RT Article
T1 Patient advocacy: Japanese psychiatric nurses recognizing necessity for intervention
JF Nursing ethics
VO 22
IS 7
SP 765
OP 777
A1 Toda, Yumiko
A1 Sakamoto, Masayo
A1 Tagaya, Akira
A1 Takahashi, Mimi
A1 Davis, Anne J.
LA English
PB Sage
YR 2015
UL https://www.ixtheo.de/Record/1779453566
AB Background:Advocacy is an important role of psychiatric nurses because their patients are ethically, socially, and legally vulnerable. This study of Japanese expert psychiatric nurses’ judgments of interventions for patient advocacy will show effective strategies for ethical nursing practice and their relationship with Japanese culture.Objectives:This article explores Japanese psychiatric nurses’ decision to intervene as a patient advocate and examine their ethical, cultural, and social implications.Research design:Using semi-structured interviews verbatim, themes of the problems that required interventions were inductively summarized by a qualitative analysis and their contexts and nursing judgments were examined.Participants and research context:The participants were 21 nurses with 5 or more years of experience in psychiatric nursing.Ethical considerations:The research was approved by Institutional Review Board of research site and study facilities. The participants gave written informed consent.Findings:Analysis of 45 cases showed that nurses decided to intervene when (a) surrounding people’s opinions impeded patients’ safety, (b) healthcare professionals’ policies impeded patients’ decision-making, (c) own violent behaviors impeded treatment and welfare services for patients, (d) own or families’ low acceptance of illness impeded patients’ self-actualization, (e) inappropriate treatment or care impeded patients’ liberty, and (f) their families abused patients’ property.Discussion:To solve conflicts between patients and their surrounding people, the nurses sought reconciliation between them, which is in accordance with Japanese cultural norms respecting harmony. When necessary, however, they protected patients’ rights against cultural norms. Therefore, their judgments cannot be explained by cultural norms alone.Conclusion:The findings indicate that the nurses’ judgments were based on respect for patients’ rights apart from cultural norms, and they first sought solutions fitting the cultural norms before other solutions. This seems to be an ethical, effective strategy if advocates know the culture in depth.
K1 psychiatric nursing
K1 patient’s right
K1 patient advocacy
K1 nursing judgment
K1 Mental Disorders
K1 Expert nurse
DO 10.1177/0969733014547971