Proot I M, Crebolder H F, Abu-Saad H H, Ter Meulen R H
Institute for Bioethics, Maastricht, The Netherlands.
Scand J Caring Sci. 1998;12(3):139-45.
This article presents a concept analysis of autonomy in relation to the rehabilitation of stroke patients. Analysis of the results of a literature survey provided three important concepts of autonomy in the field of biomedical ethics: self-governance, self-realization and actual autonomy. These concepts are compared with concepts from caring sciences and summarized in a table. The results indicate the importance of the social environment (formal and informal caregivers) for the restoration of autonomy. Because of the patient's condition and context, a social concept of autonomy makes more sense in the rehabilitation of stroke patients in nursing homes than does an individual concept. The concept analysis sheds light on the fact that the majority of studies regarding patient autonomy are primarily based on theoretical reflections, not on empirical studies. More research is warranted to gather information on how patients themselves consider and appreciate autonomy during rehabilitation, to explore the views of stroke patients' formal and informal caregivers and to investigate whether a social concept of autonomy is suitable for all phases of rehabilitation. Concerning the practice of rehabilitation, no definite conclusion can be given as yet.
本文介绍了与中风患者康复相关的自主性概念分析。对文献调查结果的分析得出了生物医学伦理学领域自主性的三个重要概念：自我治理、自我实现和实际自主性。这些概念与护理科学中的概念进行了比较，并汇总在一个表格中。结果表明社会环境（正式和非正式护理人员）对自主性恢复的重要性。由于患者的病情和背景，在养老院中风患者的康复中，自主性的社会概念比个体概念更有意义。该概念分析揭示了这样一个事实，即大多数关于患者自主性的研究主要基于理论思考，而非实证研究。需要进行更多研究，以收集关于患者在康复过程中如何看待和重视自主性的信息，探索中风患者正式和非正式护理人员的观点，并调查自主性的社会概念是否适用于康复的所有阶段。关于康复实践，目前尚无定论。
