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Frontiers in Medical Science Research, 2023, 5(9); doi: 10.25236/FMSR.2023.050903.

Research advance in self-advocacy in elderly patients


Meiqin Feng1, Hongfang Chen2, Xinghuan Wang1, Jinyan Chen1

Corresponding Author:
Hongfang Chen

1School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China

2Personnel Department, Shaanxi Provincial Hospital of Chinese Medicine, Xi'an, Shaanxi, China


Elderly patients have become the main focus of China's elderly care industry, and solving the various needs of elderly patients is currently a key issue in China's nursing industry and even the whole society. Improving the level of self-advocacy of elderly patients can enable them to independently collect disease-related information, obtain social support, and then take the initiative to carry out various medical treatment, cooperation and care, and effectively manage their own diseases. At present, there are many foreign studies on the self-advocacy of elderly patients and some progress has been made, but China is still in its infancy in this regard. Therefore, this article will review the influencing factors, evaluation tools and interventions of self-advocacy in elderly patients, in order to provide a basis for the development of self-advocacy in elderly patients.


Self-advocacy; Elderly patients; Research advance; Review

Cite This Paper

Meiqin Feng, Hongfang Chen, Xinghuan Wang, Jinyan Chen. Research advance in self-advocacy in elderly patients. Frontiers in Medical Science Research (2023) Vol. 5, Issue 9: 11-17. https://doi.org/10.25236/FMSR.2023.050903.


[1] Du Peng. China's road to actively cope with the aging of the population [J]. Population research, 2022, 46(06):17-22. 

[2] Report on Actively Responding to the Development of Population Aging in the New Era: 20 Years of China's Aging Society: Achievements, Challenges and Prospects Chapter 15 International Exchange and Cooperation[C]//. Report on Actively Responding to the Aging of Population in the New Era--20 Years of China's Aging Society: Achievements, Challenges and Prospects, 2021:374-398. 

[3] Zhang Luwen, Lu Qiaochu, Zhao Yang, et al. Combination of chronic diseases and their health outcomes in middle-aged and elderly people [J/OL]. Journal of Sun Yat-sen University (Medical Science Edition):1-12[2023-01-10]. DOI:10. 13471/j. cnki. j. sun. yat-sen. univ(med. sci). 20221215. 001. 

[4] Chen Xiaoyun, Wu Yuhang, Cao Yu, et al. Association of leisure activities and self-care ability in older adults: a prospective cohort study in an 80-year-old population [J]. Journal of China Medical University, 2022, 51(12):1079-1084+1089. 

[5] Brashers, Dale E et al. “Taking Control: The Efficacy and Durability of a Peer-Led Uncertainty Management Intervention for People Recently Diagnosed With HIV. ” Health communication vol. 32, 1 (2017): 11-21. doi:10. 1080/10410236. 2015. 1089469

[6] Hagan TL. Donovan HS. Ovarian cancer survivors' experiences of self-advocacy: a focus group study [J]. Oncol Nurs Forum. 2013. 40(2): 140-147. 

[7] Martin LT. Schonlau M. Haas A. et al. Patient activation and advocacy: which literacy skills matter most [J]. J Health Commun. 2011. 16(Suppl 3): 177-190. 

[8] Brashers DE. Klingle RS. The influence of activism on physician-patient communication [Z]. Chicago: 1992. 

[9] Walsh-Burke K. Marcusen C. Self-advocacy training for cancer survivors. The Cancer Survival Toolbox [J]. Cancer Pract. 1999. 7(6): 297-301. 

[10] Hagan TL. Donovan HS. Self-advocacy and cancer: a concept analysis [J]. J Adv Nurs. 2013. 69(10): 2348-2359. 

[11] Schmidt EK. Faieta J. Tanner K. Scoping review of self-advocacy education interventions to improve care [J]. OTJR (ThorofareN J). 2020. 40(1): 50-56. 

[12] Daniels J. Struthers H. Soler J. et al. Building self-advocacy in HIV care: the use of role-play to examine healthcare access for HIV-positive MSM in rural South Africa [J]. Glob Health Promot. 2021. 28(3): 32-40. 

[13] Homas TH. Donovan HS. Rosenzweig MQ. et al. A conceptual framework of self-advocacy in women with cancer [J]. ANS Adv Nurs Sci. 2021. 44(1): E1-E13. 

[14] Kolmes SK. Boerstler KR. Is there a gender self-advocacy gap? An empiric investigation into the gender pain gap [J]. J Bioeth Inq. 2020. 17(3): 383-393. 

[15] Lindsay, Sally, et al. “Gender matters in the transition to employment for young adults with physical disabilities.” Disability and rehabilitation vol. 41, 3 (2019): 319-332. doi:10. 1080/09638288. 2017. 1390613

[16] Sharma, Rashmi K et al. “Male-female patient differences in the association between end-of-life discussions and receipt of intensive care near death.” Cancer vol. 121, 16 (2015): 2814-2820. doi:10. 1002/cncr. 29417

[17] Wiltshire, Jacqueline, et al. “Self-advocacy during the medical encounter: use of health information and racial/ethnic differences.” Medical care vol. 44, 2 (2006): 100-109. doi:10. 1097/01. mlr. 0000196975. 52557. b7

[18] Novinmehr N. Hasanpour M. Salsali M. et al. Older adults' self-advocacy in patient safety: a cross-sectional study[J]. Br J Nurs. 2019. 28(16): 1076-1084. 

[19] Cleveland Manchanda, Emily C, et al. “Heart Failure Admission Service Triage (H-FAST) Study: Racialized Differences in Perceived Patient Self-Advocacy as a Driver of Admission Inequities.” Cureus vol. 13, 2 e13381. 16 Feb. 2021, doi:10. 7759/cureus. 13381 

[20] Hagan TL. Gilbertson-White S. Cohen SM. et al. Symptom burden and self-advocacy: exploring the relationship among female cancer survivors[J]. Clin J Oncol Nurs. 2018. 22(1): E23- E30. 

[21] Wang Nannan, Qiao Yue, Wu Yuan, et al. Analysis of the status quo and influencing factors of female cancer survivors' self-advocacy[J]. Chinese Journal of Practical Nursing, 2022, 38(32):2512-2517. 

[22] Bishop, Sonia J, and Christopher Gagne. “Anxiety, Depression, and Decision Making: A Computational Perspective.” Annual review of neuroscience vol. 41 (2018): 371-388. doi:10. 1146/annurev-neuro-080317-062007

[23] Thomas, Teresa H et al. “A Conceptual Framework of Self-advocacy in Women With Cancer. ” ANS. Advances in nursing science vol. 44, 1 (2021): E1-E13. doi:10. 1097/ANS. 0000000000000342

[24] Tilley E. Strnadová I. Danker J. et al. The impact of self-advocacy organizations on the subjective well-being of people with intellectual disabilities: a systematic review of the literature[J]. J Appl Res Intellect Disabil. 2020. 33(6): 1151-1165. 

[25] Michael R. Zidan HM. Differences in self-advocacy among hard of hearing and typical hearing students [J]. Res Dev Disabil. 2018. 72: 118-127. 

[26] Hagan TH. Rosenzweig M. Zorn K. et al. Perspectives on self-advocacy: comparing perceived uses. benefits. and drawbacks among survivors and providers[J]. Oncol Nurs Forum. 2017. 44(1): 52-59. 

[27] Hermansen-Kobulnicky, Carol J. “Measurement of self-advocacy in cancer patients and survivors.” Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer vol. 16, 6 (2008): 613-618. doi:10. 1007/s00520-008-0442-0

[28] Zhang Yazhi, Fang Hanping, Zhu Lisi, et al. Construction of a conceptual framework for shared decision-making in cancer patients based on clinical decision theory[J]. Nursing research. 2020, 34(1): 136-141. 

[29] Fenn K. Scior K. The psychological and social impact of self-advocacy group membership on people with intellectual disabilities: a literature review[J]. J Appl Res Intellect Disabil. 2019. 32(6): 1349-1358

[30] Elder, Nancy C et al. “Development of an instrument to measure seniors' patient safety health beliefs: the Seniors Empowerment and Advocacy in Patient Safety (SEAPS) survey. ” Patient education and counseling vol. 69, 1-3 (2007): 100-107. doi:10. 1016/j. pec. 2007. 07. 007

[31] Brashers, D E et al. “The patient self-advocacy scale: measuring patient involvement in health care decision-making interactions.” Health communication vol. 11, 2 (1999): 97-121. doi:10. 1207/s15327027hc1102_1

[32] Hawley, Lenore, et al. “Initial validation of personal self-advocacy measures for individuals with acquired brain injury. ” Rehabilitation psychology vol. 61, 3 (2016): 308-316. doi:10. 1037/rep0000093

[33] Malec, James F et al. “Two new measures for assessing advocacy activities and perceived control after acquired brain injury.” Disability and rehabilitation vol. 32, 1 (2010): 33-40. doi:10. 3109/09638280902980936

[34] Hagan, Teresa L et al. “Theoretical to Tangible: Creating a Measure of Self-Advocacy for Female Cancer Survivors.” Journal of nursing measurement vol. 24, 3 (2016): 428-441. doi:10. 1891/1061-3749. 24. 3. 428

[35] Feldman, M A et al. “Health self-advocacy training for persons with intellectual disabilities.” Journal of intellectual disability research: JIDR vol. 56, 11 (2012): 1110-1121. doi:10. 1111/j. 1365-2788. 2012. 01626. x

[36] Andrews A., Bishop C. , Agnew S. , Hamelin J. , Griffiths D. , Owen F. & Feldman M. (2010) Teaching Health Self-Advocacy Skills to Adults With Intellectual Disabilities. Community Living Welland Pelham, Welland, ON, Canada. 

[37] Volk, Robert J et al. “Entertainment education for prostate cancer screening: a randomized trial among primary care patients with low health literacy.” Patient education and counseling vol. 73, 3 (2008): 482-489. doi:10. 1016/j. pec. 2008. 07. 033

[38] Hoffman, Aubri S et al. “An entertainment-education colorectal cancer screening decision aid for African American patients: A randomized controlled trial.” Cancer vol. 123, 8 (2017): 1401-1408. doi:10. 1002/cncr. 30489

[39] Hawley, Lenore, et al. “Improving personal self-advocacy skills for individuals with brain injury: A randomized pilot feasibility study.” Brain injury vol. 31, 3 (2017): 290-296. doi:10. 1080/02699052. 2016. 1250952

[40] Pickett, Susan A et al. “Consumer empowerment and self-advocacy outcomes in a randomized study of peer-led education.” Community mental health journal vol. 48, 4 (2012): 420-430. doi:10. 1007/s10597-012-9507-0