Home Health Care Nurses' Perceptions of Empowerment

Abstract

This exploratory study involved the triangulation of qualitative (interview and observation) and quantitative methods (Psychological Empowerment Instrument). This study examined the individual home care nurses' perception of empowerment and how it influences decisions in the home clinical setting. Fifteen nurses were self-selected to participate. All completed an interview, and were observed and given Likert Instrument to complete. A framework analysis was performed to identify mutually exclusive and exhaustive emergent themes and patterns within the data. Home care nurses described that enpowerment is in the interaction between nurse and patient, and nurse and health care provider. Empowered is defined as being independent, confident, trusting, and comfortable with providing quality care. Home health care nurses believe that having the ability to practice collaboratively and build professional relationships was essential. Nurses in this study perceived empowerment as having meaning, choice, and competence in their job.

CNE Article: Moral Distress and Psychological Empowerment in Critical Care Nurses Caring for Adults at end of Life

“…This finding is consistent with results of a mixed-method study using the PEI and interviews done by Williamson 14 examining home health nurses' perception of psychological empowerment. PEI scores were high in this study, and interviews of participants identified collaboration as one of the most important facets of empowerment.…”

“…The MDS uses 3 factors or subscales to measure moral distress: (1) individual responsibility (refers to the nurse participating in care not agreed with or ignoring actions one should take-20 items), (2) not in patient's best interest (refers to participating built on the work of Jameton. 7 Multiple studies 4,10,[13][14][15][16][17][18] have shown that futile care, where nurses perceived that the patient would not benefit from care, caused the most significant levels of moral distress in nurses.…”

Atuação do enfermeiro na atenção domiciliar: uma revisão integrativa da literatura

“…The way roles and relationships are built, negotiated, and experienced shows the relevance of the relationship between nurses and patients when defining their experiences and perceptions of the quality of care in general (16) . A large part of nursing care in HC is dedicated to active listening to patients, in an effort to comfort them (18) . In one of the studies, nurses were named as the professionals most sensitive to patient demands, which turns the acts of being polite and offering dialog into care strategies, in tandem with conscience and responsibility (20) .…”

“…The HC space requires highly qualified nurses, with various abilities and commitment (33) , who possess a wide range of clinical and care competencies and a high degree of autonomy to conduct their work, performing continuous monitoring of their patients, in chronic or acute conditions, in the family and community spheres, and who employ a balance of curative and preventive actions (33) . In addition, their role in the practice of home care is based on the recognition of their competence regarding their skills, abilities, aptitudes, and experiences (18) . However, concerning challenges inherent to the complexity of nursing practice in home care, it was possible to verify that insufficient training or little experience in HC services (19) and lack of ability and knowledge (28)(29) can negatively influence home care.…”

“…Relationship of help/Interaction (14,(17)(18)(19)(20)(24)(25)(29)(30)35,42,44,46,(48)(49)54) Emotional, mental, or psychological support (37,40,42,46,51,55) Communication (12,18,21,51,56) Relationship of trust (10,22,26,42,56) Negotiation (16,21,26,52) Respect (11,41,56) Dialog (20,26) and listening (18) Educational actions Guidelines for families, caregivers, and/or patients (13,19,25,27,29,32,36-40,44-46, 48,51,53) Development of teaching strategies (48) Learning about social resources (51) Training of patients, family, and neighbor network and other sectors for risk prevention in emergencies (38) Guidelines for other nurses (40) Care actions Medication management or infusion …”