Strengthening the Policy Advocacy Functions of Professional Nursing Associations

  • Author / Creator
    Chiu, Pak Cheong Patrick
  • Background: Advocacy is core to the nursing profession as illustrated within the literature, codes of ethics, and regulatory standards. While scholars have advanced our collective understandings about how advocacy can be strengthened within the profession, the focus has remained largely situated at the individual nurse-client level, with less attention to advocacy undertaken by nursing organizations at the policy level. Across the globe, nursing organizations have a long history of engaging in policy advocacy to advance the profession, strengthen health systems, and influence public policy. While this work continues to be viewed by nurses as essential for the profession to meet its social mandate, there is a dearth of research that has critically examined the policy advocacy work of nursing organizations and the ways in which it could be strengthened given shifting social, political, and economic landscapes. The lack of literature focused on this topic and the emergence of the COVID-19 pandemic presented an opportunity to develop knowledge to advance this domain of practice within the profession.
    Purpose: The purpose of this dissertation is to advance our collective understanding of policy advocacy undertaken by nursing organizations to identify ways to strengthen influence and impact. The aims of this research were to a) explore what constitutes nursing policy advocacy knowledge and the ways in which it can be advanced; b) examine the existing scholarly work focused on nursing organizations and policy advocacy to identify knowledge gaps; and c) to draw on the COVID-19 pandemic as an exemplar to examine the lessons that could be learned from professional nursing associations’ policy advocacy responses to the global pandemic to inform future large-scale public health crises.

    Methods: I conducted three studies including a) a theoretical exploration to explore how nursing and policy theories, models, and frameworks can be developed and integrated to advance nurses’ and nursing’s policy advocacy knowledge; b) a scoping review to examine the nature, extent, and range of scholarly work focused on nursing organizations and policy advocacy; and c) an interpretive description study to explore the lessons that could be learned from professional nursing associations’ policy advocacy response to the COVID-19 pandemic. This consisted of studying four professional nursing associations (two local, one national, and one global) through key informant interviews and document analysis.
    Findings: The theoretical exploration highlighted the various models, theories and frameworks within the nursing and policy literature that nurses can use to develop policy advocacy knowledge within nursing. This framework focused on four key areas including policy content, context, processes, and actors. The scoping review revealed that the extant literature covered a broad range of topics ranging from the role and purpose of nursing organizations in policy advocacy, the identity of nursing organizations, the development and process of policy advocacy initiatives, the policy advocacy products of nursing organizations, and the impact and evaluation of organizations’ policy advocacy work. While the breadth and depth of literature has expanded over the years, significant knowledge gaps exist, and several areas of require further inquiry. Specifically, this includes understanding the relationships between decision-making processes and theories of policy process and change, understanding the impact of organizational factors on policy advocacy processes and outcomes, examining external perspectives to inform policy advocacy approaches, engaging in advocacy and policy change evaluation, and adopting a critical lens to challenge the status quo. Findings from the interpretive description study identified several lessons learned about professional nursing associations’ policy advocacy response to the COVID-19 pandemic including their role in supporting a wide audience (the ‘who), the breadth of their policy priorities (the ‘what’), their use of various advocacy strategies (the ‘how’), the factors that influence their decision-making processes (the ‘why), their perspectives on evaluating policy advocacy work, and the importance of capitalizing on windows of opportunity.
    Conclusions: The integration of studies conducted in this dissertation advances our collective understanding of the concept of advocacy and how it can be applied and studied at the policy level within the organizational context. While nursing organizations play a vital role in policy advocacy, greater scholarship is needed to build the knowledge base required to inform the ways in which this critical function can be strengthened for optimal influence and impact.

  • Subjects / Keywords
  • Graduation date
    Spring 2023
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.