Mallik M
School of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Queens Medical Centre, Nottingham, UK.
J Clin Nurs. 1997 Jul;6(4):303-13.
This paper reports on a qualitative study which examined the interpretation of patient advocacy by practising nurses. Focus group interviews, which allowed respondents to recount and share their particular 'stories' of patient advocacy, were used to collect data. Results indicate that a triadic model of advocacy predominated which involved the nurse in a conflict/potential conflict situation. The patient's requests, the patient's fear, the patient's vulnerability or threats to the patient's human rights provoked an advocacy response in the perceptive nurse. The nurse was sustained in the role through patient recognition, the nurse-patient relationship, emotional strength, moral justification and knowledge/expertise legitimacy. The nurse used direct and indirect means to protect the patient against incompetent/inappropriate practice and/or represent patient/family choice, the advocacy activity resulting in positive or negative outcomes. In conclusion it is argued that if the triadic conflict model of advocacy outlined by this research is to be sustained by practising nurses, the potential risks involved should be recognized. Professionalization of the role may be the only way forward if the ethical code (United Kingdom Central Council, 1992) continues to make patient advocacy a mandatory activity for the professional nurse.
本文报告了一项定性研究，该研究探讨了执业护士对患者维权的理解。通过焦点小组访谈收集数据，这种访谈方式让受访者讲述并分享他们在患者维权方面的具体“故事”。结果表明，一种三方维权模式占主导地位，该模式使护士置身于冲突/潜在冲突的情境中。患者的请求、恐惧、脆弱性或对其人权的威胁会促使有洞察力的护士做出维权反应。护士通过患者的认可、护患关系、情感力量、道德合理性以及知识/专业技能的正当性来维持这一角色。护士采用直接和间接的方式保护患者免受不称职/不恰当的行为影响，和/或代表患者/家属的选择，这种维权活动会产生积极或消极的结果。总之，有人认为，如果本研究概述的三方冲突维权模式要由执业护士持续践行，就应该认识到其中涉及的潜在风险。如果道德规范（英国中央理事会，1992年）继续将患者维权作为专业护士的一项强制性活动，那么该角色的专业化可能是唯一的前进方向。
