Patient Advocacy: A Concept Analysis

Running Head: CONCEPT ANALYSIS

Concept Analysis: Patient Advocacy

Abstract

The purpose of this concept analysis is to clarify, define, and refine how patient advocacy is perceived in the nursing community. Much of the literature has attempted to define patient advocacy and emphasis its role within the nursing profession. This paper will discuss multiple definitions of patient advocacy from existing literature and refine them into two critical characteristics.

Concept Analysis: Patient Advocacy

(10%)I Ð'- SELECTION OF CONCEPT

Patients often have a limited knowledge of illness and medicine, yet they desire more control over their healthcare. In many healthcare settings, patient care is inconsistent and "patients' quality of life and right to self-determination tend to be ignored" (Bu & Jezewski, 2006, p. 102). Nurses are in a unique position to "support and thereby advocate the patient's interests in the restoration of their health and well-being" (Marshall, 1994, p. 11). However, this is not always put into practice.

"The definition of patient advocacy is still confusing, and there is no consensus about its meaning among nurses and nurse authors" (Bu & Jezewski, 2006, p. 102). Today, many nurses have a limited view of what patient advocacy is and how to perform the challenging task of protecting and supporting patinets'rights. Greater clarity about the concept of patient advocacy is needed within the nursing field in order to improve practice.

(10%)II Ð'- AIM OR PURPOSE OF THIS CONCEPT ANALYSIS

The aim of this paper is to clarify, define, and refine the concept of patient advocacy in order to expand its understanding in nursing practice.

(20%)III Ð'- IDENTIFY ALL DEFINITIONS AND USES OF THE CONCEPT

A search of the literature reveals several different definitions of patient advocacy. Merriam-Webster's Online Dictionary defines advocacy as "the act or process of advocating or supporting; to promote the interests or cause of " and an advocate as "one that pleads the cause of another; one that supports or promotes the interests of another"(Merriam-Webster, 2006). Curtin's (1979) concept of advocacy is based on the nurse/patient relationship that forms from the common bond of humanity. The nurse must realize patient reactions and needs created by illness, which may threaten the integrity of the person (Bu & Jzewski, 2006, p103)(McSteen & Peden-McAlpine, 2006, p. 260). Gadow (1980) states that advocacy not only preserves, but also positively contributes to self-determination. "The effort to assist patients become clear about what they want in a situation, to assist them in discerning and clarifying their values and examining available options in light of those values" (MacDonald, 2007, p.120) Kohnke's (1982) definition of advocacy focuses on ensuring patient self-determination over decision-making (MacDonald, 2007, p. 120). Advocacy involves the nurse supplying patients with information needed to make appropriate choices and then supporting the decisions they make along with their right to make that decision (Bu & Jzewski, 2006, p103). Robinson (1985) thought advocacy involved allowing patients to make decisions without pressure and promote informed decision-making" (Baldwin, 2003, p. 35). Chafey et. al. (1998) indicated that the nurse-patient relationship is an important feature of advocacy. Teaching, informing, and supporting are activities of patient advocates. Lindahl and Sandman (1998) described patient advocacy as "building a caring relationship, carrying out a commitment, empowering, making room for and interconnecting, being a risk-taker and moral agent" (Bu & Jzewski, 2006, p. 106).

(20%)IV Ð'- REFINING AND DEFINING ATTRIBUTES/CHARACTERISTICS OF THE CONCEPT

The defining attributes that occur consistently throughout the literature include:

Ð'* Therapeutic nurse/patient relationship that is formed to secure a patient's freedom and self-determination.

Ð'* Preserving the patients' right to self-determination. This represents a specific series of actions that preserve and respect patients' values, beliefs, and rights in healthcare situations. Actions that are taken to promote and protect patients' rights include teaching, informing, educating, caring, and supporting.

(20%)V Ð'- APPLYING THE CONCEPT IN ACTUAL CASES

Case study example: A 29 year old male with a new diagnosis of an inoperable grade IV glioblastoma. He was offered the opportunity to participate in a trial involving a new chemotherapy that could possibly prolong his life. He confided to the nurse involved in his care that he was having difficulty deciding whether or not to participate due to the need for an extended hospital stay to more closely monitor treatment. He asked the nurse to help find more information about the drug.

1-Model case: The nurse contacted a helpline and obtained written information about the nature of the cancer and the drug. She also contacted an oncologist who provided the patient with additional