Patient Advocacy Concept - Research Paper Example

? PATIENT ADVOCACY CONCEPT Patient advocacy concept Introduction The term advocacy appears more often in nursing, but its primary meaning is unclear to many people. Advocacy emanates from the legal word advocate, which denotes an individual who helps, defends, take legal action and pleads for another person (Schramm, 2000). The advocacy meaning for nurses in practice is intensively complicated than the legal meaning, and the concept of advocacy has been the central focus of various nursing studies and research. Patient advocacy entails a therapeutic bond and a dialogue amidst the nurse or the advocate and the sick person. Advocates act as informers to the decision making process of the patient, support their patients and allow the patient to make her independent decisions. A nurse advocacy can include acting for a patient, defending, speaking and supporting the patient. In addition, an advocate can be a linkage that reduces the communication breach between the patient, the system of health care and other professionals. Various people think they understand the concept of patient advocacy (De, 2006), but they, sometimes do not recognize the origin of the concept. Patient advocacy concerns any task that directly favors the sick. Patient advocacy can apply to care provision for an individual victim, to teams that make policies and directions that assist the patients, to groups of government that make Legislations enhance patient processes and systems. The patient advocacy concept refers to various efforts to help sick people and their interests in the health care system context, (Kohnke, 1987). The discussion aims at expounding the patient advocacy concept as defined by various prominent experts in practice of advocacy. This will provide a better understanding of the concept as used in nursing. Additionally, analysis of the concept will offer an intensive understanding of personal and specialized functions related to patient advocacy and its main goals, methodologies, benefits and limitations, (Galow, 1980). Similarly, the analysis will clarify, highlight, define and summarize the perception of patient advocacy in the nursing context. The discussion will explore various definitions of the concept from existing literature and case studies, and break them down into critical features. Aims and purpose of patient advocacy Patient advocacy has always been the focus in the nursing community, but with the intensifying health care dynamics, the need is more intensified. Patient advocacy roles range from helping patients and their families with shifts from clinics to home care, to influencing government departments for issues of health care. Patient advocacy as a concept entails analyzing, reacting, counseling and whistle blowing to help and enhance health care quality for patients, (Bu & Jezewsky, 2006). Doctors promote transit and strive to safeguard the security, health, liberty and rights of their patients. Patient advocacy denotes that role of policymakers, legitimate professionals and advocates who work to enhance health care for patients marginalized and oppressed by social and cultural stigmatizing diseases like HIV. Similarly, given the multiple contexts in which patient advocacy concept is applied, studies can aid advocates better explore the concept, a task vital for enhancing both applied and professional efforts to enhance the quality of health care, (Berns & Newberry 2000). Patient advocacy ensures that issues and concerns of patients and their families are communicated and addressed appropriately and at the right time. Patients are intensively sensitive to diseases, (McDonald, 2007). Clinicians, in most cases, decide the best practices for the patients regardless of the patient interests and wishes but sometimes out of necessity, (Curtin & Thomas, 2006). Similarly, when the patient or caregiver is afraid to provide information, the doctor must speak for the family. Sometimes it implies death or life. Sometimes, it can offer help for the family, and their patient to support them bear the uncertainties and unpredictability of the situation. In most instances, nurses advocate, interpret and support victims and their caregivers comprehend what translates to be healthcare gibberish. As the nurse investigates, informs, interprets, supports and reinforces, the decisions of patients in case of challenges, the nurse should remain to be the advocate of the patient even if it was not his choice to be an advocate, (Berns & Newberry 2000). DEFINITION AND USE OF THE CONCEPT Patients always lack expertise and skills of illness and medication, yet they need maximum power over their healthcare. Similarly, Bu & Jezewsky (2006) argues that, in multiple healthcare contexts, patient care is paradoxical and quality of life of patients and their right to freedom tend to be highly assumed. Nurses are able to help and, therefore, safeguard the interest of the patients in the management of their health, (Marshall, 1994). Nevertheless, this is not mostly the case in most clinics. The definition of the concept is highly controversial, and medics, philosophers, critical thinkers and scholars have never reached an agreement regarding the true definition and implication of the concept, (Bu & Jezewsky, 2006). Currently, various nurses and healthcare providers are committed to the idea of patient advocacy the complex task of safeguarding and supporting the rights of patients. Significant clarity regarding the concept is required in the nursing career to enhance the practice. Multiple studies suggest varied explanations for the concept. For instance, according to Merriam Webster Dictionary, patient advocacy is the means or process of helping or advocating; to enhance the interest of the patient, and an activist as the person who prosecutes the cause of the patient; a person that enhances and supports another person’s interest, (Merriam-Webster, 2006). According to Curtin and Thomas (2006), the patient advocacy concept is centered on the doctor-patient bond that results from a similar humanity relationship. The doctor must understand the patient’s response and needs generated by the condition, which may risk the patient’s integrity, (McSteen & Mc-Alpine, 2006). According to Gadow (1980), patient advocacy safeguards and positively influences the patient’s self-determination. Similarly, it is the effort to assist patients realize what they want in a certain situation, to help them in understanding and defining their values and exploring available opportunities in relation to such morals, (McDonald, 2007). Robinson and Waring (2011) believes that patient advocacy entails permitting individuals to make choices without interference and enhance informed making of decisions. Taylor, (2008) revealed that the patient-nurse bond is a vital characteristic of patient advocacy. Informing, backing up and teaching is the roles of patient advocates. Bramelwtt, Gueldner and Sowell, 1989), defined the concept of patient advocacy as establishing a caring bond, practicing commitment, creating room for and networking, empowering, taking a risk and moral agent. According to nursing dictionary, patient advocacy is a central focus of the professional role of the healthcare practitioner, (Willard, 1996). As a practitioner’s duty, a nurse, who used her responsibility to enhance and protect the value, well being and the attitude of his patient, by making sure that they are well informed of their liberty and have access to relevant information to gain informed consent (Oxford Nursing Dictionary, 1998) is accountable to the well being of the patient. According to Mallik (1997), patient advocacy emphasizes on the activist’s role in the system of law. Other patient advocacy definitions those are oriented on the right to human safety, mandates intensive, active involvement on the nurse’s part. In such definitions, advocacy is defined as reducing pain and sufferings (Grace & Gaylord, 1996), protecting the interests, values and the well being of the person (Thomas, 2006), representing the victim, and protecting the rights of the patient, even when she is dead, (Berns & Newberry 2000). Nurse activists plays a role of a cultural broker or whistle blower, for instance, revealing information about workstation misconduct that they think infringes the law and risks the patient’s welfare, (Jezewski, 2006). This may include rights violation, insufficient staffing, embezzlement of public resources, (Ahern & McDonald, 2000). Based on the above, various definitions, advocacy can be viewed as the role of advocates or activists to verify personal, human rights to self-esteem, self-determination and individual safety, or the right of the patient to the vital information, confidentiality and informed consent. Similarly, as a rule, patient advocacy occurs in direct victim contact, although it can occur without direct patient contact, (Kohnke, 1982). Similarly, most of the definitions are anchored on the fundamental human rights, mainly those of self-esteem and self-determination. Others are grounded on the power of the sufferer to skilful decisions making and access of relevant medical details, (Snowball, 1996). The primary aim of patient advocacy is to ensure that people have relevant information to make informed choices and exercise power and autonomy (Webb, 1987), or as supporting and informing patients in their decisions. CRITICAL OR DEFINING ATTRIBUTES OF PATIENT ADVOCACY Defining attributes or characteristics are the features of the concept that occur repeatedly (Walker & Avant, 1995). Patient advocacy attributes include the therapeutic patient-nurse bond created to safeguard the right, self-determination and freedom of patients. Safeguarding, supporting and protecting liberty and self-determination of the patient is crucial. The above patient advocacy definitions and practices show some certain series of practices or actions that protect and respect the values, interests, beliefs, morals and rights of the patient, his family, care providers and other professionals in the healthcare setting, (Mallik, 1997). Some of the actions taken to enhance, safeguard and inform decisions of the sufferer and his care providers or family include teaching, counseling, informing, interpreting, educating, protecting and supporting the patient, (Mason-Whitehead, 2008). In addition, there must be an advocate or activist to plead, interpret and prosecute for the patient and his family. APPLYING THE PATIENT ADVOCACY CASE IN THE REAL LIFE SITUATION A CASE STUDY ILLUSTRATION John, a thirty five year-old man, diagnosed with an inoperable Glioblastoma type four was given a chance to take part in a trial treatment involving a modern chemotherapy with the aim of enhancing his life. The man disclosed to the nurse, in the therapeutic relationship, that he had some challenges in choosing whether or not take part in the therapy. This is because the chemotherapy requires an extended stay in the hospital to allow evaluation and monitoring of the treatment. The patient had limited knowledge of the drug and feared that the therapy might confine him in the hospital forever. The nurse developed a close therapeutic relationship with John to allow him feel free and disclose his fears. The nurse also befriended the patient to win his trust and confidence. THE MODEL CASE EXAMPLE This practical life situation involves all the defining characteristics of the aspect (Walker & Avant, 1995). The above outline case study of John represents all the defining characteristics of patient advocacy. For instance, there was a patient-nurse bond established to provide the patient with the necessary information about drugs and chemotherapy practice. This bond provided security-enabling John to disclose crucial information, express his fears and dissatisfaction of the process to the nurse (his advocate). The nurse telephoned a helpline and gathered written details concerning the nature of John’s cancer and appropriate drugs. The nurse also called an oncologist to give the patient extra information about the condition. The oncologist revealed to the patient that the attempt might provide some life quality, although, due to the characteristics of the trial, the processes could not be clear. The nurse explained the details to the patient to ensure that he was satisfied, and he accepted the treatment. The information provided by the nurse (advocate) was essential to boost self-determination of the patient and inform his decision to pursue the trail. Also, John and the nurse’s rights were well safeguarded in the encounter. Borderline case This involves a number of the unique characteristics of the concept at hand but not the entire characteristics (Walker & Avant, 1995). John’s case above represents some but not the entire patient advocacy attributes. For instance, the nurse called helpline and consulted written details about relevant drugs and nature of cancer. She conveyed the information to the patient, asked him to evaluate it, and makes a decision. The nurse said, “I think this information assist you to make a choice”. John did not comprehend the information and consulted another expert to interpret it further. John subjectively evaluated his condition, and although he was somehow happy, he was dissatisfied with the information, and called another health care expert to elaborate the information. THE CONTRARY CASE These are the events different from the situation. In John’s case, the nurse replied, “I will give you the details some other time”, but if were you, I would consider chemotherapy to help me prolong and save my life”. The doctor left to attend to other patients delaying in getting back to John. John feared disturbing his nurse by making further inquiries and chose to wait. Consequently, due to scarcity of information, he refused to attempt the trail. This situation is against the distinctive features of the patient concept. John has inadequate information to inform his decisions. In addition, he is denied access to relevant information concerning his health condition, and he has no advocate to plead for her rights and needs as a patient. RELATED CASE These are cases connected to the concept at hand but do not involve defining characteristics (Wallker & Avant, 1995). The nurse collected numerous phone contacts and websites with similar information concerning the drug. She gave John directions to the research library and asked him research for more information. In addition, she encouraged him to close examine the details and make the practical decision. She stressed, “I will support your decision in any way possible”. It may appear that the nurse is helping the patient, but this case is missing various patient advocacy characteristics. For instance, it does not help the patient understand the information or give a sense of satisfaction and security to the patient. Although, the patient has access to the information, his self-determination, self-esteem and personality may be deemed. ANTECEDENTS Walker defines antecedents as things that must appear before the existence of the Patient advocacy strategy, (Walker & Avant, 1995). The key occurrences of advocacy include pre-determinants of advocacy initiation. For instance, an advocate and information access to allow advocacy and informed the decision-making process. In addition, attributes and skills of a nurse are crucial. In a bid to arbitrate, nurse requires professional expertise, clinical skills and experience and ethical and cooperative skills. Additionally, nurses must have the emotional strength, confidence and motivation, be reflective to serve as activists of patients. A strong patient-nurse bond is crucial to allow continuity of the therapeutic process. CONSEQUENCES Impacts are the things follow the occurrence of the strategy (Walker & Avant, 1995). Patient advocacy leads to the victim and nurse empowerment. For example, patient is empowered to care for his pain and improve his self-determination and security. The nurse acquires both psychological and professional empowerment. Patient advocacy leads to a therapeutic patient-nurse bond created to safeguard the right, self-determination and freedom of patients. EMPIRICAL REFERENTS These are attributes or things whose presence demonstrates the happening of a concept (Avant & Walker, 1995). Because of defining characteristics of the patient, advocacy includes patient empowerment and security. Another empirical referent of the patient advocacy concept would be a patient’s satisfaction, prolonged life, pain alleviation and ability to make informed choices concerning his health. The main information needed to indicate the presence of the patient advocacy concept is related to the patient-nurse relationship and their characteristics. For instance, patient characteristics such as alleviation of pain, prolonged life, high quality life and making of highly informed decisions concerning therapeutic practices and diagnosis are some patient advocacy empirical referents, (Jezewsky, 2006). Additionally, other outcomes such as nurse empowerment in terms of gaining clinical experiences and skills, successful nursing interventions and their outcome attributes are crucial. Patient advocacy, according to Baldwin (2003), emphasizes on ensuring the self-determination of the patient over decision making ability. It entails a nurse providing patients with relevant information to make right choices, and then, augmenting the choices they make regarding their liberty to take these decisions. In this case, the nurse needs to hold back her personal opinions are on what would improve the quality of life and instead listen to the patient’s wishes and goals. Patient advocacy is ultimately what an individual says it is, and when that is heard and respected, the highest and most individualized quality of care can be provided. Patient’s satisfaction is demonstrated by the level of self-determination in pursuing clinical therapies after accessing the relevant information required, (Taylor, 2008). Other empirical referents include some series of practices or actions that protect and respect the values, interests, beliefs, morals and rights of the patient, his family, care providers and other professionals in the healthcare setting, (De, 2006). Some of the actions taken to enhance, safeguard and inform the decision-making process of the patient and his care providers or family include teaching, counseling, informing, interpreting, educating, protecting and supporting the patient can also be indicators of the concept. Conclusion Advocacy is a crucial aspect in nursing. Experts agree that if advocacy need is not adequately realized and initiated, then appropriate health care may not be achieved. Some of the patient advocacy practices are grounded on the realization and realization of the rights of patients and the duty of nurses as activists of the attitudes and rights of people. Self-determination, as the right of patients, is always the center of the moral discussion, (Baldwin, 2003). This is because patients have limited knowledge concerning their health issues and healthcare experiences. Real power over health care choices demands that people acquire relevant information and comprehension to make right decisions, so that they enjoy liberty of making a decision because of their own morals, personal circumstances and interests. References Walker, L. & Avant, K. 1995. Strategies for Theory Construction in Nursing. 3rd edition. Norwalk: Appleton & Lange. Baldwin , M. A. (2003). Patient advocacy: a concept analysis. Nursing Standard (Royal College of Nursing (Great Britain): 1987). 17(21), 33-39. Berns, R., & Newberry, S. (2000). 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