Patient advocacy by intensive care nurses: na integrative literature review




Health advocacy; Defense of the patient; Intensive care unit; Nursing.


Objective: To identify scientific production on the theme of patient advocacy by nurses in the context of intensive care between the years 2010 to 2020. Methods: Integrative literature review on the subject of patient advocacy in an intensive care unit (ICU) between the years 2010 to 2020, carried out in the databases: Publisher Medline (PUBMED), Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library and Web of Science, and also in the electronic library Scientific Electronic Library Online (SCIELO). electronic library, 217 references were found, of which, 18 met the inclusion and exclusion criteria of the research. Result: The 18 selected articles were categorized according to the themes identified with the greatest recurrence, which consist of: nurse as a defender of the patient and family, barriers for the defense of the patient and nurse as an articulator between team, patient and family. Conclusion: This review makes it possible to take to the scientific community, what has been studied about the advocacy of patients in the ICU for the past 10 years, both nationally and internationally, in addition to highlighting the importance of nurses as defenders of the rights of the patient and the family, explain the existing barriers for the patient advocacy by the intensive care nurse to occur in a qualified way, and also demonstrates how the nurse performs the role of intermediary between his patient, family and multiprofessional team.


Ahluwalia, S. C., Schreibeis-Baum, H., Prendergast, T. J., Reinke, L. F., & Lorenz, K. A. (2015). Nurses as intermediaries: how critical care nurses perceive their role in family meetings. American Journal Of Critical Care, 25(1), 33-38, 2015.

Annas, G. J., & Healey, J. (1974). The patient rights advocate. Journal of Nursing Administration, 4(3), 25-31.

Bagherian, B., Sabzevari, S., Mirzaei, T., & Ravari, A. (2017). Effects of technology on nursing care and caring attributes of a sample of Iranian critical care nurses. Intensive And Critical Care Nursing, 39, 18-27.

Becker, C. A., Wright, G., & Schmit, K. (2017). Perceptions of dying well and distressing death by acute care nurses. Applied Nursing Research, 33, 149-154.

Beigzadeh, M., Borhani, F., Ahmadi, F., & Abbaszadeh, A. (2016). Nurses attribution to the role of patient advocacy in intensive care units of hospitals of Tehran University of Medical Sciences. Bioscience biotechnology research communications, 9(4), 884-890. 10_045.pdf.

Borowske, D. (2012). Straddling the Fence: ICU Nurses Advocating for Hospice Care. Critical Care Nursing Clinics Of North America, 24(1), 105-116.

Cypress, B. S. (2011). The lived ICU experience of nurses, patients and family members: A phenomenological study with Merleau-Pontian perspective. Intensive And Critical Care Nursing, 27(5), 273-280.

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. Journal Of Medical Ethics & History Of Medicine, 9(5), 1-8.

Engström, B., Uusitalo, A., & Engström, Å. (2011). Relatives’ involvement in nursing care: A qualitative study describing critical care nurses’ experiences. Intensive And Critical Care Nursing, 27(1), 1-9.

Forsberg, A., Lennerling, A., Fridh, I., Rizell, M., Lovén, C., & Flodén, A. (2015) Attitudes towards organ donor advocacy among Swedish intensive care nurses. Nursing In Critical Care, 20(3), 126-133.

Jakimowicz, S., Perry, L., & Lewis, J. (2018). Insights on compassion and patient-centred nursing in intensive care: A constructivist grounded theory. Journal Of Clinical Nursing, 27(7-8), 1599-1611.

Luz, K. R. D., Vargas, M. A. D. O., Peter, E., Barlem, E., Viana, R. A. P. P., & Ventura, C. A. A. (2019). Advocacy in intensive care and hospitalization by court order: what are the perspectives of nurses?. Texto & Contexto-Enfermagem, 28.

Mortell, M., Abdullah, K. L., & Ahmad, C. (2017). Barriers deterring patient advocacy in a Saudi Arabian critical care setting. British Journal of Nursing, 26(17), 965-971.

Nogario, A. C. D., Barlem, E. L. D., Tomaschewski-Barlem, J. G., Lunardi, V. L., Ramos, A. M., & Oliveira, A. C. C. (2015). Nursing Actions in practicing inpatient advocacy in a Burn Unit. Revista da Escola de Enfermagem da Usp, 49(4), 0580-0588.

Parsons, L. C., & Walters, M. A. (2019). Management Strategies in the Intensive Care Unit to Improve Psychosocial Outcomes. Critical care nursing clinics of North America, 31(4), 537-545.

Pasek, T. A., & Licata, J. (2016). Parent Advocacy Group for Events of Resuscitation. Critical Care Nurse, 36(3), 58-64. ccn2016759.

Pecanac, K., & Schwarze, M. L. (2016). Conflict in the intensive care unit: Nursing advocacy and surgical agency. Nursing Ethics, 25(1), 69-79.

Rout, J., & Brysiewicz, P. (2017). Exploring the role of the ICU nurse in the antimicrobial stewardship team at a private hospital in KwaZulu-Natal, South Africa. South. Afr. j. crit. Care, 33(2), 46-50.

Salmond, S. W. (2011). When the family member is a nurse: The role and needs of nurse family members during critical illness of a loved one. Intensive And Critical Care Nursing, 27(1), 10-18.

Souza, M. T., Silva, M. D., & Carvalho, R. (2010). Revisão integrativa: o que é e como fazer. Einstein, 8(1), 102-106.

Tomaschewski-Barlem, J. G., Lunardi, V. L., Barlem, E. L. D., Silveira, R. S. D., Ramos, A. M., & Santos, J. M. D. (2018). Ações dos enfermeiros no exercício da advocacia do paciente: revisão integrativa. Texto contexto - enferm., 27(2), e0730014. pid=S0104-07072018000200501&lng=pt&nrm=isso.

Vargas, C. P., Vargas, M. A. D. O., Tomaschewski-Barlem, J. G., Ramos, F. R. S., Schneider, D. G., & Camponogara, S. (2019). Patient advocacy actions by intensivist nurses. Revista da Escola de Enfermagem da USP, 53.

Ventura, C. A. A., Mello, D. F. D., Andrade, R. D., & Mendes, I. A. C. (2012). Aliança da enfermagem com o usuário na defesa do SUS. Rev. bras. enferm., 65(6), 893-898.

Versa, G. L. G. S. & Matsuda, L. M. (2014). Satisfação profissional da equipe de enfermagem intensivista de um hospital de ensino. Revista Enfermagem Uerj, 22(3), 409-415.



How to Cite

MENEZES, J. A. L. de .; MANOEL, M. S.; VARGAS, M. A. de O. .; CAMPONOGARA, S.; BREHMER, L. C. de F. .; SCHNEIDER, D. G. . Patient advocacy by intensive care nurses: na integrative literature review. Research, Society and Development, [S. l.], v. 10, n. 6, p. e53110615968, 2021. DOI: 10.33448/rsd-v10i6.15968. Disponível em: Acesso em: 28 mar. 2023.



Review Article