Introduction
As the healthcare system embraces new models of clinician-patient relationships, particular concepts gain importance. One of the growing trends is patient involvement introduced in conversations between healthcare providers and their clients and the decision-making process related to treatment. The concept of empowerment is adjacent to this evolution, and an increasing number of studies consider it not in relation to nurses but to patients (Akpotor and Johnson, 2018). The following paper looks at two articles performing a concept analysis of empowerment. The first study by Akpotor and Johnson (2018) considers client empowerment in community health nursing. The second one by Weisbeck et al. (2019) looks at patient empowerment among people with chronic pain. Both articles present an in-depth investigation of the concept in their fields, using different approaches but showing similar conclusions about the role of empowerment in nursing.
Article One: Client Empowerment
Akpotor and Johnson (2018) employ the approach of Walker and Avant. Walker and Avant’s model of concept analysis includes eight steps (McEwen & Wills, 2019). They involve the selection of a concept, identification of aims uses and defining attributes, a description of the model, borderline, related contrary, and other cases, the listing of antecedents and consequences, and empirical referents (McEwen & Wills, 2019). Akpotor and Johnson (2018) complete all steps; their working definition of client empowerment is “a process by which the community health nurse and her client institute a therapeutic relationship within a supportive social climate” (p. 748). The latter has to facilitate “respect, mutual decision-making, and power-sharing,” and empowerment has to result in the client gaining “independence, increased confidence, self-reliance, and self-management” (Akpotor & Johnson, 2018, p. 748). This definition aligns with the environment in which the authors operate as it is focused on the clinician-patient relationship.
The scholars consider the history of empowerment in other disciplines. For instance, from the viewpoint of women’s empowerment, it is a power delegation process (Akpotor & Johnson, 2018). In marketing, firms use empowerment for increased customer control and collaboration between businesses and clients (Akpotor & Johnson, 2018). However, Akpotor and Johnson (2018) note that this concept is often misused to present an idea of power without any actual authority over choices and actions. Thus, the nursing field should be wary of such artificial empowerment and focus on the client outcomes mentioned above.
Following Walker and Avant’s approach to concept analysis, the scholars list defining attributes of empowerment. They include a therapeutic practitioner-client relationship, shared decision-making, giving the client a sense of control or sharing social power, and focusing on the client’s strengths and not weaknesses (Akpotor & Johnson, 2018). Through their model, borderline, and contrary cases, scholars try to demonstrate these elements’ value in nursing. The researchers suggest that the lack of client power and consensus decision-making leads to the nurse dominating the discussion about patient health and assuming a paternalistic role (Akpotor & Johnson, 2018). This may lead to ineffective treatment and patients’ lack of response to advice. In contrast, the use of attributes leading to empowerment results in clients taking charge of their condition and developing a sense of confidence and independence (Akpotor & Johnson, 2018). As a result, the relationship between nurses and clients may improve and allow for acknowledging patients’ needs.
Article Two: Patient Empowerment
Weisbeck et al. (2019) consider a similar concept of patient empowerment, but they use Rodger’s evolutionary concept analysis approach. The authors do not provide a clear definition of the concept, stating that they “depend on the domain and dimensions in which they are used” (Weisbeck et al., 2019, p. 1150). Nevertheless, they present a list of attributes, including self-determination, supportive relationship and mutuality, and the process of enabling (Weisbeck et al., 2019). These characteristics are preceded by the partnership, competency, and motivation.
Different disciplines seem to use similar characteristics when discussing empowerment. Al-Omari et al. (2020) consider employee empowerment and conclude that the sharing of power and increased self-confidence and self-responsibility are the results of an empowering organization. Santoso et al. (2019) discuss women’s empowerment as women’s growing ability to make important life choices. This description is similar to the latter attribute by Weisbeck et al. (2019), as the enabling process is the facilitation of being in control. Thus, the absence of a definition of the concept of nursing leaves the authors’ description of empowerment flexible and universal.
Similar to the previous article, the application of the concept is presented in the form of a case. Weisbeck et al. (2019) suggest that nurses can establish a supportive environment, engage in active listening, and open up the possibility of patient decision-making to facilitate empowerment (Weisbeck et al., 2019). As a result, it is expected that patients’ quality of life will increase, and they will gain a new value of life and self (Weisbeck et al., 2019). Therefore, in nursing, empowerment acts as a vital part of treatment and a strategy for improving patient-nurse relationships and patient outcomes.
Conclusion
The concept of empowerment has a history in nursing and other disciplines. The interpretation of empowerment may differ, but they highlight such characteristics as sharing power, support, and mutual decision-making. The two articles under review utilize different concept analysis approaches and consider two somewhat varying fields of implementation. The authors come to similar conclusions that empowerment benefits nurses’ relationships with patients and the latter’s health and self-determination.
References
Akpotor, M. E., & Johnson, E. A. (2018). Client empowerment: A concept analysis. International Journal of Caring Sciences, 11(2), 743-750.
Al-Omari, Z., Alomari, K., & Aljawarneh, N. (2020). The role of empowerment in improving the internal process, customer satisfaction, learning and growth. Management Science Letters, 10(4), 841-848.
McEwen, M., & Wills, E. M. (2019). The theoretical basis for nursing (5th ed.) Wolters Kluwer Health.
Santoso, M. V., Kerr, R. B., Hoddinott, J., Garigipati, P., Olmos, S., & Young, S. L. (2019). Role of women’s empowerment in child nutrition outcomes: A systematic review. Advances in Nutrition, 10(6), 1138-1151.
Weisbeck, S., Lind, C., & Ginn, C. (2019). Patient empowerment: An evolutionary concept analysis. International Journal of Caring Sciences, 12(2), 1148-1155.