On autonomy and participation in rehabilitation

Cardol, M.; Jong, B. A. De; Ward, C D

doi:10.1080/09638280210151996

Cited by 258 publications

(269 citation statements)

References 34 publications

(22 reference statements)

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“…It is ethical in the sense that acknowledges the relevance of activities in this phase of life and context. This engagement, as revealed in the exemplars, could be enacted through small‐scale events within everyday activities, adding the acting dimension to care The understanding of influence illuminated in this study differs from conceptualizations of autonomy and decision‐making grounded in individualism, proposing a relational and acting understanding instead (Abma & Baur, 2015; Baur et al., 2013; Cardol et al., 2002; Ceci, Ttir, et al., 2013; Katz & Alegria, 2009; Nolan et al., 2004). …”

Section: Discussionmentioning

confidence: 99%

“…More specifically, this framework makes explicit the need to move beyond technical competences and engage in the promotion of partnerships and collaborative practices with older adults (McCormack, 2004; McCormack & McCance, 2006). This relational perspective (Cardol, De Jong, & Ward, 2002; Nolan et al., 2004; Smebye & Kirkevold, 2013) also serves to counteract and problematize concepts such as autonomy, decision‐making, and self‐determination in person‐centered care, which assign a central value to individualism and cognitive competences (Boyle, 2008). …”

Section: Introductionmentioning

confidence: 99%

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Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

et al. 2017

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This study focuses on influence that older adults, living in nursing homes, have over everyday activities. Everyday activities are key to sustain a sense of stability, predictability, and enjoyment in the local world of people's everyday and therefore a critical dimension of the person‐centeredness framework applied within gerontology. This narrative ethnographic study aimed to shed light on how influence can be situated contextually, and how it can emerge through activities as well as how it is negotiated in everyday by frail older adults living in a nursing home. Residents, staff members, and significant others from one nursing home in an urban area of Sweden participated in this study. Data were gathered through fieldwork, including participant observation and formal and informal conversations during a period of 6 months. Data were analyzed through a narrative interpretative approach. The findings are presented in narrative form as exemplars. The exemplars—Craquelures as justification, Seeking a place for other life worlds and An almost perfect trip—reveal a gap between the client‐centeredness framework and lived experiences regarding older adults’ influence in everyday activities. The role of everyday activities in the context of frailty is discussed in terms of ethical and responsive engagement, and implications for health‐care practices are considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

et al. 2017

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“…This finding aligns with previous calls for rehabilitation practice to shift its focus away from assisting clients to maximize their physical independence towards enhancing participation and autonomy. [55,80,81] There is a growing body of research illustrating the impact of TBI on self-conceptualization. [1,37,38,42,53,54,82,83] Based on the findings of previous research, several possible links between decision-making participation and self-conceptualization were identified.…”

Section: Discussionmentioning

confidence: 99%

“…[80,[88][89][90][91] While a paradigm shift may be the most effective way of wholly achieving this aim, [92] clinicians may consider immediate steps that support increased decision-making participation in their practice. The findings of this study suggest several possible avenues.…”

Section: Implications For Practicementioning

confidence: 99%

“I’ve never been a yes person”: Decision-making participation and self-conceptualization after severe traumatic brain injury

Knox

Douglas

Bigby

2016

Disability and Rehabilitation

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Purpose: Although adults who sustain a severe traumatic brain injury (TBI) require support to make decisions in their lives, little is known about their experience of this process. The aim of this study was to explore how participation in decision making contributes to self-conceptualization in adults with severe TBI. Method: We used constructivist grounded theory methods. Data included 20 in-depth interviews with adults with severe TBI. Through a process of constant comparison, analysis involved open and focused coding until clear categories emerged and data saturation was achieved. Results: Self-conceptualization emerged as a complex and multifaceted process, as individuals with TBI aimed to reestablish a sense of autonomy. We describe a recursive relationship in which decision-making participation assists the dynamic construction of self, and self-concept contributes to the experience of making decisions. The role of an individual's social support network in acting as a bridge between participation and self-conceptualization is presented. Conclusions: Findings emphasize that contributing to decisions about one's own goals across a range of life areas can reinforce a positive self-concept. It is vital that supporters understand that participation in decision making provides a pathway to conceptualizing self and aim to maximize the person's participation in the decision-making process. ä IMPLICATIONS FOR REHABILITATIONPrevious research has identified that the experience of sustaining TBI has a significant impact on a person's conceptualization of self. This study identified that decision-making experiences play an important role in the ongoing process of self-conceptualization after injury. Decision-making experiences can reinforce a person's self-concept or lead them to revise (positively or negatively) their sense of self. By maximizing the person's decision-making participation, those around them can support them to develop positive self-attributes and contribute to shaping their future goals. ARTICLE HISTORY

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“…Care ethicists have often criticized this biomedical concept of autonomy for its wrongful overlap with an independently made decision (Cardol et al 2002;Gilligan 1982, p. 71;Noddings 1984Noddings , pp. 359-362, 2002.…”

Section: Alienation ("Reducing the Victims To Their Animal-like Basicmentioning

confidence: 99%

Regulation as an Obstacle to Care? A Care-Ethical Evaluation of the Regulation on the Use of Seclusion Cells in Psychiatric Care in Flanders (Belgium)

Opgenhaffen

2017

Care in Healthcare

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On autonomy and participation in rehabilitation

Abstract: Autonomy is central to client-centred rehabilitation since it is a pre-requisite for effective participation. It is suggested that autonomy, conceived as a basis for participation, is the ultimate aim of rehabilitation.

Cited by 258 publications

References 34 publications

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

“I’ve never been a yes person”: Decision-making participation and self-conceptualization after severe traumatic brain injury

Regulation as an Obstacle to Care? A Care-Ethical Evaluation of the Regulation on the Use of Seclusion Cells in Psychiatric Care in Flanders (Belgium)

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