Relational ethics and advocacy in nursing: literature review.
OBJECTIVE
The purpose of this paper is to analyse themes from accounts of nurses' experiences with advocacy that may expand our understanding of advocacy in nursing practice.


BACKGROUND
Although the ethical obligation to advocate is universal, a lack of clarity persists about the nature of advocacy in nursing practice.


METHODS
This discussion of advocacy is based on a synthesis of qualitative studies that focus on nurses' experiences with advocacy in practice. Empirical studies were retrieved through searches on the CINAHL and Academic Search Premier databases for the years 1993-2005. The search terms used were advocacy, advocate role, ethics, nursing practice and qualitative research.


RESULTS
Empirical studies related to the role of advocacy in nursing are limited in number. Nurses' experiences with advocacy reveal important themes in relation to factors that influence the application of advocacy in nursing practice. Evidence suggests that the nature and context of relationships plays a significant role in influencing the enactment of advocacy.


CONCLUSIONS
The application of advocacy in nursing practice is complex. The philosophy of relational ethics emphasizes the contextual features of relationships. An examination of relational ethics as it applies to advocacy in nursing brings us closer to a deeper understanding of the process by which nurses make advocacy choices in practice, and raises implications for the development of advocacy in nurses' practice. Advocacy is universally considered a moral obligation in nursing practice, and thus advancement of our knowledge about its nature in nursing is relevant to nursing across multiple contexts and cultures.
MacDonald
Hannah
H
University College of the Fraser Valley, Chilliwack, British Columbia, Canada. hannah.macdonald@ucfv.ca
D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making / Q000941:ethics; D004993:Ethics, Nursing; D006801:Humans; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010344:Patient Advocacy / Q000523:psychology*; D010687:Philosophy, Nursing