Facilitators and Barriers for Advocacy among Nurses - A Cross-Sectional Study

Abstract

Background: Nurses serve as patient advocates by protecting their autonomy, representing their interests, and promoting social justice in healthcare delivery. Healthcare advocacy has embraced a crucial role for nurses, but its extent is often limited in practice. Patient advocacy has not been completely clear. Objective: This study aimed to assess the facilitators and barriers to advocacy among nurses at selected tertiary care hospitals in India. Design: A descriptive study was conducted in tertiary care hospitals. Methods: A purposive sample of 150 nurses was recruited, and data was collected using the Modified Hans Protective Nursing Advocacy Scale (HPNAS) directly by the self-report method. The data were analyzed using SPSS, version 24. Results: The majority of nurses had mean facilitator scores of advocacy among nurses of 12.79, and the mean barrier score was 9.45. The item-wise facilitators of nursing advocacy that showed above 50% were communication skills (81%), problem-solving skills (69%), and the readiness of the nurses for patient care (60%). The item-wise barriers to nursing advocacy depicted were a risk to their job (81%), poor team coordination and cooperation (79%), and poor self-image (69%). Lack of job satisfaction, burnout, lack of time, and lack of confidence showed up equally (63%). There was no significant difference in the mean scores of nursing advocacy between male and female nurses, whereas there was a statistical association between advocacy facilitators scores and age and area of work and barrier scores with the gender of nurses. Conclusion: Nurses must be empowered by providing opportunities for them to speak up and break down barriers. Recommendations: The focus should be on coordinating institutional, national, and international efforts in order to conduct various nursing leadership and professional development programs, contributing effectively upholding and improving the nursing profile and status.