Browsing by Subject "patient advocacy"
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Item Giving voice to the vulnerable: Advocacy and oncology nursing(2008-07-24) Pamela J Haylock; Carolyn K. Kinney, PhD, RN, AHN-BC; Poldi Tschirch, PhD, RN, BC; Michele A. Carter, PhD; M. Patricia Donahue, PhD, RN, FAAN; Judith C. Drew, PhD, RN; Darlene Martin, PhD, RNDespite common use of the term, there is no consensus among nursing professionals on a definition of advocacy, how to teach it, measure it, and determine its effectiveness. The purpose of this grounded theory study was to generate descriptions of the cognitive and social processes of advocacy as it is practiced by a purposely selected group of expert oncology nurse clinicians. Informants, nineteen registered oncology nurses working in direct care roles, participated in semi-structured interviews which were audio-recorded and transcribed verbatim to comprise data collection. Informant recruitment and data collection continued until saturation was apparent. Analytic techniques of constant comparative analysis, theoretical coding, and development of theoretical concepts were consistent with grounded theory methodology. Oncology nurses as voices for the vulnerable, the core finding, characterizes the lived experience of advocacy among the study sample. Identified themes were: 1) The meaning of advocacy as a component of ethical practice; 2) Nurses’ ways of being combine holistic philosophy, expertise, knowledge and personal values; 3) Nurses’ ways of knowing includes recognition of patients’ inherent vulnerabilities, knowing the population, and modeling patients’ worlds; 4) Nurses’ ways of doing incorporates the nurse-patient relationship, informing, educating and navigating; and 5) Value of nurses’ advocacy to the health care system, individual patients, and nurses. Interpretation of findings suggest that core components of advocacy are nurses’ 1) Intention to give voice; 2) Provision of a lifeline of love; and 3) Fulfillment of a moral covenant with patients. Nurses recognize patients’ needs and intentionally enter into relationships with patients, acting on the knowledge that their advocacy can assist patients with directing their energy to their healing work rather than being diverted to surviving the health care system. The data-driven theory can serve as a basis for defining, teaching, measuring, and supporting advocacy among students and practicing nurses, contribute to codifying advocacy competencies for clinical practice, and could serve as a catalyst for additional research and translation into practice of this complex and still immature construct.Item Protective Nursing Advocacy Scale(2008-09-24) Robert Gordon Hanks; Regina Lederman; Zhao Wu; Robin Fleschler; Ira Bernstein; Darlene MartinNursing advocacy for patients is considered to be an important function of nursing practice. The research surrounding nursing advocacy is relatively new, with few psychometric instruments developed to measure nursing advocacy. The purpose of this study was to determine the psychometric properties of the Protective Nursing Advocacy Scale (PNAS) and provide measures to support validity.\r\n The study design was a descriptive correlational design using a randomly selected sample of 419 medical-surgical registered nurses in the State of Texas. The data were collected using a mailed survey and the mailed survey included demographic data, the PNAS, a nursing ethics instrument, the Nursing Professional Values Scale Revised (NPVSR), and an existing nursing advocacy instrument, the Attitudes toward Patient Advocacy Scale (APAS). In addition, narrative responses to three open-ended questions were analyzed for category response frequency. The resulting dataset of PNAS items was analyzed for significance of PNAS scores among the demographic groups. The PNAS items were further analyzed using an exploratory factor analysis along with other psychometric descriptions of the data.\r\n The PNAS analysis resulted in the items loading onto four theoretically connected components, subsequently referred to as subscales. The overall reliability of the PNAS demonstrated an acceptable level of reliability, as did the four subscales. No significant differences were noted between mean total PNAS scores and the majority of the demographic data. Construct validity evidence was provided by exploratory factor analysis. Convergent validity evidence was supported by correlations of the PNAS scores and the APAS and NPVSR scores. Content analysis by an expert panel demonstrated an acceptable level of validity index. Narrative responses to open-ended questions help provide support for the items from the PNAS. The six PNAS items that did not load onto components or that were not theoretically connected need revision and piloting in a future version of this instrument. \r\n Implications for nursing include using with practicing nurses to improve their advocacy skills, which may help improve patient outcomes. Additional versions of the PNAS could be written to be used in the education of nursing students and for use by patients in evaluating the nurse’s advocacy ability.\r\n