The perceptions of advocacy behaviors in end-of-life nursing care among novice, experienced and expert nurses
Karen W. Thacker, Ph.D, RN, CNE
- Sigma Affiliation
- Upsilon Zeta
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Thacker, Karen W. by View
Popular Works for Thacker, Karen W. by Download
Nurses have difficulty describing the steps of advocacy to guide practice. In order to improve the status of end-of-life care, nurse educators need to be cognizant of the advocate role in nursing practice. The purpose of this comparative descriptive study was to describe nurses' perceptions of advocacy behaviors in end-of-life nursing practice. The novice to expert process and the seven domains of a caring practice as they relate to advocacy behaviors (Benner, 1984) provided a framework in which the nurse can move towards becoming an effective patient advocate. This study used a naturally occurring practice setting of three regional hospitals with a convenience sample of 317 practicing nurses, with the majority reporting frequent contact with dying patients. Practicing nurses completed the 38-item Ethics Advocacy Instrument (Wlody, 1993), including two open-ended questions and a demographic survey, with 33.3% return rate by postal mail. Despite the recent emphasis on end-of-life nursing education, practicing acute-care nurses report modest exposure to end-of-life training. The perception of hospital supports was modest with no significant differences among novice, experienced and expert nurses. Three substantial supports to advocacy practice identified by the participants included nurse managers, co-workers and multi-disciplinary services. The study participants described considerable barriers to their advocacy practice including the physician, the patient's family and fear. Novice nurses reported with great frequency that lack of communication and lack of time and/or support served as barriers to their practice. This study added to the empirical data base and its findings were congruent with the literature in that the majority of nurse participants agreed that they practiced advocacy behaviors, despite the reported barriers. A cross-method triangulation served to strengthen internal validity by measuring the concept of advocacy from two approaches. This study did not confirm an over-all difference in advocacy behaviors among the novice, experience and expert nurse as measured by the APS and ABS combined score. However, it offered insight into the supports and barriers nurses at different skill levels experienced in the practice of advocacy.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3221907; ProQuest document ID: 304918564. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
|Review Type||None: Degree-based Submission|
|Research Approach||Mixed/Multi Method Research|
|CINAHL Subject(s)||Palliative Care;
Terminally Ill Patients;
Palliative Care--Ethical Issues
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subjects.
Suffering had enough: Family caregivers' experiences of patients with terminal illness at the end-of-life Shanmugasundaram, Sujatha (2013-10-22)Session presented on: Wednesday, July 24, 2013: Introduction: Many literatures proved that it is a great challenge for the family members caring for the terminally ill person at home. With an ageing population and increasing ...
Evaluating undergraduate nursing students' knowledge before and after a palliative and end-of-life care course Thrane, Susan E. (2017-10-25)Basic palliative care knowledge is important for all nurses and nursing students. Undergraduate students' knowledge of palliative and end-of-life care concepts was measured before and after a semester-long elective palliative ...
A qualitative descriptive study of novice and advanced beginner nurse's experiences caring for patients and their families at the end-of-life Nasser, Bethany A.Nurses are the primary healthcare professionals that spend the most time caring for seriously ill patients. Nurses have a responsibility to care for patients at the end of their lives, to relieve pain, and promote dignity ...
Qualitative exploration of undergraduate nursing student perceptions of end-of-life care of families of dying patients Alt-Gehrman, Penny A. (2017-10-18)Nurses spend the most time with dying patients and their families. Nursing school is an optimal place to provide this information, which is not well-developed. The purpose is to examine nursing students need to feel confident ...
Newly licensed nurses' experiences with end-of-life in the pediatric intensive care unit (PICU) Hillier, Maureen (2017-07-19)Purpose: Nursing education has identified gaps in student knowledge and has admitted to a sub-optimal amount of student education on death and dying education in current curriculums (Beck, 1997; Delaney, 2003; Rush, Adamack, ...