Breitholtz Agneta, Snellman Ingrid, Fagerberg Ingegerd
Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, 141 83 Huddinge, Sweden ; School of Health, Care and Social Welfare, Mälardalen University, P.O. Box 883, 721 23 Västerås, Sweden.
Nurs Res Pract. 2013;2013:403717. doi: 10.1155/2013/403717. Epub 2013 Mar 7.
The aim of the study was to illuminate the meaning of older persons' independent decision making concerning their daily care. Autonomy when in care is highly valued in the western world. However, research shows that autonomy can give rise to problematic issues. The complexity of independence and dependence for older people when living at home with help has also been highlighted. In Sweden, older people are increasingly expected to live at home with help from municipal home care services, and study into this aspect of care is limited. This study is a part of an ongoing project and has a qualitative life world perspective. Audiotaped narrative interviews were conducted and analysed using a phenomenological hermeneutic method. Findings revealed a main theme: "living with uncertainty as to how to relate one's own independence and dependence with regard to oneself, and others." This involves a constant process of relating to one's independence controlled by others or oneself, and adjusting one's independence and dependence with regard to oneself and others. The conclusion is that professional carers need to acknowledge the changing vulnerability of dependent older persons over time. The implication is a relational approach to autonomy beyond the traditional individualistic approach.
该研究的目的是阐明老年人在日常护理方面自主决策的意义。在西方世界,接受护理时的自主性备受重视。然而,研究表明自主性可能引发一些问题。老年人在家中接受帮助时独立与依赖的复杂性也已得到凸显。在瑞典,越来越多的老年人期望在市政家庭护理服务的帮助下居家生活,而针对这一护理方面的研究有限。本研究是一个正在进行的项目的一部分,具有质性生活世界视角。通过录音叙事访谈,并运用现象学诠释学方法进行分析。研究结果揭示了一个主要主题:“在如何处理自身相对于自己及他人的独立与依赖关系上存在不确定性地生活”。这涉及到一个不断与由他人或自己掌控的自身独立性建立联系,并调整自身相对于自己及他人的独立与依赖关系的过程。结论是专业护理人员需要认识到随着时间推移,依赖型老年人的脆弱性在不断变化。这意味着要采用一种超越传统个人主义方法的自主性的关系性方法。