Wednesday, July 11, 2007
This presentation is part of : Global Collaboration and Health Issues
Nursing and Patient Advocacy: A Grounded Theory
Reza Negarandeh, PhD, community health nursing, tehran university of medical sciences, tehran, Iran
Learning Objective #1: understand how iranian nurses enact in patient advocacy role
Learning Objective #2: introduce developed patient advocay model

Background: nursing as an independent profession has its unique values, characteristics and practices, one of which is advocacy. An examination of advocacy in the nursing literature reflects broad and sometimes different perspective. This study is an attempt to explain the nurses’ patient advocacy role and develop a model for this issue. Method: Participants were 24 Iranian registered nurses working in a large university hospital in Tehran, Iran. Semi-structured interview were used for data collection. All recorded interviews were transcribed verbatim and simultaneously, constant comparative analysis was used according to the Strauss and Corbin method. Results: Patient vulnerability necessitates nurses’ advocacy as a role being acknowledged by them as a professional role. In reply to the question, what patient advocacy is, nurses identified informing and educating; valuing and respecting; physical, emotional and financial supporting; protecting; and promoting continuity of care as means of advocacy. There are some factors like powerlessness, lack of support & code of ethics and risk of advocacy as barriers to advocacy. Regarding factors facilitating nurses’ activities towards patient advocacy; it was found that the many factors such as nurse-patient relationship, nurses’ responsibility & knowledge could be influential in adopting advocacy role by nurses. Finally, advocacy endeavors could culminate in one of the following outcomes: effective advocacy, failure or limited advocacy. Conclusion: participants believed that within the current context and circumstances, adopting an advocacy role by the nurses are difficult. Therefore, they make decisions and act as a patient’s advocate according to patient needs and status of barriers and facilitators. In most cases, they cannot act at an optimal level; instead, they accept only what they can do, what was called in this study ‘limited advocacy’. It can be concluded that advocacy is a contextually complex phenomenon, and is a controversial and risky component of the nursing practice.