| Kap Chul Cho | 3 Articles |
Since 1990, descriptive studies about the concept of client advocacy have been published in the health journals.
However, empirical studies of the concept are still lacking.
There are not enough bases to apply the concept of client advocacy in nursing practice. The purpose of this paper is to encourage empirical research about client advocacy by clarification of the concept and to discusses application of the theory in child healthcare. The literature was reviewed that empirical studies on client advocacy conducted after the year 2000. The changing trends in the client advocacy concept was examined; it was changed from the philosophical concept to nursing action and changed from individual advocacy to collective advocacy, with the rise of the self advocacy concept. The research trends on client advocacy evolves from descriptive study to quasi-experimental study and instrument development study, with diversification and expansion of research methods, advocates, clients and settings. The advocacy role of the nurse in child healthcare is significant due to the child's lack of self determination ability. In ill child care, the application of individual advocacy is potent, while in healthy child care, collective advocacy, policy advocacy, and social advocacy is effective.
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This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses.
Almost of the callers (98.4%) were mothers. Among them 89.6% were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36%), followed by 28% from Kyung Gi Province, and 20% were from the Kyung Sang area. Among 8,261 callers, 72.8% were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5%) was the less than six month age group.
The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3%), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25% and 23.3% respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3% with diaper rash being the second highest among the skin problems. About 80% of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.
This descriptive study was done to detect the possibilities of the development of the advocacy concept in nursing. The subjects consisted of 3 nurses who had agreed to participate to the study, working at nursery room in a general hospital. Data was collected from May 22 to June 13 in 1995 through tape recorded intensive-interview, and written down, then content analyzed qualitatively related to the infant advocacy. 1. Derivation fo the meaning about advocacy concept 1) The situations in need of infant advocacy were 12 categories : malpractice, overcharing, negligence, unnecessary services, and services without consent, and so on. 2) Fourteen categories of advocacy activities percived by nurses were derived from participants' statements. Protesting infant or his /her families against their counterpart, providing informations to families, cooperating with medical staffs for her patient, then calling medical staff not so as to be maleficient to her patient in its rank. 3) The expected result of advocacy activities perceived by nurses was respectively positive to her patient or families, but negative to nurse. 4) The feelings of nurses in the sitution of advocacy were expressed in to concern, comprehension, regret, powerlessness, charity, desire, and so on. 5) Nurses perceived that advocacy activities could be influenced positively by factors related to nurses' qualification and negatively by factors related to doctor's overdo and nurse's underdo. 2. Categorization of the meaning and their relationships In case of antecedental situation in need of infant advocacy, nurse perceives her patients need the advocacy to get a benefit through nurse's information, intervention speaking, building cooperations. The expected factors to influence advocacy activities perceived by nurses, are the power imbalance between medical staffs, the nurse's qualification, and the nurse's feeling from the situation. The above results suggest that the infant care situation will be recommendable field work place for concept development of advocacy with hybride model when it involves infant's families.
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