Self-determination among community-dwelling older persons: explanatory factors

ABSTRACT

Background Although it is acknowledged that exercising self-determination in daily activities affects older people’s health and well-being, few studies have focused on the explanatory factors for self-determination in daily life. Objective To investigate explanatory factors for self-determination in the context of community-dwelling older persons. Method: This cross-sectional study combined two sets of data that included community-dwelling persons 80 years and older (n = 456). A bivariate logistic regression was performed to analyse the association of self-determination and a set of explanatory factors. Results The final bivariate logistic regression model revealed five explanatory factors that were significantly associated with perceiving reduced self-determination: high education (OR = 2.83), frailty (OR = 2.70), poor self-rated health (OR = 2.54), dissatisfaction with physical health (OR = 6.50), and receiving help from public homecare service (OR = 2.46). Conclusion Several explanatory factors related to the ageing body and environmental aspects were associated with reduced self-determination. To help older people maintain self-determination, healthcare professionals should consider using a person-centred and capability approach to care.

KEYWORDS:

• Activities of daily living (ADL)
• aged 80 and over
• capability
• cross-sectional study
• decision-making

Acknowledgements

The authors thank PhLic Statistics Kjell Pettersson on Akademistatistik, Gothenburg University for his valuable statistical discussions and support. This study was supported by grants from the Local Research and Development Board for Gothenburg and Södra Bohuslän, and the Swedish Research Council for Health, and Working Life and Welfare (AGECAP 2013-2300).

Declaration of interest

The authors declare they have no competing interests.