Nurses' Perspective of Patient Advocacy: A Systematic Mixed Studies Review

Aim: The aim of this review is to report on nurses’ attitude and perception toward patient advocacy. Design: Systematic reviews. Data Source: We searched for evidence regarding nurses’ attitude, perceptions, feelings, thoughts, or behaviors toward patient advocacy in three databases: CINHAL, MEDLINE, and OVID. Review Methods: The inclusion criteria were studies on nurses’ attitude, perception, feelings, thoughts, and behaviors toward patient advocacy published in academic journals in English language. Qualitative, quantitative, or mixed-method research studies were included. The Critical Appraisal Skills Program (CASP) as a quality assessment tool was used as a framework to review the quality of the full-text articles. Each article was awarded a value score out of 20. Results: A total of 21 studies were eligible, of the 998 studies retrieved from selected databases. The review resulted in two findings: (1) nurses consistently have positive attitude toward patient advocacy, and (2) the patient advocacy process includes four elements: (1) the client situation, (2) the nurse, (3) advocacy interventions, and (4) the advocacy consequences. Conclusion: Preparing professional nurses for the advocacy role is essential part of quality nursing care. Impact: Patient advocacy is a complex concept and there has been inconsistencies on the use of this concept in the literature. Patient advocacy should be defined as a process with four elements: the patient situation, the nurse, and advocacy action, and the advocacy consequences. Al nurses in different areas of nursing practice can utilize the findings of this study to improve patient care outcome.