Exploring the Emergent Concept of Patient Advocacy in Acute and Perioperative Settings: A Scoping Review.

Introduction: Staff shortages following the pandemic and the growing complexity of healthcare require continuous reflection on the part of professionals to improve patient protection efforts in high-pressure environments. This makes it essential to better understand and reinforce the role of patient advocacy in clinical practice. This study aims to map the concept of patient advocacy in nursing, identifying its key attributes, antecedents, and consequences in acute and perioperative settings, contributing to its update and integration into the current healthcare paradigm. Methods: A scoping review, based on Arksey and O'Malley's framework and PRISMA-ScR guidelines, analyzed studies from 2019 to 2024, across CINAHL, PubMed, Scopus, Web of Science, and Google Scholar databases. It focused on nursing-related patient advocacy in acute and perioperative settings, excluding non-nursing roles, self-advocacy, and non-research articles. Two independent reviewers independently selected 14 studies using Rayyan®. Results: Key attributes of patient advocacy include safeguarding, effective communication, empowerment, and ethical decision-making support. Facilitating antecedents were professional motivation, training, nurse autonomy, and spiritual care, while hindering factors included ineffective communication, religious/cultural conflicts, and gaps in patients' health literacy. The consequences were mostly positive for patients, such as empowerment and shared decisions, and mixed for nurses, ranging from moral distress and frustration to gratitude and professional satisfaction. Conclusion: This study synthesized the evolving conceptualizations of patient advocacy, addressing post-pandemic challenges and reinforcing the importance of communication, ethical support, and training. It revealed emerging facilitators and previously overlooked barriers, highlighting the need for stronger policies and organizational structures to empower nurses and safeguard patients.