Because of advances in technology and scientific knowledge, the number of children living with chronic illness is ever increasing. The burden of responsibility for the care of chronically ill children falls increasingly to the involved parents, and, particularly, to mothers. Nurses have a key role in providing support to these families. In order to build the necessary supportive and collaborative relationships that will assist families in dealing with the effects of chronic illness, nurses need to understand the process of empowerment.

The purposes of the study were to identify if and describe how parents of chronically ill children feel empowered and to describe the process of empowerment. The Hybrid Model developed by Schwartz-Barcott and Kim (1986) was used to study the phenomena. The model, which interfaces theoretical analysis with empirical observation, is composed of three phases: an initial theoretical phase, a field work phase (involving participant observation and in-depth interviewing), and a final analytical phase.

The field work phase took place in a children's hospital in the northeastern states. Twelve mothers, ranging in age from 25 to 49 years, of neurologically challenged children, aged 11 months to 16 years, consented to be interviewed.

The definition that emerged from this study indicates that empowerment was largely a personal process in which the mothers developed and employed the necessary knowledge, competence, and confidence for making their voices heard. The outcome of the process of empowerment, originally conceptualized as feeling empowered, was reconceptualized as participatory competence, which was defined as the ability to be heard by those in power. The new label, participatory competence, allowed a movement from an original focus on feeling to a focus on ability that was acquired and developed over time and maintained. Four phases of the process of empowerment were identified: (a) discovering reality, (b) critical reflection, (c) taking charge, and (d) holding on. Although the unique finding in this study suggests that the process of empowerment was largely intrapersonal, clearly, there was a relational element in the process.

Findings of the study are discussed in relation to nursing theory, practice, education, and research.