Patient advocacy: barriers and facilitators

Area of Science:

• Nursing
• Healthcare Ethics
• Patient Advocacy

Background:

• Patient advocacy is a debated but crucial role for nurses, often limited in practice.
• Barriers and facilitators influencing patient advocacy require further identification.
• This study explores these factors among Iranian nurses.

Purpose of the Study:

• To explore the barriers and facilitators influencing the patient advocacy role of Iranian nurses.
• To understand the contextual complexities of nursing advocacy in Iran.

Main Methods:

• Grounded theory methodology.
• Semi-structured interviews with 24 registered nurses in Tehran.
• Constant comparative analysis following Strauss and Corbin.

Main Results:

• Barriers include powerlessness, lack of support, legal and ethical constraints, limited communication, physician dominance, peer loyalty, and time constraints.
• Facilitators include the nurse-patient relationship, recognizing patient needs, nurses' sense of responsibility, collegial physician relationships, and nurses' knowledge and skills.

Conclusions:

• Nurses face significant barriers to optimal patient advocacy, leading to a practice of "limited advocacy."
• Advocacy is contextually complex, controversial, and risky in nursing.
• Further research is needed to correlate barriers/facilitators with advocacy utilization.