Botana Gronek Melissa, Bleijlevens Michel, Vluggen Stan, Moonen Esmee, Van Dijk Aileen, Erkens Petra, Zwakhalen Sandra, Hamers Jan, Meijers Judith
Living Lab in Ageing and Long-Term Care, Department of Health Services Research, CAPHRI, Faculty of Health, Medicine and Life Science, Maastricht University, Duboisdomein 30, Maastricht, GT, 6229, The Netherlands.
Zuyderland Medisch en Zorgconcern, Zuyderland Care, Parklaan 10, Sittard, KG, 6131, The Netherlands.
BMC Nurs. 2025 May 1;24(1):479. doi: 10.1186/s12912-025-02990-5.
Supporting others with self-care activities lies at the core of nursing practices. While supporting autonomy within essential care is important, there remains a lack of knowledge on what autonomy comprises and how nurses can demonstrate autonomy-supportive behavior. In order to find guidance, we consulted nursing theories that have shaped the profession. This study aims to explore in what way autonomy is described within the nursing theories and how they describe what nurses could/should undertake to demonstrate autonomy-supportive behaviors within activities of daily living.
A scoping review was performed, in adherence to the Johanna Briggs Institute methodology for scoping reviews, adhering to the EQUATOR guidelines, using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews, PRISMA-ScR, in order to report the scoping review results. Nursing theories were identified through textbooks, PubMed and expert feedback during the period of April to July 2023. No publication year restrictions were applied. Theories (writings that informed, under pinned, or described nursing care) were included if published in English or Dutch. Data extraction was carried out, performing a content analysis using inductive coding to identify categories of autonomy-supportive behavior.
Of 25 nursing theories identified, nine met the inclusion criteria. While none provided explicit definitions of autonomy-supportive behavior, autonomy was described as encompassing being oneself, having freedom and control over one's life, expressing and making choices, and engagement in carrying out actions. Six categories of autonomy-supportive behavior were identified: being aware of one's own behavior, respecting individual uniqueness, fostering interpersonal connections, facilitating open communication, allowing the other person to choose the best action, and collaborative guidance and assistance.
This review explored how autonomy is defined in prominent nursing theories and how nurses can foster autonomy in activities of daily living. Despite its central role in healthcare, no consistent definition of autonomy or autonomy-supportive behavior was identified. While nursing theories provide valuable insights, these remain largely theoretical and lack practical applicability. Further research is needed to translate these concepts into actionable strategies for everyday practice.
通过自我护理活动来支持他人是护理实践的核心。虽然在基本护理中支持自主性很重要，但对于自主性的构成以及护士如何表现出支持自主性的行为，仍然缺乏相关知识。为了找到指导方向，我们查阅了塑造该专业的护理理论。本研究旨在探讨在护理理论中自主性是如何被描述的，以及这些理论如何描述护士在日常生活活动中可以/应该采取哪些行动来表现出支持自主性的行为。
按照乔安娜·布里格斯研究所的范围综述方法进行了一项范围综述，遵循EQUATOR指南，使用系统评价和元分析扩展的首选报告项目（PRISMA-ScR）来报告范围综述结果，以报告范围综述的结果。在2023年4月至7月期间，通过教科书、PubMed和专家反馈确定护理理论。不设出版年份限制。如果理论以英文或荷兰语发表，则纳入（那些为护理提供信息、支撑或描述护理的著作）。进行了数据提取，使用归纳编码进行内容分析，以确定支持自主性行为的类别。
在确定的25种护理理论中，有9种符合纳入标准。虽然没有一种理论对支持自主性的行为给出明确的定义，但自主性被描述为包括做自己、对自己的生活拥有自由和控制权、表达和做出选择以及参与行动。确定了六类支持自主性的行为：意识到自己的行为、尊重个体独特性、培养人际关系、促进开放沟通、允许他人选择最佳行动以及协作指导和协助。
本综述探讨了在著名护理理论中自主性是如何定义的，以及护士如何在日常生活活动中促进自主性。尽管自主性在医疗保健中具有核心作用，但未找到关于自主性或支持自主性行为的一致定义。虽然护理理论提供了有价值的见解，但这些见解在很大程度上仍然停留在理论层面，缺乏实际适用性。需要进一步的研究将这些概念转化为日常实践中可行的策略。
