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Chapter 2: Literature Review
and personal preferences. When the subjective element of autonomy is recognised,
the health care professional and the resident together can negotiate care (Meyer,
1989). However open and respectful communication must also be maintained in this
process (Collopy, 1988; Kant, 1989; Meyers, 1989; Feinberg, 1989; Gillon, 1990;
Beauchamp and Childress, 1994; Atkins, 2006). Residents must be involved in
decision making (Collopy, 1988; Agich, 1990; Hofland, 1994; Faulkner and Davies,
2006; McCormack et al, 2008) and dignity should be maintained as it was suggested
to be integral to autonomy (Agich, 2004).
2.6.1 Identifying antecedents and consequences
Step five of Rodgers’ (1989) approach to concept analysis requires one to identify
antecedents and consequences (Appendix 2) of the concept. This can further help in
explaining how the concept is used in the social context. The antecedents (Table 2.3)
answer the question “what happens before?” the concept, and the consequences
answer the question “what happens after?” the occurrence of the concept (Rodgers,
1989).
Several papers suggested that the organisation’s approach to care is an essential
antecedent to resident autonomy. The approach to care should be person-centred,
non-paternalistic, should recognise individuals’ needs, values and histories, should
be flexible in order to accommodate these needs, and there should be a move away
from task-based routine care(Manley and McCormack, 2008; Faulkner and Davies,
2006; Forbes-Thompson and Gessert, 2005; Swaggerty, Lee and Smith, 2005;
Tutton, 2005; McCormack, 2004, 2001;Beauchamp and Childress, 1994).
Furthermore, staff should perform robust assessments and work with residents and
their families in gathering life histories and compiling life plans (McCormack et al.,
2008; Atkins, 2006; Forbes-Thompson and Gessert, 2005; Swaggerty, Lee and
Smith, 2005; Tutton, 2005; Burkhardt and Nathaniel, 2002; Davies, Ellis and Laker,
2000; McCormack 2001; Beauchamp and Childress, 1994;Lidz, Fischer and Arnold,
1992;Agich, 1990; Meyers, 1989). The approach to care should recognise the
importance of maintaining resident dignity (evident between staff, and between staff
and residents)(Randers and Mattiasson, 2004; Beauchamp and Childress, 1994). The
approach to care should create an atmosphere that enables staff to communicate
effectively with each other, with residents and with visitors (Redfern et al., 2002;