Journal articles: 'Autonomy for self-care'

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Proot, Ireen M., Huda Huijer Abu-Saad, Gijs GJ Van Oorsouw, and Jos JAM Stevens. "Autonomy in Stroke Rehabilitation: the perceptions of care providers in nursing homes." Nursing Ethics 9, no. 1 (January 2002): 36–50. http://dx.doi.org/10.1191/0969733002ne479oa.

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Twenty-seven health care providers from three nursing homes were interviewed about the autonomy of stroke patients in rehabilitation wards. Data were analysed using the grounded theory method for concept development recommended by Strauss and Corbin. The core category ‘changing autonomy’ was developed, which identifies the process of stroke patients regaining their autonomy (dimensions: self-determination, independence and self-care), and the factors affecting this process (conditions (i.e. circumstances) and strategies of patients; strategies of care providers and families; and the nursing home). Teamwork on increasing patient autonomy is recommended, which can be stimulated by multidisciplinary guidelines and education, and by co-ordination of the process of changing autonomy.

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Koponen, Anne M., Nina Simonsen, and Sakari Suominen. "Quality of primary health care and autonomous motivation for effective diabetes self-management among patients with type 2 diabetes." Health Psychology Open 4, no. 1 (January 2017): 205510291770718. http://dx.doi.org/10.1177/2055102917707181.

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This study showed, in line with self-determination theory, that of the six central quality dimensions of primary health care (access to care, continuity of care, diabetes counseling, autonomy support from one’s physician, trust, patient-centered care), autonomy support from one’s physician was most strongly associated with autonomous motivation (self-regulation) for effective diabetes self-management among patients with type 2 diabetes ( n = 2866). However, overall support for diabetes care received from friends, family members, other patients with diabetes, and health care professionals may even play a greater role.

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Bedin, Liarine Fernandes, Josefine Busanello, Graciela Dutra Sehnem, Fernanda Machado da Silva, and Márcia Adriana Poll. "Strategies to promote self-esteem, autonomy and self-care practices for people with chronic wounds." Revista Gaúcha de Enfermagem 35, no. 3 (September 2014): 61–67. http://dx.doi.org/10.1590/1983-1447.2014.03.43581.

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This is a qualitative study of an exploratory nature that aims to identify the strategies used by nurses in primary care, in situations involving nursing care, to promote self-esteem, autonomy and self-care practices for people with chronic wounds. The study included eight nurses. Data were collected by means of a focus group in July 2012. The thematic analysis technique was used to identify the following categories: Nursing care from the perspective of comprehensiveness; Recovering support networks: family and social movements; Multidisciplinary work; Autonomy and nurses. It was concluded that the presented strategies value, above all, the social environment of these individuals, the family, religion and the nurse's approximation to the realities of people with chronic wounds.

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Matsui, Miho, and Elizabeth Capezuti. "Perceived Autonomy and Self-Care Resources among Senior Center Users." Geriatric Nursing 29, no. 2 (March 2008): 141–47. http://dx.doi.org/10.1016/j.gerinurse.2007.09.001.

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Rocha, Lucimara Sonaglio, Margrid Beuter, Eliane Tatsch Neves, Marinês Tambara Leite, Cecília Maria Brondani, and Nara Marilene Oliveira Girardon Perlini. "Self-care of elderly cancer patients undergoing outpatient treatment." Texto & Contexto - Enfermagem 23, no. 1 (March 2014): 29–37. http://dx.doi.org/10.1590/s0104-07072014000100004.

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This is a qualitative descriptive study with the aim to analyze the self-care of elderly cancer patients undergoing outpatient treatment, from the perspective of their autonomy. Fifteen elderly individuals undergoing treatment in a blood-oncology outpatient center of a university hospital participated in the research. Data were collected with semi-structured interviews conducted in 2010. Independence and ability for self-care by the elderly patients were evaluated using the Katz and Lawton scales. The data collected were submitted to thematic analysis. Four categories were identified: manifestations of self-care of elderly cancer patients; care in the family and its dynamics; adaptation to the limitations of the disease; and living with finiteness. In conclusion, the autonomy for self-care of the elderly patients is manifested in the concern with diet, knowing their bodies' limits, the changes imposed by living with cancer and family support.

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Hata, Chiemi, and Sachiko Kasahara. "THE STRUCTURE OF CARE MANAGERS’ PRACTICE RESPECTING THE AUTONOMY OF THE FRAIL ELDERLY IN JAPAN." Innovation in Aging 3, Supplement_1 (November 2019): S504. http://dx.doi.org/10.1093/geroni/igz038.1865.

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Abstract The objectives of current study are to clarify the structure of practice respecting the autonomy of the frail elderly under the Long-Term Care Insurance system in Japan and to discuss the related factors to the practice. The mailed self-administered questionnaire survey was conducted on 1398 care managers who working in In-Home Long-Term Care Support Providers in A City in Osaka with the condition that “office with multiple care managers engaged and one care manager with more than 5 years’ experience”. The response rate was 51.0% (713persons) and no missing data 615 (44.0%) was analyzed. Analysis was carried out using Mplus.ver8. The structure of practice respecting the autonomy of the frail elderly and the rerated factors were examined as a causal model using structural equation modeling. As the result, it was confirmed the goodness of fit to the data (RMSEA=0.049, CFI=0.927). By the confirmatory factor analysis, the care manager’s practice respecting the autonomy of the elderly was confirmed associating with three-factors structure; (1)data collection and assessment, (2) strength perspective and (3) professional relationship. Furthermore the practice was significantly affected by self-esteem of care-managers performance (β=0.494) and self-reflection to own work (β=0.269). In conclusion, the current study supported the hypothetical consideration in which self-esteem and self-reflection in care manager’s practice significantly affected the practice respecting the autonomy of the frail elderly.

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Wysocki, T., A. Taylor, B. S. Hough, T. R. Linscheid, K. O. Yeates, and J. A. Naglieri. "Deviation from Developmentally Appropriate Self-Care Autonomy: Association with diabetes outcomes." Diabetes Care 19, no. 2 (February 1, 1996): 119–25. http://dx.doi.org/10.2337/diacare.19.2.119.

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Dashiff, C., D. Vance, H. Abdullatif, and J. Wallander. "Parenting, autonomy and self-care of adolescents with Type 1 diabetes." Child: Care, Health and Development 35, no. 1 (January 2009): 79–88. http://dx.doi.org/10.1111/j.1365-2214.2008.00892.x.

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McKearney, Patrick. "The Weight of Living: Autonomy, Care, and Responsibility for the Self." Journal of Disability & Religion 22, no. 3 (July 3, 2018): 266–82. http://dx.doi.org/10.1080/23312521.2018.1483219.

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Oliveira e Castro, Pedro, Maria Martins, Glória Couto, and Maria Reis. "Mirror therapy and self-care autonomy after stroke: an intervention program." Revista de Enfermagem Referência IV Série, no. 17 (June 20, 2018): 95–106. http://dx.doi.org/10.12707/riv17088.

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Leontowitsch, Miranda. "Self-Care – Embodiment, Personal Autonomy and the Shaping of Health Consciousness." Social Theory & Health 5, no. 1 (February 2007): 103–4. http://dx.doi.org/10.1057/palgrave.sth.8700079.

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Jacobs, Gaby. "Patient autonomy in home care: Nurses’ relational practices of responsibility." Nursing Ethics 26, no. 6 (May 7, 2018): 1638–53. http://dx.doi.org/10.1177/0969733018772070.

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Background: Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. Aim: To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course (‘learning circle’) for home care nurses, including participant observations and focus groups. The theoretical notion of ‘relational agency’ and the moral concept of ‘practices of responsibility’ were used to conduct a narrative analysis on the nurses’ stories about autonomy. Participants: Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Findings: Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients’ strengths and collaboration with patients and informal caregivers. Discussion: On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. Conclusion: The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.

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Cyrino, Antonio Pithon, Lilia Blima Schraiber, and Ricardo Rodrigues Teixeira. "Education for type 2 diabetes mellitus self-care: from compliance to empowerment." Interface - Comunicação, Saúde, Educação 13, no. 30 (September 2009): 93–106. http://dx.doi.org/10.1590/s1414-32832009000300009.

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Through a critical review of the literature on education for diabetes self-care and self-management, it was sought to point out the inappropriateness of traditional approaches towards compliance with treatment and transmission of information, considering the complexity of self-care under chronic conditions. The influence of the social sciences on the field of studies on chronic degenerative diseases in general, and diabetes in particular, was explored. From this perspective, it can be recognized that the fields of anthropology and sociology have been incorporated into research focusing more on individuals as patients, and on the experience gained through this process. Recently, there has been a slight change within the field of health education research relating to diabetes, with the introduction of strategies that seek to value the experience and autonomy of patients as self-care agents. This paper discusses the strategy for empowerment in education for diabetes self-care and self-management, as a dialogue-focused practice that respects patients' moral and cognitive autonomy.

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Jeong, Hye Won, Chi Eun Song, and Minjeong An. "Feasibility and preliminary effects of a theory-based self-management program for kidney transplant recipients: A pilot study." PLOS ONE 16, no. 6 (June 30, 2021): e0248947. http://dx.doi.org/10.1371/journal.pone.0248947.

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Self-care activities are important to prevent transplant-related side effects and complications among kidney transplant recipients. Therefore, we developed a theory-based self-management program for kidney transplant recipients hospitalized after surgery. This study aimed to examine the feasibility of the program and to identify its preliminary effects on autonomy, competence, and self-care agency. We assessed feasibility using quantitative data collected based on a single group repeated-measures design, along with qualitative data such as patients’ feedback on satisfaction during patient counseling. The program comprised video education and individual counseling by nurses. Thirty patients completed this program. Outcome variables were measured thrice: before education, immediately following the first week of video education, and after two consecutive weeks of counseling. A repeated measures ANOVA showed a statistically significant increase in autonomy (F = 5.03, p = .038), competence (F = 17.59, p < .001), and self-care agency (F = 24.19, p < .001). Our pilot study provided preliminary evidence supporting the feasibility for implementation of the theory-based self-management program, and suggesting its preliminary effects in improving autonomy, competence, and self-care agency among kidney transplant recipients. Further research is needed to examine the short- and long-term effects of this program in a longitudinal, randomized control study with a larger sample.

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Williams, Geoffrey C., Heather Patrick, Christopher P. Niemiec, L. Keoki Williams, George Divine, Jennifer Elston Lafata, Michele Heisler, Kaan Tunceli, and Manel Pladevall. "Reducing the Health Risks of Diabetes." Diabetes Educator 35, no. 3 (March 26, 2009): 484–92. http://dx.doi.org/10.1177/0145721709333856.

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Purpose The purpose of this study is to apply the self-determination theory (SDT) model of health behavior to predict medication adherence, quality of life, and physiological outcomes among patients with diabetes. Methods Patients with diabetes (N = 2973) receiving care from an integrated health care delivery system in 2003 and 2004 were identified from automated databases and invited to participate in this study. In 2005, patients responded to a mixed telephone-and-mail survey assessing perceived autonomy support from health care providers, autonomous self-regulation for medication use, perceived competence for diabetes self-management, medication adherence, and quality of life. In 2006, pharmacy claims data were used to indicate medication adherence, and patients' non—high-density lipoprotein (HDL) cholesterol, A1C, and glucose levels were assessed. Results The SDT model of health behavior provided adequate fit to the data. As hypothesized, perceived autonomy support from health care providers related positively to autonomous self-regulation for medication use, which in turn related positively to perceived competence for diabetes self-management. Perceived competence then related positively to quality of life and medication adherence, and the latter construct related negatively to non-HDL cholesterol, A1C, and glucose levels. Conclusions Health care providers' support for patients' autonomy and competence around medication use and diabetes self-management related positively to medication adherence, quality of life, and physiological outcomes among patients with diabetes.

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Lakanmaa, Riitta-Liisa, Tarja Suominen, Marita Ritmala-Castrén, Tero Vahlberg, and Helena Leino-Kilpi. "Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study." BioMed Research International 2015 (2015): 1–12. http://dx.doi.org/10.1155/2015/536724.

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Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1–5, 1 = poor and 5 = excellent) was employed among Finnish intensive care unit nurses (n=431). Intensive care unit nurses’ self-assessed basic competence was good (mean 4.19, SD 0.40). The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses’ basic competence was their experience of autonomy in nursing care (Fvalue 60.85,β0.11, SE 0.01, andP≤0.0001). Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses’ experienced autonomy in nursing.

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Jenkins, Fiona. "Care of the Self or Cult of the Self?" International Journal of Philosophical Practice 1, no. 1 (2001): 48–64. http://dx.doi.org/10.5840/ijpp2001113.

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How might philosophically based counseling avoid becoming just one more form of private therapy, to be set alongside all the others now sold to individual consumers? Although several practitioners of philosophical counseling have sought to distinguish their approach from psychotherapeutic models, Foucault’s critique of the dominant modern model of ethical reflection might be used to argue for their essential continuity with one another, based on their common acceptance of the primacy of the imperatives of knowledge. Foucault turned in his late writings to ancient Greek models of ethics as ‘care of the self ’, delineating a self-relation prior to knowledge. This paper argues for the interest and importance for philosophical counseling of the idea of ethics as ‘care of the self ’ in articulating a model of ethical reflection distinct from both rationalist and irrationalist tendencies in modern thought and focussed on self-mastery conceived as addressing our relation to otherness rather than as authenticity or autonomy. Moreover, the ‘aesthetics of existence’ that Foucault prescribes to the present has a significant and affirmative relationship to political life; this distinguishes it from the private and individualistic project, dismissed by Foucault as ‘the Californian cult of the self ’, for which philosophical counseling can all too readily be mistaken.

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Maharmeh, Mahmoud. "Understanding critical care nurses’ autonomy in Jordan." Leadership in Health Services 30, no. 4 (October 2, 2017): 432–42. http://dx.doi.org/10.1108/lhs-10-2016-0047.

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Purpose The aim of this study was to describe Jordanian critical care nurses’ experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse’s autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses’ job satisfaction. Therefore, improving nurses’ clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

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Hardiman, Karin M., Christina D. Reames, Marshall C. McLeod, and Scott E. Regenbogen. "Patient autonomy–centered self-care checklist reduces hospital readmissions after ileostomy creation." Surgery 160, no. 5 (November 2016): 1302–8. http://dx.doi.org/10.1016/j.surg.2016.05.007.

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Goldberg, Lisa. "In the Company of Women: enacting autonomy within the perinatal nursing relationship." Nursing Ethics 10, no. 6 (November 2003): 580–87. http://dx.doi.org/10.1191/0969733003ne648oa.

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An understanding of autonomy has important significance in North American health care. Although a respect for autonomy is necessary to protect the self-determination and agency of birthing women in hospital settings, I suggest that enactments of autonomy that are independent of relationships offer only an incomplete interpretation of such a vital concept. In this article I explore an understanding of autonomy situated within the context of a relational birthing narrative. In so doing, autonomy becomes conceptualized as contextual and concrete, giving rise to an embodied view of the birthing woman.

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Lestari, Lilis, Elisabeth Siti Herini, and Indria Laksmi Gamayanti. "MAIN CAREGIVER’S EXPERIENCE IN MEETING SELF-CARE NEEDS AMONG ADOLESCENTS WITH ASD IN PONTIANAK MUNICIPALITY, WEST BORNEO, INDONESIA: A QUALITATIVE STUDY." Belitung Nursing Journal 3, no. 4 (August 31, 2017): 316–28. http://dx.doi.org/10.33546/bnj.123.

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Background: Autism spectrum disorder (ASD) is a complex developmental disorder, increasing in number, faster than that of other developmental disorders in the world. This complex disorder affects a child’s self-autonomy, which is important for individual self-care.Objective : This study is to explore main caregivers’ experience to meet self-care needs among adolescents with ASD in Pontianak, West Borneo, Indonesia.Methods: Qualitative semi-structured in-depth interviews were done with 7 main caregivers that have lived together and taken care of the adolescents with ASD in Pontianak Municipality, West Borneo Province. Sampling was taken with purposive sampling (maximum variation). Source (interviews) and method (observations of self-care activities and documents like photos, learning reports and field notes) triangulations were taken on 1 participant and 7 autistic adolescents. Participants’ statements were recorded by using a voice recorder, and then transcribed, coded, interpreted, and categorized in order that sub-topics and main topics could be formed.Results: The study identified five main topics: i.e., 1) Autonomy in self-care; 2) Care effort; 3) Feelings, support, and expectations. Three findings of the study emphasize the potentials of children with autism to be autonomous in daily self-care.Conclusions: Adolescents with ASD can potentially meet the needs of their daily care independently.

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Sadeghzadeh, Behnam, Ghasem Fattahzadeh-Ardalani, Azad Rahmani, Vahid Zamanzadeh, Mojgan Behshid, and Arman Azadi. "Iranian stroke patient’s perception of dignity, autonomy and privacy: a questionnaire survey." International Journal of Scientific Reports 2, no. 9 (September 1, 2016): 237. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20163112.

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Background: Patients with stroke have many problems which may have adverse effects on opportunities for dignified care. So, any plans to improve the providing of dignified care in these patients need to identify the level of maintaining their dignity in hospital settings and its related factors in particular privacy and autonomy. Accordingly, the aim of this study was to recognize the level of self-perceived dignity and its relationships with the perception of respected autonomy and privacy among Iranian stroke patients.Methods: This descriptive-correlational study was undertaken among 166 patients with stroke admitted to a public educational centre affiliated to Ardebil University of Medical Sciences, Ardebil/Iran. They were selected using convenience sampling method. Patients’ levels of self-perceived dignity, autonomy and privacy were assessed using valid questionnaires. Results: The study findings showed a significant negative correlation between patients’ self-perceived dignity and autonomy. Also there was no significant relationship between patients’ self-perceived dignity and patients’ perception of protected privacy.Conclusions: According to the findings of this study respect to autonomy of patient increases the amount of patient dignity. But there isn’t this relationship about respect to the privacy of patient.

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Shryock, Kelly, Jacinta Dickens, Anisha Thomas, and Suzanne Meeks. "END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS." Innovation in Aging 3, Supplement_1 (November 2019): S669. http://dx.doi.org/10.1093/geroni/igz038.2474.

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Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

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Ruszkowska, Marzena, and Józefa Matejek. "FACTORS AFFECTING EDUCATIONAL AND VOCATIONAL PLANS OF FOSTER CARE CHARGES." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 3 (May 21, 2019): 381. http://dx.doi.org/10.17770/sie2019vol3.3716.

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The objective of a foster care is to ensure that a child who is deprived of the adequate care from the biological family lives in the adequate environment. People who deal with Foster care responsibilities are bound to ensure a proper care to a child as well as prepare this child to future life, including vocational one. Thus, essential are educational and vocational plans of charges since they affect the process of gaining the autonomy by a youngster. The three actions: firstly, analysing the literature, secondly, doing researches in bialski poviat, thirdly, conducting a narrative questionnaire with an educator who simultaneously holds the responsibility for teaching charges autonomy, these three are supposed to identify factors that affect educational and vocational plans that foster care charges have. Factors that play significant role are as follows: a kind of foster care (family-run children houses versus educational care centres), the influence exerted by a subject and people who are supposed to support the process of gaining autonomy (foster care provider, tutor, pedagogue, educator responsible for teaching autonomy), personal characteristics (for example low self-esteem, lack of willingness and motivation to learn, lack of skills) and environmental factors (impact of dysfunctional family environment, peer environment, local environment).

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Rippe, Klaus-Peter. "Alzheimer-Erkrankungen, Autonomie und zwei Paradigmen der Pflegeethik." Deutsche Zeitschrift für Philosophie 66, no. 1 (March 26, 2018): 75–86. http://dx.doi.org/10.1515/dzph-2018-0007.

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Abstract Family members and professional care-givers are often confronted with challenging and self-destructive behaviours of people suffering from dementia, and it is not clear at all if these situations should be regulated by principles of autonomy or by principles of care, which consider the best interests of the patients. With reference to a thought experiment, this paper argues that it is not possible to control these situations by implementing principles of autonomy. Instead, while taking into account the patients’ capacity to consent, it is better to apply principles of care in challenging situations.

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van Thiel, Ghislaine JMW, and Johannes JM van Delden. "The Principle of Respect for Autonomy in the Care of Nursing Home Residents." Nursing Ethics 8, no. 5 (September 2001): 419–31. http://dx.doi.org/10.1177/096973300100800506.

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Respect for autonomy is well known as a core element of normative views on good care. Most often it is interpreted in a liberal way, with a focus on independence and self-determination. In this article we argue that this interpretation is too narrow in the context of care in nursing homes. With the aim of developing an alternative view on respect for autonomy in this setting we described four interpretations and investigated the moral intuitions (i.e. moral judgements) of caregivers regarding these approaches. We found that these caregivers seemed to value different notions relating to respect for autonomy under different circumstances. There was no significant difference in moral judgements between men and women or between doctors and nurses. We conclude that a multidimensional understanding of this principle would best fit this context. We end this article with a description of a modest theory of respect for autonomy in nursing homes.

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Leitner, Katharina, Sigrid Beyer, and Maria Kletečka-Pulke. "O-53 Between autonomy and paternalism – self-determination in end of life care." BMJ Supportive & Palliative Care 5, Suppl 2 (September 2015): A17.2—A17. http://dx.doi.org/10.1136/bmjspcare-2015-000978.52.

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Newdick, Christopher. "Health equality, social justice and the poverty of autonomy." Health Economics, Policy and Law 12, no. 4 (May 2, 2017): 411–33. http://dx.doi.org/10.1017/s1744133117000093.

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AbstractHow does the concept of autonomy assist public responses to ‘lifestyle’ diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a ‘nanny’ state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.

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Abrams, Lynn. "THE SELF AND SELF-HELP: WOMEN PURSUING AUTONOMY IN POST-WAR BRITAIN." Transactions of the Royal Historical Society 29 (November 1, 2019): 201–21. http://dx.doi.org/10.1017/s0080440119000094.

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ABSTRACTIn the history of post-war womanhood in Britain, women's self-help organisations are credited with little significance save for ‘helping mothers to do their work more happily’. This paper suggests that the do-it-yourself impetus of the 1960s and 1970s should be regarded as integral to understanding how millions of women negotiated a route towards personal growth and autonomy. Organisations like the National Housewives’ Register, the National Childbirth Trust and the Pre-School Playgroups Association emerged from the grass roots in response to the conundrum faced by women who experienced dissatisfaction and frustration in their domestic role. I argue that these organisations offered thousands of women the opportunity for self-development, self-confidence and independence and that far from being insufficiently critical of dominant models of care, women's self-help operating at the level of the everyday was to be one of the foundations of what would become, by the 1970s, the widespread feminist transformation of women's lives.

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Wysocki, Tim, Michael A. Harris, Lisa M. Buckloh, Karen Wilkinson, Michelle Sadler, Nelly Mauras, and Neil H. White. "Self-Care Autonomy and Outcomes of Intensive Therapy or Usual Care in Youth with Type 1 Diabetes." Journal of Pediatric Psychology 31, no. 10 (March 16, 2005): 1036–45. http://dx.doi.org/10.1093/jpepsy/jsj017.

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Slettebø, Åshild, and Eli Haugen Bunch. "Solving Ethically Difficult Care Situations in Nursing Homes." Nursing Ethics 11, no. 6 (November 2004): 543–52. http://dx.doi.org/10.1191/0969733004ne737oa.

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Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients’ autonomy and thus to optimize health care outcomes.

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Moreno Murcia, Juan Antonio, and Yolanda Silveira Torregrosa. "Hacia una mejor predicción de la percepción de competencia laboral en los universitarios." REDU. Revista de Docencia Universitaria 13, no. 1 (March 28, 2015): 277. http://dx.doi.org/10.4995/redu.2015.6444.

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El objetivo de este trabajo ha sido diseñar y validar la Escala de Percepción de Competencia Laboral, y determinar el poder de predicción de las variables de cuidado del docente, autonomía, y motivación autodeterminada sobre la percepción de competencia laboral. Para ello, se realizaron dos estudios. La muestra del estudio 1 estuvo compuesta por 274 estudiantes universitarios de ocho grados de la Universidad Miguel Hernández de Elche, y la muestra del estudio 2 estuvo compuesta por 431 estudiantes universitarios (202 hombres y 220 mujeres) de nueve grados de la misma Universidad. Se midió el cuidado del docente, la percepción de autonomía, la motivación autodeterminada y la percepción de competencia laboral. La Escala de Percepción de Competencia Laboral presentó unas adecuadas medidas psicométricas a través de un análisis factorial exploratorio y la consistencia interna. En el estudio 2, el análisis factorial confirmatorio también presentó medidas que permitió asumir la bondad de la escala. Para determinar en qué grado el cuidado del docente, autonomía y motivación autodeterminada predecían la percepción de competencia laboral se llevó a cabo un análisis de regresión lineal. Se predijo en un 35% la varianza explicada y fue la motivación autodeterminada el factor que más predijo la percepción de competencia laboral. Por lo que, para lograr una mayor percepción competencial en el ámbito profesional, durante la etapa de formación se podría utilizar una metodología fundamentada en el soporte de autonomía.ABSTRACTToward greater prediction of the perception professional competence in college students.The aim of this study is designs and validates the Scale of Professional Competence, and determines the predictive power of the variables of teacher´s care, autonomy, self-determined motivation on perceived professional competence. It has carried out two studies. The sample of study 1 included of 274 university students from eight degrees at the University Miguel Hernández of Elche, and the sample of Study 2 included of 431 college students (202 men and 220 women) from nine degrees of the same university. The teacher´s care, perceived autonomy, self-determined motivation and perceived professional competence was measured. The exploratory factor analysis and internal consistency revealed adequate psychometric measures of Professional Competence Scale. In the study 2, the results of confirmatory factor analysis also indicated goodness of this scale. The linear regression analysis was used to determine if teacher´s care, autonomy and self-determined motivation predicted the perceived professional competence. It was predicted 35% of explained variance where self-determined motivation was the most predictive factor the perceived professional competence. So, to achieve greater professional competence, could be used a methodology based on the support of autonomy during the training stage.

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Reindl, Marie-Sol, Mitzi Waltz, and Alice Schippers. "Personalization, self-advocacy and inclusion." Journal of Intellectual Disabilities 20, no. 2 (February 10, 2016): 121–36. http://dx.doi.org/10.1177/1744629516631449.

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This study focused on parent-initiated supported living schemes in the South of the Netherlands and the ability of these living schemes to enhance participation, choice, autonomy and self-advocacy for people with intellectual or developmental disabilities through personalized planning, support and care. Based on in-depth interviews with tenants, parents and caregivers, findings included that parent-initiated supported housing schemes made steps towards stimulating self-advocacy and autonomy for tenants. However, overprotective and paternalistic attitudes expressed by a significant number of parents, as well as structural constraints affecting the living schemes, created obstacles to tenants’ personal development. The study calls for consideration of interdependence as a model for the relationship of parents and adult offspring with disabilities. The benefits and tensions inherent within this relationship must be taken into consideration during inclusive community building.

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GROOTEGOED, ELLEN, and DIANA VAN DIJK. "The Return of the Family? Welfare State Retrenchment and Client Autonomy in Long-Term Care." Journal of Social Policy 41, no. 4 (July 4, 2012): 677–94. http://dx.doi.org/10.1017/s0047279412000311.

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AbstractEuropean welfare states are cutting back their responsibilities for long-term care, emphasising ‘self-reliance’ and replacing care as an entitlement of citizenship with targeted services. But we do not know how former long-term care recipients cope with retrenchment and if they are able to negotiate support from their family and friends. Through an analysis of 500 telephone interviews and thirty face-to-face interviews with long-term care recipients facing reduced care rights in the Netherlands, we found that disabled and elderly persons resist increased dependence on their personal networks. Most clients who face reduced access to public long-term care do not seek alternative help despite their perceived need for it, and feel trapped between the policy definition of self-reliance and their own ideals of autonomy.

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Killackey, Tieghan, Elizabeth Peter, Jane Maciver, and Shan Mohammed. "Advance care planning with chronically ill patients: A relational autonomy approach." Nursing Ethics 27, no. 2 (May 23, 2019): 360–71. http://dx.doi.org/10.1177/0969733019848031.

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Advance care planning is a process that encourages people to identify their values, to reflect upon the meanings and consequences of serious illness, to define goals and preferences for future medical treatment and care, and to discuss these goals with family and health-care providers. Advance care planning is especially important for those who are chronically ill, as patients and their families face a variety of complex healthcare decisions. Participating in advance care planning has been associated with improved outcomes; yet, despite over 25 years of public awareness campaigns, research, and interventions developed to increase participation, advance care planning completion rates for people with chronic illnesses are no different than those in the general public (approximately 25%). Advance care planning has traditionally used an individualistic approach to autonomy, which puts forward an understanding of agents as independent, rational and self-interested persons. Because this individualistic approach has been largely unsuccessful in improving advance care planning uptake, a re-examination of the philosophical underpinnings of this practice and an exploration of alternative frameworks is warranted. In offering this exploration, we briefly outline two current perspectives on autonomy: the individualistic view and the relational view as articulated by feminist philosophers. Using a critical examination of the theoretical and empirical work on this topic, we argue that the individualistic view of autonomy does not sufficiently capture the relational and social complexities of the decision-making process of advance care planning. To offer a counterpoint, we examine the relational view of autonomy and suggest that this perspective is better aligned with the process of advance care planning. Specifically, we demonstrate that a relational model of autonomy is well suited to exploring advance care planning for four main reasons: (1) it recognizes the importance of relationships, (2) it reflects the fluctuating nature of autonomy in chronic illness, (3) it recognizes vulnerability, and (4) it is consonant with empirical work examining the advance care planning process.

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Godby, Katherine. "Courage in the Development of Self in Women." Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications 57, no. 3 (September 2003): 293–304. http://dx.doi.org/10.1177/154230500305700305.

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The author discusses the development of self in women, explores the role of courage inherent in this movement, and, employing existentialist notions of courage as authenticity, explicates how these notions may lead to the development of a stronger sense of self. Notes as well that this development of self entails a dangerous complexity and that pastoral care providers will want to aid women in holding together both autonomy and connection.

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Carter, Jane V., Norman J. Galbraith, Woihwan Kim, and Susan Galandiuk. "Comment on: Patient autonomy-centered self-care checklist reduces hospital readmissions after ileostomy creation." Surgery 162, no. 3 (September 2017): 693–94. http://dx.doi.org/10.1016/j.surg.2017.05.014.

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Phelan, Amanda, and Patricia Rickard Clarke. "6 The Intersection of Human Rights and Decision Making Capacity Legislation with Person Centred Approaches." Age and Ageing 48, Supplement_3 (September 2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.01.

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Abstract Background A major focus on decision making capacity (as opposed to cognitive capacity and competence) legislation in many Western countries is the integration of a human rights approach focused on self-determination and autonomy. This paper examines modern day concepts of personhood and person centred care and presents Irish and United Kingdom legal commentaries which focus on health services’ and society's approaches to risky decision making. Integrating human rights into decision making capacity legislation has been central in contemporary discourses on health and welfare. Methods A literature review was undertaken charting the emergence of personhood, person centred care and human rights. Case studies of influential legal commentaries in Ireland and the United Kingdom where decision-making capacity was addressed were mapped to person centred care principles. Results Findings point to a convergence of discourses of human rights in contemporary approaches to health and social care as well as the evolution of legislation to support person centredness in fostering safeguarding and promoting autonomy and self-determination. Specific legal commentaries point to the need of health and social care to be mindful of paternalism and to conceptualise the concept of ‘risk’ with a particular emphasis on the inclusion and defence of the voice of the older or vulnerable person. Conclusion The intrinsic worth of each human is articulated through an implicit and explicit vindication of their human rights. The emergence of the third generation of human rights has argued the value of self-determination and autonomy, articulated through robust national legislation on decision-making capacity based on the core principles of person centred care approaches. This move from paternalism is imperative and is imbued in contemporary legislation and legal commentaries, which has noted the need for revisions in health and social care case management perspectives.

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Molchanov, S. V., N. N. Poskrebysheva, A. A. Zapunidi, and O. S. Markina. "Development of Autonomy as a Precondition of Adolescents’ Orientation in Moral Sphere." Cultural-Historical Psychology 11, no. 4 (2015): 22–29. http://dx.doi.org/10.17759/chp.2015110402.

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The paper discusses the outcomes of a research on the relationship between developmental levels of autonomy and features of moral orientation in adolescents determined by the priority of the value of justice or care within the cognitive (J. Piaget, L. Kohlberg) and empathy approach (C. Gillian, N. Eisenberg. The research proved that high levels of autonomy in the cognitive component correlate with the adolescent’s high estimation of moral qualities in various communicative contexts. Low level of emotional autonomy correlates with orientation towards the value of care, while high level correlates with orientation towards the value of justice. Levels of autonomy also correlate with moral judgments. Adolescents with low levels of autonomy reveal greater dependence on the opinion of other people and a stronger desire to appear a better person in the eyes of others. Adolescents with heterochrony of autonomy structure are more oriented towards the stage of the conventional level, i.e. the opinion of other people, a strong desire to appear a better person in the eyes of others, the significance of social rules and order, and the reflective empathic position that affirms the idea of self-sacrifice and defending the rights of others.

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Costa, Vanessa Sofia Henriques, Ana Sara Resende Pereira Marques, Mário Jorge Oliveira, Nélson Filipe Lameiro Lino, Cristina Lavareda Baixinho, and Óscar Ferreira. "Promotion of self-care to the person dependent on nursing care." Revista de Enfermagem UFPE on line 6, no. 1 (December 11, 2011): 165. http://dx.doi.org/10.5205/reuol.2052-14823-1-le.0601201223.

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ABSTRACTObjective: to identify the difficulties in self-care, on the elderly person with fracture of the proximal end of the femur. Method: literature review, informal interviews and practice reflection based on the Gibbs Cycle. Results: There is a marked dependence on the self-care of elderly persons with fracture of the proximal end of the femur, at the moment of hospitalization; a positive evolution occurs towards independence during hospitalization; when the elderly persons were asked about the main difficulties that will arise at home, all of them referred walking, transfers, and dressing/undressing lower limbs; the caregivers mentioned by the elderly persons are mostly the spouses or the sons, whom require more information for a home return with confidence. Conclusion: in one continuum of care perspective, it is essential to prepare the returning home of the elderly person in order to increase the autonomy and independence, enable the family for the management of care that increase the functionality, decreasing the limitations imposed by the fracture, surgery and the risk of developing complications, namely those associated with immobility; such fact will have direct consequences on the motivation and responsibility for the restoring of his health and progress towards independence. Descriptors: self-care; aged; femoral fractures; Patient discharge.RESUMOObjectivo: identificar as dificuldades no autocuidado, no idoso com fractura do terço proximal do fémur. Método: estudo em que foi usada a revisão da literatura, entrevistas informais e reflexão sobre a prática de cuidados tendo por base o ciclo de Gibbs. Para sustentar a reflexão utilizaram-se como instrumentos: o Índice de Barthel, aplicado no 1º dia de internamento, no 2º dia do pós-operatório e no último dia de internamento, a idosos submetidos a cirurgia por fractura da extremidade proximal do fémur e realizaram-se entrevistas informais a enfermeiros, a cuidadores e a clientes, durante o internamento e na primeira consulta após o regresso a casa. Resultados: há dependência marcada no autocuidado dos idosos com fractura da extremidade proximal do fémur, no momento da admissão hospitalar; ocorre uma evolução positiva, no sentido da independência durante o internamento; quando questionados sobre as principais dificuldades que irão surgir no domicílio, todos os idosos referiram a deambulação, as transferências e o vestir/despir os membros inferiores. Conclusão: na perspectiva de continuidade de cuidados, é fundamental preparar o regresso a casa para aumentar a autonomia e independência do idoso, capacitar a família para a manutenção dos cuidados que aumentem a funcionalidade, diminuindo as limitações impostas pela fractura e cirurgia e o risco de aparecimento de complicações, nomeadamente as associadas à imobilidade; tal facto terá consequências directas na motivação e responsabilização pelo restabelecimento do seu estado de saúde e progressão para a independência. Descritores: autocuidado; idoso; fraturas do fémur; alta do paciente.RESUMENObjetivo: Identificar las dificultades en el auto-cuidado en pacientes ancianos con fractura del extremo proximal del fémur. Método: revisión de la literatura, entrevistas informales y la deliberación sobre la práctica del cuidar teniendo en cuenta el ciclo de Gibbs. Resultados: existe una marcada dependencia en el auto-cuidado de los pacientes ancianos con fractura del extremo proximal del fémur, en el momento de ingreso en el hospital; hay una evolución positiva, en el sentido de la independencia durante la hospitalización; cuando se les preguntó acerca de las principales dificultades que surgen en el hogar, todos os adultos mayores señalaron la deambulación, los traslados y vestir/desvestir los miembros inferiores; los cuidadores referidos por los ancianos son en su mayoría las esposas y los hijos, los cuáles necesitan más información para poder regresar a su casa con confianza. Conclusión: con el objetivo de mantener la continuidad de los cuidados, es fundamental la preparación del regreso a casa para aumentar así la autonomía e independencia del anciano, capacitando a la familia para el mantenimiento de los cuidados que aumenten la funcionalidad, disminuyendo las limitaciones impuestas por la fractura y la cirugía y el riesgo de desarrollar complicaciones, especialmente aquellas asociadas con la inmovilidad; este hecho tendrá consecuencias directas en la motivación y la responsabilidad para la restauración de su estado de salud y el progreso hacia la independencia. Descriptores: autocuidado; anciano; fracturas del fémur; alta del paciente.

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Trotter, LaTonya. "“Church Is Important to Our Clients”: Autonomy, Community, and Religious Expression within a Long-term Care Organization." Journal of Contemporary Ethnography 49, no. 5 (June 4, 2020): 638–65. http://dx.doi.org/10.1177/0891241620922882.

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Autonomy and selfhood are primary concerns for scholars of long-term care. Previous work has shown how organizational routines threaten client autonomy and disrupt access to the material and symbolic resources that ground the biography of the self. In this article, I examine how a group of African-American older adults within an adult day service center ameliorated these threats through religious expression. In most health care settings, religion is delivered as an individual, clinical resource. At this site, religion and recreation became intertwined such that religion became a participatory resource that affirmed client membership to a community beyond the walls of the organization. However, as an institutionally provided resource, religion was delivered through work routines that constrained which versions of community to which clients could belong. I conclude by considering the implications for the expanding universe of long-term care organizations tasked with the maintenance of the body as well as the continuity of the self.

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Lindsay, Robin, and Helen Graham. "Relational Narratives: Solving an Ethical Dilemma Concerning an Individual’s Insurance Policy." Nursing Ethics 7, no. 2 (March 2000): 148–57. http://dx.doi.org/10.1177/096973300000700208.

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Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient’s nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin’s care. Gadow’s concept of a relational narrative and Keller’s concept of a relational autonomy guide this particular case. As an ethics framework influenced by feminist ethical theory, Gadow’s, Keller’s and Tisdale’s ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing.

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Dutta, Oindrila, Priya Lall, Paul Victor Patinadan, Josip Car, Chan Kee Low, Woan Shin Tan, and Andy Hau Yan Ho. "Patient autonomy and participation in end-of-life decision-making: An interpretive-systemic focus group study on perspectives of Asian healthcare professionals." Palliative and Supportive Care 18, no. 4 (November 8, 2019): 425–30. http://dx.doi.org/10.1017/s1478951519000865.

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AbstractObjectivesAsia's first national advance care planning (ACP) program was established in Singapore in 2011 to enhance patient autonomy and self-determination in end-of-life (EoL) care decision-making. However, no known study has examined the extent to which ACP in Singapore successfully met its aims. The purpose of the current study was to examine the attitudes of local healthcare professionals on patients’ autonomy in decision-making at the EoL since they strongly influence the extent to which patient and family wishes are fulfilled.MethodsGuided by the Interpretive-Systemic Framework and Proctor's conceptual taxonomy of implementation research outcomes, an interview guide was developed. Inquiries focused on healthcare professionals’ attitudes towards ACP, their clinical experiences working with patients and families, and their views on program effectiveness. Sixty-three physicians, nurses, medical social workers, and designated ACP coordinators who were actively engaged in ACP facilitation were recruited from seven major hospitals and specialist centers in Singapore through purposive sampling. Twelve interpretive-systemic focus groups were conducted, recorded, transcribed, and analyzed using a thematic analysis.ResultsThe extent to which patients in Singapore can exert autonomy in EoL care decision-making is influenced by five themes: (i) collusion over truth-telling to patient, (ii) deferment of autonomy by patients, (iii) negotiating patient self-determination, (iv) relational autonomy as the gold standard and (v) barriers to realization of patient choices.Significance of resultsHealthcare practitioners in Asian communities must align themselves with the values and needs of patients and their family and jointly make decisions that are consistent and congruent with the values of patients and their families. Sensitivity towards such cross-cultural practices is key to enhancing ACP awareness, discourse, and acceptability in Asian communities.

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Segovia, Jimena Silva, Pablo Zuleta Pastor, and Estefany Castillo Ravanal. "A Methodological Model for the Promotion of Sexual Corporeal Health and Self-Care." International Journal of Environmental Research and Public Health 18, no. 9 (May 10, 2021): 5034. http://dx.doi.org/10.3390/ijerph18095034.

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The objective of this article is to contribute to sex education with a methodology that facilitates subjective expression through the body in its different experiences. For that, we propose an intertextual model of sexual self-care that focuses on gender and rights. This work strategy stimulates the emergence of meanings and discourses embodied in a protagonist’s body. These procedures are applied in interactive workshops, where the experience narrated, written and graphed on one’s own body and sexuality is articulated. Based on this amalgam, a body map is drawn that illustrates a geography of interpersonal relationships. In the process, the importance of gender mandates, coming from meaningful figures, is understood. From these findings it is possible to self-analyze experiences that emerge from the intrapsychic levels weaved with sociocultural and emotional experiences, which opens opportunities for the deconstruction of hegemonic positions. The relationship that develops between the person who produces the intertextual map of the body and the person who orients the process is dialogical in that the notions of authorship, agency and subjective autonomy are recognized, which increases the possibilities of redefining gender’s position in social relationships and provides a strategy for educational programs considered from the protagonist’s perspective. It is concluded that this model facilitates the process of corporeal self-care in that it strengthens autonomy through the recognition of authorship and agency, strengthening the redefinition of a gendered position in social relationships, providing a strategy for educational prevention programs and the promotion of sexuality.

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O’Hara, Mary E. "Consent to treatment." Journal of the European Wound Management Association November 2020 21, Issue 1 Volume 21, 2020 (November 12, 2020): 29–32. http://dx.doi.org/10.35279/jewma202011.05.

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Seeking a person’s consent to treatment is, not only a legal obligation, but also enmeshed with respecting the person’s autonomy and dignity for self-determination. This article discusses the evolving concept of consent among patients requiring wound care.

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Monsen, Karen A., and Jos de Blok. "Buurtzorg: Nurse-Led Community Care." Creative Nursing 19, no. 3 (2013): 122–27. http://dx.doi.org/10.1891/1078-4535.19.3.122.

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Buurtzorg is a nurse-led, nurse-run organization of self-managed teams that provide home care to patients in their neighborhoods. Championing humanity over bureaucracy, autonomous teams work with primary care providers, community supports, and family resources to bring patients to optimal functioning as quickly as possible. The award-winning organization grew out of a common sense approach based on principles of trust, autonomy, creativity, simplicity, and collaboration. These organizational principles translate into highly effective and efficient care, satisfied patients, and enthusiastic nurses. The model is being replicated worldwide, with teams starting in Minnesota, Sweden, Japan, and other countries.

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Zebracki, Kathy, Michelle Melicosta, Cody Unser, and Lawrence C. Vogel. "A Primary Care Provider’s Guide to Pediatric Spinal Cord Injuries." Topics in Spinal Cord Injury Rehabilitation 26, no. 2 (March 2020): 91–99. http://dx.doi.org/10.46292/sci2602-91.

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Spinal cord injury (SCI) in youth presents with unique manifestations and complications as compared to adult-onset SCI. The primary care clinician must consider the physical, physiological, cognitive, and psychological changes transpiring during childhood and adolescence. Physical changes include increasing size, weight, and bladder volume. Physiologic considerations include decreasing heart rate and increasing blood pressure with age. Cognitive issues include communication, executive functioning, and self-management skills. Lastly, psychological processes involve emotional functioning and establishment of self-identify and autonomy in the context of life with SCI.

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Shackleford, Jenna L., Regena Spratling, and Susan J. Kelley. "The Self-Determination Theory: Health-Related Quality of Life in Adolescents with Congenital Heart Disease." Nursing Science Quarterly 34, no. 4 (September 18, 2021): 420–29. http://dx.doi.org/10.1177/08943184211031588.

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The purpose of this paper is to present a conceptual-theoretical-empirical model addressing variables associated with self-management of care and adherence to treatment and its relationship to health-related quality of life for adolescents with congenital heart disease. There is limited research on adolescents with congenital heart disease regarding the relationship between autonomy, relatedness, competence, self-management of care and adherence to treatment, and health-related quality of life. The proposed Health-Related Quality of Life and Transition of Adolescents With Congenital Heart Disease to Self-Manage in Adulthood model, adapted from the Self-Determination Theory, will help to better understand these relationships.

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Moore, Jean Burley. "Effects of assertion training and first aid instruction on children's autonomy and self-care agency." Research in Nursing & Health 10, no. 2 (April 1987): 101–9. http://dx.doi.org/10.1002/nur.4770100206.

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Wisor, Ronald L. "Community Care, Competition and Coercion: A Legal Perspective on Privatized Mental Health Care." American Journal of Law & Medicine 19, no. 1-2 (1993): 145–75. http://dx.doi.org/10.1017/s0098858800006699.

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Even as the Clinton administration considers an increased federal commitment to mental health care, delivery of such care remains fixed at the state level. In Massachusetts, state officials are privatizing mental health care on an unprecedented scale, an experiment that promises to provide better care at lower cost. This Note explores whether privatization can achieve that lofty goal, given a legal system that has made individual patient autonomy its preeminent value. The author concludes that wide-scale privatization and modern notions of self-determination can only coexist with a significant investment in the support services that are critical to the community tenure of former state hospital patients.

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Journal articles on the topic 'Autonomy for self-care'

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