Self‐determination of patients with rheumatoid arthritis: Model development during action research

Abstract

The purpose of this article is to describe the content and the development of the model to promote self-determination of patients with rheumatoid arthritis from a point of view of patients and nurses. For the patients the data were gathered using semistructured interviews and for the nurses through three focus groups in the initial and evaluation phases. The data were analysed by themes using qualitative content analysis. The model consisted of the concept of self-determination, impediments to and preconditions for self-determination, promoting and focusing on consequences. Patient's activity was a new view of the concept. Impediments to self-determination were linked to limitations and preconditions to patients' freedom to express themselves. Support developed an important factor promoting self-determination. The results indicate a clear need for various types of supportive nursing care to promote self-participation in patient care.

Concept analysis: patient autonomy in a caring context

“…Mental support was shown to be about a good, caring atmosphere and encouragement involving, for example, asking for the patient's opinion (Lofman et al . ). Informative support was discussed in terms of providing or withholding information, as well as decisions about the amount of information that ought to be disclosed to the patient as a precondition for the realization of autonomy (Humphreys , Sorenson et al .…”

“…It could also involve discovering the patient's needs and giving them the chance to make decisions regarding small, daily activities, such as muscle exercise or basic nursing (Lofman et al . ). These activities were shown to have a significant impact on older patients’ sense of control.…”

Life values and self‐regulation behaviours among adults with type 2 diabetes

“…Many of the participants also considered this value to have a major influence on self‐regulation behaviours. According to the Self‐determination Theory, this is a universal psychological need and involves the right of competent people to determine their own affairs and be permitted to act according to their wishes (Ryan & Deci 2000, Löfman et al. 2008).…”

“…Many of the participants also considered this value to have a major influence on self-regulation behaviours. According to the Selfdetermination Theory, this is a universal psychological need and involves the right of competent people to determine their own affairs and be permitted to act according to their wishes (Ryan & Deci 2000, Lö fman et al 2008. Pelletier et al (2004) demonstrated that, although people may be motivated to regulate their eating behaviours, successful regulation is more likely if the motivation is self-determined.…”

Selbstbestimmung in der medizinischen Rehabilitation – Erstellung eines konzeptuellen Modells zur weiteren theoretischen Diskussion

“…Zu den externen Faktoren, die beeinflussen, ob nutzbare Selbstbestimmungsmöglichkeiten für Rehabilitanden vorhanden sind, gehören sowohl gesellschaftlich-rechtliche Rahmenbedingungen als auch Faktoren, die direkt im Umfeld von medizinischen, insbesondere stationären, Reha-Einrichtungen zu verorten sind. Einige der nachfolgenden externen Faktoren wurden in Anlehnung an die Ergebnisse einer qualitativen Untersuchung an Menschen mit rheumatoider Arthritis abgeleitet [25]. Informationen Rehabilitanden können im Rahmen des medizinischen Rehabilitationsaufenthaltes nur dann verantwortlich und selbstbestimmt handeln, wenn sie über alle möglichen Maßnahmen informiert und ernstgenommen werden [28].…”