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自我决定与老年人——一项概念分析

Self-determination and older people--a concept analysis.

作者信息

Ekelund Christina, Dahlin-Ivanoff Synneve, Eklund Kajsa

机构信息

Vårdalinstitutet - The Swedish Institute for Health Sciences , Gothenburg , Sweden.

出版信息

Scand J Occup Ther. 2014 Mar;21(2):116-24. doi: 10.3109/11038128.2013.853832. Epub 2013 Nov 29.

Abstract

BACKGROUND

Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural.

OBJECTIVE

To define and clarify the concept of self-determination in relation to community-dwelling frail older people.

METHOD

Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes.

RESULTS

Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice.

PRINCIPAL CONCLUSION

This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

摘要

背景

自主决定权已成为医疗保健领域的一个重要概念,用于强调服务对象在参与康复过程中的控制权和独立性。增强服务对象的自主决定权是职业治疗的核心目标。然而,对于社区居家老年人的自主决定权,目前尚无明确的定义。该定义应在不同背景下保持灵活性,比如文化背景。

目的

界定并阐明与社区居家体弱老年人相关的自主决定权概念。

方法

采用沃克和阿万特的分析程序来确定自主决定权概念的文本属性,并辅以对21篇文章的内容分析,这些文章用于定义并进一步论证文本属性。

结果

自主决定权在社区居家老年人的不同背景下有不同应用,涉及:日常生活中的决策、专业人员的观点、健康以及法律/伦理权利。确定了不同的文本属性,从而提出了与社区居家体弱老年人相关的自主决定权的概念性定义:一个人拥有控制权和法律/伦理权利,并有知识和能力做出自主选择决定的过程。

主要结论

这一概念分析有助于明确该概念,以便于对社区居家体弱老年人进行研究。

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