Community Health Nursing Advocacy: A Concept Analysis

Ezeonwu, Mabel

doi:10.1080/07370016.2015.1024547

Cited by 13 publications

(14 citation statements)

References 50 publications

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“…The nurse-related antecedents of patient advocacy included job motivation, professional commitment, self-concept, having professional knowledge and skills of caring, recognizing the patients’ needs and preferences, and having skills to collaborate with patients and healthcare team. Ezeonwu 44 reported these as possessing good knowledge/information about the issue, having public health core competencies, and having strong working relations with the community. In addition, health organization–related factors such as the support of nurse managers, as nurses with positional power in the healthcare system, are essential for patient advocacy.…”

Section: Discussionmentioning

confidence: 99%

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Patient advocacy in nursing: A concept analysis

2019

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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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Section: Discussionmentioning

confidence: 99%

“…Confronting inappropriate policies or rules in the healthcare system, 7,32,42 identifying and correcting inequalities in delivery of health services, 32,43,44 facilitating access to community health services and health resources 45,46…”

Section: Mediatingmentioning

confidence: 99%

Patient advocacy in nursing: A concept analysis

2019

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“…Nurses are not only expected to advocate for clients at the bedside, but also for change within and across institutions, communities and societies [3]. Over the decades, nurses have advocated for people and communities in need, as reflected in the work of early nurse pioneers [4]. For instance, Florence Nightingale pursued environmental health advocacy and reforms, particularly for British soldiers during the Crimean War [5]; Lillian Wald advocated for home health nursing programs, the reform of child labour practices, and workplace protections in the United States of America (USA) [6];…”

mentioning

confidence: 99%

“…and Margaret Sanger fought for access to birth-control information and services for vulnerable and underserved populations in the USA [4]. These nurses not only advocated for vulnerable populations that they worked with, but also pushed for policy changes at the health systems level.…”

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confidence: 99%

“…Mardell [8] warned about these risks, stating that health advocacy may predispose the nurse to conflict with their medical colleagues and management, the employer, which can lead to job termination. However, 4 Winslow [9] argues that accepting the risks creates an ideal ethical basis for professional practice, with 'shying' away from health advocacy being comparable to medical negligence [10].…”

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confidence: 99%

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Barriers to nurses using their health advocacy role in nursing practice: A Ghanaian perspective

Laari

Duma

2020

Preprint

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Background: While nursing is complex, transforming and multi-faceted profession, its focus of providing a safe and caring environment that promotes client health and wellbeing has remained unchanged. To do this, nurses need to use their professional roles and skills to advocate for such an environment to provide quality nursing care. However, this can be difficult, as health advocacy is a contextually intricate and complex component of nursing practice.Speaking up to protect clients’ rights is a key ethical and moral mandate for nurses, with many remaining silent, even when presented with circumstances that require them to use their health advocacy role during their practice. The barriers to Ghanaian nurses using their role as health advocates for clients in the healthcare and communities’ settings are not well understood. Identifying and describing these barriers is important to inform contextually relevant strategies to empower nurses to use their health advocacy role in their daily nursing practice. Methods: An inductive descriptive qualitative design, based on Strauss and Corbin Grounded Theory, was used to collect and analyse data on barriers that prevent nurses from practising their health advocacy role in Ghana. Twenty-four professional nurses were recruited from three regional hospitals in Ghana and interviewed using a semi-structured interview guide. Data were analysed using Strauss and Corbin’s general guidelines and framework. Results: Three categories emerged as barriers to the health advocacy role practice by nurses, these being intra-personal, inter-personal and structural barriers.Conclusion: The barriers to nurses using their health advocacy role in practice are many and complex and have implications for nursing practice. Incorporating health advocacy into their curriculum may help address the barriers to nurses’ practice of health advocacy.

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Health advocacy role performance of nurses in underserved populations: A grounded theory study

Laari

Duma

2023

Nursing Open

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AimNurses' health advocacy (HA) role requires them to speak up for patients, clients, and communities in relation to healthcare. Various studies report the importance of the HA role of the nurse in healthcare. However, nurses' performance in this role is not clear yet. The present study aims to identify and explain how nurses perform their HA role in underserved populations.DesignQualitative grounded theory by Strauss and Corbin.MethodsData were gathered from three regional hospitals in Ghana with 24 registered nurses and midwives as participants through purposive and theoretical sampling techniques. Face‐to‐face in‐depth semi‐structured interviews were conducted from August 2019 to February 2020. The data were analysed using Strauss and Corbin's method and Nvivo software. The reporting follows Consolidated Criteria for Reporting Qualitative Research guidelines.FindingsThe HA role performance theory emerged from data with role enquiry, role dimension, role context, role influence, role reforms and role performance as building blocks. Data analysis showed that the main concerns of the nurses during their daily practice were mediating, speaking up, and negotiating. Among others, the intervening conditions were clientele influence and interpersonal barriers, whereas the outcome was a balance between role reforms and role performance.ConclusionAlthough some nurses proactively initiated biopsychosocial assessment and performed the HA role, most of them relied on clients' requests to perform the role. Stakeholders should prioritise critical thinking during training and intensify mentoring programmes in the clinical areas.Relevance for Clinical PracticeThe present study explains the process by which nurses perform their roles as health advocates in their daily activities as nurses. The findings can be used to teach and guide clinical practice for the HA role in nursing and other health care fields. There was no patient or public contribution.

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Community Health Nursing Advocacy: A Concept Analysis

Cited by 13 publications

References 50 publications

Patient advocacy in nursing: A concept analysis

Patient advocacy in nursing: A concept analysis

Barriers to nurses using their health advocacy role in nursing practice: A Ghanaian perspective

Health advocacy role performance of nurses in underserved populations: A grounded theory study

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