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Individual and organisational factors influencing registered nurses' attitudes towards patient advocacy in Swedish community health care of elders
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. (Omvårdnad)
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Norway.ORCID iD: 0000-0001-7082-6834
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Norway.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. City Council Värmland.ORCID iD: 0000-0003-1382-4386
2014 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, 486-495 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to describe and explore individual and organisational factors potentially influencing registered nurses' (RNs) attitudes towards patient advocacy. Methods and Sample: In a quantitative cross-sectional study, data were collected from 226 RNs in community health care of elders. A questionnaire was used to measure a number of factors including attitudes towards patient advocacy, nursing competence, personality traits, individual preferences regarding the quality of health care and working climate. A multiple regression analysis was performed. Results: The results showed that individual factors of nursing competence and individual preferences of the quality of health care, as well as organisational factors of the working climate, explained 26.2% of the variance in the RNs' attitudes towards patient advocacy. Conclusions: Although the mentioned individual factors may be intertwined, the conclusion is that both individual and organisational factors influenced RNs' attitudes towards patient advocacy. The results do not verify that nursing experience, workplace experience, educational level or personality traits influence the RNs' attitudes towards patient advocacy. The proportion of explained variance indicates that additional factors also influence attitudes towards patient advocacy, and more research is needed to shed further light on these factors.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014. Vol. 28, no 3, 486-495 p.
Keyword [en]
community health care, geriatric nursing, nursing comptence, patient advocacy, quality of health care
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-29345DOI: 10.1111/scs.12073ISI: 000340288100008OAI: oai:DiVA.org:kau-29345DiVA: diva2:655047
Note

The article was published in manuscript form at the time of the thesis defense. It was then titled: Individual and organizational factors influencing nurses’ attitudes towards patient advocacy in community healthcare of older people.

Available from: 2013-10-09 Created: 2013-10-09 Last updated: 2016-08-26Bibliographically 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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Eklund, Anna JosseWilde-Larsson, BodilPetzäll, KerstinSandin-Bojö, Ann-Kristin
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