Journal of Health, Medicine and Nursing www.iiste.org ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN Vol.63, 2019 64 How Patients and Nurses defined Advocacy in Nursing? A Review of the Literature Elsa Vitale 1* Francesco Germini 2 Michele Massaro 3 Rosa Silvia Fortunato 4 1.PhD, MSN, BSN, ASL Bari, Italy 2.MSN, BSN, RN, ASL Bari, Italy 3.MSN, BSN, ASL Bat, Italy 4.BSN, RN, ASL Bologna, Italy Abstract Objectives: Advocacy is an important aspect in current professional nursing care and it is a relatively new role for nursing, emerged in the United States in 1980s. This article aimed to explore the basis of advocacy concept viewed by both nurses and patients.Design: A computerized search in PubMed, Medline, Embase databases was conducted to highlight the relevance of nursing advocacy by nurses and patients. This review included qualitative studies which explained better advocacy concept in nursing practice and analyzed the concept of nursing advocacy. Data sources: Fifteen articles were found. Of these, only six met all the requirements of the inclusion criteria Review methods: Articles were compared by considering for each paper the purpose, the design, the methodology, the finding, in order to define advocacy concept by both patients and nurses.Results: Six articles were found, which were published between 1996 and 2018.Conclusions: It was found that the concept and the practice of the nursing advocacy was still enshrouded in confusion, conflict and change. Keywords: Advocacy; Nursing Advocacy; Literature Review; Patient Advocacy. DOI: 10.7176/JHMN/63-08 Publication date:June 30 th 2019 1. Introduction Advocacy, as defined in a dictionary, describes “the act of pleading for, supporting, urging by argument, recommending publicly, and active espousal”. Inherent to the definition of the term is the concept of action. Advocacy implies taking action to achieve a goal, either on behalf of oneself or on behalf of another. In nursing, it is directly related to patient care, with the patient’s needs or wishes often serving as the impetus for, or defining feature of, the advocacy itself. Advocacy is an important aspect in current professional nursing care, both for nurses and patients. The nurse represents a moral agent of the patient, so he must be ready and able to advocate for the patient’s needs Nursing has not always practiced advocacy; rather, advocacy is a relatively new role for nursing, emerging in the United States in 1980s. Much of the philosophical work has formed the basis of advocacy. For example, “Curtin, 1979” based her philosophy of nursing advocacy on the belief that the humanity of each individual came forth from human needs. The nurse, according to Curtin, provided a supportive atmosphere for the patient’ s decision – making process, which was the basis of all other nursing activities. As human advocates, nurses assist patient to discover the significance of their life process. Moreover, “Gadow, 1980” had a similar philosophy of nursing advocacy, which she called existential advocacy. Gadow described existential advocacy as the nurse’ s assistance to patients in exercising the client’ s right of self - determination, utilizing judgments that realize the complexity of the patient’ s value. She argued that only patient could decide what was in his or her own best interest, and that nurse was entirely engaged in assisting the patient in this process. Gadow also has explored advocacy for the vulnerable patient, concluding that nurses have a moral commitment in regards to a patient’ s autonomy. In addition, “Kohnke, 1980” viewed the role of nurse advocate as having two functions: that of an informer to the patient and as supporter of the patient’ s decision. Both these functions of nurse advocacy carry the risk of alienating the nurse advocate in regards to other healthcare professionals. Kohnke revealed that for a nurse to be proficient as a nurse advocate, the nurse might have an adequate knowledge based in areas such as ethics, social law, and politics. Understanding advocacy, as an essential component of nursing practice, is the first step in becoming a patient advocate. Many nurses do not feel that they have the power or autonomy to take action for patients. The code for nursing identifies the responsibility for advocacy, and yet nurses often are not supported by their employers in this . This literature review is focused on the relevance of the advocacy concept in the nursing practice and both in the patient perception. 2. Methods A computerized search in PubMed, Medline, Embase databases was conducted between 1996 and 2018. The search