Nurses perspective of patient advocacy: A systematic mixed studies review

<p>Usama Saleh</p>

Nurses perspective of patient advocacy: A systematic mixed studies review

Usama Saleh

Saudi Arabia

: J Nurs Patient Care

Abstract

Background: Nursing advocacy is a relatively modern concept and became a very important function of nursing practice as it is considered a fundamental value of professional nursing. Patient advocacy is a complex concept and there have been inconsistencies on the use of this concept and the literature indicate immaturity of the concept. Purpose: The purpose of this review is to present the current state of evidence to report on nurses’ attitude and perception toward patient advocacy. Search Methods: We searched for evidence regarding nurses’ attitude, perceptions, feelings, thoughts, or behaviors toward patient advocacy in three databases: CINHAL, MEDLINE, and OVID. Gray literature and online resources were used during the search strategy. There was no restriction to the date of publication. Search Criteria: The inclusion criteria were studies on nurses’ attitude, perception, feelings, thoughts, and behaviors toward patient advocacy published in academic journals in English language. Qualitative, quantitative, or mixed-method research studies were included in the review. The review excluded studies focused on pediatric and/or neonatal nurses. Appraisal Process: The Critical Appraisal Skills Program (CASP) as a quality assessment tool was used as a framework to review the quality of the full-text articles. The articles were assessed against each CASP criterion. Each article was awarded a value score out of 20 to signify its adherence to the CASP criteria. Results: A total of 22 studies were eligible, of the 987studies retrieved from selected databases. The total appraisal points of the articles ranged from 13-19 out of 20. The review resulted in two findings: (1) regardless of their clinical areas, nurses consistently have positive attitude toward patient advocacy, and (2) the patient advocacy process includes four elements: (1) morally inappropriate client situation, (2) a professional nurse, (3) advocacyspecific nursing interventions, and (4) the consequences of the advocacy intervention. Conclusion: The Patient Advocacy Process Model can be effective in defining the multidimensional construct of the advocacy. Preparing professional nurses for the advocacy role is essential part of quality nursing care.