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Supporting Autonomy in ADL Care. How Nursing Students Learn in Theory Classes: A Qualitative Multi-Perspective Study
Marjolein M C J Knibbeler1, Stan Vluggen, Erik van Rossum
1About the Authors Marjolein M. C. J. Knibbeler, MA, RN, Stan Vluggen, PhD, Erik van Rossum, PhD, Sandra M. G. Zwakhalen, PhD, are affiliated with Faculty of Healthcare, Academy of Nursing, Research Centre Community Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands. Marjolein M. C. J. Knibbeler, MA, RN, Erik van Rossum, PhD, Sandra M. G. Zwakhalen, PhD, Petra M. G. Erkens, PhD, are affiliated with Living Lab in Ageing and Long Term Care, Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Aim:
This qualitative study examined how autonomy and autonomy support are addressed in the theoretical part of Dutch nursing education.
Background:
Supporting clients' autonomy in activities of daily living is essential for dignity and quality of life, but remains complex and often suboptimal due to contextual factors such as care settings, nurse-client relationships, and systemic pressures. Nurses must balance professional skills with sensitivity to clients' values. Little is known about how nursing students are prepared to support autonomy.
Method:
A document analysis of curricula and teaching materials was combined with interviews with 10 nursing students and 10 nurse educators.
Results:
Findings show that autonomy is rarely mentioned in educational documents and lacks clear guidance. Teachers rely on personal experience, leading to inconsistent understanding among students, who mainly learn about autonomy support during internships.
Conclusion:
Both students and teachers suggest updating teaching materials and integrating best practices to strengthen education on autonomy support.
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