Oral Presentation – Jerofke-Owen
Perceptions of Patient-Empowering Nurse Behaviors
Teresa Jerofke-Owen, PhD, RN & Margaret Bull, PhD, RN
Marquette University College of Nursing, Milwaukee
414-288-3867
Background and Significance: The process of patient empowerment has been promoted as a way to engage patients in chronic illness self-management. The majority of patient empowerment research has been conducted in outpatient settings. There have been no studies examining whether nurses believe they utilize patient-empowering behaviors in acute care settings, nor is there an instrument to measure nurse perception of delivery of patient-empowering behaviors.
Purpose: The purpose of this two-phase study was to examine the validity and reliability of the newly constructed Nurse Perceptions of Patient-Empowering Nurse Behaviors Scale (NPPNBS) and then examine nurses’ perceptions and experiences of utilizing patient-empowering behaviors.
Framework: The NPPNBS was constructed based on Kanter/Laschinger's framework of structural empowerment applied to patient care and an extensive literature review.
Method/Approach: This study utilized a two-phase mixed methods design to evaluate registered nurses’ experiences using patient-empowering behaviors in acute-care settings. Phase 1 included psychometric evaluation of the reliability and construct validity of the NPPNBS and predictors of nurse use of patient-empowering behaviors. Phase 2 utilized focus groups to explore nurse experiences utilizing patient-empowering behaviors in practice. A semi-structured interview guide was utilized. Interviews were digitally recorded and transcribed. Content analysis was used to identify themes.
Sample: Using convenience sampling, 336 nurses from 6 hospitals in Southeastern Wisconsin were enrolled into phase 1 and 34 nurses from 4 hospitals participated in a total of 4 focus groups during phase 2.
Results/Outcomes: Psychometric analysis is in process. Facilitators of empowerment included establishing a therapeutic relationship, fostering communication, providing education, respecting patient autonomy, engaging support systems, and lifting spirit/giving hope. Barriers included high acuity, fear and anxiety over unfamiliar environments and routines, ineffective or inadequate support systems, killing the soul, receiving conflicting information about plan of care, and lack of time. Nurses consistently identified strategies they used to overcome barriers to empowerment in focus groups.
Conclusion/Implications for Practice: This study provided insight into nurses’ experiences of engaging patients in their care through the process of empowerment. Nurses play a key role in the process of patient empowerment in acute care settings. The findings from this study will help to inform the development and testing of interventions to increase the effectiveness of patient-empowering nurse behaviors in acute care settings.