patient advocacy and its importance in providing health care to patients

patient advocacy and its importance in providing health care to patients

Introduction

The article, “Developing a mid-range theory of patient advocacy through concept analysis” by Bu and Jezewski (2017) is a report of a study conducted about patient advocacy and its importance to nurses and patients (Bu & Jezewski, 2007). The authors say that the topic of patient advocacy has achieved significant popularity over the past three decades. Its impacts on improving the quality of care and patient outcomes have also been significant over the stated period. However, the topic lacks a consistent definition, something that can only be achieved through research. For that reason, the authors call for more studies to come up with a more comprehensive description of patient advocacy in a bid to improve its application in providing care to patients (Bu & Jezewski, 2007). Bu and Jezewski found a mid-range theory of patient advocacy by analyzing pieces of literature related to advocacy (Bu & Jezewski, 2007). They identified several characteristics of patient advocacy, which included supporting and defending social justice in the provision of healthcare, acting on behalf of patients, and protecting patient’s autonomy. The researchers also found that the patient advocacy behaviors of a nurse can have significant impacts on other nurses, patients, and the entire nursing profession. It can also affect the activities of other nurses who try to advocate for patients (Bu & Jezewski, 2007). The researchers concluded that the proposed mid-range theory could be of significant importance in promoting the practice of advocacy in nursing. It can also be essential guidance for research in the area of advocacy. They call for further refining and testing of the proposed theory. This paper discusses patient advocacy and its importance in providing health care to patients. This paper provides an analysis of the theory’s application to professional, clinical practice and a critical appraisal of the theoretical adequacy of the theory. It also discusses how patient advocacy can be applied in the inpatient surgery/medicine unit.

Brief Description of the Selected Theory

A patient advocate may be defined as a person who guides a patient through the process of receiving medical care. They help in areas that are associated with significant difficulties such as during treatment, diagnosis, screening, and follow up on health problems such as diabetes (Davoodvand, Abbaszadeh, & Ahmadi, 2016). One of the significant roles of a patient advocate is that of connecting the patient with their health provider in a bid to get the information necessary for decision making. The advocate can also help the patient in the process of getting appointments for visiting healthcare providers (Davoodvand, Abbaszadeh, & Ahmadi, 2016). They can also facilitate the processes of understanding social and legal support from various individuals and organizations. Other significant roles include connecting the patient with their employers, insurance companies, and lawyers and offering the necessary support needed to get the assistance of the stated parties. According to Davoodvand, Abbaszadeh, and Ahmadi (2016), an advocate is a person who pleads that cause of another (Davoodvand, Abbaszadeh, & Ahmadi, 2016). They are people who offer various forms of support to a person’s bid to achieve particular goals in life. With that definition, the person that receives the assistance of an advocate lacks adequate strength to deal with specific situations that come in the processes of achieving their goals. According to Bu and Jezewski (2007), patients need significant support from other people in their bid to get medical care (Bu & Jezewski, 2007). The researchers define a patient as a vulnerable and powerless person that can only achieve the best form of treatment possible with the help of other people. Vulnerability and powerlessness are more significant in cases where a person falls sick without much knowledge and experience about healthcare systems. Bu and Jezewski saw the need for coming up with a theory that would enable the patient to speak up in situations where they do not have a voice (Bu & Jezewski, 2007). The researchers wanted to create a theory that would help maintain the integrity of the patient.

 Analysis of the Theory’s Application to Professional, Clinical Practice

Promoting autonomy appears to be one of the most significant roles of a patient advocate. According to Bu and Jezewski (2007), autonomy is the ability to make important decisions about a person’s own life (Bu & Jezewski, 2007). The patient needs to have the ability to make crucial decisions regarding the kind of treatment they receive in the hospital. For the case of the inpatient surgery/medicine unit, the patient should be allowed to accept or reject particular surgeries for various reasons. Children can enjoy that right through the help of their parents or caregivers (Davoodvand, Abbaszadeh, & Ahmadi, 2016). In patient advocacy, the advocate is supposed to employ various strategies that enable a patient to make important decisions about the kind of care they receive in the hospital. The advocate is expected to understand and respect the patient’s role in making decisions that affect their health and the kind of care that they receive (Davoodvand, Abbaszadeh, & Ahmadi, 2016). The advocate should also know that the patient can only make appropriate decisions when they have the necessary information related to the issues that affect the processes of healthcare provision.

Patient Advocacy in the Inpatient Surgery/Medicine Unit

One fact is that the advocate is, in most cases, more informed about the appropriate forms of treatment that the patient should receive. Saliba (2019) discusses a situation in which a doctor recommended the separation of conjoined twins (Saliba, 2019). Doing so required the permission of the court for various reasons. The doctor sought the mandate of the court and won, but parents of the twins did not want the children to be separated. In that case, the doctor’s decision prevailed because he was more experienced and knowledgeable about the necessary treatment for the twins. Such events may cause significant conflicts for several reasons. Parents are the primary decision-makers on matters related to the health of their children (Davoodvand, Abbaszadeh, & Ahmadi, 2016). That is based on the fact that they have more knowledge about their children. That knowledge is combined with that of the healthcare providers is necessary when deciding the most appropriate form of medical treatment for the children. Parents are also significantly affected by the kind of medical decisions made about their children by providing the necessary care for the chosen approaches (Davoodvand, Abbaszadeh, & Ahmadi, 2016).  However, the parent’s role in making important decisions about their children can be limited, especially when they disagree with particular treatment approaches that the healthcare providers find necessary.

As a nurse in the inpatient surgery/medicine unit, I understand that I owe the patient the responsibility of being their advocate. Nurses can offer to their patients full scope care by doing, among other things, seeking social justice for them and acting in various ways that promote the patients’ autonomy (Davoodvand, Abbaszadeh, & Ahmadi, 2016). Treating patients well and making them as comfortable as possible in the hospital is one of the ways that significantly improve the quality of care and patient satisfaction (Davoodvand, Abbaszadeh, & Ahmadi, 2016). Advocating for patients in times of powerlessness is one o the significant ways to achieve the stated goals.

Critical Appraisal of the Theoretical Adequacy of the Theory

On the issue of clarity, there is a need for more and more research about patient advocacy in a bid to come up with a more precise definition.  According to Davoodvand, Abbaszadeh, and Ahmadi (2016), the literature on patient advocacy is inadequate in most countries of the world even though it is practiced in many hospitals (Davoodvand, Abbaszadeh, & Ahmadi, 2016). On the issue of accessibility, the nurse’s role as an advocate is significantly affected by many factors, both negatively and positively (Saliba, 2019). Some nurse’s characteristics, such as being assertive, nurturing, and empathetic, significantly promote advocacy. Compassion is another factor that also promotes advocacy among nurses. Factors such as frustration and fatigue significantly discourage patient advocacy (Saliba, 2019).  Knowledge about the stated factors is necessary for nurses because it can enable them to make changes required to promote advocacy for their patients. They can do so by developing positive characteristics and overcoming the negative traits. Managers of healthcare organizations can also use the knowledge during recruitment, mentoring, and training of health care providers (Saliba, 2019). On the importance of patient advocacy, the nurse acts as a cheerleader, friend, supporter, confidant, and partner to the patient (Davoodvand, Abbaszadeh, & Ahmadi, 2016). Sometimes the nurse is forced to perform all the stated roles to the same client. The effects of patient advocacy are more or less similar to other health care practices performed by a nurse in the hospital (Davoodvand, Abbaszadeh, & Ahmadi, 2016). The role of advocacy is performed better by the nurse compared to other health care personnel for many reasons. The most significant is the fact that nurses interact with patients more than most of the other health personnel in the hospital environment. On the issue of generality, nurses are expected to perform the role of advocacy to all patients regardless of their differences. A nurse is supposed to promote healthcare equality to all patients (Bu & Jezewski, 2007). That is according to the Code of Ethics for nursing, which requires every nurse to provide care with respect and dignity. The nurse should understand that every person is unique and should be treated in ways that maintain their worth and dignity (Davoodvand, Abbaszadeh, & Ahmadi, 2016). The nurse should do the same to all patients regardless of factors such as the nature of health problems, personal characteristics, and socio-economic factors. On the issue of simplicity, many factors act as facilitators, while others work as barriers for patient advocacy. Powerlessness is one of the significant factors that discourage advocacy. Nurses may sometimes find it difficult to talk about cases of neglect or shortcomings at work, especially when working as a team because the person who identifies the events feels powerless to do so (Davoodvand, Abbaszadeh, & Ahmadi, 2016). Inadequate support from leaders of health care organizations is another significant challenge that faces patient advocacy. A nurse needs adequate help from various parties in the hospital setting for them to be effective advocates (Saliba, 2019). When the nurses are not supported well, they also fail to support the patients. Several factors promote patient advocacy. The positive nurse-patient relationship is the most significant. A nurse can become an effective advocate by having a positive relationship with the patient (Saliba, 2019). Through that, they can listen carefully to their patients and act according to their wishes. For example, a nurse may feel that the nurse-patient relationship gives the patient a more meaningful sense of security compared to that of the patient and their family members. For that reason, the nurse may try to show the patient that they will always be available to help when the need arises.

Conclusion

Patient advocacy is an essential factor in the hospital setting. Most patients have inadequate information about various healthcare processes. The weakness can only overcome by seeking support from people who are more informed about matters of health care. Nurses appear to be in a better position to do so because they interact with patients more than other health care providers. Patient advocacy can be applied in the inpatient surgery/medicine unit with similar results. In conclusion, promoting patient advocacy is a potential method of improving patient satisfaction and quality of health care, which are some of the most significant goals for all health care organizations

References

Bu, X., & Jezewski, M. A. (2007). Developing a mid‐range theory of patient advocacy through concept analysis. Journal of Advanced Nursing, 57(1), 101-110.https://intel-writers.com/wp-content/uploads/2019/10/Assignment-on-Middle-Range-Theory-on-Patient-Advocacy.pdf

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. Journal of medical ethics and the history of medicine, 9.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958925/

Saliba, D. (2019). Comparing Patient Engagement and Patient Advocacy Activities and Measuring Preferred Roles in Medical Decision Making among Cystic Fibrosis Patients, Caregivers, Family Members, and Patient Advocates (Doctoral dissertation). https://tspace.library.utoronto.ca/bitstream/1807/99101/1/Saliba_Daniel_%20_201911_PhD_thesis.pdf