Elderly Patients' Self-Determination Questionnaire

Välimäki, Maritta; Haapsaari, Helena; Katajisto, Jouko; Suhonen, Riitta

doi:10.1037/t37269-000

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“…Six empirical studies, four qualitative studies and two quantitative studies, also contribute to the demand for developing knowledge about the meanings and implications of autonomy. The two quantitative studies (Välimäki, 1998 ; Vernooij-Dassen, Osse, Schadé, & Grol, 2005 ) may contribute to a general operationalisation of the concept of patient autonomy, emphasising in particular factors such as dependency, loss of control, limitations of activities, and informational support offered by health care professionals on patients’ informed decision making. The four qualitative studies (Dickert & Kass, 2009 ; Ellefsen, 2002 ; Lomborg, Bjørn, Dahl, & Kirkevold, 2005 ; Luoma & Hakamies-Blomqvist, 2004 ), however, point to specific experiences that report patients’ attempts to preserve their dignity by various adaptive manoeuvres and compensatory acts.…”

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confidence: 99%

The implications of autonomy: Viewed in the light of efforts to uphold patients dignity and integrity

Delmar

Alenius-Karlsson

Mikkelsen

2011

International Journal of Qualitative Studies on Health and Well

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This article focuses on Danish patients’ experience of autonomy and its interplay with dignity and integrity in their meeting with health professionals. The aim is to chart the meanings and implications of autonomy for persons whose illness places them in a vulnerable life situation. The interplay between autonomy and personal dignity in the meeting with health care staff are central concepts in the framework. Data collection and findings are based on eight qualitative semi-structured interviews with patients. Patients with acute, chronic, and life threatening diseases were represented including surgical as well as medical patients. The values associated with autonomy are in many ways vitalising, but may become so dominant, autonomy seeking, and pervasive that the patient's dignity is affected. Three types of patient behaviour were identified. (1) The proactive patient: Patients feel that they assume responsibility for their own situation, but it may be a responsibility that they find hard to bear. (2) The rejected patient: proactive patients take responsibility on many occasions but very active patients are at risk of being rejected with consequences for their dignity. (3) The knowledgeable patient: when patients are health care professionals, the patient's right of self-determination was managed in a variety of ways, sometimes the patient's right of autonomy was treated in a dignified way but the opposite was also evident. In one way, patients are active and willing to take responsibility for themselves, and at the same time they are “forced” to do so by health care staff. Patients would like health professionals to be more attentive and proactive.

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