Exploring critical care nurses' perception on their role as patient advocacy

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Exploring critical care nurses' perception on their role as patient advocacy


Author: Wong, Kar-ling Selina
Title: Exploring critical care nurses' perception on their role as patient advocacy
Degree: M.Sc.
Year: 1997
Subject: Patient advocacy -- China -- Hong Kong
Intensive care nursing -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Pages: viii, 91 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1403362
URI: http://theses.lib.polyu.edu.hk/handle/200/3561
Abstract: This study attempted to explore how critical care nurses comprehended the role of patient advocacy. Factors that nurses perceived to have influence in enacting this role were also identified. A descriptive design was employed in the study. Four experienced critical care nurses were interviewed to provide information and narrate some difficult ethical dilemmas in the intensive care unit that nurses might anticipate the role of patient advocacy. With the intense literature review and information from the interview, an instrument in the form of a questionnaire was formulated. After the content validity and reliability test of that instrument, the questionnaires were distributed to nurses in the intensive care units of two major hospitals in Hong Kong. Data were collected from forty six participants and were analysed by determining the frequencies of respondents to different options and justification of action in each situation described in the questionnaire. The qualitative comments were analysed with content analysis techniques to identify common elements. Based on the finding, the following conclusion were drawn. Most critical care nurses had enacted the role of patient advocacy when they encountered the similar ethical dilemmas, the moral reasoning of their actions mainly based on the right of patients and their family, protection from any harm, and emphasis on the justice to the care of patients. Moreover, they were concerned about the relationship with patients and their family. They attempted to explore their feeling and support them. On the other hand, they also attended to their relationship with the doctors and tried to avoid direct confrontation to doctors. Usually, legal implication was an important factor affecting them how to act in these ethical dilemmas. For the factors that nurse thought to be the most agreeable items to enhance the role of patient advocacy were related to the code of ethics and professional conduct such as ethical knowledge, protection of patients' right, and protection of patients from possible harm. For the factors that nurses perceived to be the hindrances in the role of patient advocacy were those related to medical dominance such as doctors has the largest say, different values of different medical personnel and medical personnel know what is the best. This indicated that the common difficult situations might be related to deprivation of the consideration of patients' values and interests in patients' health care decision making. Finally, this study gave a better understanding of how critical care nurses enacted the role of patient advocacy. In addition, nursing administrators could make use of those identified factors to induce changes in the health care arena and enhanced the consolidation of nurses' role in patient advocacy.

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