Aalborg Hospital Science and Innovation Center, Aarhus University Hospital, Denmark.
Int J Qual Stud Health Well-being. 2011;6(2). doi: 10.3402/qhw.v6i2.6045. Epub 2011 May 27.
This article focuses on Danish patients' experience of autonomy and its interplay with dignity and integrity in their meeting with health professionals. The aim is to chart the meanings and implications of autonomy for persons whose illness places them in a vulnerable life situation. The interplay between autonomy and personal dignity in the meeting with health care staff are central concepts in the framework. Data collection and findings are based on eight qualitative semi-structured interviews with patients. Patients with acute, chronic, and life threatening diseases were represented including surgical as well as medical patients. The values associated with autonomy are in many ways vitalising, but may become so dominant, autonomy seeking, and pervasive that the patient's dignity is affected. Three types of patient behaviour were identified. (1) The proactive patient: Patients feel that they assume responsibility for their own situation, but it may be a responsibility that they find hard to bear. (2) The rejected patient: proactive patients take responsibility on many occasions but very active patients are at risk of being rejected with consequences for their dignity. (3) The knowledgeable patient: when patients are health care professionals, the patient's right of self-determination was managed in a variety of ways, sometimes the patient's right of autonomy was treated in a dignified way but the opposite was also evident. In one way, patients are active and willing to take responsibility for themselves, and at the same time they are "forced" to do so by health care staff. Patients would like health professionals to be more attentive and proactive.
本文聚焦丹麦患者的自主权体验，以及其在与医疗专业人员互动时与尊严和完整性的相互作用。目的是描绘自主权对那些因疾病而处于脆弱生活状况的人的意义和影响。自主权和个人尊严在与医护人员的互动中是框架中的核心概念。数据收集和发现基于对 8 名患有急性、慢性和危及生命疾病的患者的 8 次定性半结构式访谈。这些患者包括外科和内科患者。与自主权相关的价值观在很多方面都是充满活力的，但可能会变得如此主导、寻求自主和普遍，以至于影响到患者的尊严。确定了三种类型的患者行为。（1）积极主动的患者：患者感到他们对自己的情况负责，但这可能是他们难以承受的责任。（2）被拒绝的患者：积极主动的患者在许多情况下承担责任，但非常积极主动的患者有被拒绝的风险，这对他们的尊严有影响。（3）知识渊博的患者：当患者是医疗保健专业人员时，会以各种方式管理患者的自决权，有时会以有尊严的方式对待患者的自主权，但也有相反的情况。一方面，患者积极主动，愿意为自己负责，同时也被医护人员“强迫”这样做。患者希望医护人员更加关注和积极主动。
