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Older adults' experiences of self-determination when needing homecare services—an interview study
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0002-1074-0729
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0002-5877-3458
Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia; Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.ORCID iD: 0000-0001-8787-2327
2023 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 23, no 1, article id 824Article in journal (Refereed) Published
Abstract [en]

Background: Self-determination has been shown to be an important factor in mental health and wellbeing, but from the homecare recipients' point of view, autonomy and self-determination is not fully integrated into homecare services. The aim of this study was to explore older adults’ experiences of self-determination when needing homecare services.

Methods: In 2018, a qualitative descriptive study was conducted and a convenience sample of 15 older adults from 3 homecare service facilities were invited to participate in individual interviews. Data were analysed using qualitative content analyse.

Results: The theme Transitioning from self-determination as independence towards self-determination as shared decision-making emerged through the older adults' narratives. This ‘transition’ is one in which older adult’s understanding of self-determination and self-esteem was transitioning towards the acceptance of shared decision-making. The person's inner strength and willingness to make decisions was promoting to enact and preserve independence. Accepting one's dependence on others and being in a positive atmosphere were described as promoting self-determination and shared decision-making, and vice versa. The above overarching theme permeated all subthemes, which included: mobilising inner strength to enact independence; accepting increasing dependence on others; and being influenced by the atmosphere.

Conclusions: The study contributes increased understanding of older adults' experiences of self-determination. The results can act as a guide when planning future person-centred care interventions in the context of homecare services and help improve homecare services' ability to meet the needs of older adults. To summarise, older adults' reflections on their own self-determination highlighted relationships with other people as important for shared decision-making, which could help preserve older adults’ autonomy and self-esteem.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 23, no 1, article id 824
Keywords [en]
Decision-making, Homecare service, Interview, Involvement, Older adults, Personal autonomy, Self-determination
National Category
Nursing Occupational Therapy
Identifiers
URN: urn:nbn:se:umu:diva-218097DOI: 10.1186/s12877-023-04533-6PubMedID: 38066429Scopus ID: 2-s2.0-85178953748OAI: oai:DiVA.org:umu-218097DiVA, id: diva2:1819835
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2023-12-15 Created: 2023-12-15 Last updated: 2024-07-04Bibliographically approved

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Bölenius, KarinLämås, KristinaEdvardsson, David

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