PATIENT/CLIENT AGENCY IN AMERICAN NURSING, 1900-1986.
Contributors: University of Southern California.
Published: 1988
Number of pages: 379
Subjects: Health Sciences, Nursing.
Description: The purpose of this study was to inquire into the meaning and development of the concept, agency, within the context of American nursing literature, from 1900-1986. For the purposes of this study, agency was defined as the power or instrumentality which an individual marshalls, commands, and demonstrates in pursuit of identified ends.

Three analytic methods were utilized: content analysis, sociology of knowledge approach, and the historical method. Initially, the concept, agency, was clarified via concept analysis, utilizing the parallel methods of Wilson and Soltis. Four necessary and sufficient conditions were determined for the concept of agency: (1) decision-making capacity, (2) intellectual capacity, (3) physical capacity, and (4) rationality.

Primary data sources included every fifth volume of American Journal of Nursing (AJN), Nursing Outlook (NO), and Nursing Research (NR), published since their inceptions, plus the 1986 volume for each. Selected secondary sources assisted in interpretation of contextual trends. For the period 1900-1950, 141 articles were reviewed. For the period 1952-1986, 362 articles were reviewed: 204 from AJN, 93 from NR, and 65 from NO.

Results of the study indicated that trends were much more complex and numerous after 1950. Agency-related articles were also more prevalent after 1950. Comparison of agency-related themes before and after 1950 revealed: (1) a relative decrease in nurse-focused articles after 1950, (2) an increase in patient-focused articles after 1950, (3) a relative decrease in disease-oriented articles after 1950, (4) an increase in articles focused on psychosocial care after 1950, and (5) an increase in articles focused on family or caregiver concerns after 1950.

In conclusion, agency-related changes in the nurse-patient relationship have demonstrated a change in the locus of control for health care decisions and actions moving from the nurse to the patient. In turn, the nurse's role has moved from a nurturant doer to a teacher, counselor, and enabler.
Notes: Source: Dissertation Abstracts International, Volume: 49-11, Section: B, page: 4754.

Thesis (PH.D.)--UNIVERSITY OF SOUTHERN CALIFORNIA, 1988.

School code: 0208.