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- Lindberg, Catharina, et al.
(författare)
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A trajectory towards partnership in care : patient experiences of autonomy in intensive care, a qualitative study
- 2015
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 31:5, s. 294-302
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe and elucidate patient experinces of autonomy in an intensive care context from a caring perspective. Patients in intensive care units (ICUs) are critically ill and in a dependent and vulnerable position. There is thus a risk of staff taking command not only of the patients' vital functions but also of their decision-making. A qualitative design was selected. Individual interviews were conducted with 11 adult patients with an intensive care episode of two days or more at six Swedish ICUs. Data were analysed using Inductive Content Analysis. Patient autonomy in intensive care was shown to be "A trajectory towards partnership in care depending on state of health and mutual understanding". It was experienced through acknowledged dependence, being recognised as a person, invited participation and becoming a co-partner in care. Patients in need of intensive care wanted to be involved in making decisions about their care as this creates a trusting and healthy care environment. Greater awarness is required about the ICU patient not only being a passive care recipient but also an active agent and where involvment in decision-making and participation in care are crucial.
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| 3. |
- Lindberg, Catharina, et al.
(författare)
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Befriending everyday life when bringing technology into the private sphere
- 2017
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 27:6, s. 843-854
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Tidskriftsartikel (refereegranskat)abstract
- We present the findings of our phenomenological interview study concerning the meaning of being an autonomous person while dependent on advanced medical technology at home. This was elucidated in the participants' narratives as befriending everyday life when bringing technology into the private sphere. We discovered four constituents of the phenomenon: befriending the lived body, depending on good relationships, keeping the home as a private sphere, and managing time. The most important finding was the overall position of the lived body by means of the illness limiting the control over one's life. We found that the participants wanted to be involved in and have influence over their care to be able to enjoy autonomy. We therefore stress the importance of bringing the patients into the care process as chronic illness will be a part of their everyday life for a long time to come, hence challenging patient autonomy.
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| 4. |
- Lindberg, Catharina, et al.
(författare)
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Concept analysis : patient autonomy in a caring context
- 2014
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 10:70, s. 2208-2221
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Tidskriftsartikel (refereegranskat)abstract
- This paper is a report of an analysis of the concept of patient autonomy. 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 experince reveal a lack of consensus among nurses regarding the meaning of this ethical concept. This is a concept analysis with data sources: MedLine, CINAHL, The Cochrane Library and PsycINFO, searched 2005-June 2013 using the search blocks 'autonomy', 'patient', and 'nursing/caring'. A total of 41 articles were retrieved. 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. 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 episod. A tentative model has been constructed, thus extending the understanding of this critical concept in a caring context.
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| 5. |
- Lindberg, Catharina, et al.
(författare)
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Patient autonomy in a high-tech care context : A theoretical framework
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 27:21-22, s. 4128-4140
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesTo synthesise and interpret previous findings with the aim of developing a theoretical framework for patient autonomy in a high-tech care context. BackgroundPutting the somewhat abstract concept of patient autonomy into practice can prove difficult as when it is highlighted in healthcare literature, the patient perspective is often invisible. Autonomy presumes that a person has experience, education, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could therefore be considered paradoxical, as in most cases, these persons are vulnerable, with impaired physical and/or metacognitive capacity, thus making extended knowledge of patient autonomy for these persons even more important. DesignTheory development. MethodsThe basic approaches in theory development by Walker and Avant were used to create a theoretical framework through an amalgamation of the results from three qualitative studies conducted previously by the same research group. ResultsA theoretical frameworkthe control-partnership-transition frameworkwas delineated disclosing different parts cocreating the prerequisites for patient autonomy in high-tech care environments. Assumptions and propositional statements that guide theory development were also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients were revealed as follows: the strategy of control, the strategy of partnership, the strategy of trust and the strategy of transition. ConclusionsAn extended knowledge base, founded on theoretical reasoning about patient autonomy, could facilitate nursing care that would allow people to remain/become autonomous in the role of patient in high-tech care environments. Relevance to clinical practiceThe control-partnership-transition framework would be of help in supporting and defending patient autonomy when caring for individual patients, as it provides an understanding of the strategies employed by patients to achieve autonomy in high-tech care contexts. The guiding principles for patient autonomy presented could be used in nursing guidelines.
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