Preconditions for and consequences of self‐determination: the psychiatric patient’s point of view

Abstract

In the context of an interview study concerned with self-determination in psychiatric patients, this paper describes the preconditions for and consequences of self-determination from the point of view of psychiatric patients themselves. The data were collected in semi-structured interviews with long-term psychiatric patients (n = 72) and analysed using the method of content analysis. Responses on the preconditions for self-determination were grouped into three categories: firstly, there were those who said that reference to self-determination in the case of psychiatric patients is nonsense; secondly, there were those who said that self-determination requires no preconditions; and thirdly, there were those who said that there are certain preconditions, such as the ability to think and make decisions, activity, obedience, and illness. Both positive and negative consequences were identified in situations where self-determination is maintained, but only negative consequences in situations where self-determination is lost. On the basis of these tentative results, self-determination seemed to be relevant in psychiatric nursing. We are continuing to develop and test an instrument for the evaluation of the opportunity for self-determination in clinical practice.

Patients’ perceptions of self‐determination as expressed in the context of care

“…Self‐determination is an important concept within health care as well as an important right for the patient regardless of age, sex, cultural or social background (Välimäki & Leino‐Kilpi 1998). The concept originates in the liberal idea of free and independent individuals having the ability to take rational decisions (Mill 1974).…”

Nursing Students' Perceptions of Self-Determination in Elderly People

“…40 These are, for example, the nature of patients' disease, their motivation, their current health status and information they have received. 46 Nursing staff therefore have an important role in supporting the realization of patient self-determination in health care settings. 40,[44][45][46][47] …”

“…46 Nursing staff therefore have an important role in supporting the realization of patient self-determination in health care settings. 40,[44][45][46][47] …”

Coercion and the Mentally Ill: Ethical Perspectives

“…Olofsson and Jacobsson (2001) found that patients' experiences of the involuntary process produced three themes: not being involved in one's care, receiving care that is perceived as meaningless and not good, and being an inferior kind of human being. Involvement in care is related to greater patient satisfaction and improved outcomes (Hamann et al, 2005;Lowry, 1998;Valimaki & Leino-Kilpi, 1998). Thus, efforts to involve patients in their care are desirable even when their autonomy is limited.…”