Concept Development of Political Competence for Nurses

Nam Kyung Han; Gwang Suk Kim

doi:10.4040/jkan.2020.50.1.81

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Han and Kim: Concept Development of Political Competence for Nurses

Original Article

J Korean Acad Nurs 2020;50(1):81-100.

Published online: 17 January 2020

DOI: https://doi.org/10.4040/jkan.2020.50.1.81

Concept Development of Political Competence for Nurses

Nam Kyung Han^1,², Gwang Suk Kim^3,

¹Department of Nursing, Gyeongbuk College of Health, Gimcheon

²College of Nursing, Yonsei University, Seoul

³College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea

Address reprint requests to : Kim, Gwang Suk College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2228-3342 Fax: +82-2-2227-8303 E-mail: GSKIM@yuhs.ac

Received 22 May 2019 Revised 9 January 2020 Accepted 19 January 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose:

The purpose of this study was to define and clarify the concept of political competence for nurses.

Methods:

A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.

Results:

The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.

Conclusion

This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses’ political competence.

Keywords: Nurses, Politics, Professional Competence, Concept Formation

REFERENCES

1. Ministry of Health and Welfare (MOHW). Ministry of health and welfare white book 2017. Sejong: MOHW;2018. Sep. Report No.: 11-1352000-000160-10. p. 6–7.

2. Ministry of Health and Welfare (MOHW). Health and welfare statistical year book2018. Sejong: MOHW;2019. Dec. Report No.: 11-1352000-000137-10. p. 2–9.

3. Boswell C, Cannon S, Miller J. Nurses’ political involvement: Responsibility versus privilege. Journal of Professional Nursing. 2005; 21(1):5–8. https://doi.org/10.1016/j.profnurs.2004.11.005.

4. Conger CO, Johnson P. Integrating political involvement and nursing education. Nurse Educator. 2000; 25(2):99–103. https://doi.org/10.1097/00006223-200003000-00013.

5. Jun SY, Ko IS, Bae KR. Political interest, political efficacy, and media usage as factors influencing political participation in hospital nurses. Journal of Korean Academy of Nursing Administration. 2014; 20(3):342–352. https://doi.org/10.11111/jkana.2014.20.3.342.

6. Abood S. Influencing health care in the legislative arena. Online Journal of Issues in Nursing. 2007; 12(1):3.

7. Vandenhouten CL, Malakar CL, Kubsch S, Block DE, Gallagher-Lepak S. Political participation of registered nurses. Policy, Politics, & Nursing Practice. 2011; 12(3):159–167. https://doi.org/10.1177/1527154411425189.

8. Warner JR. A phenomenological approach to political competence: Stories of nurse activists. Policy, Politics, & Nursing Practice. 2003; 4(2):135–143. https://doi.org/10.1177/1527154403004002007.

9. O’Grady ET, Johnson J. Health policy issues in changing environments. Hamric AB, Hanson CM, Tracy MF, O’Grady ET, editors. Advanced Practice Nursing: An Integrative Approach. 5th ed. St. Louis (MO): Elsevier Saunders;2014. p. 595–602.

10. Melo WSD, Oliveira PJFD, Monteiro FPM, Santos FCDA, Silva MJND, Calderon CJ, et al. Guide of attributes of the nurse’s political competence: A methodological study. Revista Brasileira de Enfermagem. 2017; 70(3):526–534. https://doi.org/10.1590/0034-7167-2016-0483.

11. Primomo J, Björling EA. Changes in political astuteness following nurse legislative day. Policy, Politics, & Nursing Practice. 2013; 14(2):97–108. https://doi.org/10.1177/1527154413485901.

12. Korean Nurses Association. The code ethics of nurses [Internet]. Seoul: Korean Nurses Association;2014. [cited 2018 Jul 16]. Available from:. http://www.koreanurse.or.kr/about_KNA/ethics.php.

13. International Council of Nurses (ICN). The ICN code of ethics for nurses. Geneva: ICN;2012. p. 1–10.

14. Almond GA, Verba S. The civic culture: Political attitudes and democracy in five nations. Princeton (NJ): Princeton University Press;1963. p. 1–574.

15. Campbell A, Gurin G, Miller WE. The voter decides. Evanston (IL): Row, Peterson;1954. p. 1–242.

16. Barnes SH. Participation, education, and political competence: Evidence from a sample of Italian socialists. American Political Science Review. 1966; 60(2):348–353. https://doi.org/10.2307/1953361.

17. Converse PE. Change in the American electorate. Campbell A, Converse PE, editors. The Human Meaning of Social Change. New York: Russell Sage Foundation;1972. p. 263–337.

18. Fratczak-Rudnicka B, Torney-Purta J. Competencies for civic and political life in a democracy. Rychen DS, Salganik LH, McLaughlin ME, editors. Contributions to the Second DeSe-Co Symposium. Proceedings of the 2nd International DeSeCo Symposium; 2002 Feb 11-13; Swiss Federal Statistical Office, Geneva, Switzerland. Neuch telp (Switzerland): Swiss Federal Statistical Office;2003. p. 71–86.

19. Pausch M. Democratic citizenship as an indicator for the quality of democracy. Paper presented at: The 22nd IPSA World Congress of Political Science. 2012. Jul 8-12; Madrid, Spain.

20. Gabriel OW. Politische einstellungen und politische kultur. Gabriel OW, Kropp S, editors. Die EU-Staaten im Vergleich: Strukturen, Prozesse, Politikinhalte. 3rd ed. Wiesbaden: VS Verlag für Sozialwissenschaften;2008. p. 181–214. German.

21. Jansson BS. Becoming an effective policy advocate: From policy practice to social justice. 4th ed. Pacific Grove (CA): Brooks/Cole Publishing Company;2003. p. 1–464.

22. Krouse R, Marcus G. Electoral studies and democratic theory reconsidered. Political Behavior. 1984; 6(1):23–39. https://doi.org/10.1007/bf00988227.

23. Krammer R. [Kompetenzen durch politische bildung: Ein kom-petenz-strukturmodell]. Informationen zur Politischen Bildung. 2008; 29:5–14. German.

24. Detjen J, Massing P, Richter D, Weißeno G. Politikkompetenz - ein modell. Wiesbaden: Springer-Verlag;2012. p. 35–64. https://doi.org/10.1007/978-3-658-00785-0.

25. Arendt H. The human condition. Chicago (IL): University of Chicago Press;1998. p. 1–370. https://doi.org/10.7208/chicago/9780226924571.001.0001.

26. Easton D. The political system: An inquiry into the state of political science. Political Science Quarterly. 1953; 68(3):434–436. https://doi.org/10.2307/2145610.

27. Schwartz-Barcott D, Kim HS. An expansion and elaboration of the hybrid model of concept development. Rodgers BL, Knafl KA, editors. Concept Development in Nursing: Foundations, Techniques, and Applications. 2nd ed. Philadelphia (PA): W.B. Saunders;2000. p. 161–192.

28. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. NECA’s guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Healthcare Collaborating Agency;2011. p. 141–142.

29. Krueger RA, Casey MA. Focus groups: A practical guide for applied research. 3rd ed. Thousand Oaks (CA): Sage;2000. p. 1–215.

30. Colaizzi PF. Psychological research as the phenomenologist views it. Valle RS, King M, editors. Existential-Phenomenological Alternatives for Psychology. New York: Oxford University Press;1978. p. 48–71.

31. Guba EG, Lincoln YS. Fourth generation evaluation. Newbury Park (CA): Sage;1989. p. 21–252.

32. National Institute of Korean Language. Standard Korean language dictionary [Internet]. Seoul: National Institute of Korean Language;2008. [cited 2018 Jul 12]. Available from:. https://stdict.korean.go.kr/main/main.do.

33. Craig SC, Niemi RG, Silver GE. Political efficacy and trust: A report on the NES pilot study items. Political Behavior. 1990; 12(3):289–314. https://doi.org/10.1007/bf00992337.

34. Abravanel MD, Busch RJ. Political competence, political trust, and the action orientations of university. The Journal of Politics. 1975; 37(1):57–82. https://doi.org/10.2307/2128891.

35. Vis JCPM. Citizenship and political knowledge. Csepeli G, German D, Kéri L, Stumpf I, editors. From Subject to Citizen. Budapest: Hungarian Center for Political Education;1995. p. 33–54.

36. Rains JW, Barton‐Kriese P. Developing political competence: A comparative study across disciplines. Public Health Nursing. 2001; 18(4):219–224. https://doi.org/10.1046/j.1525-1446.2001.00219.x.

37. Delors J. The four pillars of education. Delors J, editor. Learning: The Treasure within: Report To UNESCO of the International Commission on Education for the Twenty-First Century. Paris: UNESCO;1996. p. 304–313.

38. Primomo J. Changes in political astuteness after a health systems and policy course. Nurse Educator. 2007; 32(6):260–264. https://doi.org/10.1097/01.NNE.0000299480.54506.44.

39. Bu X, Jezewski MA. Developing a mid‐range theory of patient advocacy through concept analysis. Journal of Advanced Nursing. 2007; 57(1):101–110. https://doi.org/10.1111/j.1365-2648.2006.04096.x.

40. Deschaine JE, Schaffer MA. Strengthening the role of public health nurse leaders in policy development. Policy, Politics, & Nursing Practice. 2003; 4(4):266–274. https://doi.org/10.1177/1527154403258308.

41. Maynard CA. Political influence: A model for advanced nursing education. Clinical Nurse Specialist. 1999; 13(4):191–195. https://doi.org/10.1097/00002800-199907000-00011.

42. Arabi A, Rafii F, Cheraghi MA, Ghiyasvandian S. Nurses’ policy influence: A concept analysis. Iranian Journal of Nursing and Midwifery Research. 2014; 19(3):315–322.

43. Spencer LM, Spencer SM. Competence at work: Models for superior performance. New York: John Wiley & Sons;1993. p. 3–15.

44. Wilson J. Philosophy: Thinking about meaning. London: Heinemann Educational Books;1969. p. 1–257.

45. Rodgers BL, Knafl KA. Concept development in nursing: Foundations, techniques, and applications. 2nd ed. Philadelphia (PA): W.B. Saunders Company;2000. p. 1–458.

46. Walker LO, Avant KC. Strategies for theory construction in nursing. 3rd ed. Norwalk (CT): Appleton & Lange;1995. p. 1–243.

Figure 1.

Procedure of literature identification and selection.

Table 1.

General Characteristics of Participants

Categories	No	Gender	Age	Education	Occupation
In-depth interviewers
Nursing	1	Female	50s	Doctorate	Professor of nursing
	2	Female	60s	Doctorate	Executive of Korean Nurses Association
	3	Female	60s	Doctorate	Executive of Korean Nurses Political Society
	4	Female	50s	Bachelor	Executive of health and civil society
	5	Female	50s	Bachelor	Executive of health and civil society
Health care	6	Male	50s	Master	Aide of the national assemblyman
	7	Male	30s	Bachelor	Secretary of Ministry of Health and Welfare
	8	Male	50s	Master	Executive of health and civil society
	9	Male	40s	Master	Consultant of Korean Nurses Association
	10	Male	40s	Bachelor	Representatives of patient groups
	11	Male	50s	Bachelor	Journalist in the area of Health and Welfare
Focus group interviewers
Nursing	1	Female	50s	Bachelor	Executive of health and civil society
	2	Female	50s	Bachelor	Executive of health and civil society
	3	Female	40s	Bachelor	Executive of health and civil society
Health care	4	Male	50s	Master	Executive of health and civil society

Table 2.

Dimensions and Attributes of Political Competence in Theoretical Stage

Classification		Dimension and attributes [Sources]
Other	Political knowledge [19,20,24,35]	Internal political efficacy	Organizational membership [21]	Political activity
disciplines	Political information [19,22]	[14-16,18,33,34]	Cooperation act [18,22]	[16-18,21,23,24]
	Perceived political insight [20,22]	External political efficacy	Networking [18,21]	Voting, campaign
	Political thought [20,24,35]	[16,18]	Political tolerance [22]	[14-15,17,23,34]
	Systematic analysis ability [20,24]	Expectations for	Negotiation [21,24]	Political participation
	Politically determination [20,24,35]	government [16-18]	Political skill [16,18,21]	[16-18,21,23,24,26,34]
	Issue sustainability [19,20,24]	Governmental	Persuasive power [22,24]	Civil rights [23]
		responsiveness [16-18]	Political interaction [18]	Political expression [23,24]
		Political interest		Leadership [16]
		[14,24,34]		Political advocacy [23,39]
		Political trust [16-18,		Policy intervention [18,21]
		23,24,32,34]		Decision making [21,24]
		Political attitude		Assertiveness [24]
		[14-16,18,24,33,34]
		Behavior intention and
		will of participation
		[14,16,18]
Nursing	Deep knowledge [9,38,40]	Learning to Be [10]	Approach with genuine warmth	Use power [9,40-42]
	Knowledge of both content and	Autonomy [10,39]	and interpersonal skills [9]	Bring nursing stories to
	policy process [9,40]	Representativeness [10]	Give useful expertise freely	policy arena [9]
	Seek expertise from others [9]	Resilience [10]	partnership [9]	Education the pubic [9]
	Anticipate focus, “What if?” [9]	Strength [10]	Develop effective relationships	Dynamism [10]
	Know opposition and inoculate		with everyone [9]	Creativity [10]
	against it [9]		Learning to Do [10]	Leadership [10]
	Political antenna [9]		Coordination [10]	Empowerment [10]
	Continuously scan policy		Negotiation [10]	Proactivity [10]
	environment [9]		Personal marketing [10]	Learning to Do [10]
	Offer solution that are not solely		Learning to Live Together [10]	Mobilization [10]
	nursing focused [9]		Teamwork [10]	Innovation [10]
	Bring sharp, evidence-based focus [9]		Interpersonal relationship [10]	Entrepreneurship [10]
	Learning to Know [10]		Interaction [10]	Commitment to collective
	Scientific qualification [10]		Otherness [10]	strength [8]
	Self-knowledge [10]		Opportunities created through	Strategic perspectives
	Criticality [10]		networking [8]	perseverance [8]
	Nursing expertise as valued		Powerful persuasion [8]	Intervention [38,40]
	currency [8]		Perseverance [8]	Voting, campaign [38]
				Advocacy [39,42]
				Policy development [40]

Attributes	Political knowledge	Internal political efficacy	Organizational activity	Leadership
	Political information	External political efficacy	Networking	Political expression
	Systematic analysis ability	Political interest	Negotiation	Assertiveness
			Persuasive power	Political advocacy
				Political participation
				Policy intervention

Dimensions	Political knowledge	Political efficacy	Political interaction	Political activity

Table 3.

Dimensions and Attributes of Political Compete ence in Final Stage

Dimension	Theoretical phase	Fieldwork phase	Final phase
Political knowledge	Political knowledge	Political knowledge	Political knowledge
	Political information	Political information	Political information
	Systematic analysis ability	Systematic analysis ability	Systematic analysis ability
Political efficacy	Internal political efficacy	Internal political efficacy	Internal political efficacy
	External political efficacy	Political interest	External political efficacy
	Political interest	Self-pride of nursing profession	Self-pride of nursing profession
Political interaction	Organizational activity	Organizations and service activities	Organizations and service activities
	Networking	Networking	Networking
	Persuasive power	Persuasive power	Persuasive power
	Negotiation	Negotiation
		Political interpersonal communication
Political activity	Leadership	Leadership	Political leadership
	Political expression	Political expression	Political expression
	Assertiveness	Assertive action	Assertive behavior
	Political advocacy	Political advocacy	Political advocacy
	Political participation	Political participation	Political participation
	Policy intervention	Policy intervention	Policy intervention

Table 4.

Com mponents of F Final Confirmed Political Competence for Nurses

Dimension	Attributes	Indicators [Sources]	Explanation
Political	Political	• Having structural and factual knowledge related to the political system, political	Having knowledge of political
knowledge	knowledge	process, specific issue, and etc. [8-10,19,20,24,35]	system, process, specific issue,
		• Having professional knowledge about the state or local government, political	and health care policy
		system, political process, health care policy
	Political	• Collecting and utilizing political information through various sources [19,22]	Collecting and utilizing of
	information	• Collecting and utilizing political issues and information related to health care policy	political information on various
		through various media	media
	Systematic	• Systematically analyzing political events, problems, and decisions [9,10,20,22]	Systematically analyzing
	analysis	• Reflecting the latest trends, political judgment and reasoning [8-10,19,20,24]	healthcare data and suggesting
	ability	• Collecting data related to health care and analyzing it by critical thinking	reasonable alternatives
		• Providing a reasonable alternative to improve health care policy
Political	Internal	• Participating effectively in politics and recognizing that individuals can understand	Having faith in the exercise of
efficacy	political	the political process [10,14-16,18,33,34]	political influence and political
	efficacy	• The expectation or belief in being able to exert political influence [16-18,23,24,	achievement
		32,34]
		• Having political self-concepts and self-assurance as citizens
		• Having a political consciousness and a belief system for change
	External	• The expectation or belief that government authorities and agencies will respond to	Having confidence in
	political	the needs of citizens [16-18]	the government or local
	efficacy	• Being interested in political issues [14,16,18,24,34]	governments and being
		• Interested in health care policies related to public and nurses [40]	interested in political issues or
		• Being interested in social issues or political issues as a basic motivation for political	health care policies
		participation or use of news media
	Self-pride	• Having pride in nursing profession	Recognizing political
	of nursing	• Belief in political achievement through solidarity of nursing profession	participation in improving
	profession	• Improvement of the health care system is a duty owed in terms of professional	national health based on the
		ethics	pride of nursing profession
Political	Organi-	• Having a common experience among members within a political community	Participating in activities of
interaction	zations	[8-10,18,22,38]	professional, civil society
	and service	• Having a sense of belonging within a political community [8-10,38]	organizations or performing
	activities	• Participating in heterogeneous groups or community service [8-10,21]	activities of community service
		• Participation in nursing and health-related nursing organizations in interest
		• Activating by joining civil society organizations, etc.
		• Carrying out collective activities, such as community service, beyond nursing
	Networking	• Establishing and maintaining a cooperative relationship of disparate groups or	Establishing cooperative
		related political or social institutions [10,18,21]	relationships and activities
		• Establishing cooperative relationships with government and political institutions	with external organizations to
		• Maintaining close relationships of the community and external organizations	improve the health care system
	Persuasive	• Listening the other’s opinions and requests constructively [9,10,22]	Recognizing diversity and
	power	• To compromise and cooperate through discussion, consultation, etc. [9,10,18,22]	differences, persuade decision
		• Acknowledging political differences and diversity, understanding opposition	makers with patience, and
		positions with patience and coordinating conflicts [8,10,18,22,24]	build public opinion to improve
		• Persuading policy decision makers and lobbying effectively [8,22,24]	the health care system
		• Respecting the diversity of the other’s experiences and perceptions
		• Persuading the other person through logical data and discussion
		• Listening with patience, understanding opposition and dealing with conflict
		• Persuading policy decision makers and lobbying effectively
		• Activities such as contacting the government, lawmakers, the public, and the
		media and forming public opinion
Political	Political	• Expressing political ideas or opinions in words [23,24,26]	Expressing political views easily
activity	expression	• Representing political ideas or opinions with documents [23,24,26]	in words or writings
		• Expressing in a coherent and logical language the views or content to convey
		• Expressing the opinions or contents to be conveyed in logical documents
	Assertive	• Assertive behavior that conveys the viewpoint of national health [24,38-40,42]	Raising the rights of nurses and
	action	• Raising the issue of nurse’s interests and rights [23,38,42]	the improvement of working
		• Demanding the rights and rights of nurses to raise issues and improve working	conditions, etc.
		conditions
	Political	• Being confident of having a friendly and independent view and responsibility [9,16]	Facilitating interdisciplinary
	leadership	• Leading and structuring individuals or organizations in the right direction [10,16,23]	cooperation with strategic
		• Having a strategic perspective and vision	vision
		• Prioritizing the interests in public and nursing professions
		• Demonstrating the leadership of service (empathy, trust, inclusion, horizontal
		relationship, etc.) in interdisciplinary cooperation
	Political	• Respecting the views of the people [9,10,23,39,42]	Acting as advocates and
	advocacy	• Having a willingness to change the target-oriented healthcare environment [39,42]	improving the system for public
		• Thinking about the role of advocate for the health of the people	health advocacy
		• Willingness to improve health care system
	Political	• Legitimate acts with the aim of influencing the election of government officials,	Participating in elections and
	partici-	government actions and public policy [9,10,16-18,21,23,24,26,34]	engaging in political activities
	pation	• Participating in political processes and activities such as voting, election, internet	as a citizen
		media use (online, offline) as citizens
	Policy inter-	• Understanding the policy making process [18,21,40,42]	Knowing and participating in
	vention	• Evidence-based research skills that influence policy decisions [8,21,24]	health care policy decision-
		• Having policy development skills [8,18,21,24,40,42]	making and legislative
		• Impact on policy formulation [9,18,21,24,38,40,42]	processes
		• Knowing health care issues and policy issues
		• Understanding legislation and policy making and enforcement processes
		• Recognizing the importance of presenting a reasonable alternative in the legislative
		process

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