Residents' autonomy: nursing home personnel's perceptions

While delivering quality care, nursing home personnel may unintentionally adversely affect residents' sense of personal autonomy. Faced with the challenge of respecting resident autonomy and simultaneously adhering to nursing home standards, nursing home staff often experience a frustrating ethical conflict. This study examines the effects of sets of independent variables on six autonomy dimensions to examine nursing home personnel's perceptions of how care was provided in their facility. For each of six case studies, respondents were asked the following question: "If Mr. or Mrs. X were at your facility, what would have been decided?" Responses were recorded along a continuum that indicated whether the resident would be allowed to make his or her own decisions or whether the nursing home staff would decide for the resident. Findings indicated staff members' education and race had the greatest effect on their perceptions of personal autonomy. Somewhat surprisingly, staffing levels, turnover rates, and restraint usage did not affect their views of autonomy. Additional research is recommended to more completely examine the complex dimensions of autonomy and to identify what changes nursing home staff and administrators could implement to improve residents' quality of life.