Exploring the Emergent Concept of Patient Advocacy in Acute and Perioperative Settings: A Scoping Review.

Journal of caring sciences Pub Date : 2025-06-02 eCollection Date: 2025-07-01 DOI:10.34172/jcs.025.35014
Sara Morais Pires, Ana Ramos, Idalina Gomes
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Abstract

Introduction: Staff shortages following the pandemic and the growing complexity of healthcare require continuous reflection on the part of professionals to improve patient protection efforts in high-pressure environments. This makes it essential to better understand and reinforce the role of patient advocacy in clinical practice. This study aims to map the concept of patient advocacy in nursing, identifying its key attributes, antecedents, and consequences in acute and perioperative settings, contributing to its update and integration into the current healthcare paradigm.

Methods: A scoping review, based on Arksey and O'Malley's framework and PRISMA-ScR guidelines, analyzed studies from 2019 to 2024, across CINAHL, PubMed, Scopus, Web of Science, and Google Scholar databases. It focused on nursing-related patient advocacy in acute and perioperative settings, excluding non-nursing roles, self-advocacy, and non-research articles. Two independent reviewers independently selected 14 studies using Rayyan®.

Results: Key attributes of patient advocacy include safeguarding, effective communication, empowerment, and ethical decision-making support. Facilitating antecedents were professional motivation, training, nurse autonomy, and spiritual care, while hindering factors included ineffective communication, religious/cultural conflicts, and gaps in patients' health literacy. The consequences were mostly positive for patients, such as empowerment and shared decisions, and mixed for nurses, ranging from moral distress and frustration to gratitude and professional satisfaction.

Conclusion: This study synthesized the evolving conceptualizations of patient advocacy, addressing post-pandemic challenges and reinforcing the importance of communication, ethical support, and training. It revealed emerging facilitators and previously overlooked barriers, highlighting the need for stronger policies and organizational structures to empower nurses and safeguard patients.

Abstract Image

Abstract Image

探索急诊和围手术期患者倡导的新概念:范围综述。
导言:大流行后的人员短缺和日益复杂的医疗保健需要专业人员不断反思,以改善高压环境中对患者的保护工作。这使得更好地理解和加强患者倡导在临床实践中的作用至关重要。本研究旨在描绘护理中患者倡导的概念,确定其在急性和围手术期环境中的关键属性、前因和后果,促进其更新并融入当前的医疗保健范式。方法:基于Arksey和O'Malley的框架和PRISMA-ScR指南进行范围评估,分析了2019年至2024年在CINAHL、PubMed、Scopus、Web of Science和b谷歌Scholar数据库中的研究。它侧重于急性期和围手术期护理相关的患者倡导,不包括非护理角色、自我倡导和非研究文章。两名独立审稿人独立选择了14项使用Rayyan®的研究。结果:患者倡导的关键属性包括保障、有效沟通、授权和道德决策支持。促进前因为专业动机、培训、护士自主权和精神关怀,阻碍前因为沟通不灵、宗教/文化冲突和患者健康素养的差距。结果对病人来说大多是积极的,比如授权和共同决策,而对护士来说则是好坏参半,从道德上的痛苦和沮丧到感激和职业满意度。结论:本研究综合了不断发展的患者倡导概念,解决了大流行后的挑战,并加强了沟通、道德支持和培训的重要性。它揭示了新出现的促进因素和以前被忽视的障碍,强调需要更强有力的政策和组织结构来增强护士的权能并保护患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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