Self-determination and older people – A concept analysis

Abstract

Background: Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural. Objective: To define and clarify the concept of self-determination in relation to community-dwelling frail older people. Method: Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes. Results: Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice. Principal conclusion: This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

Key words::

• research
• occupational therapy
• definition
• decisional autonomy

Acknowledgements

Vårdalinstitutet – The Swedish Institute for Health Science, Gothenburg, Sweden (http//:www.vardalinstitutet.net) and Vinnvård, Stockholm, Sweden (http://www.vinnvard.se).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.