A descriptive correlational study on the relationship between knowledge and practice of nursing advocacy among Baccalaureate nurse educators in Uganda

Abstract

Background/Purpose: Nursing advocacy constitutes a core professional responsibility, particularly for baccalaureate-prepared nurses in Uganda, where the Uganda Nurses and Midwives Council emphasizes safeguarding patient rights, promoting safe environments, and addressing unmet healthcare needs. Despite growing recognition of advocacy’s importance, limited evidence exists regarding baccalaureate nurse educators’ knowledge and actual engagement in advocacy practices. This gap may hinder effective role modelling and the preparation of future nurses. The purpose of this descriptive correlational study was to assess levels of knowledge of nursing advocacy, examine the extent of engagement in advocacy practices, and determine the relationship between knowledge and practice among baccalaureate nurse educators in Uganda’s Central Region. Theoretical/Conceptual Framework: The study was guided by the Sessler Branden Advocacy Theory, which posits that advocacy is a dynamic process influenced by internal foundational conditions (such as knowledge, values, and personal attributes) and external contextual factors (such as clinical opportunities and institutional support) that mediate the translation of knowledge into actual advocacy enactment. Method: A quantitative, descriptive correlational cross-sectional design was employed. Multisite convenience sampling yielded 64 baccalaureate nurse educators from public and private nursing training institutions in Uganda's Central Region. Data were collected using a structured, content-validated questionnaire with knowledge items, Likert-scale practice items, and open-ended questions. Data were analysed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and content analysis. Results: Findings revealed very high knowledge levels, with participants achieving near-perfect scores on ethical foundations, safe environments, policy roles, and community needs. Participants reported moderate to high advocacy practice, particularly in teaching, mentorship, direct interventions, empowerment of students and patients, and promoting supportive environments. However, engagement was lower in policy participation and coalition-building. No significant relationship emerged between knowledge and practice, *r*(62) = .02, *p* = .878. Clinical engagement was the strongest factor associated with higher practice scores. Conclusion: Consistent with the Sessler Branden Advocacy Theory, the results indicate a pronounced knowledge-practice gap. While internal foundational conditions (knowledge) were strong, external contextual factors particularly clinical involvement play a critical role in translating knowledge into advocacy behaviour. Recommendations: The study recommends strengthening simulation-based and experiential advocacy training, promoting continued clinical engagement for nurse educators, establishing institutional mentorship systems, and enhancing organizational cultures that support advocacy participation and interdisciplinary collaboration.