Patient Advocacy in Nursing: An Integrative Literature Review

Abstract

Background: Despite the crucial role of advocacy in nursing, a comprehensive understanding of its activities and their patient outcomes is lacking. Purpose: This integrative review aimed to comprehensively examine the influences of nursing advocacy, nursing activities, and their patient outcomes. Methods: An integrative review was conducted following the methods by Whittemore and Knafl (2005). Electronic databases were searched from 2000 to 2024. Studies were included if they reported patient outcomes related to nursing advocacy and involved research from med-surgical nurses or patients. Findings: Ten studies were selected and reviewed, conducted in diverse countries with various research designs, including six qualitative studies, three concept analyses, one content analysis, and one cross-sectional study. Several articles reported patient outcomes aligning with core advocacy attributes. Factors influencing nurse advocacy included nurses’ characteristics such as education, experience, autonomy, and organizational support. Advocacy activities involved ensuring patient safety, providing information, supporting decision-making, and facilitating communication. These efforts led to positive patient outcomes such as improved satisfaction, quality of life, stress reduction, and enhanced safety. Conclusion: Enhancing nurses’ advocacy competencies and creating supportive organizational environments are crucial for improving patient advocacy. Further studies with robust designs are needed to produce empirically-derived research on patient outcomes related to nursing advocacy. Future research should investigate the differential effects of advocacy attributes on patient outcomes and provide empirical evidence on the long-term impact of nurse advocacy.