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Chapter 7 Discussion
participation” domain which directed staff to discuss with the resident the
recreational activities which were important to them. The aim of this was to
enhance the residents’ autonomy as this element was an emergent theme in this
study. Horanson-Hawks (1991) suggest that one attribute of power is mutually
working toward goals and hence the new approach to care planning could
contribute to sharing the power as both the resident and the nurse engage in
mutually discussing, negotiating and planning goals of care.
7.3.3 Summary
Discussion of the findings at this point suggests further promoting and
prohibiting factors for autonomy for older people in residential care. Sub-theme
2a: Being Impersonal, identified promoting factors such as agreeing routines,
negotiating care, being flexible and being with the resident, staff having
sufficient time, a calm ward atmosphere, sufficient staffing levels, being
motivated and the resident is recognised as the expert. Prohibiting factors
identified included imposed routines, lack of negotiation, inflexibility and doing
for the resident, staff having little or no time, a hurried ward atmosphere,
insufficient staffing levels, being unmotivated and the professional being the
expert.
The discussion of the findings of this research enabled the identification of the
factors that impact on resident autonomy. These factors were analysed in the
context of the international literature and both promoting and prohibitive factor
were identified. A summary of these factors is provided in table 7.1.