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Concept analysis: patient autonomy in a caring context
Author(s) -
Lindberg Catharina,
Fagerström Cecilia,
Sivberg Bengt,
Willman Ania
Publication year - 2014
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.12412
Subject(s) - autonomy , context (archaeology) , cinahl , health care , meaning (existential) , psychology , obligation , nursing , social psychology , medicine , psychotherapist , political science , paleontology , psychological intervention , law , biology
Abstract Aim This paper is a report of an analysis of the concept of patient autonomy Background Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Design Concept analysis. Data Sources Medline, CINAHL , The Cochrane Library and Psyc INFO were searched (2005–June 2013) using the search blocks ‘autonomy’, ‘patient’ and ‘nursing/caring’. A total of 41 articles were retrieved. Review Methods The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Results Five attributes were identified, thus creating the following descriptive definition: ‘Patient autonomy is a gradual, time‐changing process of (re‐)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions’. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Conclusion Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context.