How Registered Nurses Practice Patient Advocacy? A Qualitative Study on the Perceptions, Activities and Influencing Factors

Aim: To explore the experiences of registered nurses in Korea on patient advocacy, focusing on their perceptions, activities and influencing factors. Design: A qualitative study grounded in a social constructionist paradigm. Methods: Between September and October 2024, focus group interviews were conducted with 19 Korean registered nurses who possessed at least 3 years of clinical experience. Data were evaluated using the reflexive thematic analysis by Braun and Clarke. Results: Three main themes were identified, comprising 11 sub-themes and 39 codes: the perceptions of nurses: advocacy as an invisible yet pervasive safeguard for patient safety, rights and comfort; advocacy activities: advocacy as contextual strategies involving interventions, empowerment and coordination; influencing factors: advocacy shaped by organisational, interprofessional and individual factors. Conclusion: These findings underscore the crucial role of registered nurses in safeguarding the safety, rights and comfort of patients, yet this advocacy remains frequently unrecognised and underappreciated in daily practice. Registered nurses engage in a wide range of adaptive and strategic advocacy approaches tailored to individual patient needs and clinical contexts. Multiple factors influence these practices, including those at the organisational, interprofessional and personal levels. Implications for the Profession and Patient Care: This study expands the understanding of how Korean registered nurses practice advocacy and highlights the need for greater recognition and institutional support for patient advocacy activities. Healthcare leaders can use these insights to develop supportive organisational policies and foster collaborative cultures, while also strengthening the competencies of registered nurses in clinical knowledge, ethical judgement and communication skills to enhance their capacity for patient advocacy. The identified advocacy strategies provide practical guidance for implementing patient advocacy and inform the design of nursing education and training programs that prioritise advocacy. Reporting Method: This study followed the Consolidated Criteria for Reporting Qualitative Research checklist. Patient and Public Contribution: No patient or public contribution.