Iranian Nurses' Attitudes and Perception towards Patient Advocacy

Patient's best interest as viewed by nursing students

BACKGROUND

In recent years, patient advocacy has emerged as a prominent concept within healthcare. How nursing students decide what is best for their patients is not well understood.

OBJECTIVE

The objective is to examine nursing students' views on doing what is best for patients during their clinical experiences and how they seek to establish patient interests when providing care. Research questions guiding the interview were as follows: (1) What are nursing students' perceptions of patient interests? (2) What factors influence nursing students' perceptions of advocating for patient's interests?

RESEARCH DESIGN

Qualitative descriptive research using thematic analysis.

PARTICIPANTS AND RESEARCH CONTEXT

Data was collected through individual online interviews with nine nursing students with clinical experience.

ETHICAL CONSIDERATIONS

The study was approved by the University Research Ethics Committee. Participants provided digital informed consent.

RESULTS

The students asserted that they are able to understand the patients' interests by placing emphasis on the patients' needs. They believe that it is crucial to adopt a collaborative strategy for the provision of care to meet these requirements. In addition, some of them expressed concern over the most effective methods of advocating for the interests of patients. Three themes were identified. (1) Focussing on patient needs first, (2) taking a collective approach, and (3) learning how to advocate.

CONCLUSIONS

Students understand and value the ethical commitments associated with advocating for the patient's best interest by considering factors such as prioritising the patient's needs, adopting a strategy that involves everyone, and acquiring the ability to undertake the advocacy role. Additionally, nursing education strategies in clinical contexts require additional study to inspire students to do what is in their patient's best interests.

A Pre-experimental Study to Assess the Effectiveness of Planned Teaching Program on Knowledge and Expressed Practices Regarding Selected Obstetrical Emergencies Among Staff Nurses in Selected Hospitals of Shimla District, Himachal Pradesh

Background and objective Good health and well-being occupy the third position among 17 sustainable development goals designed by the United Nations. The key to reducing maternal and newborn morbidity and mortality is competent and skilled birth attendance. The objectives of this study were to assess and compare the pre-test and post-test knowledge and expressed practices regarding selected obstetrical emergencies among staff nurses; to develop and determine the effectiveness of planned teaching programs on selected obstetrical emergencies among staff nurses; and to find out the correlation between knowledge and expressed practices regarding selected obstetrical emergencies. Materials and methods A pre-experimental study was conducted for a period of one month in 2019 among 60 staff nurses in selected hospitals through a validated tool/questionnaire, which was piloted on six staff nurses prior to starting the study. Data were collected using a structured knowledge questionnaire and expressed practices checklist. Results Of note, 70% of participants had General Nursing and Midwifery (GNM) as a professional qualification. The majority (51.7%) had one to five years of work experience; 46.7% of staff nurses had good knowledge in the pre-test assessment and 95% had good knowledge in the post-test evaluation. Significantly, 80% showed good expressed practices in the pre-test and 96.7% revealed good expressed practices in the post-test regarding selected obstetrical emergencies. In the pre-test, there was a significant association between the sociodemographic variables (age and work experience) with expressed practices, while that was not the case with post-test expressed practices. No significant association was found between pre- and post-test knowledge and selected demographic variables. There was a significant difference between pre-test and post-test knowledge and expressed practices score (mean pre- and post-test knowledge score: 18.82 vs. 25.43, p<0.001; mean pre- and post-test expressed practices score: 14.43 vs. 16.30, p<0.001). Conclusion Based on our findings, the planned teaching program is effective in improving the knowledge and expressed practices of staff nurses regarding selected obstetrical emergencies.

Perception and opinion of nursing faculties regarding advocacy role: A qualitative research

BACKGROUND

The nursing literature emphasizes that there are still inadequacies, differences, and inconsistencies in the definition of nurses' advocacy role, and that nursing education plays an important role in educating nurses for patient advocacy.

OBJECTIVE

The aim of this descriptive qualitative study is to determine nurse academics' perception of and opinions about advocacy in nursing.

METHODS

The study group consisted of five academics working as nurse educators in a university. A questionnaire and focus group interview methods were used to collect the data.

RESULTS

A framework that consisted of three categories, including the scope of advocacy in nursing; today's health system and advocacy; nurses' foundation/knowledge base for an advocacy role was set by considering the opinions of participants.

CONCLUSION

It was emphasized that nurse academics regarded advocacy as an ethical obligation and saw it from a broad perspective including social justice, that changing health system has increased the importance of advocacy role in nursing, that the personality characteristics of prospective nurses are important, and that nursing education should be improved in terms of advocacy.

Impact of planned teaching program on the attitude of nurses with regard to patient rights in two multispecialty teaching hospitals in India

BACKGROUND

The attitude of nurses with regard to patients' rights bears greater influence on its practice in the health-care settings. As health-care organizations grow toward standardization, positive changes in the attitude of health-care professionals are demanding.

OBJECTIVES

The objectives of this study were to assess the attitude of nurses with regard to patient rights in two teaching hospitals, to devise a training program on patient rights for nurses, and to compare the impact of training with regard to patient rights on the attitude of nurses in two teaching hospitals.

MATERIALS AND METHODS

This quasi-experimental study with one-group pre- and post-test research design for a sample of 200 nurses was carried out during the year 2017 at two multispecialty hospitals in India. The sample size was selected based on convenience sampling method. For the pretest, attitude was measured on a 5-point Likert scale through a questionnaire containing 27 items. Small-group teaching method was used to train nurses in groups of 8-10. Posttest was done through the same attitude questionnaire 1 week after the training program.

RESULTS

In both the hospitals, the nurses had a favorable attitude toward patient rights before the training program; after training, majority of the nurses had the most favorable attitude toward patient rights. A statistically significant difference was observed in the attitude of nurses with regard to patient rights within the hospitals, before and after training nurses on patient rights (P < 0.001).

CONCLUSIONS

Health-care organizations require developing planned teaching programs for nursing care professionals in order to influence their knowledge and attitude on patient rights. Their positive attitude toward patient rights leads to improved outcomes and effective nursing care practices.

Registered Nurses' description of patient advocacy in the clinical setting

AIM

To provide Registered Nurses description of patient advocacy in the clinical setting.

DESIGN

A qualitative approach with descriptive study design was used to meet the set objective.

METHODS

Purposive sampling was used to select the study participants. Through semi-structured interview, data were collected from 25 participants, transcribed and analysed using qualitative content analysis.

RESULTS

The Registered Nurses described patient advocacy as promoting patient safety and quality care which includes the following: protecting patients, being patients' voice, provision of quality care and interpersonal relationship as well as educating patients. The nurses had adequate understanding of patient advocacy and were willing to advocate for patients. There is, however, a need to research into barriers to patient advocacy in the clinical setting. This study made significant contribution to the understanding of patient advocacy and its positive effect on the provision of quality patient care.

Changes in ethical attitudes of clinical laboratory professionals after teaching them ethics using three different methods

Background: Ethical attitudes and personal values play a significant role in clinical decision-making; however, they have been given limited attention by professionals in laboratory medicine. Studies suggest that individual attitudes are not static and that professionals learn ethical attitudes through a variety of formal and informal learning methods. This study was conducted to investigate changes in the attitudes of clinical laboratory professionals after teaching them ethics and to compare the results among the 3 groups. Methods: Four topics were selected in the field of medical laboratory ethics as teaching materials. A questionnaire including 22 items was designed and validated. Teaching sessions for the 3 study groups were held. All 65 clinical laboratory participants completed the questionnaire before and after the classes. Paired t test and ANOVA were used to assess differences among groups. Results: Significant differences were found in the mean scores of ethical attitudes before and after the educational intervention among the lecture-based teaching group (p=0.016), problem-based learning group (p=0.001), and all participants (p=0.004). However, no significant difference was found between the mean scores before and after the intervention in role-playing group (p=0.623). Conclusion: Teaching by lecturing and problem-based learning was more effective to change ethical attitude of the laboratory professionals than the role-playing method. Thus, we suggest the implementation of teaching ethics using these methods to improve the ethical attitude of clinical laboratory professionals.

How organizational learning is associated with patient rights: a qualitative content analysis

Background

Nowadays, patient rights, particularly receiving favorable health care based on modern knowledge, informed consent, and privacy, are important issues in health care delivery systems. Organizational learning is considered an important factor influencing health care quality and patient rights. However, there is little evidence regarding this issue.

Objective

The present study was conducted to explore the role of organizational learning in patient rights from clinical nurses’ viewpoint.

Design

This qualitative study was conducted through conventional content analysis. In total, 18 nurses who met the inclusion criteria participated in this study through purposive sampling with maximum variation. Data were gathered through 20 in-depth, semi-structured interviews, which continued until data saturation was achieved. Data collection also included constant and simultaneous comparative analyses.

Results

Data analysis led to four major themes: conservation of patient safety, providing favorable care, being the patient's advocate, and informing the patients. All the participants believed that organizational learning could play a vital role in respecting patient rights and interests.

Conclusions

Participants believed that their efforts to conduct organizational learning, tried to improve respecting the patient rights via conservation of patient safety, trying to improve quality of care, being an advocate, and informing the patient. It would be appreciable if nursing managers honored the commitment of the nurses for learning, highlight their role as defenders of patient rights, and encourage them to initiate organizational learning.