Wade G H
College of Health and Nursing Sciences, University of Delaware, Newark, Delaware, USA.
J Adv Nurs. 1999 Aug;30(2):310-8. doi: 10.1046/j.1365-2648.1999.01083.x.
Professional nurse autonomy, an essential attribute of a discipline striving for full professional status, is often confused with personal autonomy, work autonomy or aggregate professional autonomy. Using Walker & Avant's (1995) model for concept analysis, this paper presents an analysis of professional nurse autonomy. Professional nurse autonomy is defined as belief in the centrality of the client when making responsible discretionary decisions, both independently and interdependently, that reflect advocacy for the client. Critical attributes include caring, affiliative relationships with clients, responsible discretionary decision making, collegial interdependence, and proactive advocacy for clients. Antecedents include educational and personal qualities that promote professional nurse autonomy. Accountability is the primary consequence of professional nurse autonomy. Associated feelings of empowerment link work autonomy and professional autonomy and lead to job satisfaction, commitment to the profession, and the professionalization of nursing. A student-centred, process-orientated curricular design provides an environment for learning professional nurse autonomy. To support the development of professional nurse autonomy, the curriculum must emphasize knowledge development, understanding, and clinical decision making.
专业护士自主性是一门追求完全专业地位的学科的基本属性，却常常与个人自主性、工作自主性或总体专业自主性相混淆。本文运用沃克和阿万特（1995年）的概念分析模型，对专业护士自主性进行分析。专业护士自主性被定义为在独立和相互依赖地做出负责任的自由裁量决策时，坚信服务对象的核心地位，这些决策体现了对服务对象的支持。关键属性包括关怀、与服务对象的亲和关系、负责任的自由裁量决策、同事间的相互依赖以及对服务对象的积极支持。先决条件包括促进专业护士自主性的教育和个人品质。问责制是专业护士自主性的主要结果。相关的赋权感将工作自主性和专业自主性联系起来，并导致工作满意度、对职业的承诺以及护理的专业化。以学生为中心、注重过程的课程设计为学习专业护士自主性提供了一个环境。为支持专业护士自主性的发展，课程必须强调知识发展、理解和临床决策。
