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**EMPOWERMENT** by Mind Map: **EMPOWERMENT**

1. **Key Themes**

1.1. **Relationships** [1-3,5,7,9,11,12,20,21]

1.1.1. Shared decision-making [3,5-7,9-12,14,15,18,20-22]

1.1.2. Communication [3,7,13,14,18,20,22]

1.1.3. Collaboration [6,12,13,16,18,20,21]

1.1.4. Trust [3,4,6,14,18]

1.1.5. Respect [3,6-9,11,12,20]

1.2. **Engagement** [2,3,8,13,16-18,20-22]

1.2.1. Participation [5,7,8,9,10,17,19-21]

1.2.2. Motivation [1,2,4,9,13,20]

1.2.3. Social support [3,6,11]

1.2.4. Shared Power [2,7,20]

1.3. **Education** [3,8,15,19]

1.3.1. Health literacy [3,5,8]

1.3.2. Shared knowledge [3,11,16,17]

1.3.3. Experiential knowledge [7,12-14,19]

1.3.4. Motivation [1,2,4,9,13,20]

1.4. **Self-awareness** [3-5,8,19,22]

1.4.1. Identity [3,11,12,14,19,22]

1.4.2. Confidence [6,8,17,19,22]

1.4.3. Self-determination [4,12,20]

1.4.4. Self-efficacy [4,10,11,15,22]

1.4.5. Goals [4-6,8,14,20-22]

1.5. **Autonomy** [3-7,9,10,12,18-22]

1.5.1. Control [2-8,11,12,14-16,20,21]

1.5.2. Choice [5,8-10,12,16]

1.6. **Safety** [3]

2. **Use in Research**

2.1. **Within Nursing**

2.1.1. Diabetes Empowerment Scale [5]

2.1.2. Patient Enablement Instrument [5]

2.1.3. Particapatory action research [12,13,]

2.1.4. Bulding community engagement and empowerment through a primary care model [16]

2.2. **Within Education**

2.2.1. Participatory research [19]

2.2.2. Youth-led participatory action research [22]

3. **Use in Practice**

3.1. **Within Nursing**

3.1.1. For nurses

3.1.1.1. Fundamental strategy for promoting health [16]

3.1.1.2. Patient-centred training interventions [5]

3.1.1.3. Shared-decision making [5,21]

3.1.1.4. Improved role awareness [14]

3.1.1.5. Empowerment techniques [7]

3.1.1.5.1. Promote better understanding and communication [7]

3.1.1.5.2. Connect with clients more meaingfully [7]

3.1.1.5.3. Reduce power imbalances [7]

3.1.2. For patients

3.1.2.1. Shared decision-making [3-5,19-21]

3.1.2.2. Motivational interviewing [5]

3.1.2.3. Expert Patient Programme [5]

3.1.2.4. Personalised care planning [5]

3.2. **Within Education**

3.2.1. For learners

3.2.1.1. Reinforcing women’s empowerment as it gives women the intellectual skills needed to respond to challenges, confront the traditional and societal role that has been imprinted on them" [8]

3.2.1.1.1. "grants them the power of visibility and acknowledgement” [8]

3.2.1.2. "Literacy is apowerful tool in empowering women"[8]

3.2.1.3. Empowerment as a “philosophy of education that can help students to be productive in school as well as become productive members of society” [9]

3.2.1.4. Youth Empowerment Solutions (YES) program [22]

3.2.2. For teachers

3.2.2.1. "Empowered teachers use support and wisdom to empower their students" [9]

3.2.2.2. "Empowering children actually frees the teacher to join children in facilitating growth rather than constantly monitoring, directing and supervising the children's learning and behavior” [9]

3.2.2.3. "Ability to prompt, influence, and guide the achievements of others through the teaching and learning process” [10]

3.2.2.4. Attending professional development activities [18]

3.2.2.5. New roles (leader, researcher, curriculum developer) [18]

4. **Related Theories in Nursing**

4.1. Kanter's theory of structural empowerment [1,21]

4.2. Symbolic Interactionism [3]

4.3. Rappaport (1981)'s theory of critical consciousness [4,11]

4.4. Zimmerman (1986)'s theory of empowerment [4, 22]

4.5. Spreitzer (1995)'s theory of self-determination [4,5,7,21]

4.6. Nutbeam's model of health literacy [5]

4.7. Elwyn et al. (2021)'s model of shared decision-making [5]

4.8. Integrated personal commissioning [5]

4.9. Langwe's Empowerment Theory [15]

5. **Rodgerian Categories** [23]

5.1. **Antecedents**

5.1.1. Access to key resources [1]

5.1.1.1. Knowledge, guidance, support, time, finance [1]

5.1.2. Autonomy [5]

5.1.2.1. Self-determination [1,5,7]

5.1.2.2. Self-efficacy [1]

5.1.2.3. Choice [1,2,21]

5.1.3. Co-creation of knowledge [7

5.1.4. Confidence [7]

5.1.5. Competence [16,20,21]

5.1.6. Motivation [2,16,20]

5.1.7. Partnership [5,20]

5.1.7.1. Willingness to share power [2,5]

5.1.7.2. Communication [7,16]

5.1.7.3. Engagement [16]

5.1.7.4. Respect [5]

5.2. **Conequences**

5.2.1. Internal

5.2.1.1. Control [7,16]

5.2.1.2. Integrated-self [7,20]

5.2.1.2.1. Confidence [2,15,17]

5.2.1.2.2. Sense of inner strength [7]

5.2.1.2.3. Independence [2,5,9]

5.2.1.2.4. Adaptive Resilience [1,17]

5.2.1.2.5. Problem-solving [16,22]

5.2.2. External

5.2.2.1. Social justice [2,16]

5.2.2.2. Improved quality of life [2,5-7,15,16,20]

5.2.2.3. Improved health outcomes [2,4,6,11,16]

5.3. **Contextual Factors**

5.3.1. Vulnerabilities [3,12]

5.3.1.1. Social [3,16]

5.3.1.2. Political [3,12,16]

5.3.1.3. Cultural [12]

5.3.1.4. Environmental [16]

5.3.1.5. Health [3]

5.3.2. Ethnic-racial considerations [3,12]

5.3.3. Developmental perspectives [3,11,12,16]

5.3.4. Cultural inequalities [3,12]

5.3.4.1. Discrimination [4,12]

5.3.4.2. Violence [3]

5.3.5. Opression [3,7,21]

5.3.6. Lived social situations [3]

5.3.7. Socio-economic inequality [3]

5.3.7.1. Poverty [4,12]

6. **Definitions**

6.1. **Within Nursing**

6.1.1. "Process by which the Community Health Nurse and her client institute a therapeutic relationship within a supportive social climate characterised by respect, mutual decision-making, and power sharing leading to client independence, increased confidence, self-reliance, and self-management” [2]

6.1.2. “Patient empowerment in the health care context means to promote autonomous self-regulation so that the individual’s potential for health and wellness is maximised” [5]

6.1.3. “Individual patient empowerment is a process that enables patients to exert more influence over their individual health by increasing their capacities to gain more control over issues they themselves define as important." [7]

6.1.4. "Process of giving hope, confidence and encouragement to people who feel disempowered by their health condition, ultimately promoting their well-being, decision making and self-management" [2]

6.1.5. "The social process of recognizing, promoting, and increasing people’s capacity to meet their needs, solve their own problems, and mobilize the resources needed to control their own lives" [15]

6.2. **Within Education**

6.2.1. "A multi-dimensional social process that helps people gain control over their own lives. It is a process that fosters power in people for use in their own lives, their communities and their society, by acting on issues they define as important” [8]

6.2.2. “Bringing into a state of belief one's ability to act effectively” [9]

6.2.3. “Nurturing belief in capability and competence, suggesting potency and the positive impetus to action” [9]

6.2.4. “Empowerment comes from sharpening an individual’s/group’s curiosity to learn, and by giving them knowledge and skills to question the “social template” (status quo) they have lived with all their lives” [19]

7. **Historical Evolution**

7.1. 1600s

7.1.1. William Penn (1690) popularized the term [2]

7.2. 1700-1800s

7.2.1. Industrial Revolution in the 18th Centrury [20]

7.3. 1900s

7.3.1. Expanded in the1960s during the Civil Rights movement in the US [2,7,20]

7.3.2. 1970s and 1980s

7.3.2.1. Empowerment embraced by the self-help movement [7]

7.3.2.2. Paulo Freire (Brazil) first applied empowerment to healthcare in the 1980s [20]

7.3.2.3. Ottawa Charter (1986) on Health Promotion [7,16]

8. **Current Influences**

8.1. **Withinin Nursing**

8.1.1. Technology [3]

8.1.2. WHO guidelines and frameworks [7,16]

8.1.3. Legislative policies to increase patient participation [7]

8.1.4. Covid-19 pandemic [17]

8.1.5. Black Lives Matter [21]

8.1.6. MeToo Movement [21]

8.2. **Within Education**

8.2.1. Women's empowerment movement [8,12]

8.2.2. Social media [8]

8.2.3. Schools promoting youth empowerment [3,22]

8.2.3.1. Construction of democratic and civic attitudes [3]

8.2.3.2. After-school empowerment programs [22]