Patient Advocacy: A Concept Analysis

Introduction

The framework for the nursing process is based on research ideas, primarily on the study of nursing-related concepts and variables. Performing a concept analysis helps researchers and students get a better grasp of a certain idea. The analysis’s goal is to show how a concept’s operational definition differs from its defining characteristics. Understanding a theory’s actual nature and characteristics will make it easier to put the ideas into practice in nursing (Shultz & Hand, 2015). However, this concept analysis will focus on patient advocacy since nursing practice is guided by various ideas, including patient advocacy. Hildegard Peplau’s interpersonal connections theory exemplifies this idea, which has been present since the dawn of the nursing profession. Peplau’s theory examines a nurse’s involvement in helping patients achieve better results, which looks at the nurse-patient connection (McCarthy & Aquino-Russell, 2011). The goal of this report is to recognize and describe patient advocacy more precisely. Patient advocacy will be clarified through the following steps: first will be topic explanation followed by attributes, then antecedents and consequences. After evaluating empirical understanding, an explanation of the theoretical model will be offered by different cases evaluation.

Defining Patient Advocacy

As an advocate for their patients, nurses play a critical role in their treatment. Someone who acts as an advocate is referred to as an advocate. To put it another way, nursing is concerned with safeguarding, promoting, and optimizing one’s health and talents. As a nurse, one must help those suffering by diagnosing, treating, and advocating for them (Long, 2015). When it comes to patient interactions, it’s common for the nurse to be the one. So the nurse is likely to serve as the primary point of contact for patients and their families and other members of the healthcare team and departments. As an advocate, the nurse must be well-versed in all areas of patient care and have a good working relationship with other multidisciplinary team members to do their job effectively and efficiently. In the role of patient advocate, the nurse aids patients in their dealings with the many parties that impact their health. A patient advocate assists patients with their medical conditions dealing with health care, medical expenses, and employment discrimination (Marshall & Zolnierek, 2012). Peplau’s theory of interpersonal connections helps illuminate the importance of patient advocacy in nursing practice, which she developed. She defines nursing as a therapeutic interpersonal process in Peplau’s theory. Together with another human process, it helps communities and people stay healthy. Later, she describes the bond between nurse and patient in detail.

Relationships between nurses and patients begin with two people who have a similar goal: total well-being and successful results. Both the nurse and the patient grow as a result of their collaboration. There are several responsibilities for nurses in this connection; according to Peplau, The duties of a nurse in this situation include Stranger, Educator, and Teacher; Resource Person. Surrogate nurses play an advocacy role for their patients by helping to explain dependency, interdependence, and independence and advocating for the patient’s interests. A therapeutic connection between nurse and patient can only be maintained if both parties communicate consistently and the nurse is trained to recognize the patient’s needs and use available resources accordingly. As nurses, we have a unique opportunity to advocate for our patient’s best interests while providing them with information about their treatment options. Understanding Peplau’s theory may assist guide our nursing practice and connect to our patients to advocate for improved patient outcomes and satisfaction with treatment.

Literature Review 

In a literature review, the focus is on previously published material in a certain field and academic publications that are pertinent to the topic or idea being discussed (Gessert, Waring, Bailey & VanWormer, 2015). Six academic papers on patient advocacy will be examined to determine their applicability to the theory under discussion. The terms “patient advocacy” and “nursing practice” were used to create this evaluation.

Researchers Lucatorto, Tomass, and Siek claim that nurses behave as patient advocates while providing care rather than as task-based instructions that must be fulfilled. When it comes to advocating policy change, nurses serve as both patient and industry champions. When nurses are seen as equal participants in the nurse-patient relationship and generate possibilities for patient satisfaction and well-being, they are regarded as advocates. Patients’ well-being is held in the hands of nurses, who are held responsible for duties that must be performed. They must also collaborate with other team members to reach this objective (2016).

Zolnierek demonstrates the importance of advocacy in a different manner than Marshall did in his essay. According to this article, nurses may advocate for one another and get the support they need while doing their jobs. According to this article, nurses face constant stresses, making it imperative that they be supported to promote the mental and physical health of their patients. Employee assistance programs, stress management, and psychological debriefing after traumatic incidents are just a few of nurse leaders can push for in their organizations (2012).

The following article addresses the critical role of advocacy in ensuring that high-quality nursing care is provided to patients. It stresses the importance of patients being at the core of their medical team as equal partners in all treatment decisions in order to get really optimal, high-quality care.The patient advocate’s job is to help patients express their views and requirements and provide them with the decision-making skills they need to be in charge of their health care team. Advocates play a crucial role in speaking for our patients and predicting their current and future needs (Lederman et al., 2016).

In 1973, the International Council of Nurses included advocacy into its Professional Codes, according to Levy. In the context of a personal connection, it focuses on patient service, and all registered nurses believe it to be an essential component of their profession (2015). The characteristics that every nurse advocate should have been described in this article. These include being conscious of ethical issues, being confident in oneself, being persistent, proud of one’s work, and being mature. If you want to be an effective nursing advocate, you need certain things from your workplace and coworkers. Adequate communication with management, support from both management and coworkers, and tolerance within the institution are necessary for the nurse. According to the findings in this article, a nurse can only be an effective advocate and generate good results within the confines of their hospital or working environment (Levy, 2015).

An important theme of this essay is the difficulties individuals experience while dealing with American health care and the widening communication barriers that exacerbate the issue. The author, a former emergency care physician, has changed her focus to patient advocacy to offer assistance to those families and communities who need it most. It discusses the growing need for nurses in advocacy roles due to the continuous blurring and crossing of the health care system’s financial, ethical, and legal boundaries. More individuals would be exploited by the business if there were no trained nurses to assist the public in embracing their rights to decision-making and medical treatment. Any advocate’s ultimate aim should empower the patient to take charge of their health care (Brokaw, 2016).

Finally, an article on advocacy from the perspective of a nurse is addressed. The research results were examined using a standard content analysis method to learn more about clinical nurses’ views on patient advocacy and their experiences in that field. Two consistent themes emerged from the evaluation of patient advocacy in nursing, namely empathetic treatment of patients and safeguarding patients’ rights. As advocates, nurses are always thinking about these topics as they provide care. Always, the essay concludes that patient advocacy is aimed at providing high-quality healthcare and protecting the rights of clients as a vital component of nursing care (Davoodvand, Abbaszadeh & Ahmadi, 2016).

Defining Attributes 

The definition of patient advocacy varies from field to field. Nurses often misunderstand patients’ rights, who lack a comprehensive understanding of what patient advocacy entails. If you want a better grasp of this subject, start with the basics. Defining characteristics helps to locate the underlying structure. Concept analysis must begin with the identification of defining characteristics. A concept’s attributes include things like elements that are necessary for patient advocacy to be effective. Independence, empowerment, and inclusion are some of the key characteristics of this idea. Concepts like preserving patient autonomy, acting in their best interests, and promoting social justice in healthcare may be represented (Fagan, Parker & Jackson, 2016). Patient advocacy is centered on the well-being of the patient and includes these characteristics. With the help of these characteristics, patients may make well-informed decisions about their treatment in all areas. Nursing advocacy gives patients a say in the treatment decisions that are made. To guarantee that the patient’s voice is heard, the nurse must respect a patient’s rejection of interventions when the patient has been informed and allow for a voluntary agreement to choices impacting one’s care. Advocacy encompasses far more than just offering advice to patients. It entails giving patients the tools they need to make their own decisions, including reasoning critically about the pros and cons of various options. To have the greatest chance of success, it’s critical to completely understand the implications of suggested treatment programs and forego the alternatives. Patient advocacy that emphasizes social justice as a distinguishing characteristic covers the social structures we live in is comprehensive. To guarantee that patient care and access stay at the forefront and consistent with leading the way to improved healthcare for everyone experienced nursing practice leaders must lead healthcare advocacy (Fagan, Parker & Jackson, 2016).

Antecedent and Consequence

Antecedents are occurrences or situations that occurred before the idea under investigation. According to this study, individual patient advocacy or the group patient advocacy role may be affected by these antecedents. Vulnerable groups have been identified in hypotheses about patient advocacy as a precedent (Bu & Jezewski, 2012). The elderly, the homeless, those who speak other languages, and even those illiterate are all included. As a result, these groups are seen as particularly vulnerable and need protection, both in terms of health care and decision-making skills. Patient advocacy is a nursing philosophy that informs or results in this behavior. Those events that occur due to nurses’ patient advocacy efforts have consequences, which may be good or bad (Shultz & Hand, 2015). When patients’ rights, needs, and desires are protected, advocacy has a beneficial effect. Individuals get timely and sufficient information about their health condition and health care options and are empowered to make their own choices. Through their patient advocacy, doctors and nurses may help patients improve their self-esteem, personal happiness, and sense of optimism. Advocacy may have both positive and bad consequences, such as when nurses speak out for their patients’ interests when seen as insubordinate or unprofessional. As a result of this, the nurse advocate’s reputation and self-esteem may suffer. Advocates may feel helpless to do the right thing because of moral discomfort or a moral dilemma (Bu & Jezewski, 2012).

Empirical Referents 

Empirical referents are groupings or categories of real occurrences that show the existence of the idea itself. The benefit of professional nurse advocacy may be better understood if advocacy is measured. In this concept analysis, patient advocacy is categorized as one of the fundamental characteristics, with the same empirical referents (Fagan, Parker & Jackson, 2016). Patients’ rights, the best interests of the patient, and the healthcare system’s values are some of the distinguishing characteristics of a healthcare professional. Helping people attain well-being through mobilizing resources in the environment and circumstance are two instances that demonstrate these ideas. In the second example, all patients must be assured that they have the right and duty to make their own choices and act on behalf of a patient in their best interests (Bu & Jezewski, 2012). It may seem as if these referents are unquantifiable variables, yet highlighting these instances demonstrates the concept’s occurrence.

Model Case 

A model case is a representation of a notion that demonstrates all of its distinguishing characteristics. In this situation, a good model case would contain all three of the most important characteristics: Maintaining patient autonomy, advocating for patients, and equality of opportunity in healthcare are all priorities.

The following is an example of a case scenario: During Mrs. Smith’s treatment for pancreatic cancer, her doctor discovered a tumor in her pancreas. It is often believed that the elderly are a particularly vulnerable segment of society, which may be exploited inside the healthcare system. This element serves as a precursor to someone who may need protection. Her doctor informed her at her most recent appointment that she qualified for an upcoming research study to extend the lives of people with pancreatic cancer. After many meetings with Mrs. Smith’s home health nurse, she admitted that she was lost and needed assistance making a choice. According to Peplau’s thesis, which has been discussed throughout this study, this interpersonal connection is the foundation for communication between the nurse and the patient (McCarthy & Aquino-Russell, 2011). She inquired about the medication used in the study and assisted me in comprehending the facts I had been given as a result.

Once the nurse called a hotline and the clinical trial company, she learned more about Mrs. Smith’s cancer and the medication’s components and mechanism of action. A cancer specialist outlined the advantages and disadvantages of such a study, saying it may help patients live longer and have a better quality of life. Nevertheless, the outcome could not be defined or put on a timetable due to the nature of the trial. The oncologist answered all of Mrs. Smith’s questions thoroughly and patiently. After that, the home health nurse spent enough time with Mrs. Smith to go over all she needed to know from the printed material and make sure she didn’t have any more questions before making a choice. After that, Mrs. Smith chose to participate in the study since the nurse had given her enough information to make an informed decision. She made a list of resources for patients like hers and shared it with her coworkers to see if they might assist this group in achieving better results. Evidence shows that by allowing her to participate in every rightfully, the nurse has safeguarded her patient and acted on her behalf when obtaining information she could not have obtained independently. The nurse has also championed social justice by anticipating future patients in similar situations that will require the nurse to act as an advocate in their care plan. Because of this, the patient was empowered to make an informed choice about her health care, which was a win-win situation. Ultimately, it’s a win for the patient, as shown by the case’s key characteristics. The results of each patient scenario are used to calculate this empirical reference point (Bu & Jezewski, 2012).

Alternative Cases

Alternate cases are the polar opposite of a model case in terms of behavior. Two instances that will be examined in more detail later in this study are borderline land contradictory situations. A borderline case lacks one or two of the distinguishing characteristics previously shown in the model case. A contrary case is the polar opposite of a model instance in that it lacks all of the distinguishing characteristics.

Borderline Case

The nurse has contacted the hotline and the organization conducting the clinical study, and she has received written material that she will give to Mrs. Smith. Mrs. Smith was given information on the type of her cancer and the characteristics of the new medicine, and she was encouraged to consider it. “I hope this information is helpful to you in making your choice,” the nurse says to Mrs. Smith. On the other hand, he does not attempt to explain any medical jargon in more detail or address any relevant patient queries regarding the therapy or medication. Mrs. Smith was prompted to seek another health care expert who could better explain the facts due to this activity. A communication barrier between a nurse and a patient demonstrates the absence of advocacy. According to the idea of interpersonal connections, improved communication of care may have resulted in a more favorable patient outcome; conversely, a lack of communication can be harmful to patient outcomes (McCarthy & Aquino-Russell, 2011).

Contrary Case

The nurse informs Mrs. Smith that she will look for and give more information about her cancer and the clinical trial medicine. The nurse admits that her schedule is hectic, but she pledges to obtain the information when she has more free time. She also says, “If I were in your shoes, I would participate in the research study if it promised to improve your quality of life.” The nurse proceeds to see her other patients for the remainder of the day and forgets to collect information on the patient over the following several weeks, so the patient does not see her again within that period. In light of the absence of knowledge, Mrs. Smith chooses not to participate in the courtroom proceedings. This opposing argument does not provide any examples of the fundamental characteristics of patient advocacy. It serves as an example of what not to do when dealing with a patient and their treatment, which may be used to guide future practice (McCarthy & Aquino-Russell, 2011)

Theoretical application and importance in nursing 

Preserving human dignity: patients and their families are often frightened and confused during medical procedures. Nurses with patience and expertise can help patients get their bearings in a new system and communicate effectively with their doctors. The patient may be educated about tests and treatments by nurses in certain instances. They should be mindful of the impact that culture and ethnicity may have on the patient’s experience while also following privacy regulations. A nurse’s unique position enables them to integrate all facets of patient care, ensuring that patients’ needs are met, standards are maintained, and good outcomes remain the objective.

In terms of structure and technical development, the healthcare system is continuously evolving for the better. Regulatory shifts in the delivery of health care and medical services are part of these adjustments. Patients’ intrinsic dignity, value, and individuality should not be limited by social or economic position, personal characteristics, or the type of health issues when nurses advocate on their behalf. This is stated in the ANA Code of Ethics.

Conclusion 

A systematic study of patient advocacy is the first stage in creating a theory on the subject. Using the nursing literature as a starting point, this concept analysis has looked at the antecedents, repercussions, and definitions of patient advocacy and model vs. alternative instances. All nurses have a responsibility to advocate for their patients. To improve nursing care, the nurse must protect the patient’s autonomy while also advocating on behalf of the patient and promoting social justice in the healthcare industry. Another thing to consider is the relevance of nursing theory concerning the selected topic. The idea of Peplau’s interpersonal connections may assist us in understanding how to engage with our patients while providing care and advocating on their behalf. Adopting a patient advocate position is critical to enhancing the present and future delivery of healthcare.

References

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Bu, X., & Jezewski, M. (2007). Developing a mid-range theory of patient advocacy through concept analysis. Journal Of Advanced Nursing, 57(1), 101-110. https://doi.org/10.1111/j.1365-2648.2006.04096.x

D’Antonio, P., Beeber, L., Sills, G., & Naegle, M. (2014). The future in the past: Hildegard Peplau and interpersonal relations in nursing. Nursing Inquiry, 21(4), 311-317. https://doi.org/10.1111/nin.12056

Fagan, A., Parker, V., & Jackson, D. (2016). A concept analysis of undergraduate nursing students speaking up for patient safety in the patient care environment. Journal Of Advanced Nursing, 72(10), 2346-2357. https://doi.org/10.1111/jan.13028

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Lederman, L., Madden, D., Battle, D., Connolly, H., & Smith, M. (2016). Patient Advocates Collaborate to Ensure Patients Are Members of Their Own Oncology Care Teams. Journal Of Oncology Practice, 12(11), 980-982. https://doi.org/10.1200/jop.2016.018010

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