Proot I M, Abu-Saad H H, de Esch-Janssen W P, Crebolder H F, ter Meulen R H
Institute for Bioethics, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Int J Nurs Stud. 2000 Jun;37(3):267-76. doi: 10.1016/s0020-7489(00)00008-0.
This article describes the results of a grounded theory study among stroke patients (N=17, aged 50-85) in rehabilitation wards in nursing homes. Patient autonomy (dimensions: self-determination, independence and self-care) increases during rehabilitation due to patient factors (conditions and strategies of patient) and environmental factors (nursing home and strategies of health professionals and family). During rehabilitation patients are in a state of transition regarding autonomy: patients need support to enhance autonomy, gradually regain autonomy, and thereby need less support. Although facilitating environmental factors were discovered, patients also experienced constraining factors regarding patient autonomy. Health professionals should give more attention to self-determination and independence; the nursing home should offer stroke patients more opportunities to do familiar activities autonomously.
本文描述了一项针对养老院康复病房中中风患者（N = 17，年龄在50至85岁之间）的扎根理论研究结果。由于患者因素（患者的状况和策略）和环境因素（养老院以及医护人员和家庭的策略），患者自主性（维度：自我决定、独立性和自我护理）在康复期间有所提高。在康复过程中，患者在自主性方面处于一种转变状态：患者需要支持来增强自主性，逐渐重新获得自主性，从而需要的支持减少。虽然发现了促进自主性的环境因素，但患者在患者自主性方面也经历了限制因素。医护人员应更加关注自我决定和独立性；养老院应为中风患者提供更多自主进行熟悉活动的机会。
