O'Connor Tom, Kelly Billy
School of Nursing and Midwifery, University College Dublin, Belfield, Dublin 4, Republic of Ireland.
Nurs Ethics. 2005 Sep;12(5):453-67. doi: 10.1191/0969733005ne814oa.
Advocacy has become an accepted and integral attribute of nursing practice. Despite this adoption of advocacy, confusion remains about the precise nature of the concept and how it should be enacted in practice. The aim of this study was to investigate general nurses' perceptions of being patient advocates in Ireland and how they enact this role. These perceptions were compared with existing theory and research on advocacy in order to contribute to the knowledge base on the subject. An inductive, qualitative approach was used for this study. Three focus group interviews with a total of 20 practising nurses were conducted with a sample representing different grades in a general hospital setting. Data analysis was carried out using elements of Strauss and Corbins' approach to concept development. The findings indicate that the principal role of the nurse advocate is to act as an intermediary between the patient and the health care environment. The results highlight that advocacy did, however, result in nurses becoming involved in conflict and confrontation with others and that it could be detrimental to nurses both professionally and personally. It was also clear that when enacting advocacy, nurses distinguished between 'clinical advocacy' (acting directly for patients in the clinical environment) and organizational advocacy (acting on an organizational level for one or more patients).
宣传倡导已成为护理实践中被认可且不可或缺的一项特质。尽管采用了宣传倡导这一做法，但对于该概念的确切性质以及在实践中应如何实施，仍存在困惑。本研究的目的是调查爱尔兰普通护士对成为患者代言人的看法，以及他们如何履行这一角色。将这些看法与关于宣传倡导的现有理论和研究进行比较，以便为该主题的知识库做出贡献。本研究采用归纳性的定性研究方法。对一家综合医院中代表不同级别的20名在职护士进行了三次焦点小组访谈。数据分析采用了施特劳斯和科尔宾的概念发展方法中的要素。研究结果表明，护士代言人的主要角色是在患者与医疗保健环境之间充当中间人。结果还凸显出，宣传倡导确实导致护士卷入与他人的冲突和对抗之中，而且这可能在职业和个人层面上对护士都不利。同样明显的是，在实施宣传倡导时，护士区分了“临床宣传倡导”（在临床环境中直接为患者采取行动）和组织宣传倡导（在组织层面为一名或多名患者采取行动）。
