Concept analysis: patient autonomy in a caring context.

Area of Science:

• Nursing Ethics
• Bioethics
• Healthcare Professionalism

Background:

• Healthcare challenges in patient autonomy stem from patient dependency and healthcare professional authoritarianism.
• A lack of consensus exists among nurses regarding the ethical concept of patient autonomy.
• Existing literature highlights the complexities surrounding patient autonomy in clinical settings.

Purpose of the Study:

• To analyze the concept of patient autonomy within a caring context.
• To develop a comprehensive understanding of patient autonomy in nursing and healthcare.
• To address the ambiguities surrounding patient autonomy in practice.

Main Methods:

• A comprehensive literature search was conducted across Medline, CINAHL, The Cochrane Library, and PsycINFO (2005-2013).
• Rodgers' Evolutionary Method of Concept Analysis was employed.
• 41 relevant articles were retrieved and analyzed.

Main Results:

• Patient autonomy is defined as a dynamic, evolving process of reconstructing self-governance.
• Key attributes include being recognized as a person, capacity to act, and obligation for responsibility.
• Patient vulnerability, stemming from physical or mental impairment, is an antecedent to autonomy, impacting control and freedom.

Conclusions:

• Patient autonomy is not static and can change throughout a care episode.
• A tentative model of patient autonomy in a caring context was developed.
• This analysis extends the ethical understanding of patient autonomy in nursing and healthcare.