A Pilot Study of Selected Japanese Nurses’ Ideas on Patient Advocacy

Abstract

This pilot study had two purposes: (1) to review recent Japanese nursing literature nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support as necessary to enacting this role. Discussion on meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex.

Cultural characteristics of nursing practice in Japan

“…Japanese nurses typically show deference to doctors and colleagues by using an indirect communication style. As indicated in previous studies, group harmony is so highly valued in Japan that there is a strong prohibition against making negative expressions to doctors and co‐workers . On the other hand, in the neighbouring country of South Korea, open and frank or curt verbal communication is often observed between doctors and nurses, and among nurses.…”

Advocacia Do Paciente Na Enfermagem: Barreiras, Facilitadores E Possíveis Implicações

“…24,32 Therefore, the nature of the relationship with other members within the health staff is a powerful influence on the role nurses play as advocates, especially when values and goals concerning care delivery are shared, which imposes limitations on the medico-centric model and promotes patient-driven care, reinforcing the importance of multidisciplinary teams and effective communication. 24,33 Finally, the relationship between nurse and patient, effective communication, and the recognition of patients' needs, are essential for the effective practice of advocacy.…”

“…11,31 Therefore, the work environment has been considered the factor that most influences the efficacy of nursing actions related to patient advocacy. 4,6,29,32 The efficacy of patient advocacy efforts does not depend only on the nurses' traits, skills, and the knowledge they hold as advocates, but also on a receptive environment.29 Therefore, it is important to note that advocacy always occurs in a social environment so that the identification of the characteristics of such an environment that can facilitate patient advocacy is essential. 4,6,29,32 Among the elements that facilitate the practice of patient advocacy, the following are highlighted: nurses' knowledge and competencies, as well as their personal traits; the physician, as a member of the staff; the multidisciplinary teams; communication; the relationship with patients and families; a recognition of patient needs and desires; the nursing staff; and the head nurse.…”

Predicting Patient Advocacy Engagement: A Multiple Regression Analysis Using Data From Health Professionals in Acute-Care Hospitals

“…Hard-pressed health professionals often lack time and skills to provide effective patient advocacy (Davis et al, 2003;Donaldson, 2007;Faust, 2008;Herbert & Levin, 1996;Itzhaky et al, 2004;Foley, Minick & Kee, 2002;Weiss-Gal & Gal, 2009). Fear of disrupting working relationships with physicians, becoming unpopular, being labeled a troublemaker, and exposing oneself to attack are barriers to engagement in patient advocacy by some nurses (Sellin, 1995).…”

“…A search of the literature revealed theoretical and empirical publications on the topic of patient advocacy emanating from Australia, Canada, Finland, Japan, Sweden, Turkey, the United Kingdom, and the United States (Altun & Ersoy, 2003;Baldwin, 2003;Davis, Konishi, & Tashiro, 2003;Jansson, 2011;Josse-Ecklund, Petzäll, Sandin-Bojö, & Wilde-Larsson, 2013;Lennox et al, 2004;Rudolf, 2003;Seal, 2007;Stafford et al, 2010;Vaartio & Leino-Kilpi, 2005). The topic is of import to a range of health care professionals, moreover, including social workers (Craig & Muskat, 2013;Grady, Danis, Soeken, O'Donnell, Taylor, Farrar, & Ulrich, 2008;Herbert & Levin, 1996), nurses (Altun & Ersoy, 2003;Chafey et al, 1998;Hanks, 2008;Josse-Eklund et al, 2013;Mallik, 1997;Sellin, 1995;Vaartio & Leino-Kilpi, 2005), and physicians, including medical residents (Earnest et al, 2010;Grace, 2001;Lai, 2009;Rudolf et al, 1999).…”