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The Sphere of Nursing Advocacy (SNA) model explains and depicts nursing advocacy on behalf of a client. The SNA model views the client as continually protected from the external environment by a semipermeable sphere of nursing advocacy that allows clients to self advocate if the client is emotionally and physically able or to be advocated for by the nurse if the patient is unable to advocate for him- or herself. The SNA model can be used to guide research or it can provide the basis for instruction on the subject of nursing advocacy.
Search terms: Nursing, patient advocacy
Introduction
Advocacy for clients is an important aspect in current professional nursing care and is considered to be a fundamental value of professional nursing by several nursing scholars. Nursing has not always practiced advocacy; rather, advocacy is a relatively new role for nursing, emerging in the United States in the 1980s (Hamric, 2000).
For the purposes of this article, the basis of nursing advocacy is formulated from the philosophical work of Curtin (1979), Gadow (1980), and Kohnke (1982). These authors provide definitions and models that have shaped current nursing advocacy. Curtin bases her philosophy of nursing advocacy on the belief that the humanity of each individual comes forth from human needs. The nurse, according to Curtin, provides a supportive atmosphere for the client's decision-making process, which is the basis of all other nursing activities. As human advocates, nurses assist clients to discover the significance of their life processes (Curtin, 1979).
Gadow (1980) has a similar philosophy of nursing advocacy, which she calls existential advocacy. Gadow describes existential advocacy as the nurse's assistance to clients in exercising the client's right of self-determination, utilizing judgments that realize the complexity of the client's values. She argues that...