Patient advocacy practice and associated factors among Nurses working in public hospitals of jimma zone, oromia Regional state, southwest ethiopia

Abstract

Background: Patient advocacy is key for vulnerable patients who are unable to express their feeling and unable to exercise their autonomy. Nurses as patient advocates play a great role to prevent poor quality of care. However, there is a lack of information about the nurses’ level of patient advocacy practice in Ethiopia in general and in the Jimma zone in particular. Objective: The study aimed to assess patient advocacy practice and associated factors among nurses working in public Hospitals of Jimma zone, Oromia Regional State, Southwest Ethiopia. Methods: An institutional-based cross-sectional study design using quantitative supplemented by qualitative data collection methods were employed among 422 nurses and 12 key informants respectively. Simple random sampling technique and purposive sampling technique were used to get study participants for quantitative and qualitative data respectively. Data were collected using pretested self-administered questionnaires and an in-depth interview. Quantitative data were entered into Epidata version 4.6 and exported to Statistical Package for Social Science version 23 was for analysis. Bivariate and multivariable logistic regression was done to identify factors associated with patient advocacy practice; Factors associated with patient advocacy practice were declared at AOR 95% CI and p-value less 0.05. Thematic analysis was done for qualitative data. Results: This study finding showed that about 47.9 % (95%CI; 42.9, 52.9) of nurses have good patient advocacy practice. Good knowledge about patient advocacy[AOR =1.97;95%CI (1.065,3.629); p= 0.031],good attitude towards patient advocacy [AOR=3.14; 95% CI (1.721,5.742) ; p<0.001],good nurse patient relationships,[AOR= 2.85; 95% CI (1.450,5.605) ; p=0.002],good inter-professional collaboration.[AOR=7.73;95%CI (4.004,14.937);p=<0.001], getting support [AOR=2.84; 95% CI (1.523, 5.305); p=0.001] and work experience (>10 years) [AOR=5.81;95% CI (2.656,12.723); p <0.001] were positively associated with patient advocacy practice. Conclusion and recommendations: The level of patient advocacy practice among nurses working in Jimma zone public hospital was low. Years of work experience, knowledge about patient advocacy, and attitude towards patient advocacy, nurse-patient relationship, inter-professional collaboration and support were factors significantly associated with patient advocacy practice Therefore it is necessary to establish a training program and appropriate guidelines on patient advocacy to improve the patient advocacy practice of nurses