Facilitating and constraining factors on autonomy: the views of stroke patients on admission into nursing homes.

Abstract:

:This article describes a model changing autonomy which was developed in a grounded theory study among stroke patients on admission into nursing homes for rehabilitation. Three dimensions of autonomy were identified: self-determination, independence, and self-care. On admission, patients' conditions (disabilities, multimorbidity, emotional state, and feeling like a layperson) and patients' strategies (waiting and seeing, and acting as a subordinate) constrain autonomy. Several environmental factors facilitate patient autonomy. The nursing home sustains patient autonomy by providing a hopeful atmosphere and room for autonomy. The health professionals facilitate autonomy by giving therapy, support and information, attentiveness and respect, paternalism and teamwork, Facilitating strategies of the family encompass emotional and instrumental support Care routines, lack of privacy, an unfamiliar environment, waiting periods, boredom, and lack of information were identified as constraining environmental factors. Developing guidelines and multidisciplinary courses regarding the approach to patient autonomy on admission is recommended.

journal_name

Clin Nurs Res

authors

Proot IM,Crebolder HF,Abu-Saad HH,Macor TH,ter Meulen RH

doi

10.1177/10547730022158690

keywords:

subject

Has Abstract

pub_date

2000-11-01 00:00:00

pages

460-78

issue

4

eissn

1054-7738

issn

1552-3799

journal_volume

9

pub_type

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