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Chapter 2: Literature Review
The second step in the search process involved combining references from the
databases. The third step involved a careful review of authors and titles and the
deletion of non-English language titles. In the fourth step, the abstracts from the
resulting references and selected articles were analysed for their relevance to
autonomy for older people in residential care. This step also involved identifying
further references within appropriate papers, sourcing them, and adding them to the
results for analysis. The fifth step involved conducting hand searches of gerontology-
focused journals and relevant reports (e.g. from the National Council for Ageing and
Older People and government policies). A systematic approach for identifying the
key features from each study was used. This approach required that all research
studies were reviewed and categorised according to theme, the date, methodology
and quality of the study. This information was then entered into a comparison table
that enabled the similarities and differences of the studies to be detailed.
A further check on the comprehensiveness of the search was undertaken; the subject
librarian carried out an independent search and confirmed that there were no new
papers to add to the search. An iterative analysis process was used to compare and
contrast key findings and draw out a number of themes and generalisations. Studies
were compared to identify similarities and differences, and the literature was divided
into key areas.
Throughout the course of the research, journals were reviewed regularly to identify
any new material that was pertinent to the study. Conference proceedings were also
monitored for relevant information. Dictionary definitions of “autonomy” and
internet search engines were also reviewed.
2.2 Defining Autonomy
This section looks at how autonomy is defined. The first known use of the word
autonomy was documented in 1623. It was derived from the Greek word
“autonomia” or the freedom to live by one’s own laws - “autos” meaning “self” and
“nomos” meaning “rule”, translating literally into the term “self-rule”. However, the
literature review revealed that despite its historical use in ancient Greece there is no
clear consensus on the meaning of autonomy in the context of health care today.