Exploring the Implications of Patient Advocacy Outcomes among Practicing Nurses within the Hospital Context: A Qualitative Research

Background: Nurses are expected by their international code of ethics to advocate for patients to enhance safety and quality care. However, there is a limited understanding regarding the implications of specific patient advocacy outcomes experienced by nurses who advocate for patients in the hospital context. Purpose: This study explored the implications of patient advocacy outcomes experienced among practicing nurses in the hospital context. Methods: A qualitative, descriptive study design was utilized. Data was collected through purposive sampling and an in-depth semi-structured interview of 25 Registered Nurses in an acute care hospital. An inductive qualitative content analysis method was used, and the SRQR guidelines for reporting qualitative studies were followed. Results: This study revealed that nurses who succeeded in advocating for patients experienced feelings of happiness, increased confidence levels, increased work output, and job satisfaction. However, nurses who failed to succeed in advocating for patients experienced physical, emotional, and psychological consequences, which contributed negatively to the quality of patient care. Therapeutic communication and nurses’ commitment to intervene for patients emerged as vital qualities and skills required to succeed in the patient advocacy process. Conclusions: This study showed that patient advocacy has advantages. However, when nurses fail to succeed in their attempt to advocate for patients in clinical practice, the outcomes can negatively affect their own well-being and the quality of patient care delivery. These study results could promote awareness and help nurses to develop strategies for improving patient advocacy activities based on their experiences. Additionally, nurses can seek help, including psychological counseling, when necessary to enhance their optimal well-being as they care for their patients. Nursing educational institutions and hospital managers can support, train, and equip nurses with the required skills for enhancing positive advocacy outcomes. .

Advocacy Coalition by External Actors and Strategies Used to Influence the Emergence of the National Nutrition Policy in Lao PDR

This article aims to explore the coalition of external actors and the strategies it deployed to influence the emergence of the National Nutrition Policy (NNP) in Lao People’s Democratic Republic (Lao PDR). The Advocacy Coalition Framework and the conceptual model of Effective Advocacy Strategies for Influencing Government Nutrition Policy were used to frame the data collection and their analysis. Sources of information were semi-structured interviews conducted with government and external actors, as well as all available documents on nutrition policy in Laos. The commitment of the government to achieve the Millennium Development Goals (MDGs) and to leave the Least Developed Country status created a favorable condition to support the emergence of the NNP in Laos. This context was a driving force for the building of an effective and convincing coalition of United Nations agencies able to accompany the government in redefining health priorities. Various strategies were used by the coalition to this end, including generating, disseminating, and using scientific evidence, assisting the government with a budget and technical expertise, providing decision-makers with opportunities to learn from other countries, and building relationships with the key actor. External actors can be a major force to support the emergence of a public policy in Laos, but this requires a window of opportunity like what the MDGs have been able to bring.

Social Marketing:An Advocacy Empirical Analysis of Service Objects of Public Welfare Organizations

The ultimate goal of social marketing is to change the behavior,attitude,concept,and so on of target audiences.For the public welfare organization,the basis of its service project design is the organization's mission and location.The key to achieve the organizational mission is to be able to lock the service objects and respond to the needs of service objects effectively.This research is based on the theoretical framework of social marketing and based on the questionnaire survey and analysis of the advocacy effectiveness and problems of service objects of the 327 public service organizations in China.Using the Delphi method and the entropy method,the 6P model of social marketing for service objects advocacy in the field of domestic public welfare practice is concise,and a new operational mechanism for service objects advocacy of public welfare organizations is proposed to implement the mission and value of public welfare organizations and contribute to the change of service objects.

Promoting Sex and Reproductive Health Education among Adolescent Should Place Emphasis on Advocacy

Objective To make a exploration of the function of advocacy in the promotion of sex and reproductive health education for adolescents. Methods The advocacy played a key role on the promotion of adolescent sex and reproductive education by taking ＂International cooperation project to promote Chinese youth reproductive health ＂（YRH projecO as example. Results The successful experience of YRH project indicated advocacy＇s important function in the promotion of sex and reproductive health education for adolescents, Conclusion Advocacy is a crucial element in promoting adolescent sex and reproductive health education,

Advocacy and Use of Advocates as a Quick Win in Scaling Up Biofortification in Nigeria: The Case of Building Nutritious Food Basket (BNFB) Project

The Building Nutritious Food Baskets (BNFB) Project explored advocacy and the use of advocates as a model strategy for scaling up biofortification in Nigeria during its three-year implementation. In addition to its direct advocacy efforts, the BNFB project identified and selected key personnel across disciplines, gender and sectors, based on some selected criteria, as Advocates to support the scaling up of biofortification by raise of investments, resource mobilization, the inclusion of biofortification in relevant policy documents, strategies and plans of action. To realize these, the selected 32 Advocates were empowered to mainstream biofortification into their existing and/or potential programs/projects, as well as create awareness and demand for biofortified crops within their spheres of influence. Training and retreats were organized for the Advocates to strengthen their capacities in advocacy and promotion of biofortification and biofortified crops, while a social platform was launched to share opportunities, experiences and address issues around biofortification within the Advocates. As a result of these efforts, biofortification was included in three key national policies, strategies/plans of actions with resource allocation, and investments, over USD3 million were raised for biofortification. The Federal Government of Nigeria and some external governments became committed to biofortification programs while biofortified crops were mainstreamed in at least two national programs in Nigeria. Biofortified crops were included in the Home-Grown School Feeding Program of two states. The use of Advocates proved to be a resultful strategy in the biofortification scaling up model of BNFB as the advocates, upon being trained, looked out within their sectors and disciplines to mainstream biofortification into their programs. They gave timely information on potential opportunities to follow up with in influencing favorable policies;they mobilized resources nationally, regionally and locally;they facilitated wider coverage of biofortification within a short time. However, the influence of the Advocates was limited to their number and locations;thus, for a quick win in Nigeria, there is a need to raise advocates in all the 36 states of the country while giving equal priority to national and state level advocacy. As a lesson, to engender adoption of biofortification, participation/leveraging on existing programs in advocacy works faster and easier than starting afresh in Nigeria.

Patient Advocacy and the Affordable Care Act: The Growing Need for Nurses to Be Culturally Aware

The nurse-patient relationship is centered on patient advocacy. Patient advocacy is essential in providing individualized care and improving health outcomes. With the recent implementation of the Affordable Care Act, the patient advocacy concept requires further exploration. Published literature involving patient advocacy’s history, uses, definition, past analyses and nursing perceptions were examined. Outcomes of this literature review lead to further examining patient advocacy and how it is applied to culturally diverse patient populations, patient advocacy in nursing curricula and related research. Overall study results indicate that patient advocacy is associated with enhanced health encounters that include nurses presenting patients with understandable healthcare options and supporting patients with their healthcare preference. Although, this review identified positive outcomes of patient advocacy, nursing research must be directed toward creating a patient advocacy definition and measuring advocacy from a patient’s perspective. There is also a need for nursing leaders to consider placing a higher emphasis on cultural awareness research and education due to an increased rate of culturally diverse patients now seeking care through the Affordable Care Act.

Advocacy for Camel Research and Development in Kenya

Interest in camel research and development in Kenya started with identification of its untapped potential by the United Nations Educational Scientific and Cultural Organization in 1970s, while responding to droughts in Sahelian Africa, which influenced the Government of Kenya to enhance its focus on economic returns from the camel. Concerted efforts of interest groups led to the founding of the Kenya Camel Association in 1995 to lobby and articulate camel development issues for the betterment and wellbeing of camel keepers. Initial projects dealing in camel research and development implemented from the 1970s to 1980s in the arid and semi arid lands of Kenya had varying successes and challenges. These projects demonstrated the unique adaptation of the camel to arid environments. The association＇s advocacy work uses a holistic approach to share information widely and demonstrate practically aspects of camel management, through an annual forum. Consequently, this has attracted more interest groups focusing on camel research and development.

A Probe into The Origin of“Three Advocacy”

The 18th National Congress of the Communist Party of China put forward the socialist core values of"promoting prosperity,democracy,civilization and harmony,advocating freedom,equality,fairness,rule of law and advocating patriotism,dedication,integrity and friendship."Only by actively nurturing and practicing the core values of socialism can we unify our thinking and cohere force for the socialist modernization so as to realize the grand goal of building a well-off society in an all-round way during the 100th anniversary of the founding of the founding nation and build a socialist modern nation during the 100th anniversary of the founding of the People’s Republic of China so as to realize the realization of the Chinese nation The great rejuvenation.

Advocacy inquiry and circular questioning to maintain psychological safety in training,feedback,and conversations with residents

Training of emergency physicians through an emergency medicine residency program takes 5 years,that is,3 years in junior residency and 2 years in senior residency.Throughout this period,residents will be exposed to a variety of educational methodologies and meet a spectrum of faculty,supervisors,and teachers,who will have different personalities,styles,and approaches to teaching and nurturing them.It is important to ensure the maintenance of psychological safety for these residents throughout their training journey and into the future years of practice s an emergency physician.Communications,interactions(which involve questioning),and presentations will be an important part of this training program.This article looks at two modes of questioning:advocacy inquiry and circular questioning,which can be applied as appropriate.These two methods are examples in which faculty may consider adopting in their many interactions,follow-up,feedback,tutorials,facilitation,partnerships,and counseling sessions with residents.These two techniques offer options to maintain psychological safety,which can facilitate learners sharing and opening up.It can be included in the faculty’s armamentarium of questioning techniques and applied where applicable.

Seven Steps to Business Advocacy

选注者言:本文作者首先列出了财务主管提出商业建议的七个步骤,然后强调领导实现任何一个步骤,尤其是第二和第三步骤,要依靠鼓励(inspiration)而不是权威(authority)。鼓励有两个方法:一是融洽(rapport),即建立温暖,友好和同情的人际关系;二是探讨(exploration),即启发人们明确方向和激发他们的思想和洞察力。对提出商业建议的人来说,明确第一步骤通常不是那么困难的。感情培养才是取得协同的关键;协同时注意力要集中在一个问题上,从而作出正确判断,并按此判断行动,取得成功。 Bob Gunn是Gunn Partners咨询公司的负责人。该公司为《财富》500强提供咨询服务,帮助500强改善和提高雇员的价值和生产率。you can call Bob at(617)747-5015 or e-mail him at bgunn@gunnpartners.com 本文的选注者对本文有三处不解(用黑体标出),于是和本文的作者BobGunn通了email向他请教,Bob很快作答。现将Bob对本文的两处疑难的解释刊登在文后,供读者参阅。 如果读者对本文中的若干问题感兴趣,不妨根据上面的email地址请教Bob。

Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa

AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularlypatients with complications.METHODS: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin,Burkina Faso,Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines,published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications. RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes(in the public sector) would amount to 21%-34% of the country's gross national income per capita,26%-47% in the presence of retinopathy,and above 70% for nephropathy,the most expensive complication. CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction,it is innovative and of interest for several stakeholders.

Changes in psychiatric nurse attitudes towards legal representation of inpatients at District Psychiatric Board hearings in Israel: a pilot study

Aims: To compare the initial attitudes of nurses and other professional groups in a psychiatric hospital towards the legal representation (LR) of involuntary admitted psychiatric patients before District Psychiatric Boards (DPB), and to assess how these attitudes changed after LR had become an everyday routine practice in the hospital. Background: LR of hospitalized psychiatric patients before DPB has been introduced into mental health system worldwide, including Israel. Attitudes of psychiatric staff towards LR and their changes over time are a very important –though unstudied issue. Methods: Thirty seven psychiatric nurses employed in the Tirat Carmel Mental Health Center, Israel and 30 other mental health professionals (comparison group) completed the Attitudes to Legal Representation Questionnaire before LR has been instituted in the Center (November 1, 2006) and one year later. Baseline differences between the groups were tested using one-way ANOVA, and prepost differences in the attitude scores were tested by paired t-tests. Results: Baseline psychiatric nurses attitudes towards LR were significantly more negative than those of the comparison group [F67,3 = 6.87, p 37 = 2.56, p = 0.015). Conclusion: Yearlong, routine exposure to the LR of involuntarily admitted psychiatric patients may attenuate negative nurse beliefs and attitudes towards LR of such patients at DPB hearings. The more positive attitudes may enhance the nurses’ ability to present information about patients without jeopardizing their human and civil rights, and help patients to attain a greater sense of control over their illness management and satisfaction with the services received.

The Scientist as an Advocate: When and When Not

As most of us fundamentally know, there are times a scientist should and should not act as an advocate. As an individual, advocating for environmental preservation is almost required as a member of the world’s scholarly scientific community. However, when that same scientist is asked to offer opinion testimony as an expert witness within the parameters of a lawsuit filed within their particular legal system, there is no room for advocacy. Because it appears that the line an expert scientist must not cross is becoming ever more blurred, we intend to discuss when a scientist should and should not act as an advocate and the reasons that the line between advocate and impartial expert exists. In a legal setting such as a trial or an arbitration hearing, scientists are required to be qualified as an “expert” on the technical subject being considered by the trier of fact before rendering any opinions. Indeed, scientists, unlike all other witnesses, are permitted to present opinions regarding otherwise admissible evidence after being accepted by the Judge as a qualified expert in the field to which he or she intends to testify. However, while the scientist is permitted to present his or her opinions, the scientist is not permitted to advocate for a position or for their interpretation of the evidence presented in a courtroom trial or an arbitration hearing. Rather, those roles are reserved for the parties’ attorneys. Rather, it is the role of the scientist to solely offer opinions with respect to the evidence or facts which are the subject of the dispute. In doing so, the scientist is expected to act as disinterested scholar or teacher faithfully interpreting the data whatever it may reveal. In the eyes of established legal systems, such as the United States (U.S.) or United Kingdom (U.K.), were a scientist to attempt to become an advocate, rather than a scholar and teacher, that scientist’s opinions would no longer be based on fact but, rather, the interests of his or her client, thus damaging the scientist’s credibility. In doing so, the expert could potentially cause irreparable harm to his or her client’s case and his or her reputation.

Erratum to “Is Alzheimer’s Disease an Adaptability Disorder? What Role Does Happiness Have in Treatment, Management and Prevention” [World Journal of Neuroscience 5 (2015) 180-188]

A case presentation indicating the importance of “happiness” in childhood causing memory block until the patent presented with probable mixed vascular and neurodegenerative memory loss at 60 years of age is presented to highlight the role of emotional factors in causing the disease. The question of whether Alzheimer’s disease is an adaptability disorder is raised, given the patient blocked out her memory of her childhood experience. The importance of “happiness” as a treatment goal raises issues of advocacy and Guardianship as well as capacity, which is addressed by actual case reference and court action in defence of the patient’s rights to have their wishes respected and observed. Functional mental capacity assessment, using the Functional Mental State Measure (FMSM) gives a greater indication of neuronal reserve than standard cognitive testing, as it helps to unravel the dilemma associated with pure cognitive assessment in Alzheimer’s Disease as well as vascular dementia patients and patients who, despite retained and intact functional capacity and ability to express their wishes, i.e. “best interest”, are “wrongly” placed under Guardianship. A General Systems approach, which recognises functional interaction as optimal and withdrawal or inadequate and/or inappropriate response as not, provides further understanding of the relationship between emotional factors, memory and neurodegenerative (Alzheimer’s) disease.

Is Alzheimer’s Disease an Adaptability Disorder? What Role Does Happiness Have in Treatment, Management and Prevention

A case presentation indicating the importance of “happiness” in childhood causing memory block until the patent presented with probable mixed vascular and neurodegenerative memory loss at 60 years of age is presented to highlight the role of emotional factors in causing the disease. The question of whether Alzheimer’s disease is an adaptability disorder is raised, given the patient blocked out her memory of her childhood experience. The importance of “happiness” as a treatment goal raises issues of advocacy and Guardianship as well as capacity, which is addressed by actual case reference and court action in defence of the patient’s rights to have their wishes respected and observed. Functional mental capacity assessment, using the Functional Mental State Measure (FMSM) gives a greater indication of neuronal reserve than standard cognitive testing, as it helps to unravel the dilemma associated with pure cognitive assessment in Alzheimer’s Disease as well as vascular dementia patients and patients who, despite retained and intact functional capacity and ability to express their wishes, i.e. “best interest”, are “wrongly” placed under Guardianship. Maladaptive responses, to control the change in external environment that are sensed or perceived, and which lead to disorder or to susceptibility to disease, exemplify a General Systems Theory approach, in which appropriate and adequate responses to environmental change, in behavioural terms, by a person, whether independently, or as the recipient or giver, or both, leads to functional interaction and happiness.