Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
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Review on the Theory of Nursing Client Advocacy and Its Applications in Child Healthcare

간호대상자옹호이론의 발전전망과 아동간호에의 적용방안

  • Cho, Kap-Chul (Red Cross College of Nursing, Chung-Ang University)
  • 조갑출 (중앙대학교 적십자간호대학)
  • Received : 2013.06.25
  • Accepted : 2013.07.20
  • Published : 2013.07.31
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Abstract

Since 1990, descriptive studies about the concept of client advocacy have been published in the health journals. However, empirical studies of the concept are still lacking. There are not enough bases to apply the concept of client advocacy in nursing practice. The purpose of this paper is to encourage empirical research about client advocacy by clarification of the concept and to discusses application of the theory in child healthcare. The literature was reviewed that empirical studies on client advocacy conducted after the year 2000. The changing trends in the client advocacy concept was examined; it was changed from the philosophical concept to nursing action and changed from individual advocacy to collective advocacy, with the rise of the self advocacy concept. The research trends on client advocacy evolves from descriptive study to quasi-experimental study and instrument development study, with diversification and expansion of research methods, advocates, clients and settings. The advocacy role of the nurse in child healthcare is significant due to the child's lack of self determination ability. In ill child care, the application of individual advocacy is potent, while in healthy child care, collective advocacy, policy advocacy, and social advocacy is effective.

서론 의료현장의 대형화, 관료화로 인한 인간기본권 침해로 인해 간호사의 옹호역할이 필수적인 간호활동의 하나로 부각되고 있다. 옹호 개념이 간호문헌에 대두되기 시작한 것은 약 40년 전의 일로, 그동안 꾸준히 진화되고 발전되어 왔으나 여전히 대상자옹호 개념은 명료하지 않고 임상실무 적용에 어려움이 있다는 문제 제기가 있었다. 이에 개념을 명확히 하고 아동간호실무적용의 가능성을 탐색하고자 하였다. 본론 2000년 이후에 발표된 실증적 연구논문을 분석하여 대상자옹호이론의 발전과 옹호연구의 동향, 아동간호영역에서의 적용에 대해 고찰한 결과 다음과 같은 결론을 얻었다. 첫째, 옹호 개념은 이론적 개념에서 실천적 간호활동으로 보는 견해가 우세해졌으며, 대상자옹호 개념은 체계적인 중범위 이론(mid-range theory)으로 발전하였다. 둘째, 옹호 개념에 대한 연구는 개념의 조작화나 방법론이 다양하게 확대되어, 간호대상자옹호가 간호중재로서 실무에 활용될 가능성이 있는 것으로 전망된다. 셋째, 아픈 아동이건 건강한 아동이건 아동은 성인에 비해 자신을 위한 권리주장이나 선택능력이 부족하다는 점에서 우선적인 옹호간호의 대상이다. 넷째, 임상아동간호실무, 건강한 아동을 위한 건강증진실무에 대상자옹호이론을 적용할 수 있다. 개인옹호, 단체옹호, 자기옹호 개념을 적용할 수 있다. 다섯 번째, 아동간호영역에서 대상자옹호와 관련된 다양한 연구가 수행될 수 있다. 여섯 번째, 효율적이고 능동적인 옹호역할을 수행하기 위해서 간호사의 준비가 필요하다. 결론 옹호 개념은 총합적이고 구체적인 이론적 구조로 서술되어 체계적인 중범위 이론(mid-range theory)으로 발전하였다. 이론에 대한 실증적 연구가 증가되어 개념의 조작화가 이루어졌으며, 간호중재로서 실무에 활용될 가능성이 있을 것으로 전망된다. 아동은 전형적인 취약인구층이므로 임상아동간호, 아동건강증진 실무영역, 아동간호연구 등의 분야에서 대상자옹호이론의 적용가능성이 높다. 효율적이고 전문적인 옹호역할을 수행하기 위해서 이에 대한 아동간호사의 훈련과 준비가 필요하다.

Keywords

References

  1. Baldwin, M. A. (2003). Patient advocacy: A concept analysis. Nursing Standard, 17(21), 33-39.
  2. Bu, X., & Wu, Y. B. (2008). Development and psychometric evaluation of the instrument: Attitude toward patient advocacy. Research in Nursing & Health, 31(1), 63-75. https://doi.org/10.1002/nur.20233
  3. Bu, X., & Jezewski, M. A. (2007). Developing a mid-range theory of patient advocacy through concept analysis. Journal of Advanced Nursing, 57(1), 101-110. https://doi.org/10.1111/j.1365-2648.2006.04096.x
  4. Cawley, T., & McNamara, P. M. (2011). Public health nurse perceptions of empowerment and advocacy in child health surveillance in West Ireland. Public Health Nursing, 28(2), 150-158. https://doi.org/10.1111/j.1525-1446.2010.00921.x
  5. Church, E. J. (2004). Patient advocacy: The technologist's role. Radiologic Technology, 75(4), 272-292.
  6. Cho, K. C. (1994). An analysis of situation needed a consumer advocacy. Journal of Red Cross College of Nursing, 16(1), 49-70.
  7. Cho, K. C. (1996). A content analysis of the advocacy concept perceived by nurses at nursery room. Korean Journal of Child Health Nursing, 2(1), 13-26.
  8. Cho, K. C. (2006). Nursing client advocacy as a prescriptive theory. Journal of Nursing Query, 15(1), 72-85.
  9. Choi, S. S., Kim, J., Lee, J. S., & Hwang, S. H. (2012). A review on research regarding self-advocacy intervention for students with disabilities. The Korea Journal of Learning Disabilities, 9(3), 249-273.
  10. Fowler, M. D. (1989). Social advocacy. Heart & Lung, 18(1), 97-99.
  11. Gadow, S. (1980). Existential advocacy: Philosophical foundations of nursing. In T. Pence, & J. Cantrall (Ed.), Ethics in nursing : An anthology (pp. 41-51). New York: National League for Nursing. Pub. No. 20-2294.
  12. Hanks, R. G. (2008). The lived experience of nursing advocacy. Nursing Ethics, 15(4), 468-477. https://doi.org/10.1177/0969733008090518
  13. Hanks, R. G. (2010). Development and testing of an instrument to measure protective nursing advocacy. Nursing Ethics, 17(2), 255-267. https://doi.org/10.1177/0969733009352070
  14. Hyland, D. (2002). An exploration of the relationship between patient autonomy and patient advocacy: Implications for nursing practice. Nursing Ethics, 9(5), 472-482. https://doi.org/10.1191/0969733002ne537oa
  15. Jeon, S. Y. (2005). A study of the causal relationships between social work education and advocacy: The mediating effect of social work values. Korean Journal of Social Welfare, 57(4), 35-65.
  16. Johnson, P. E. (2006). Patient assistance programs and patient advocacy foundations: Alternatives for obtaining prescription medications when insurance fails. American Journal of Health-System Pharmacy, 63(21), S13-17. https://doi.org/10.2146/ajhp060464
  17. Kim, Y. H., Kim, H. L., Kim, Y. R., Lim, J. H., & Hyun, M. S. (2012). The effects of a rights advocacy program for mentally ill persons. Perspectives in Nursing Science, 9(1), 16-23.
  18. Lee, M. H. (2004). A study on the advocacy system for service user in social welfare. Korean Journal of Social Welfare, 56(2), 29-52.
  19. MacDonald, H. (2007). Relational ethics and advocacy in nursing: Literature review. Journal of Advanced Nursing, 57(2), 119-126. https://doi.org/10.1111/j.1365-2648.2006.04063.x
  20. MacDonald, J., Edwards, N., Davies, B., Marck, P., & Guernsey, J. R. (2012). Priority setting and policy advocacy by nursing associations: A scoping review and implications using a socio-ecological whole systems lens. Health Policy, 107(1), 31-43. https://doi.org/10.1016/j.healthpol.2012.03.017
  21. Mahlin, M. (2010). Individual patient advocacy, collective responsibility and activism within professional nursing associations. Nursing Ethics, 17(2), 247-254. https://doi.org/10.1177/0969733009351949
  22. Nahigian, E. (2003). Factors associated with advocacy decisions of registered professional nurses employed as staff nurses in inpatient adult hospital. Unpublished doctoral dissertation, State University of New York, Buffalo.
  23. O'Connor, T., & Kelly, B. (2005). Bridging the gap: A study of general nurses' perceptions of patient advocacy in Ireland. Nursing Ethics, 12(5) 453-467. https://doi.org/10.1191/0969733005ne814oa
  24. Rai, S. D. (2007) Social entrepreneurship in nursing: A tool for learning, advocacy and income generation. Singapore Nursing Journal, 34(3), 7-15.
  25. Rasmussen, L. (2012). Patient advocacy in clinical ethics consultation. American Journal of Bioethics, 12(8), 1-9.
  26. Segesten, K. (1993). Patient advocacy: An important part of daily work of the expert nurse. Scholarly Inquiry for Nursing Practice, 7(2), 129-135.
  27. Vaartio, H., Leino-Kilpi, H., Suominen, T., & Puukka, P. (2009). Measuring nursing advocacy in procedural pain care: Development and validation of an instrument. Pain Management Nursing, 10(4), 206-219. https://doi.org/10.1016/j.pmn.2008.02.003
  28. Vaartio, H., & Leino-Kilpi, H. (2005). Nursing advocacy: A review of the empirical research 1990-2003. International Journal of Nursing Studies, 42(6), 705-714. https://doi.org/10.1016/j.ijnurstu.2004.10.005
  29. Ware, L. J., Bruckenthal, P., Davis, G. C., & O'Conner-Von, S. K. (2011). Factors that influence patient advocacy by pain management nurses: Results of the American society for pain management nursing survey. Pain Management Nursing, 12(1), 25-32. https://doi.org/10.1016/j.pmn.2009.12.001

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