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Abstract
Aim To clarify the ill-defined concept of patient advocacy and develop a model.
Method An eclectic concept analysis was used in the study
Results Results of the analysis reveal that advocacy has three essential attributes: valuing, apprising and interceding. Antecedents to advocacy include a vulnerable population and a nurse willing to take on the responsibility for advocacy. The consequences of acting as a patient advocate can be potentially negative or positive for patient and nurse. On their own, the attributes are one of a number of helping strategies.
Conclusion Advocacy is a contemporary nursing issue comprising three essential attributes. Individually, each of the attributes is a helping strategy used in nursing. Only when all three attributes are present can advocacy be said to be realised.
Key words
Patients: empowerment
Research methods
These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.
THE TERM advocacy has appeared in nursing literature for almost two decades (Hewitt 2002, Mallik 1997). Much of the literature has attempted to legitimise and encompass patient advocacy in the role of the nurse. However, reservations about the suitability of the nurse to act as patient advocate have also been expressed (Allmark and Klarzynski 1992, Copp 1986, Walsh 1985).
Advocacy first appeared in the Project 2000 nursing curriculum (UKCC 1988). Codes of conduct and guidelines for professional practice provide evidence that advocacy is a condition of contemporary professional nursing practice (NMC 2002, UKCC 1992, 1996).
Literature review
Concepts are labels to describe phenomena that provide a 'concise summary of thoughts' (Meleis 1991). A problem with advocacy, however, is the myriad of definitions and explanations. Descriptions range from counsellor, watchdog and representative (Abrams 1978) to potential whistleblower (Ahern and McDonald 2002, Andersen 1990). There does appear to be a consensus that advocacy involves one person representing another (Allmark and Klarzynski 1992, Konke 1982a, 1982b, Morrison 1991). However, for Copp (1986), it means more than speaking for another as it involves intervention for 'vulnerable' people who require it.
There are a number of models of advocacy. Fowler (1989) has suggested four:
* Guardian of patients' rights.
* Preservation of patient values.
* Champion of social justice in the...