Power and empowerment in nursing: three theoretical approaches

Definitions and uses of the concept of empowerment are wide-ranging: the term has been used to describe the essence of human existence and development, but also aspects of organizational effectiveness and quality. The empowerment ideology is rooted in social action where empowerment was associated with community interests and with attempts to increase the power and influence of oppressed groups (such as workers, women and ethnic minorities). Later, there was also growing recognition of the importance of the individual's characteristics and actions. Based on a review of the literature, this paper explores the uses of the empowerment concept as a framework for nurses' professional growth and development. Given the complexity of the concept, it is vital to understand the underlying philosophy before moving on to define its substance. The articles reviewed were classified into three groups on the basis of their theoretical orientation: critical social theory, organization theory and social psychological theory. Empowerment seems likely to provide for an umbrella concept of professional development in nursing.     

Learning to be a normal mother: empowerment and pedagogy in postpartum classes

This qualitative study, which was conducted in the summer of 1992, presents the findings of how six first-time mothers and two public health nurses experienced pedagogical practices within postpartum classes offered by two public health units in Ontario, Canada. How concerns and aspirations of new mothers were constructed and mediated in the postpartum class are analyzed using concepts from poststructuralist and feminist methodologies. This study goes beyond an analysis of individual teaching and learning styles and discusses how social structures of isolation, investment in a medical discourse, and processes of normalization construct an individual's experiences and practices of mothering, which in turn influence pedagogical practices in postpartum classes. Issues of empowerment, language, support, and knowledge exchange are discussed.     

A discursive exploration of nursing work in the hospital emergency setting

Emergency nurses apply specialist knowledge to the practice of emergency care. This paper discusses the ways in which three emergency nurses understand the nature of their care from their own frames of reference and experiences and presents some of the data collected in a larger study. Various discourses, which compete to inform emergency nurses' understandings of practice, are linked with the notion of nurses as subjects; that is, each discourse may inform, shape and constitute the practice of the nurse and, in turn, the ways in which the patient comes to be known and understood. I will examine the ways in which emergency nurses come to experience or position themselves vis-à-vis extant forms of knowledge of emergency care and the extent to which they articulate new or distinctive formulations of emergency care. This paper illuminates the commonalities that constitute the discourses of emergency nursing care, and also analyse nurses' language which demonstrates that within each discourse variations, contradictions and resistances exist. Emergency nursing care occurs in a context of a biomedical discourse that dominates, or tends to dominate, the work of the emergency setting and so to determine acceptable or possible practices. Nevertheless, nurses contest in various ways the 'truths' that they understand to underpin their practice. Challenges to biomedical discourses are revealed, to some extent, by drawing attention to specific situations and particular struggles encountered in emergency nurses' everyday practice.     

心理授权在护理管理中的应用进展

在介绍心理授权概念及其测量工具的基础上,重点对心理授权在护理管理中的应用情况进行综述。     

Foucault and nursing: a history of the present

While a commitment to the development of nursing theory has been a significant force in nursing scholarship, particularly in the US, the authors have noted a recent trend among nurses in different countries to develop Foucauldian interpretations of nursing. The objective of this paper is to identify those publications by nurses that employ a Foucauldian perspective and to provide a useful summative review of these works to date, which illustrate the potential contribution of a Foucauldian reading of nursing. The authors have reviewed 27 publications written by nurses which present a Foucauldian analysis. These publications were issued between 1987 and 1998 in English, Portuguese and German. The most frequent concepts treated in the literature reviewed are power/knowledge, surveillance, discourse, discipline, resistance, docile bodies, clinical gaze, and panopticon. The literature reviewed illustrates that Foucault's concepts can have a profound impact on the way we conceive of nursing as a discipline and as a profession. Nursing care becomes a political event, nursing knowledge contributes to the dissemination of regimes of truth, and nurses, rather than being powerless, are perceived as professionals who exercise power over life in society. A Foucauldian reading of nursing enables nurses to move into a broader interdisciplinary and critical scholarship.     

A concept analysis of empowerment: its relationship to mental health nursing

The concept of empowerment is described as being intuitively attractive to nurses and the nursing profession. This concept analysis represents an attempt not only to clarify meaning but also to describe the relationship, if any, between empowerment and mental health nursing. It is the argument of this author that the conceptual ambiguity said to blight the implementation of empowerment practice is underpinned by a tendency to describe the concept without direct reference to theories of power. As regards mental health nursing the author concludes that there should be an end to the quest for professionalism personified by notions such as individualized care. In its place should be an approach that recognizes that nurses and users must unite to pursue forms of knowledge that precipitate a challenge to the current hegemony of the medical and scientific elite.     

临床护理领域充权概念解析及应用

对临床护理领域充权的概念、与其他相关概念的关系、测量以及临床运用进行了介绍.     

赋能理论在护理管理中的应用现状

文章从赋能的概念界定出发,介绍了不同层面(心理层面、领导层面和组织层面)赋能的维度以及测量的常用工具,总结近年来赋能在护理管理领域的应用方法及效果,最后在对研究现状进行评析的基础上,对未来的研究方向进行了展望。     

Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care

spence laschinger h.k., gilbert s., smith l.m. & leslie k. (2010) Journal of Nursing Management 18, 4–13
Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care
Aim  The purpose of this theoretical paper is to propose an integrated model of nurse/patient empowerment that could be used as a guide for creating high-quality nursing practice work environments that ensure positive outcomes for both nurses and their patients.
Background  There are few integrated theoretical approaches to nurse and patient empowerment in the literature, although nurse empowerment is assumed to positively affect patient outcomes.
Evaluation  The constructs described in Kanter's (1993) work empowerment theory are conceptually consistent with the nursing care process and can be logically extended to nurses' interactions with their patients and the outcomes of nursing care.
Key issues  We propose a model of nurse/patient empowerment derived from Kanter's theory that suggests that empowering working conditions increase feelings of psychological empowerment in nurses, resulting in greater use of patient empowerment strategies by nurses, and, ultimately, greater patient empowerment and better health outcomes.
Conclusions  Empirical testing of the model is recommended prior to use of the model in clinical practice.
Implications for Nursing Management  We argue that empowered nurses are more likely to empower their patients, which results in better patient and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.     

Team inclusion and empowerment among nursing staff in long-term care

Team-based approaches to long-term care are increasingly part of the landscape in residential care facilities to improve staff performance and resident outcomes vis-à-vis empowering direct care staff. This study characterizes licensed and unlicensed nursing staffs’ (N = 95) perceptions of inclusion as care team members by co-workers, supervisors and non-nursing clinicians. Further, we explored whether inclusion was correlated with heightened empowerment and its related dimensions using the Perception of Empowerment Instrument. Linear regression analyses revealed that levels of total empowerment, autonomy, responsibility and participation were associated with how included team members felt and by which members of the care team. These findings shed light on the potential importance of tailoring staff training to target specific team members to increase a sense of empowerment that aligns with the specific dimension(s) for a targeted group.     

本科护理实习生结构性授权与专业护理实践环境的关系

目的:了解目前本科护理实习生结构性授权与专业护理实践环境的状况,并分析两者之间的相关性。方法:采用临床实习环境问卷、专业护理实践环境问卷对在7所三级甲等教学医院实习的200名本科护理学生进行调查。结果:结构性授权总分为11.59±2.40,4个因子得分由高到低依次为支持权力2.89±0.70、资源权力2.89±0.65、信息权力2.89±0.68、机会权力2.83±0.68;专业护理实践环境总分为12.91±1.87,5个因子得分由高到低依次为高质量护理的基础2.81±0.65、护士长的能力、领导方式和对护士的支持2.63±0.42、充足的资源配备2.56±0.48、医护关系2.48±0.46、参与医院事务2.43±0.36,本科护理实习生结构性授权与专业护理实践环境呈显著正相关(P<0.01)。结论:本科护理实习生结构性授权水平较低,专业护理实践环境水平不高,临床教学管理者应充分重视对本科护理实习生适当授权,针对授权不足之处采取有效措施,以创造良好的专业护理实践环境,提高授权水平,稳定护理学生的专业思想。     

The meaning of empowerment for nursing students: a critical incident study

AIM: This paper is a report of a study to explore the meaning of empowerment for nursing students in relation to their clinical practice experiences. BACKGROUND: Empowerment and power are well-researched areas of nursing practice, particularly in relation to Registered Nurses. Furthermore, several studies have considered the experiences of nursing students in terms of nursing culture and socialization. However, few researchers have focused specifically on nursing student empowerment. METHOD: The critical incident technique was used and anonymous data were collected between November 2005 and January 2006. One hundred and nine written critical incidents were provided by 66 nursing students relating to empowering and disempowering experiences in clinical practice. The data were content analysed. FINDINGS: Nursing students experience both empowerment and disempowerment in clinical placements, centring on three issues: learning in practice, team membership and power. Continuity of placement, the presence of a mentor and time underpinned empowering experiences whereas their absence had a disempowering effect. CONCLUSION: The consequences of nursing student empowerment are high self-esteem, motivation for learning and positive regard for placement. Supportive mentors play a pivotal role in the empowerment of nursing students and it is essential for the nursing profession that they are supported to undertake their mentorship role.     

心理授权在脑卒中患者早期康复护理中的应用研究

目的 研究心理授权在脑卒中患者早期康复护理中的应用效果。方法 采用非同期对照方法,选取2020年3月-2020年5月在某三级综合性医院神经内科住院的47名符合纳入排除标准的脑卒中患者作为对照组,2020年7月-2020年9月的47名符合纳入排除标准的脑卒中患者作为观察组;对照组患者住院期间实施常规早期康复护理方案,观察组住院期间实施基于心理授权理论形成的早期康复护理方案。评价不同护理方案下两组患者在住院期间康复护理训练项目完成率、自我护理能力（ESCA）评分、生活自理能力（ADL）评分、肌力分级、跌倒发生率、压力性损伤发生率和肩关节脱位发生率。结果 观察组患者康复护理训练项目完成率较对照组明显提高,差异有统计学意义（P<0.05）;出院时自我护理ESCA评分、ADL评分、肌力分级均明显优于对照组,差异有统计学意义（P均<0.05）;两组患者住院期间跌倒发生率、压力性损伤发生率及肩关节脱位发生率无统计学差异（P>0.05）。结论 采用心理授权方式可提高脑卒中早期康复患者住院期间康复训练项目完成的依从性并帮助患者改善肌力,提高自护能力及自理能力。     

Kanter结构授能理论及其在护理领域中的研究进展

通过介绍Kanter结构授能理论的框架及其在护理领域的适用性,重点阐述了护理人员结构授能与身心健康、工作满意度、离职意向和护理质量的相关研究进展,并提出对我国护理领域结构授能研究的启示.     

From iron gaze to nursing care: mental health nursing in the era of panopticism

The purpose of this paper is to question the utilization of mechanical devices (cameras and microphones) to ensure the surveillance of hospitalized patients on psychiatric wards. The works of French philosopher, Michel Foucault, and those of nursing theorist, Jean Watson, are used to support this analysis. A growing number of Canadian psychiatric health care institutions are using mechanical devices for surveillance. The security of staff and patients as well as therapeutic purposes are stated as rationale for these practices. However, a Foucauldian perspective leads us to think otherwise. The metaphor of the panopticon is then used to uncover another reality: a disciplinary one. Within the scope of this paper, the question of surveillance, disciplinary power, caring philosophy, and mental health nursing will be examined.