Hedman Maria, Pöder Ulrika, Mamhidir Anna-Greta, Nilsson Annika, Kristofferzon Marja-Leena, Häggström Elisabeth
Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
Scand J Caring Sci. 2015 Dec;29(4):824-33. doi: 10.1111/scs.12215. Epub 2015 Apr 9.
There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility--still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase 'ability to act' in different ways, based on older people's descriptions of the meaning of autonomy and participation.
对于患有慢性病的老年人如何描述自主性和参与的意义,人们缺乏了解,这表明他们在日常生活中存在自主性降低和参与度减少的风险。本研究的目的是根据患有慢性病的老年人的生活经历来描述自主性和参与的意义。研究设计采用描述性现象学方法,以 Giorgi 的描述性现象学心理学方法为指导。采用目的抽样法,16 名居住在普通家庭的患有慢性病的老年人参与了个人访谈。研究结果表明,当自主性和参与的意义受到挑战并引发对患有慢性病的生活经历的情感考量时,老年人的自主性和参与的意义就会显现出来。这涉及到过一种与众不同的生活,但仍然是一个有能力、值得信赖且被赋予责任的人——仍然被看到和认可。自主性和参与的意义源自生活记忆,并被老年人在日常生活中用于调整或适应当前生活和未来。我们的结论是,自主性和参与是相对于老年人过去的生活记忆、当前的状况以及他们未来的愿望来考虑的。在老年人中,能力或残疾的重要性低于日常生活的意义。我们建议在照顾老年人时,减少对日常生活中限制的标签使用,更多地根据老年人对自主性和参与意义的描述,以不同方式使用“行动能力”这一表述。