Empowerment and disempowernent: Models of staff/patient interaction

Abstract

This study aimed to develop valid models of empowerment and disempowerment relevant to staff/patient interaction as a means of generating a greater understanding of how these concepts are expressed in healthcare. This involved submitting the concepts of empowerment and disempowerment to an act frequency approach (Buss and Craik, 1983). Using this approach, registered nurses (n=38) were asked to nominate empowering and disempowering acts relevant to staff/patient interactions, yielding a list of 98 acts. Following this, older hospitalised people (n=20) were asked hypothetically to judge these acts as to the extent they would be 'control giving' if personally experienced. The 20 highest scoring acts for each concept were then incorporated into an act frequency observation scale. Using this composite scale, older hospitalised people (n=102) were asked to judge how often they had encountered each act over a pre-determined period of time. Act frequencies for each concept were then submitted to a principal components factor analysis. The principal components of empowerment were identified as 'promoting patient independence,' 'promoting information exchange' and 'being aware of patient needs'; and for disempowerment, 'impeding patient collaboration in care planning,' 'domination' and 'indifference to patient needs'. Models of these concepts illustrate the therapeutic and non-therapeutic aspects of interpersonal care.