8058University of Turku, Finland.
8058University of Turku, Finland; Oulu University Hospital, Finland.
Nurs Ethics. 2021 May;28(3):414-434. doi: 10.1177/0969733020948115. Epub 2020 Oct 1.
Autonomy has been recognised as a key principle in healthcare, but we still need to develop a consistent understanding of older people's perceived autonomy in residential care. This study aimed to identify, describe and synthesise previous studies on the perceived autonomy of older people in residential care. Ethical approval was not required, as this was a review of published literature. We carried out an integrative review to synthesise previous knowledge published in peer-review journals in English up to September 2019. Electronic and manual searches were conducted using the CINAHL, Philosopher's Index, PubMed, SocINDEX, Scopus and Web of Science databases. The data were analysed using the constant comparison method. The review identified 46 studies. Perceived autonomy referred to the opportunities that older people had to make their own choices about their daily life in residential care, and achieving autonomy promoted both health and quality of life. Autonomy was linked to older people's individual capacities, including their level of independence, physical and mental competence, personal characteristics, and whether relatives shared and supported their perceived autonomy. Professionals could facilitate or hinder older peoples' autonomy in a number of ways, including providing opportunities for autonomy, how daily care needs and activities were managed, and controlling older people's choices. Professionals' characteristics, such as education and attitudes, and the older people's living environments were also associated with their perceived autonomy and included organisational characteristics and physical and social care facilitators. Older people's perceived autonomy promoted health and quality of life in residential care. However, their autonomy was associated with a number of protective and restrictive individual and environmental factors, which influenced whether autonomy was achieved.
自主性已被认为是医疗保健的一个关键原则，但我们仍需要对老年人在居住护理中的感知自主性形成一致的理解。本研究旨在识别、描述和综合以前关于居住护理中老年人感知自主性的研究。由于这是对已发表文献的综述，因此不需要伦理批准。我们进行了综合评价，以综合 2019 年 9 月之前在同行评议期刊上发表的英文文献中的先前知识。使用 CINAHL、Philosopher's Index、PubMed、SocINDEX、Scopus 和 Web of Science 数据库进行电子和手动搜索。使用恒定性比较法对数据进行分析。综述共确定了 46 项研究。感知自主性是指老年人在居住护理中对自己日常生活做出选择的机会，实现自主性既促进了健康，又提高了生活质量。自主性与老年人的个体能力有关，包括独立性、身体和心理能力、个人特征，以及亲属是否分享和支持他们的感知自主性。专业人员可以通过多种方式促进或阻碍老年人的自主性，包括提供自主性的机会、如何管理日常护理需求和活动，以及控制老年人的选择。专业人员的特征，如教育和态度，以及老年人的生活环境也与他们的感知自主性有关，包括组织特征和物理和社会护理促进因素。老年人在居住护理中的感知自主性促进了健康和生活质量。然而，他们的自主性与许多保护性和限制性的个体和环境因素有关，这些因素影响着自主性的实现。
