Date of Award

1990-11-01

Degree Name

Doctor of Nursing Science

Dissertation Committee

N/A

Keywords

advocacy, nursing, patients

Abstract

The purpose of this phenomenological study was to describe clients' lived experiences of advocacy associated with the nurse-client relationship. The sample consisted of ten non-hospitalized adults, 19 to 72 years of age, who had a hospitalization or ambulatory relationship with a registered nurse within the previous six months. Data were gathered via interviews initiated with the same open-ended question. Georgi's five step method was used for data analysis. Four essential characteristics of advocacy associated with the nurse-client relationship were identified. Described by clients as nurse attributes, behaviors, and actions, they were labelled: Competent Knower, Competent Doer, Humanizer, and Communicator. Clients perceived the Competent Knower to be knowledgeable about client conditions and needs, experienced in nursing practice, and capable. The Competent Doer acted on behalf of clients, either by own initiative or at clients' requests, solved problems, served as intermediary, followed through on the clients' needs and desires, demonstrated competence in technical and supportive skills, and exhibited leadership, including taking responsibility for care given by others under supervision. In relationships with client, family, and professional colleagues, the Humanizer was perceived as a personable, caring team member/leader who intervened on clients' behalf, supported their decisions, treated them as valued individuals, encouraged clients, went the extra mile and made self available to clients by being there in presence. The Communicator transmitted and exchanged information with client, family, physician, and other health care professionals, served as liaison between them, provided explanations and education, and kept clients informed by disclosing pertinent information voluntarily and by request. Clients perceived that advocacy was not demonstrated by all nurses and was integrated with other roles within the whole of the nurse-client relationship. Comparisons are made between clients' positive experiences (nurses demonstrated characteristics of advocacy) and negative experiences (which lacked advocacy), and between clients' and nurses' perspectives of advocacy. Implications and research recommendations for clinical practice, education, and administration are addressed, including the development of further validation studies to determine generalizability, and dissemination of the new description to other nurses and disciplines.

Document Type

Dissertation: Open Access

Department

Nursing

Included in

Nursing Commons

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