Increasing use of research in clinical practice is inevitable, and therefore, integrative reviews can play a greater role in developing evidence-based nursing practices. Because of this, nurse researchers should pay more attention to sound integrative nursing research to systematise the review process and make it more rigorous.
These results may indicate that the empowerment approach to health promotion within the modern health promoting role of nurses requires critical reflection. Therefore, effective methods and evaluation tools of reflective learning are needed to support learning from practice via critical reflection.
Negotiation, an essential communication activity in lifestyle counseling, has rarely been studied at the micro level of interaction. Furthermore, the evidence for interpersonal negotiation to occur in counseling practice is inconclusive. In this study, the authors describe how negotiation focused on lifestyle changes was produced in nurse-patient interaction. The research data, 73 videotaped diabetes counseling situations, were analyzed using conversation analysis. The process of negotiation consisted of recognizing the problems in the patients' health behavior, offering proposals as solutions to the problems, and reaching an agreement on them. Negotiation had characteristics similar to those mentioned in the literature, but there were also prominent inadequacies. The authors suggest that nurses might need to become more aware of their counseling practices in routine situations through conscious effort for self-evaluation. In addition, further research would be required to demonstrate the effectiveness of negotiation for facilitating changes in patients' health behavior.
This study illustrates practices that a nurse uses in order to empower patients. The emphasis is on speech formulae that encourage patients to discuss their concerns and to solicit information about impending surgery. The study is a part of a larger research project and a single case was selected for presentation in this article because it differed from the rest of the data by manifesting empowering practice. A videotaped nurse-patient health counseling session was conducted in a hospital and transcribed verbatim. The investigator interviewed the nurse and the patient after the conversation, and these interviews were transcribed as well. The encounter that is presented here as a case study is a concrete example of a counseling session during which the patient is free to discuss with the nurse. The empowering practices that the nurse employed were as follows: encouraging the patient to speak out, tactfully sounding out the patient's concerns and knowledge of impending surgery, listening to feedback, and building a positive vision of the future for the patient. We suggest that nurses should pay attention to verbal expression and forms of language. This enables them to gain self-awareness and discover new tools to work with.
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