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2. Literature Review
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Chapter 2: Literature Review
In this chapter the literature about autonomy is reviewed. Analysis of the literature
identified three key areas: 1) Definitions and determinants of autonomy, 2)
Residential care research and 3) Autonomy for older people research. The review of
the literature also led to a subsequent analysis of the concept of autonomy for older
people in residential care. Prior to the literature review a brief overview of the
search strategy is given.
2.1 Literature Search Strategy
This section outlines the literature search strategy and review process adopted for
this study. The purpose of the review was two-fold. Firstly, to establish what is
known about the concept of autonomy. Secondly, to identify any research studies
that had been undertaken that would inform the phenomenon of autonomy for older
people in residential care.
Six main steps were undertaken. The first step of the review process involved
searching two health-related bibliographic databases: Cumulative Index to Nursing
and Allied Health Literature (CINAHL) and Medline. The initial database results for
the broad search term of “autonomy” yielded papers which had broad associations
with autonomy including nurse autonomy, autonomy and assisted living, autonomy
and restraint and ethical autonomy. Many of the same papers appeared in both
CINAHL and Medline. At this point 3 criteria were established to focus the search:
1) primary research studies that were peer-reviewed (years 1990 to present day), 2)
theoretical work that focused on defining autonomy would be included and 3) studies
focused specifically on autonomy and older people or autonomy and residential care
would be reviewed. Hence the search terms were narrowed (using the Boolean
operators) in order to adhere to this criteria. Various key word combinations using
Boolean operators were searched and these included: 1) Autonomy for older people,
2) Autonomy for older people in residential care, 3) Autonomy for older people and
patient autonomy and 4) Resident autonomy.