ABSTRACT
This chapter is concerned with the concept of the nurse as empowerment facilitator. As with the nurse as behaviour change agent, an individual action perspective is maintained but the focus is on process as much as on outcome, i.e. not on top-down, traditional, professionally determined behaviour change. It is about the nature of the relationship between the nurse and the patient/client, a more bottom-up, negotiated way of working and a shift in the locus of control from the former to the latter, as illustrated in the health promotion framework in Chapter 5. It pursues patient participation, a nurse-patient partnership or patient/client led, non-hierarchical, non-coercive practice and includes informed choice, adherence and concordance, shared decision-making and advocacy. The emphasis is on patient/client-centred active participation and thus the associated indicators of the health promotion aims, process, impact and evaluation criteria and outcomes of pragmatic empowerment, i.e. empowerment as a technology (Tones 2001). It represents a radical departure from traditional nurse-patient interaction (Devine 1993) and a humanistic ideology.
