Facilitators and Barriers for Advocacy among Nurses - A Cross-Sectional Study

Authors

  • Lizy Sonia Benjamin Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, 61421 Asir - Abha, Saudi Arabia
  • Sumathi Robert Shanmugam Department of Maternity and Pediatric Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, 13412 Riyadh, Saudi Arabia
  • Savvato Karavasileiadou Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, 13412 Riyadh, Saudi Arabia
  • Yahya Showkan Ali Hamdi Director of Nursing, Nursing Service, Aseer Central Hospital, 7663 Aseer, Saudi Arabia
  • Saieda Fayez Moussa Department of Child Health Nursing, School of Nursing, Bader University, Cairo Governorate 4942340, Egypt
  • Amel Dawod Kamel Gouda Maternity Nursing, College of Nursing-Riyadh, King Saud bin Abdul-Aziz University for Health Sciences, 22384 Riyadh, Saudi Arabia ; King Abdulaziz Medical City. King Abdullah International Medical Research Center , Ar Rimayah, 11481 Riyadh, Saudi Arabia

DOI:

https://doi.org/10.31674/mjn.2024.v16i01.018

Abstract

Background: Nurses serve as patient advocates by protecting their autonomy, representing their interests, and promoting social justice in healthcare delivery. Healthcare advocacy has embraced a crucial role for nurses, but its extent is often limited in practice. Patient advocacy has not been completely clear. Objective: This study aimed to assess the facilitators and barriers to advocacy among nurses at selected tertiary care hospitals in India. Design: A descriptive study was conducted in tertiary care hospitals. Methods: A purposive sample of 150 nurses was recruited, and data was collected using the Modified Hans Protective Nursing Advocacy Scale (HPNAS) directly by the self-report method. The data were analyzed using SPSS, version 24. Results: The majority of nurses had mean facilitator scores of advocacy among nurses of 12.79, and the mean barrier score was 9.45. The item-wise facilitators of nursing advocacy that showed above 50% were communication skills (81%), problem-solving skills (69%), and the readiness of the nurses for patient care (60%). The item-wise barriers to nursing advocacy depicted were a risk to their job (81%), poor team coordination and cooperation (79%), and poor self-image (69%). Lack of job satisfaction, burnout, lack of time, and lack of confidence showed up equally (63%). There was no significant difference in the mean scores of nursing advocacy between male and female nurses, whereas there was a statistical association between advocacy facilitators scores and age and area of work and barrier scores with the gender of nurses. Conclusion: Nurses must be empowered by providing opportunities for them to speak up and break down barriers. Recommendations: The focus should be on coordinating institutional, national, and international efforts in order to conduct various nursing leadership and professional development programs, contributing effectively upholding and improving the nursing profile and status.

Keywords:

Advocacy, Barriers, Facilitators, Nurses, Patients, Skills

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References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141-151. https://doi.org/10.1177/0969733019832950

Abbaszadeh, A., Borhani, F., & Motamed‐Jahromi, M. (2013). Nurses' attitudes towards nursing advocacy in the Southeast part of Iran. Journal of Applied Environmental and Biological Sciences, 3(9), 88–93. https://www.textroad.com/pdf/JAEBS/J.%20Appl.%20Environ.%20Biol.%20Sci.,%203(9)88-93,%202013.pdf

Adjei, M. D., Diji, A. K. A., Oduro, E., Bam, V. B., Dzomeku, V. M., Budu, I. H., ... & Kyerew, A. A. (2023). Experiences of patient advocacy among nurses working in a resource constrained emergency department in Ghana. International Emergency Nursing, 67, 101252. https://doi.org/10.1016/j.ienj.2022.101252

Alanezi, F. Z. (2022). Nurses’ attitude towards patient advocacy in a single tertiary care hospital. Nursing Open, 9(6), 2602-2607. https://doi.org/10.1002/nop2.958

Alexander, C., Tschannen, D., Argetsinger, D., Hakim, H., & Milner, K. A. (2022). A qualitative study on barriers and facilitators of quality improvement engagement by frontline nurses and leaders. Journal of Nursing Management, 30(3), 694-701. https://doi.org/https://doi.org/10.1111/jonm.13537

Black, L. M. (2011). Original Research: Tragedy into Policy: A Quantitative Study of Nurses' Attitudes Toward Patient Advocacy Activities. AJN The American Journal of Nursing, 111(6), 26-35. https://doi.org/10.1097/01.NAJ.0000398537.06542.c0

Brennan, N. B., Gallagher, M. A., Elliott, D., Michela, N., & Sellers, K. (2023). Advocacy and policy in action: Developing a financial and healthcare safety net for nurses. Journal of Nursing Scholarship, 55(1), 29-32. https://doi.org/10.1111/jnu.12805

Brickley, B., Williams, L. T., Morgan, M., Ross, A., Trigger, K., & Ball, L. (2021). Putting patients first: development of a patient advocate and general practitioner-informed model of patient-centred care. BMC Health Services Research, 21(1), 261. https://doi.org/10.1186/s12913-021-06273-y

Choi, P. P. (2015). Patient advocacy: the role of the nurse. Nursing Standard, 29(41), 52-58. https://doi.org/10.7748/ns.29.41.52.e9772

Dadzie, G., Aziato, L., & Aikins, A. d.-G. (2017). “We are the best to stand in for patients”: a qualitative study on nurses’ advocacy characteristics in Ghana. BMC Nursing, 16(1), 61. https://doi.org/10.1186/s12912-017-0259-6

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses' viewpoint: a qualitative study. Journal of Medical Ethics and History of Medicine, 9. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/127 . Accessed on 10th September, 2023

Ediz, C., & Uzun, S. (2024). The perspectives of nurses, as prominent advocates in sustainability, on the global climate crises and its impact on mental health. Journal of Advanced Nursing. https://doi.org/10.1111/jan.16131

El Seesy, N. A. E.-A., & Al Nagshabandi, E. A. (2016). Nurses’ Attitudes Toward Patient Advocacy in Oncology Department University Hospital. American Journal of Nursing, 5(6), 266-271. https://dx.doi.org/10.11648/j.ajns.20160506.15

Elewa, A. H., ElAlim, E., & Etway, E. (2016). Nursing interns’ perception regarding patients’ rights and patients’ advocacy. SOJ Nursing & Health Care, 2(3), 1-6. https://dx.doi.org/10.15226/2471-6529/2/3/00123

Figueira, I., Domingues, A. R., Caeiro, S., Painho, M., Antunes, P., Santos, R., ... & Ramos, T. B. (2018). Sustainability policies and practices in public sector organisations: The case of the Portuguese Central Public Administration. Journal of Cleaner Production, 202, 616-630. https://doi.org/10.1016/j.jclepro.2018.07.244

Gazarian, P. K., Fernberg, L. M., & Sheehan, K. D. (2016). Effectiveness of narrative pedagogy in developing student nurses’ advocacy role. Nursing Ethics, 23(2), 132-141. https://doi.org/10.1177/0969733014557718

Hanks, R. G. (2010). Development and testing of an instrument to measure protective nursing advocacy. Nursing Ethics, 17(2), 255-267. https://doi.org/10.1177/0969733009352070

Jeon, J.-Y., & Choi, H. (2020). Factors influencing clinical nurses’ advocacy for people with disability. The Journal of Korean Academic Society of Nursing Education, 26(3), 269-280. https://doi.org/10.5977/jkasne.2020.26.3.269

Josse-Eklund, A., Jossebo, M., Sandin-Bojö, A.-K., Wilde-Larsson, B., & Petzäll, K. (2014). Swedish nurses’ perceptions of influencers on patient advocacy:A phenomenographic study. Nursing Ethics, 21(6), 673-683. https://doi.org/10.1177/0969733013515488

Kolawole, I. O., & Adejumo, P. O. (2020). Nurses’ view on impact of patient advocacy in oncology care at university college hospital, Nigeria. ARC Journal of Nursing and Healthcare, 6(1), 1-9. https://dx.doi.org/10.20431/2455-4324.0601001

Laari, L., & Duma, S. E. (2021). Facilitators of the health advocacy role practice of the nurse in Ghana: A qualitative study. Health Science Reports, 4(1), e220. https://doi.org/https://doi.org/10.1002/hsr2.220

Mandal, I., Basu, I., & De, M. (2020). Role of nursing professionals in making hospital stay effective and less stressful for patients with ASD: A brief overview. International Journal of Advancement in Life Sciences Research, 3(1), 1-9. https://dx.doi.org/10.31632/ijalsr.2020v03i01.001

Mortell, M., Abdullah, K. L., & Ahmad, C. (2017). Barriers deterring patient advocacy in a Saudi Arabian critical care setting. British Journal of Nursing, 26(17), 965-971. https://doi.org/10.12968/bjon.2017.26.17.965

Negarandeh, R., Oskouie, F., Ahmadi, F., Nikravesh, M., & Hallberg, I. R. (2006). Patient advocacy: barriers and facilitators. BMC Nursing, 5, 3. https://doi.org/10.1186/1472-6955-5-3

Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses' description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124-1132. https://doi.org/https://doi.org/10.1002/nop2.307

Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2020). Barriers to practicing patient advocacy in healthcare setting. Nursing Open, 7(2), 650-659. https://doi.org/https://doi.org/10.1002/nop2.436

Oranta, O., Routasalo, P., & Hupli, M. (2002). Barriers to and facilitators of research utilization among Finnish registered nurses. Journal of Clinical Nursing, 11(2), 205-213. https://doi.org/https://doi.org/10.1046/j.1365-2702.2002.00587.x

Pratama, M. Y., Yustina, I., & Sudaryati, E. (2022). Community engagement and associated factors for the covid-19 vaccination at the work area of batang kuis public health center, indonesia. Malaysian Journal of Medical Research (MJMR), 6(1), 19-23. https://doi.org/10.31674/mjmr.2022.v06i01.005

Rainer, J. (2015). Speaking Up: Factors and Issues in Nurses Advocating for Patients When Patients are in Jeopardy. Journal of Nursing Care Quality, 30(1), 53-62. https://doi.org/10.1097/ncq.0000000000000081

Roddy, J. T., & Muehlbauer, J. (2020). Redefining Self-Interest - The US Response to COVID-19. Wisconsin Medical Journal, 119(3), 147-148. https://wmjonline.org/wp-content/uploads/2020/119/3/147-1.pdf

Souza, A. D. Z.. D., Hoffmeister, L. V., and Moura, G. M. M. S.S. S.S. D. (202) ). Facilitators and barriers of patient involvement in hospital services: integrative review. Text & Context-Nurse, 31, e20200395. https://doi.org/10.1590/1980-265X-TCE-2020-0395en

Tomasik, T. (2018). Primary health care in Poland: certain health professional groups are placing self-interest before patients. The British Journal of General Practice, 68(673), 379. https://doi.org/10.3399%2Fbjgp18X698129

Ucar, O., Celik, S., Karahan, E., Altıntas, S., & Yucel, M. (2024). Exploring the relationship between spiritual care and patient advocacy of nurses from generations X, Y and Z working in intensive care clinics: A cross-sectional study. Intensive and Critical Care Nursing, 84, 103754. https://doi.org/10.1016/j.iccn.2024.103754

Vaartio-Rajalin, H., & Leino-Kilpi, H. (2011). Nurses as Patient Advocates in Oncology Care. Clinical Journal of Oncology Nursing, 15(5) . https://doi.org/10.1188/11.cjon.526-532

Published

03-09-2024

How to Cite

Benjamin, L. S. ., Shanmugam, S. R. ., Karavasileiadou, S. ., Ali Hamdi, Y. S. ., Moussa, S. F. ., & Gouda, A. D. K. . (2024). Facilitators and Barriers for Advocacy among Nurses - A Cross-Sectional Study. The Malaysian Journal of Nursing (MJN), 16(1), 178-188. https://doi.org/10.31674/mjn.2024.v16i01.018

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