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Swedish registered nurses’ and nurse managers’ attitudes towards patient advocacy in community care of older patients
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing. (Omvårdnad)ORCID iD: 0000-0003-1382-4386
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
2013 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 21, no 5, 753-761 p.Article in journal (Refereed) Published
Abstract [en]

Aim To describe and compare registered nurses’ (RNs) and nurse managers’ (NMs) attitudes towards patient advocacy in the community care of older patients.

Background RNs may act as patients’ advocates in the care of older patients. NMs should support patient advocacy in order to make the best care available to patients.

Method A modified Attitudes towards Patient Advocacy Scale was used to collect data from 207 RNs and 23 NMs in the Swedish community care of older patients. The response rate was 52%. Descriptive and inferential statistics were used.

Results Both RNs and NMs showed positive attitudes towards patient advocacy. They were more positive towards patient advocacy for patients unable to help themselves than for competent patients.

Conclusions This study showed that RNs and NMs did not differ in their attitudes towards patient advocacy. This result is consistent with the idea of giving the neediest and vulnerable patients greater care.

Implications for Nursing Management It is important for NMs to clarify their own and RNs attitudes towards patient advocacy as disparities may affect cooperation between the groups. Any effects on cooperation may, by extension, affect the quality of care.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013. Vol. 21, no 5, 753-761 p.
Keyword [en]
community care, nurse managers, older patients, patient advocacy
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-15281DOI: 10.1111/j.1365-2834.2012.01453.xISI: 000321981800006PubMedID: 23409794OAI: oai:DiVA.org:kau-15281DiVA: diva2:562137
Available from: 2012-10-23 Created: 2012-10-23 Last updated: 2015-07-29Bibliographically approved
In thesis
1. Sjuksköterskor som patienters företrädare: Med huvudsakligt fokus på företrädarskap för äldre patienter i kommunal hälso- och sjukvård
Open this publication in new window or tab >>Sjuksköterskor som patienters företrädare: Med huvudsakligt fokus på företrädarskap för äldre patienter i kommunal hälso- och sjukvård
2013 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Nurses as patient advocates : With the main focus on advocacy for older patients in community healthcare
Abstract [en]

The overall aim was to study nurses’ and managers’ attitudes towards micro social patient advocacy (I) and factors related to patient advocacy (II, III) with the main focus being on advocacy in the care of older patients in community health care together with psychometric testing of the instrument 'Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy' (IV).

Methods: A quantiative cross-sectional study and a qualitative study were carried out. Nurses (n=207) and managers (n=23) in community health care responded to a questionnaire about patient advocacy, nursing competence, personal traits, quality of care and organisational climate (I, II, IV). Nurses' (n=18) perceptions of influencers of patient advocacy was studied in a phenomenographic study (III).

The results showed that nurses and managers reported positive attitudes to patient advocacy (I, II), especially for patients unable to speak for themselves (I). Two areas of nursing competence (Performing the nursing process, Supervision and cooperation) and a dimension of quality of care of older patients were positively associated with attitudes towards patient advocacy (II). Two organisational dimensions were, negatively (dynamism) respectively positively (playfulness), associated with attitudes towards patient advocacy. The nurses' perceptions of influencers of patient advocacy consist of three hierarchically related levels: The nurse's character traits, The nurse’s bond with the patient and The organisational conditions (III). The Swedish version of APAS-AMIA consists of 33 items in a four-factor structure (APAS-AMIA/SE): Support patients’ beliefs and decision-making, Safeguard patients' health care, Support patients to communicate their wishes and Respect patients’ wishes not to participate in decisions regarding care (IV).

Conclusions: Maintaining the continuing professional competence of nurses is important, and is ensuring the organisational prerequisites to enable nurses' advocacy for patients.

Abstract [sv]

Det övergripande syftet var att studera sjuksköterskors och chefers attityder till mikrosocialt företrädarskap för patienter (I), faktorer relaterade med företrädarskap (II, III) med huvudsakligt fokus på företrädarskap för äldre patienter inom kommunal hälso- och sjukvård samt psykometriskt testa instrumentet Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy (IV).

Metod: En kvantitativ tvärsnittstudie och en kvalitativ studie genomfördes. Sjuksköterskor och chefer (n=230) i kommunal hälso-och sjukvård besvarade frågor om företrädarskap, yrkeskompetens, personlighet, vårdkvalitet och organisationsklimat (I, II, III). Sjuksköterskors (n=18) uppfattningar av vad som påverkar företrädarskap studerades i en fenomenografisk studie (III).

Resultat: Sjuksköterskor och chefer rapporterade positiva attityder till företrädarskap (I, II), framför allt för oförmögna patienter (I). Två områden av yrkeskompetens (Att utföra omvårdnadsprocessen, Arbetsledning och samarbete) liksom en dimension av kvalitet i vården av äldre var positivt associerade med attityder till företrädarskap (II). Två organisatoriska dimensioner var negativt (livfullhet) respektive positivt (lekfullhet) associerade med attityder till företrädarskap. Sjuksköterskors uppfattningar av vad som påverkar företrädarskap omfattar tre hierarkiskt relaterade nivåer: Sjuksköterskans karaktärsdrag, Sjuksköterskans förhållande till patienten och Arbetsplatsens beskaffenhet (III). Den svenska versionen av APAS-AMIA omfattar 33 påståenden i en fyrfaktorstruktur (APAS-AMIA/SE): Stödja patienternas önskemål och beslutsfattande, Värna om patienternas vård, Stödja patienterna att kommunicera sina önskemål och Respektera patienternas önskemål om att inte delta i beslut (IV).

Konklusioner: Sjuksköterskors yrkeskompetens bör upprätthållas för att de ska ha förutsättningar att företräda patienter. Det är viktigt att skapa organisatoriska förutsättningar för att sjuksköterskor ska kunna etablera en relation till patienten som underlag till företrädarskap.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2013. 89 p.
Series
Karlstad University Studies, ISSN 1403-8099 ; 2013:2
Keyword
APAS-AMIA/SE, community care, instrument, patient advocacy, psychometrics, older patients, organisation, nursing competence, företrädarskap, omvårdnad, äldre, APAS-AMIA/SE, företrädarskap, kommunal hälso-och sjukvård, organisation, psykometri, sjuksköterskans yrkeskompetens, äldre patienter
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-16127 (URN)978-91-7063-474-1 (ISBN)
Public defence
2013-03-01, Lagerlöfssalen 1A 305, Karlstads universitet, Karlstad, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2013-02-07 Created: 2012-12-11 Last updated: 2016-06-30Bibliographically approved

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