Abstract:Background
Identifying facilitators of health advocacy role practice of nurses is important in reducing health disparities and inequities in Ghana. The struggle to reducing these disparities and inequities needs a combination of bravery, courage, and professionalism. In many instances, many barriers hinder nurses from practicing their health advocacy role in Ghana. Facilitators that motivate nurses who would perform this health advocacy role have not been identified and adequately described in Ghana.
Aim
To ex… Show more
“…These conditions emerged as ones that aided nurses in their HA roles. These facilitators included: (1) clientele influence, which relates to the readiness and openness of the client to receive assistance from the nurse; (2) the intrinsic influence of the nurse, where the nurse is self‐motivated and driven by empathy and compassion to speak out for the client; (3) professional influence, where the nurse sees advocacy as a professional obligation that links with years of experience and the educational background of the nurse; and (4) cultural influence relating to the nurse's religious background, where they perform advocacy as a religious obligation (Laari & Duma, 2021). For me, I see it as a religious obligation; yes, to speak up for someone and help them get what they couldn't get on their own is a privilege for me as a religious person (PN20, 33‐year‐old male).…”
Section: Resultsmentioning
confidence: 99%
“…Some conditions, such as clientele influence, professional influence, cultural influence, and intrinsic influence, promote the performance of the HA role (Laari & Duma, 2021). The presence of these influencers made it easier for the nurse to perform their HA role.…”
Section: Discussionmentioning
confidence: 99%
“…This is consistent with Bu and Jezewski (2007) findings that nurses safeguard patients' autonomy, act on behalf of patients, and champion social justice in the provision of health care. Some conditions, such as clientele influence, professional influence, cultural influence, and intrinsic influence, promote the performance of the HA role (Laari & Duma, 2021). The presence of these influencers made it easier for the nurse to perform their HA role.…”
Section: Discussionmentioning
confidence: 99%
“…This indicates a lack of clarity regarding the description of health advocacy (HA) and the definition of clinicians' scope of responsibility (Hubinette et al, 2017). Consequently, a description of the process of nurses' roles as health advocates is required, particularly in developing countries such as Ghana, a country with a fractured health system (Laari & Duma, 2021), where many rural folks live with an inequitable distribution of health facilities and poor social amenities.…”
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.
“…These conditions emerged as ones that aided nurses in their HA roles. These facilitators included: (1) clientele influence, which relates to the readiness and openness of the client to receive assistance from the nurse; (2) the intrinsic influence of the nurse, where the nurse is self‐motivated and driven by empathy and compassion to speak out for the client; (3) professional influence, where the nurse sees advocacy as a professional obligation that links with years of experience and the educational background of the nurse; and (4) cultural influence relating to the nurse's religious background, where they perform advocacy as a religious obligation (Laari & Duma, 2021). For me, I see it as a religious obligation; yes, to speak up for someone and help them get what they couldn't get on their own is a privilege for me as a religious person (PN20, 33‐year‐old male).…”
Section: Resultsmentioning
confidence: 99%
“…Some conditions, such as clientele influence, professional influence, cultural influence, and intrinsic influence, promote the performance of the HA role (Laari & Duma, 2021). The presence of these influencers made it easier for the nurse to perform their HA role.…”
Section: Discussionmentioning
confidence: 99%
“…This is consistent with Bu and Jezewski (2007) findings that nurses safeguard patients' autonomy, act on behalf of patients, and champion social justice in the provision of health care. Some conditions, such as clientele influence, professional influence, cultural influence, and intrinsic influence, promote the performance of the HA role (Laari & Duma, 2021). The presence of these influencers made it easier for the nurse to perform their HA role.…”
Section: Discussionmentioning
confidence: 99%
“…This indicates a lack of clarity regarding the description of health advocacy (HA) and the definition of clinicians' scope of responsibility (Hubinette et al, 2017). Consequently, a description of the process of nurses' roles as health advocates is required, particularly in developing countries such as Ghana, a country with a fractured health system (Laari & Duma, 2021), where many rural folks live with an inequitable distribution of health facilities and poor social amenities.…”
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.
“…Broadly described, health advocacy can be seen as either representational, where the professional represents the clients and speaks for them, or facilitational, where the professional facilitates the advocacy process on behalf of the client (Laari & Duma, 2021). The nursing profession is in a good position to perform any of these for their clients.…”
Nurses in Ghana believe that training, practise, practitioner and policy reforms are required for total nursing profession reform to be effective. Their views for role reformation in the nursing profession, which is currently needed, are not only academic but also clinically relevant in the pursuit of health equity and quality nursing care. We explored and described nurses’ views on their roles in the profession using data collected from 24 professional nurses in three regional hospitals in Ghana. Using an inductive descriptive qualitative design, data were gathered and analysed using a qualitative content analysis to describe the views of the nurses. Four major themes, namely practise reforms, practitioner reforms, training reforms and policy reforms have emerged in relation to role reformation in the nursing profession. Three strategic areas, practitioner attitudes, new training modalities and policy realignment, must be reviewed and remodelled for better positioning of the nursing profession before its entire role reformation.
Background Ghana has a large and growing burden of injury morbidity and mortality. There is a substantial unmet need for trauma surgery, highlighting a need to understand gaps in care. Methods We conducted 8 in-depth interviews with trauma care providers (surgeons, nurses, and specialists) at a large teaching hospital to understand factors that contribute to and reduce delays in the provision of adequate trauma care for severely injured patients. The study aimed to understand whether providers thought factors differed between patients that were enrolled in the National Health Insurance Scheme (NHIS) and those that were not. Findings were presented for the third delay (provision of appropriate care) in the Three Delays Framework.Results Key findings included that most factors contributing delays in the provision of adequate care were related to the costs of care, including for diagnostics, medications, and treatment for patients with and without NHIS subscription. Other notable factors included conflicts between providers, resource constraints, and poor coordination of care at the facility. Factors which reduce delays included advocacy by providers and informal processes for prioritizing critical injuries.
ConclusionWe recommend facility-level changes including increasing equity in access to trauma and elective surgery through targeted system strengthening efforts (e.g., a scheduled back-up call system for surgeons, anesthetists, other specialists, and nurses; designated operating theatres and staff for emergencies; training of staff), policy changes to simplify the insurance renewal and subscription processes, and future research on the costs and benefits of including diagnostics, medications, and common trauma services into the NHIS benefits package.
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