20155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022]
Abstract
There has been a growth in Australian school-based nurses to address the inequities confronted by vulnerable students and school populations. Failure to address inequities can be evidenced in intergenerational poverty, poorer health and educational attainment and diminished life opportunities. School-based nurses are ideally located to advocate for public health policies and programs that address social determinants that detrimentally affect the health of school populations. However, school-based nurses can confront professional and speciality challenges in extending their efforts beyond individual student advocacy to effect change at the school population level. Guidance is required to redress this situation. This paper describes public health advocacy, the professional and speciality advocacy roles of school-based nurses and the barriers they confront in advocating for the health of school populations and strategies that can be used by key stakeholders to enhance school-based nursing public health advocacy efforts. School-based nurses who are competent, enabled and supported public health advocates are required if we are to achieve substantial and sustained health equity and social justice outcomes for vulnerable school populations.
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Affiliation(s)
- Debra Jones
- Broken Hill University Department of Rural Health, The University of Sydney, PO Box 457, Broken Hill, NSW 2880, Australia; and Corresponding author
| | - Sue Randall
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, The University of Sydney, Room A5.23, Building M02, 88 Mallett Street, Camperdown, NSW 2050, Australia
| | - Danielle White
- Broken Hill University Department of Rural Health, The University of Sydney, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Lisa-Marie Darley
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Gabrielle Schaefer
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Jennifer Wellington
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - Anu Thomas
- Far West Local Health District, PO Box 457, Broken Hill, NSW 2880, Australia
| | - David Lyle
- Broken Hill University Department of Rural Health, The University of Sydney, PO Box 457, Broken Hill, NSW 2880, Australia
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Kerppola J, Halme N, Perälä ML, Maija-Pietilä A. Empowering LGBTQ parents: How to improve maternity services and child healthcare settings for this community – ‘She told us that we are good as a family’. ACTA ACUST UNITED AC 2019. [DOI: 10.1177/2057158519865844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parental empowerment plays an essential role in maternity and child healthcare. Professionals delivering these services are ideally placed to improve parents' empowerment and well-being. This study aims to describe the supporting factors of parental empowerment from the perspective of self-identified lesbian, gay, bisexual, trans, or queer (LGBTQ) parents in Finland. The study was conducted using a qualitative inductive design, and 22 parents participated. Interviews were conducted between July and September of 2016 and analysed using inductive content analysis. Four categories emerged: 1) Parents' willingness to create socially recognized families, 2) Parenthood support, 3) Respectful partnership with all parents, and 4) Accessible services. Services were more empowering when parents were treated with dignity. This focus requires gender-neutral communication and a clear sense of security for parents. The findings indicate more education on LGBTQ-related issues is still needed.
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Affiliation(s)
- Jenni Kerppola
- Department of Nursing Science, University of Eastern Finland, Finland
| | - Nina Halme
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Anna Maija-Pietilä
- Department of Nursing Science, University of Eastern Finland, Finland
- Kuopio Social and Health Care Services, Finland
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Kerppola J, Halme N, Perälä ML, Maija-Pietilä A. Parental empowerment-Lesbian, gay, bisexual, trans or queer parents' perceptions of maternity and child healthcare. Int J Nurs Pract 2019; 25:e12755. [PMID: 31233257 DOI: 10.1111/ijn.12755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 01/14/2019] [Accepted: 05/09/2019] [Indexed: 11/28/2022]
Abstract
AIM Describe empowerment in maternity and child healthcare from the perspective of self-identified lesbian, gay, bisexual, trans, or queer (LGBTQ) parents in Finland. BACKGROUND Parental empowerment is a core aspect of maternity and child healthcare. However, knowledge about LGBTQ parents' perceptions about empowerment is still lacking. METHOD Qualitative design, 22 parents participating. The interviews were conducted in between July and September 2016 and analysed using inductive content analysis. FINDINGS Three core categories emerged as follows: (a) recognition and acknowledgment, particularly being treated as a parent, irrespective of any biological or legal ties to a child; (b) cooperation and interaction, such as working together, respecting parents' autonomy, and supporting parents' full involvement; (c) equitable care, such as parents' trust in services, but also a health-care professional's knowledge of a family's special needs. CONCLUSION Empowerment was perceived as the parents' sense of being visible and recognized as a parent. This recognition requires education and structures that are inclusive of all families. In addition, the language used by professionals was a key indicator for promoting positive feelings of comfort and safety for all families.
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Affiliation(s)
- Jenni Kerppola
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Nina Halme
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Anna Maija-Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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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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Cohen BE, Marshall SG. Does public health advocacy seek to redress health inequities? A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:309-328. [PMID: 26749000 DOI: 10.1111/hsc.12320] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2015] [Indexed: 06/05/2023]
Abstract
The public health (PH) sector is ideally situated to take a lead advocacy role in catalysing and guiding multi-sectoral action to address social determinants of health inequities, but evidence suggests that PH's advocacy role has not been fully realised. The purpose of this review was to determine the extent to which the PH advocacy literature addresses the goal of reducing health and social inequities, and to increase understanding of contextual factors shaping the discourse and practice of PH advocacy. We employed scoping review methods to systematically examine and chart peer-reviewed and grey literature on PH advocacy published from January 1, 2000 to June 30, 2015. Databases and search engines used included: PubMed, CINAHL, PsycINFO, Social Sciences Citation Index, Google Scholar, Google, Google Books, ProQuest Dissertations and Theses, Grey Literature Report. A total of 183 documents were charted, and included in the final analysis. Thematic analysis was both inductive and deductive according to the objectives. Although PH advocacy to address root causes of health inequities is supported theoretically and through professional practice standards, the empirical literature does not reflect that this is occurring widely in PH practice. Tensions within the discourse were noted and multiple barriers to engaging in PH advocacy for health equity were identified, including a preoccupation with individual responsibilities for healthy lifestyles and behaviours, consistent with the emergence of neoliberal governance. If the PH sector is to fulfil its advocacy role in catalysing action to reduce health inequities, it will be necessary to address advocacy barriers at multiple levels, promote multi-sectoral efforts that implicate the state and corporations in the production of health inequities, and rally state involvement to redress these injustices.
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Affiliation(s)
- Benita E Cohen
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Helen Glass Centre for Nursing, Winnipeg, Manitoba, Canada
| | - Shelley G Marshall
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Helen Glass Centre for Nursing, Winnipeg, Manitoba, Canada
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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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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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Dahl BM, Clancy A. Meanings of knowledge and identity in public health nursing in a time of transition: interpretations of public health nurses’ narratives. Scand J Caring Sci 2015; 29:679-87. [DOI: 10.1111/scs.12196] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Berit Misund Dahl
- University of Bergen Bergen Norway
- Faculty of Health Sciences Aalesund University College Ålesund Norway
| | - Anne Clancy
- Department of Health and Social Work School of Nursing Harstad University College Harstad Norway
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Swallow VM, Knafl K, Santacroce S, Campbell M, Hall AG, Smith T, Carolan I. An interactive health communication application for supporting parents managing childhood long-term conditions: outcomes of a randomized controlled feasibility trial. JMIR Res Protoc 2014; 3:e69. [PMID: 25472567 PMCID: PMC4275487 DOI: 10.2196/resprot.3716] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/17/2014] [Accepted: 11/01/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Families living with chronic or long-term conditions such as chronic kidney disease (CKD), stages 3-5, face multiple challenges and respond to these challenges in various ways. Some families adapt well while others struggle, and family response to a condition is closely related to outcome. With families and professionals, we developed a novel condition-specific interactive health communication app to improve parents' management ability-the online parent information and support (OPIS) program. OPIS consists of a comprehensive mix of clinical caregiving and psychosocial information and support. OBJECTIVE The purpose of this study was to (1) assess feasibility of a future full-scale randomized controlled trial (RCT) of OPIS in terms of recruitment and retention, data collection procedures, and psychometric performance of the study measures in the target population, and (2) investigate trends in change in outcome measures in a small-scale RCT in parents of children with CKD stages 3-5. METHODS Parents were recruited from a pediatric nephrology clinic and randomly assigned to one of two treatment groups: usual support for home-based clinical caregiving (control) or usual support plus password-protected access to OPIS for 20 weeks (intervention). Both groups completed study measures at study entry and exit. We assessed feasibility descriptively in terms of recruitment and retention rates overall; assessed recruitment, retention, and uptake of the intervention between groups; and compared family condition management, empowerment to deliver care, and fathers' involvement between groups. RESULTS We recruited 55 parents of 39 children (42% of eligible families). Of those, about three-quarters of intervention group parents (19/26, 73%) and control group parents (22/29, 76%) were retained through completion of 20-week data collection. The overall retention rate was 41/55 (75%). The 41 parents completing the trial were asked to respond to the same 10 questionnaire scales at both baseline and 20 weeks later; 10 scores were missing at baseline and nine were missing at 20 weeks. Site user statistics provided evidence that all intervention group parents accessed OPIS. Analysis found that intervention group parents showed a greater improvement in perceived competence to manage their child's condition compared to control group parents: adjusted mean Family Management Measure (FaMM) Condition Management Ability Scale intervention group 44.5 versus control group 41.9, difference 2.6, 95% CI -1.6 to 6.7. Differences between the groups in the FaMM Family Life Difficulty Scale (39.9 vs 36.3, difference 3.7, 95% CI -4.9 to 12.2) appeared to agree with a qualitative observation that OPIS helped parents achieve understanding and maintain awareness of the impact of their child's condition. CONCLUSIONS A full-scale RCT of the effectiveness of OPIS is feasible. OPIS has the potential to beneficially affect self-reported outcomes, including parents' perceived competence to manage home-based clinical care for children with CKD stage 3-5. Our design and methodology can be transferred to the management of other childhood conditions. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 84283190; http://www.controlled-trials.com/ISRCTN84283190 (Archived by WebCite at http://www.webcitation.org/6TuPdrXTF).
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Affiliation(s)
- Veronica M Swallow
- School of Nursing, Midwifery and Social Work, Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom.
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Hanafin S, Roe S, O'Dowd M, Barry C. Supporting the use of evidence in community nursing: a national strategic approach. Br J Community Nurs 2014; 19:496-501. [PMID: 25284186 DOI: 10.12968/bjcn.2014.19.10.496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
While there is an acceptance across all stakeholders that nursing practice should be informed by evidence, there is a substantial literature on the challenges this creates for nurses in the delivery of services. These challenges are accentuated for nurses in community settings, where accessible, up-to-date research evidence is more problematic because of the decentralised organisation and delivery of these services. Recognising this gap, and the consequent needs of its members, the Institute of Community Health Nursing (ICHN) in Ireland has commenced a national strategic development in this area. The purpose of the strategy is to actively support and facilitate public health and community nurses to provide services to individuals, families and communities that are based on the best available research evidence. This article provides a brief overview of the development and key components of the ICHN strategy.
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Affiliation(s)
- Sinéad Hanafin
- Visiting Research Fellow, School of Nursing and Midwifery, Trinity College Dublin
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Vuorenmaa M, Halme N, Åstedt-Kurki P, Kaunonen M, Perälä ML. Validity and reliability of the personnel version of the Family Empowerment Scale (FES) for the social, health and educational services in Finland. J Adv Nurs 2013; 70:927-36. [DOI: 10.1111/jan.12242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Maaret Vuorenmaa
- School of Health Sciences, Nursing Science; University of Tampere; Finnish Post Graduate School in Nursing Science; Finland
| | - Nina Halme
- National Institute for Health and Welfare; Helsinki Finland
| | - Päivi Åstedt-Kurki
- School of Health Sciences, Nursing Science; University of Tampere; Department of General Administration; Pirkanmaa Hospital District; Finland
| | - Marja Kaunonen
- School of Health Sciences, Nursing Science; University of Tampere; Department of General Administration; Pirkanmaa Hospital District; Finland
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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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Lin BYJ, Lin YK, Lin CC, Lin TT. Job autonomy, its predispositions and its relation to work outcomes in community health centers in Taiwan. Health Promot Int 2011; 28:166-77. [DOI: 10.1093/heapro/dar091] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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